Dr Tarek F Antonios

• Senior Lecturer & Consultant Physician
• Blood Pressure Unit,
• St. George?, University of London
• London

The current research was conducted using sleep are also more likely to smoke cigarettes skin care for eczema purchase accutane in india, engage in sexual activ the data from the state repositories of 29 schools in 7 states and 8 ity acne quizlet generic accutane 40mg without prescription, and use marijuana acne xenia gel best order for accutane. This design controls for school-to-school differences and eliminates competing explanations for any observed changes in Evidence suggests that a delay in school start time promotes im the response variables skin care doctors edina 30 mg accutane overnight delivery. It is acknowledged that not all schools calcu provement in attendance and tardiness during? This is the recommended times are coded as a bivariate categorical variable coded as a 0 technique for a study that may include data with potential measure (early start times) and 1 (later start times). However, the source for this studyis lim Table 2 includes thedescriptive statisticsfor each variable. Hence, schools and school districts are Completion rates range predelay from 51% to 94% and postdelay from not a random sample of all high schools and this may limit the gener 68% to 97%. Toensurea comprehensivetreatment effect,only districts with post?start delay of more than 2 years are included. The Data analysis pre-post design ensures that each school serves as its own control, minimizing effects due to school-to-school variability. Descriptive statistics summarized each var complete list of participating schools within each district along with iable to identify any potentially erroneous entries or any the date of the time changes and increase in number of minutes nonnormality in the continuous variables. School attendance is re School graduation (predelay) 79% 51% 94% 13% School graduation (postdelay) 88% 68% 97% 9% ported as percentages and could range from 0 to 100. Analysis of variance assumptions (independence, normal distri Research Question 2. To remediate this, each What are pre? to post?start time delay differences in the same response variable was reverse coded (subtracted by 1), and the log of schools 1 year before implementation of delayed start vs 2 years after this variable was calculated. The results for all inferential procedures the implementation of delayed start times in attendance rates? Descriptive statistics Table 2 includes the means, median, and standard deviations for Research Question 1 predelay and postdelay attendance rates. The mean at the predelay, earlier start times, is 90%, and the mean at the postdelay is 94%. The What are pre? to post?start time delay differences in graduation upward trend in the rates suggests attendance rates may be improv rates in the same schools 1 year before implementation of delayed start ing with changesin school start times. For both periods,the median is vs 2 years after the implementation of delayed start times? There is at least one school in the Schools ranged from a minimum of 51% to a maximum of 97%. The predelay time that appears to have extremely low attendance, and standard deviation of 11% indicates that differences greater than one school that has extremely low attendance in the postdelay time 36% were considered extreme. The next step in the descriptive statistics is a bivariate presenta tion of graduation rates by time. Table 2 includes the means, median, Inferential statistics and standard deviations for predelay and postdelay graduation rates. For both periods, the median is slightly higher than the mean, indicating that both periods may also be left skewed, similar Attendance rate? Independence is still violated by the design of attendance rates as a measure of social?emotional well-being? The remaining 11 schools sleep, the results are consistent with prior research linking later were found in school districts located in the states of Virginia, New 11,35 school start times to more sleep. The connection between later York, North Carolina, Oregon, Arkansas, and Minnesota. Again, these connections are beyond the scope of this study, but cer tainly, this is a promising opportunity for further research. Implications for future research and practical application the current study provides statistical evidence that both gradua tion rates and attendance rates signi? Clark / Sleep Health xxx (2017) xxx?xxx start times,9,35,10,12 contributing to improved graduation and atten change agents and advocates for high school students by teaching dance rates. Basic sleep needs are met so students attend school all stakeholders about adolescent sleep. With additional evidence such as what all educators and educational leaders aspire to: student success. Sleep, circadian rhythms, and delayed sleep this study supports a relationship between adolescent sleep and phase in adolescence. The promise of increased student success fects on attention levels in adolescents. Sleep and Psychiatric Disorders in Children and ment later school start times in high schools. Sociodemographic and behavioral predictors of bed times could