Palliative Medicine:Scoping the level and extent of service provision to people with intellectual disability at end of life Poster Presentation

Background: Concerns exist about the end of life care
that people with intellectual disabilities receive. This population
are seldom referred to palliative care services and
inadequate data sets exist about their place of death.
Aim: To scope the extent of service provision to people
with intellectual disabilities at the end of life by specialist
palliative care and intellectual disability services in one
region of the United Kingdom.
Methods: As part of a larger doctoral study a regional survey
took place of a total sample (n=66) of specialist palliative
care and intellectual disability services using a postal
questionnaire containing forty items. The questionnaire
was informed by the literature and consultation with an
expert reference group. Data were analysed using SPSS to
obtain descriptive statistics.
Results: A total response rate from services of 71.2%
(n=47) was generated. Findings showed a range of experience
among services in providing end of life care to people
with intellectual disabilities in the previous five years, but
general hospitals were reported the most common place of
death. A lack of accessible information on end of life care
for people with learning disabilities was apparent. A few
services (n=14) had a policy to support this population to
make decisions about their care or had used adapted Breaking
Bad News guidelines (n=5) to meet their additional
needs. Both services recognised the value of partnership
working in assessing and meeting the holistic needs of
people with intellectual disabilities at end of life.
Conclusions: A range of experience in caring for people
with intellectual disabilities was present across services,
but more emphasis is required on adapting communication
for this population to facilitate them to participate in their
care. These findings could have international significance
given that studies in other countries have highlighted a
need to widen access to palliative care for this group of
people.

Cross-section and panel estimates of peer effects in early adolescent cannabis use: With a little help from my ‘friends once removed’

Peer effects in adolescent cannabis are difficult to estimate, due in part to the lack of appropriate data on behaviour and social ties. This paper exploits survey data that have many desirable properties and have not previously been used for this purpose. The data set, collected from teenagers in three annual waves from 2002-2004 contains longitudinal information about friendship networks within schools (N = 5,020). We exploit these data on network structure to estimate peer effects on adolescents from their nominated friends within school using two alternative approaches to identification. First, we present a cross-sectional instrumental variable (IV) estimate of peer effects that exploits network structure at the second degree, i.e. using information on friends of friends who are not themselves ego’s friends to instrument for the cannabis use of friends. Second, we present an individual fixed effects estimate of peer effects using the full longitudinal structure of the data. Both innovations allow a greater degree of control for correlated effects than is commonly the case in the substance-use peer effects literature, improving our chances of obtaining estimates of peer effects than can be plausibly interpreted as causal. Both estimates suggest positive peer effects of non-trivial magnitude, although the IV estimate is imprecise. Furthermore, when we specify identical models with behaviour and characteristics of randomly selected school peers in place of friends’, we find effectively zero effect from these ‘placebo’ peers, lending credence to our main estimates. We conclude that cross-sectional data can be used to estimate plausible positive peer effects on cannabis use where network structure information is available and appropriately exploited.

Exceptional activity of gallium(III) chloride and chlorogallate(III) ionic liquids for Baeyer–Villiger oxidation

Baeyer–Villiger oxidation of cyclic ketones, using H2O2 as the oxidising agent, was systematically studied using a range of metal chlorides in different solvents, and in neat chlorogallate(III) ionic liquids. The extremely high activity of GaCl3 in promoting oxidation with H2O2, irrespective of solvent, was reported for the first time. The activity of all other metal chlorides was strongly solvent-dependent. In particular, AlCl3 was very active in a protic solvent (ethanol), and tin chlorides, SnCl4 and SnCl2, were active in aprotic solvents (toluene and dioxane). In order to eliminate the need for volatile organic solvent, a Lewis acidic chlorogallate(III) ionic liquid was used in the place of GaCl3, which afforded typically 89–94% yields of lactones in 1–120 min, at ambient conditions. Raman and 71Ga NMR spectroscopic studies suggest that the active species, in both GaCl3 and chlorogallate(III) ionic liquid systems, are chlorohydroxygallate(III) anions, [GaCl3OH]−, which are the products of partial hydrolysis of GaCl3 and chlorogallate(III) anions; therefore, the presence of water is crucial.