encourage new support for policy change. High School Students with a Delayed School Start Time Sleep longer, Report less Daytime Sleepiness. Sleep tendency during extended wakefulness: insights into adolescent sleep regulation and behavior. SleeplessinFairfax:the difference one more hour of sleep can make for teen hopelessness, suicidal idea the overall? Obese youthsare not morelikelytobecome depressed, but extend the evidence in the literature. Adolescent sleep, school start times, and teen motor vehicle access to attending, learning, and graduating, then all of society crashes. Dissimilar teen crash rates in two neighboring southeastern Virginia cities with different high school of life. Wahlstrom K, Wrobel G, Kubow P, Center for Applied Research and unique set of sleep needs that should be considered before school Educational Improvement. University of Minnesota, Center for Ap plied Research and Educational Improvement; 1998. With support of empirical investigations University of Minnesota Digital Conservancy, hdl. The Causal Effect of School Start Time on the Academic Achievement of Adolescents? 62 I. Background 64 American Economic Journal: Economic Policy 3 (August 2011): 62?81 A. West* Recent sleep research fnds that many adolescents are sleep-deprived because of both early school start times and changing sleep patterns during the teen years. Results show that starting the school day 50 minutes later has a signifcant positive effect on student achievement, which is roughly equivalent to raising teacher quality by one standard deviation. While some students may be raring to go, many are strug gling to stay awake and alert. In fact, survey evidence shows that over a quarter of high school students report falling asleep in class at least once per week (National Sleep Foundation 2006). As parents and administrators look for ways to improve student academic achievement, some question whether early start times are hinder ing the learning process for teenagers. Sleep research supports this notion, fnding that many adolescents are sleep-deprived because of both early school start times and changing sleep patterns during the teen years. Consequently, policy initiatives to delay high school start times have gained momentum across the country. State legislatures and local school districts have also introduced similar proposals. Although some districts have adopted later start times, most were forced to maintain the status quo as a result of conficting bussing schedules or vehement opposition from coaches and skeptical parents. For instance, research has shown that early start times in high school lead to sleep deprivation among students (Amy R. Additionally, the number of hours of sleep is positively correlated with measures of academic achievement (Wolfson and Carskadon 1998; James F. Pagel, Natalie Forister, and Carol Kwiatkowki 2007; Howard Taras and William Potts-Datema 2005; Katia Fredriksen et al. However, in these studies, grades are not a consistent measure of student academic achievement due to heterogeneity of assignments and exams, as well as the subjectivity of assigning grades to assessments across instruc tors. Additionally, existing studies have been unable to take into account confounding factors, which likely bias the results. For instance, self-selection of coursework, sched ules, and instructors, make it diffcult to distinguish the effect of school start time from peer and teacher effects. This paper identifes the causal effect of school start time on the academic achievement of adolescents. Random assignment, mandatory attendance, along with extensive background data on students, allow us to examine how school start time affects student achievement without worrying about confounding factors or self selection issues that bias existing estimates.

The dementia is usually the result of infarction of the brain due to vascular diseases acne off order accutane 40 mg on-line, including hypertensive cerebrovascular disease acne 5 days after ovulation cheap 20mg accutane visa. Diagnostic guidelines the diagnosis presupposes the presence of a dementia as described above acne 4 dpo purchase accutane 10 mg fast delivery. Impairment of cognitive function is commonly uneven acne active purchase accutane 20mg amex, so that there may be memory loss, intellectual impairment, and focal neurological signs. An abrupt onset or a stepwise deterioration, as well as the presence of focal neurological signs and symptoms, increases the probability of the diagnosis; in some cases, confirmation can be provided only by computerized axial tomography or, ultimately, neuropathological examination. Associated features are: hypertension, carotid bruit, emotional lability with transient depressive mood, weeping or explosive laughter, and transient episodes of clouded consciousness or delirium, often provoked by further infarction. Personality is believed to be relatively well preserved, but personality changes may be evident in a proportion of cases with apathy, disinhibition, or accentuation of previous traits such as egocentricity, paranoid attitudes, or irritability. Diagnostic guidelines Presence of a dementia as described above; presence of features characteristic of one of the specified syndromes, as set out in the following categories. The neuropathological picture is one of selective atrophy of the frontal and temporal lobes, but without the occurrence of neuritic plaques and neurofibrillary tangles in excess of that seen in normal aging. Diagnostic guidelines the following features are required for a definite diagnosis: -51 (a) a progressive dementia; (b)a predominance of frontal lobe features with euphoria, emotional blunting, and coarsening of social behaviour, disinhibition, and either apathy or restlessness; (c)behavioural manifestations, which commonly precede frank memory impairment. Onset is usually in middle or later life, typically in the fifth decade, but may be at any adult age. Diagnostic guidelines Creutzfeldt-Jakob disease should be suspected in all cases of a dementia that progresses fairly rapidly over months to 1 or 2 years and that is accompanied or followed by multiple neurological symptoms. In some cases, such as the so-called amyotrophic form, the neurological signs may precede the onset of the dementia. There is usually a progressive spastic paralysis of the limbs, accompanied by extrapyramidal signs with tremor, rigidity, and choreoathetoid movements. Other variants may include ataxia, visual failure, or muscle fibrillation and atrophy of the upper motor neuron type. The triad consisting of rapidly progressing, devastating dementia, pyramidal and extrapyramidal disease with myoclonus, and a characteristic (triphasic) electroencephalogram is thought to be highly suggestive of this disease. The rapid course and early motor involvement should suggest Creutzfeldt-Jakob disease. Symptoms typically emerge in the third and fourth decade, and the sex incidence is probably equal. In a proportion of cases, the earliest symptoms may be depression, anxiety, or frank paranoid illness, accompanied by a personality change. Involuntary choreiform movements, typically of the face, hands, and shoulders, or in the gait, are early manifestations. They usually precede the dementia and only rarely remain absent until the dementia is very advanced. Other motor phenomena may predominate when the onset is at an unusually young age. The dementia is characterized by the predominant involvement of frontal lobe functions in the early stage, with relative preservation of memory until later. Includes: dementia in paralysis agitans dementia in parkinsonism Differential diagnosis. Apathy, reduced spontaneity, and social withdrawal are common, and in a significant minority of -53 affected individuals the illness may present atypically as an affective disorder, psychosis, or seizures. Physical examination often reveals tremor, impaired rapid repetitive movements, imbalance, ataxia, hypertonia, generalized hyperreflexia, positive frontal release signs, and impaired pursuit and saccadic eye movements. The neurological involvement most often occurs in the absence of opportunistic infections and neoplasms, which is not the case for adults. Parkinsonism-dementia complex of Guam should also be coded here (identified by a fifth character, if necessary). It is a rapidly progressing dementia followed by extrapyramidal dysfunction and, in some cases, amyotrophic lateral sclerosis. The disease was originally described on the island of Guam where it occurs with high frequency in the indigenous population, affecting twice as many males as females; it is now known to occur also in Papua New Guinea and Japan. While immediate recall is preserved, the ability to learn new material is markedly reduced and this results in anterograde amnesia and disorientation in time. Retrograde amnesia of varying intensity is also present but its extent may lessen over time if the underlying lesion or pathological process has a tendency to recover. Perception and other cognitive functions, including the intellect, are usually intact and provide a background against which the memory disturbance appears as particularly striking. The prognosis depends on the course of the underlying lesion (which typically affects the hypothalamic-diencephalic system or the hippocampal region); almost complete recovery is, in principle, possible. Diagnostic guidelines For a definitive diagnosis it is necessary to establish: (a)presence of a memory impairment manifest in a defect of recent memory (impaired learning of new material); anterograde and retrograde amnesia, and a reduced ability to recall past experiences in reverse order of their occurrence; (b)history or objective evidence of an insult to , or a disease of, the brain (especially with bilateral involvement of the diencephalic and medial temporal structures); (c)absence of a defect in immediate recall (as tested, for example, by the digit span), of disturbances of attention and consciousness, and of global intellectual impairment. Confabulations, lack of insight and emotional changes (apathy, lack of initiative) are additional, though not in every case necessary, pointers to the diagnosis. This disorder should be distinguished from other organic syndromes in which memory impairment is prominent. F05 Delirium, not induced by alcohol and other psychoactive substances An etiologically nonspecific syndrome characterized by concurrent disturbances of consciousness and attention, perception, thinking, memory, psychomotor behaviour, emotion, and the sleep-wake cycle. The delirious state is transient and of fluctuating intensity; most cases recover within 4 weeks or less. The distinction that is sometimes made between acute and subacute delirium is of little clinical relevance; the condition should be seen as a unitary syndrome of variable duration and severity ranging from mild to very severe. This category should not be used for states of delirium associated with the use of psychoactive drugs specified in F10-F19. Delirious states due to prescribed medication (such as acute confusional states in elderly patients due to antidepressants) should be coded here. Diagnostic guidelines For a definite diagnosis, symptoms, mild or severe, should be present in each one of the following areas: (a)impairment of consciousness and attention (on a continuum from clouding to coma; reduced ability to direct, focus, sustain, and shift attention); (b)global disturbance of cognition (perceptual distortions, illusions and hallucinations most often visual; impairment of abstract thinking and comprehension, with or without transient delusions, but typically with some degree of incoherence; impairment of immediate recall and of recent memory but with relatively intact remote memory; disorientation for time as well as, in more severe cases, for place and person); (c)psychomotor disturbances (hypo or hyperactivity and unpredictable shifts from one to the other; increased reaction time; increased or decreased flow of speech; enhanced startle reaction); (d)disturbance of the sleep-wake cycle (insomnia or, in severe cases, total sleep loss or reversal of the sleep-wake cycle; daytime drowsiness; nocturnal worsening of symptoms; disturbing dreams or nightmares, which may continue as hallucinations after awakening); (e)emotional disturbances. The onset is usually rapid, the course diurnally fluctuating, and the total duration of the condition less than 6 months. The above clinical picture is so characteristic that a -56 fairly confident diagnosis of delirium can be made even if the underlying cause is not clearly established. In addition to a history of an underlying physical or brain disease, evidence of cerebral dysfunction. Includes: acute brain syndrome acute confusional state (nonalcoholic) acute infective psychosis acute organic reaction acute psycho-organic syndrome Differential diagnosis. Delirium should be distinguished from other organic syndromes, especially dementia (F00-F03), from acute and transient psychotic disorders (F23. Delirium, induced by alcohol and other psychoactive substances, should be coded in the appropriate section (F1x. These conditions have in common clinical features that do not by themselves allow a presumptive diagnosis of an organic mental disorder, such as dementia or delirium. Rather, the clinical manifestations resemble, or are identical with, those of disorders not regarded as "organic" in the specific sense restricted to this block of the classification. Their inclusion here is based on the hypothesis that they are directly caused by cerebral disease or dysfunction rather than resulting from either a fortuitous association with such disease or dysfunction, or a psychological reaction to its symptoms, such as schizophrenia-like disorders associated with long standing epilepsy. The decision to classify a clinical syndrome here is supported by the following: (a)evidence of cerebral disease, damage or dysfunction or of systemic physical disease, known to be associated with one of the listed syndromes; (b)a temporal relationship (weeks or a few months) between the development of the underlying disease and the onset of the mental syndrome; (c)recovery from the mental disorder following removal or improvement of the underlying presumed cause; (d)absence of evidence to suggest an alternative cause of the mental syndrome (such as a strong family history or precipitating stress). Conditions (a) and (b) justify a provisional diagnosis; if all four are present, the certainty of diagnostic classification is significantly increased. Delusional elaboration of the hallucinations may occur, but insight is not infrequently preserved. Includes: Dermatozoenwahn organic hallucinatory state (nonalcoholic) Excludes: alcoholic hallucinosis (F10. It is not known whether the full range of catatonic disturbances described in schizophrenia occurs in such organic states, nor has it been conclusively determined whether an organic catatonic state may occur in clear consciousness or whether it is always a manifestation of delirium, with subsequent partial or total amnesia. This calls for caution in making this diagnosis and for a careful delimitation of the condition from delirium. Encephalitis and carbon monoxide poisoning are presumed to be associated with this syndrome more often than other organic causes. Diagnostic guidelines the general criteria for assuming organic etiology, laid down in the introduction to F06, must be met.

Life and consciousness never arose skin care blog best accutane 30 mg, he said acne vulgaris description cheap 40 mg accutane amex, but are original activities of the universe; they are two expressions of the same thing and differ only as a circle seen from within differs from one seen from without acne 7 year old buy generic accutane 40mg. From without all is manifold skin care zinc oxide discount accutane 30 mg otc, from within all is unity, and both together constitute all there is. Those processes immediately bound up with consciousness are psycho-physic movements and they are primordial and cosmogonic. The physical world operates under one law and we must assume that the spiritual world is no less so. There must be then, a priori, some exact mathematical relationship between the physical and the psychical, some law of concomitant variations, for all that is psychic is but the self-appearance of the physical; a material process runs parallel to every conscious process. This Pythagorean insight as to the mathematical relationship between the physical and psychic worlds led directly to the development of modern, scientific psychology. The Theosophical Society A most intriguing chapter in consciousness history involves the Theosophical Society, founded in 1875 by Madame Helena Petrovna Blavatsky (H. Mead (right) Madame Blavatsky declared herself to be a chela or disciple of a brotherhood of spiritual adepts in Tibet whose members had acquired psychic powers beyond the reach of ordinary men. She asserted that they took a special interest in the Theosophical Society and all initiates of occult lore, being able to communicate 149 intelligently with individuals by visiting them in a phantom or astral form. Within the halls upon whose blue and golden vaults the weird signs attract attention, but whose secret meaning is never penetrated by idle gazers, they have been seen, but seldom recognized. Historical memoirs have recorded their presence in the brilliantly illuminated salons of European aristocracy. They have been encountered again on the arid and desolate plains of the Great Sahara, or in the caves of Elephanta. They may be found everywhere, but they make themselves known only to those who have devoted their lives to unselfish study and are not likely to turn back. Judge, a New York lawyer who was one of the co-founders of the Theosophical Society, such a Mahatma appeared to the first Theosophists when they held a meeting to frame their constitution. On opening the package they found the necessary forms of organization, rules, etc. Vice-president Henry Wallace and Annie Besant (the former mistress of George Bernard Shaw, who succeeded Blavatsky as head of the movement). After seeing the Society well established in New York, Madame Blavatsky moved to India. Marvelous phenomena of an occult nature were alleged to have taken place there at the Adyar headquarters. Mysterious, ghostly appearances of Mahatmas were seen, and messages were constantly received by supernatural means. One of the apartments, named the Occult Room in the headquarters, contained a sort of cupboard against the wall, known as the Shrine. What followed was perhaps the most complicated and confused investigation in the history of psychical research. Hodgson concluded Madame Blavatsky was a phony "one of the most accomplished, ingenious, and interesting imposters of history. Most of the evidence was of a circumstantial nature as the original shrine had been destroyed by the time Hodgson had arrived at Adyar. More recently, Theosophical apologist Victor Endersby has written a book challenging the Hodgson report point for point. Endersby cites independent testimony from handwriting experts who clearly disagree with those hired by Hodgson. The teachings of the Theosophists continue to have an enormous impact on the esoteric folklore of western culture and for that reason are quoted several times in this book. A Course in Miracles Since the original publication of the Roots of Consciousness, there have emerged numerous examples of ostensible contact with higher intelligence. One of the foremost among these is A Course in Miracles, which is a system of spiritual transformation. Hundreds of thousands of individuals have used this material; and its emphasis on love, foregiveness and freedom from guilt have had an influence on a new generation of spiritual seekers comparable to that of the Theosophical Society in previous years. A Course in Miracles suggests that a miracle is really a shift in perception to see the spirit that lies behind all forms. Judith Skutch Whitson, is the president of the Foundation for Inner Peace, the organization which published A Course in Miracles. Judith Skutch Whitson (courtesy Thinking Allowed Productions) In the following excerpt from a Thinking Allowed interview, she describes the origins of this material: In 1975, I met William Thetford and Helen Suchman, two medical psychologists at Columbia Presbyterian School of Physicians and Surgeons, who served as scribes for the material. They had had a very long period together, teaching, researching, writing grant proposals; yet their life together and among their faculty was not very harmonious. They described it as one of the most stress-filled domains in the world academia, medical academia. One day the quieter of the two of them, Bill Thetford, who was a very gentle man, a very thorough scientist, a very solid person he just blew up. He said in a very meaningful way to her, so that she heard him, that he was sick and tired of the attitudes that that stress seemed to have promoted between the two of them, and that they just were not getting along, that there had to be a better way to live in the world. Instead of laughing at him because she was quite an acerbic woman, very sharp, the older of the two of them by fourteen years she actually took his hand, and she said, "You know, Bill, I think you are right. Not too long after, Helen started to experience what she called heightened visual imagery which gave her the feeling that there was something within her catching her attention and very gently taking her along the way, through experience, to an opening up. After many of these visions, she started to become very familiar with an inner voice which spoke with a gentleness and yet an authority she could not avoid listening to . She called up Bill on the phone, and she said, "You know that voice I told you about? Before the staff came in, they locked the door and pulled down the shades so no one should catch them at this. She actually read from her notebook to him what she had taken down, and he typed it up. Free will does not mean you can establish the curriculum, only the time in which you need to take it. It also said the course could be summed up very simply this way: "Nothing real can be threatened, and nothing unreal exists. At that time she called herself a militant atheist, and he was an agnostic, and here was something that mentioned G-O-D, and it just was not in her vocabulary. So he convinced her that it was beautifully written, and whatever it was, if it should happen again, to keep on doing it. Any time she wished, when she was ready, she could pick up her shorthand notebook and her pen, and literally start from where she left off before, without even checking what the book said. With Bill typing what she had taken down every day, A Course in Miracles came into being. I could not have predicted, in 1975, that there would be three hundred thousand copies of A Course in Miracles in circulation. I have no idea how many people study one copy, so I am guessing over a half a million folk are students of A Course in Miracles. I think we are probably laying the foundation, along with many others, who share basically the same point of view but go about it in different ways a foundation for a tremendous change of mind, which I call the great transformation. Shafica Karagula, director of the Higher Sense Perception Research Foundation in Los Angeles. Karagula specialized in clinical studies of individuals who are gifted with unusual perceptive talents. One of her subjects, whom she called Vicky described a series of experiences she had in her sleep where she seemed to be visiting a college and attending classes in many different subjects. Her vision was quite lucid, recalling the architecture of the buildings, and the subject matter of her lectures. The lectures follow an orderly sequence and Karagula claimed to have carefully recorded a number of them from Vicky. On one occasion, Vicky remembered that a friend of hers, who lived across the United States was in the classroom with her. After some cautious questioning on the telephone, this person verified that he also remembered being present although he did not recall the details of the lecture as clearly as she did. Although similar experiences have been reported by many people, and are known to dream-researchers, they have yet to be more systematically probed. The notion of the Invisible College, of course, stems from the Rosicrucian writings of Francis Bacon. Peter Dawkins, a Francis Bacon scholar, tells a story of his own involvement with this work that falls very much in the Invisible College tradition. Peter Dawkins (courtesy Thinking Allowed Productions) 153 the following excerpt is from my Thinking Allowed interview with him: One day we went on a retreat, my wife and I, and on that retreat was a lady who was the secretary of the Francis Bacon Society in England.

Develop yourself so that you are enabled to hold consciousness up to the very moment of "rising to sleep skin care products for rosacea discount accutane 20mg fast delivery. The dream must be of the aviation type acne when pregnant buy on line accutane, in which you move upward and outward acne xlr purchase accutane 5mg amex, corresponding to the action of the astral body while projecting skin care help order accutane 30 mg otc. Hold the dream clearly in mind; visualize it as you are rising to sleep; project yourself right into it and go on dreaming. Through the use of properly applied suggestion, prior to the dream, you will be able to remember yourself in your dream and bring your dream body-or astral body-to full waking consciousness. In one "superconscious" experience, after a lonely evening, he found himself in a strange house, watching a young lady, who happened to be sewing at the time. Six weeks later, he chanced to recognize this woman on the streets of the small Wisconsin town where he lived. Upon his approaching her, she was startled to discover he was able to accurately describe the inside of her home. She eventually became a very close friend of his and participated with him in a number of projection experiments. By systematically observing his own condition in the out-of-body state, Muldoon was able to derive some very interesting hypotheses. For example, he made numerous measurements of the "silver cord" connecting the astral and the physical bodies, stating that it varied in thickness from about 1 1/2 inches to about the size of a sewing thread according to the proximity of the astral body to the physical. It was only after this occurred that Muldoon was able to exercise complete control over his astral body. He also noticed that the impulses for the heartbeat and breath seemed to travel from the astral through the cord to the physical body. I have tried the experiment many times of holding the breath, while consciously projected, and within cord activity range. The instant that it is suspended the before-mentioned action of slight expansion and contraction ceases, in the psychic cable, as it likewise does in the physical body; but while the respiration ceases the regular pulsating action [the heartbeat] continues. A deep breath in the astral will produce an 82 identical breath in the physical; a short one will produce a short one; a quick one will produce a quick one, etc. Muldoon also observed that physical debilities and morbid physical conditions seemed to provide an incentive for projection. He himself was quite frail and sickly during the years when his experiences were most pronounced. It was his hypothesis that the unconscious will motivated by desires, necessities, or habits that would otherwise have resulted in somnambulism or sleep walking led to astral projection for him because of the debility of his body. When he was thirsty at night, for instance, he might find his astral body travelling to the pump for water. He went to a doctor who told him his pulse was only 42 beats �r minute and gave him a cardiac stimulant strychnine to correct the condition. He also noticed that if he experienced intense emotions while out of his body, it tended to cause his heart to beat faster. This resulted in his being suddenly "interiorized" again, often against his conscious will. Such sudden interiorization often resulted in painful, sometimes cataleptic, repercussions within the body. Eventually he lost all interest in astral projection-after having made the most significant contribution of his time. Since then several other individuals have contributed extensive reports of their own out-of-body experiences. Monroe, the author of Journeys Out of the Body, describes how he visited several medical doctors looking for an explanation of his condition. In fact, Monroe is an excellent example of an individual whose reported experiences could not easily be attributed to defective mental or emotional functioning. A former vice-president of Mutual Broadcasting Corporation, Monroe is now president of two corporations active in cable-vision and electronics. They had no electricity or internal combustion motors, yet a rather sophisticated technology was built around a sort of steam power. Their automobiles held a single bench seat large enough for five or six people abreast. Monroe is currently engaged in a very sophisticated program of training scientists and others to participate in out-of-body experiences. A small, but important, step in this direction has been made by the eminent British geologist, Dr. At the moment of separation, there is generally a blackout of consciousness"much as the changing of gears in a car causes a momentary break in the transmission of power. Many different phenomena are viewed after separation and the return of the double follows a reversal of the pattern just indicated. One group contained projections resulting naturally and gradually from illness, exhaustion or sleep. The other included forcible and sudden projections caused by accidents, anesthetics, suffocation, or willful projection. Crookall reports that people who left their bodies in a natural manner enjoyed consciousness of a clear and extensive type-with telepathy. While the consciousness of the forcibly ejected was remarkably restricted and dim, with dreamlike elements. The forcibly ejected, if not on earth, tended to be in the confused, and semi-dreamlike conditions corresponding to the "Hades" of the ancients. The former met many helpers (including dead friends and relatives), the latter sometimes encountered discarnate would-be hinderers. A third analysis compared the differences in experiences reported by ordinary people with those of individuals who claim to be psychics. By and large, the psychics reported experiences very much like enforced projections, whereas the non-psychics had experiences of natural projection. He also noted that the psychic and mediumistic people commonly observed a mist or vapor leaving their bodies and forming part of the double. Similar statements are often made by those who observe the permanent release of the double during the process of death. This suggested to Crookall that the double actually comprised a semi-physical aspect called the vital or etheric body as well as an astral or super-physical Soul Body. If after the projection, the semi-physical body is still attached, the double will be able to move physical objects, cause rappings, etc. However, if the projection occurs in two stages, so that the Soul Body is separate from the vital body, then the Soul Body is free to travel to the higher "paradise" realms. In his most recent work, Crookall documents many cases in which the projection experience occurs in two stages. For example, in a survey of 321 people by British psychologist Susan Blackmore, twelve percent reported out of body experiences. When groups are asked if they have had an out-of-body experience, the percentage of Yes answers varies so widely that it demands an explanation. This analysis indicates that the differences do not depend on the wording of the question or the explanation of it. A unique perspective on out-of-body experience has been developed by the Jungian analyst Arnold Mindell and his concept of the "dreambody. He says tha near death, dying people experience their dream bodies as clairvoyant or lucid dreams. They feel they can go places and often actually hear, see, and feel what is going on at a distance even though their real bodies still lie in bed. He suggests that their dreambody is almost free to do the impossible because their proprioception no longer relates to the pressures, pains, and agonies of their physical body. He suggests that death may be the last edge, the one at which we truly begin to live as we are. Some out-of-body experiencers describe the sensation of possessing and, in some instances, simultaneously occupying a multiple number of "bodies" at varying locations, sometimes in conjunction with the sense of being disembodied. A variant of this experience, during which subjects seem to shift awareness alternately between two or more locations. Researchers tend to think that, if the phenomenology of this experience is to be taken at face value, it could possible be modelled by a hyperdimensional view of consciousness (such as is presented in the Appendix). Whiteman, a South African mathematician and physicist who has written extensively on his own out-of-body experiences. Dean Sheils, "A Cross-Cultural Study of Beliefs in Out-Of-The-Body Experiences, Waking and Sleeping," Journal of the Society for Psychical Research, 49(775), March 1978, 697-741.

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