Barriers of sentiment : Identity -formation, -regulation and subjectification in preschools

This thesis studies preschool socialization in terms of identity -formation, -regulation, and subjectification. Both the methodology and theoretical backdrop draws on Critical Management Studies, and the contribution to research comes from studying a subject otherwise non-prioritized. I have performed a qualitative study entailing interviews of pedagogues and preschool chiefs working within the same company in the Stockholm region. The study indicate that preschool discourse emphasize the importance of social competences and rituals, and moreover that the institution also accentuates its role in setting the proper ‘preconditions’. Furthermore, the study demonstrates how pedagogues – using mechanisms such as individual discourses, the children’s agency, and the milieu – try to form individuals who are: social, independent, self-reliant, have a strong ‘self’, joyful towards learning, and ‘can do it themselves’. I make a liaison between the aforementioned ideals and certain trends discussed by managerial literature, like for instance currents towards: self-management, neo-normative control, self-entrepreneurial attitudes, ambidextrousness, and the ‘principle of potential’ (Costea et al., 2012; Fleming & Study, 2009; Holmqvist & Spicer, 2013; Maravelias, 2011; Pongratz & Voß, 2003). Finally the thesis concludes by firstly underscoring that the Discourse of for example ‘joyful learning’ and ‘independency’ in preschools tend to demolish physical modes of control in place of psychological ones; and secondly, by discussing historical practices, the thesis brings attention to a shift from safekeeping children to preparing them for industrial, urbanistic, and capitalistic social existence. 

On the Economics and Politics of Mobility

Exit, Voice and Political Change: Evidence from Swedish Mass Migration to the United States. During the Age of Mass Migration, 30 million Europeans immigrated to the United States. We study the long-term political effects of this large-scale migration episode on origin communities using detailed historical data from Sweden. To instrument for emigration, we exploit severe local frost shocks that sparked an initial wave of emigration, interacted with within-country travel costs. Because Swedish emigration was highly path dependent, the initial shocks strongly predict total emigration over 50 years. Our estimates show that emigration substantially increased membership in local labor organizations, the strongest political opposition groups at the time. Furthermore, emigration caused greater strike participation, and mobilized voter turnout and support for left-wing parties in national elections. Emigration also had formal political effects, as measured by welfare expenditures and adoption of inclusive political institutions. Together, our findings indicate that large-scale emigration can achieve long-lasting effects on the political equilibrium in origin communities. Mass Migration and Technological Innovation at the Origin. This essay studies the effects of migration on technological innovations in origin communities. Using historical data from Sweden, we find that large-scale emigration caused a long-run increase in patent innovations in origin municipalities. Our IV estimate shows that a ten percent increase in emigration entails a 7 percent increase in a muncipality’s number of patents. Weighting patents by a measure of their economic value, the positive effects are further increased. Discussing possible mechanisms, we suggest that low skilled labor scarcity may be an explanation for these results.  Richer (and Holier) Than Thou? The Impact of Relative Income Improvements on Demand for Redistribution. We use a tailor-made survey on a Swedish sample to investigate how individuals' relative income affects their demand for redistribution. We first document that a majority misperceive their position in the income distribution and believe that they are poorer, relative to others, than they actually are. We then inform a subsample about their true relative income, and find that individuals who are richer than they initially thought demand less redistribution. This result is driven by individuals with prior right-of-center political preferences who view taxes as distortive and believe that effort, rather than luck, drives individual economic success. Wealth, home ownership and mobility. Rent controls on housing have long been thought to reduce labor mobility and allocative efficiency. We study a policy that allowed renters to purchase their rent-controlled apartments at below market prices, and examine the effects of home ownership and wealth on mobility. Treated individuals have a substantially higher likelihood of moving to a new home in a given year. The effect corresponds to a 30 percent increase from the control group mean. The size of the wealth shock predicts lower mobility, while the positive average effect can be explained by tenants switching from the previous rent-controlled system to market-priced condominiums. By contrast, we do not find that the increase in residential mobility leads to a greater probability of moving to a new place of work.

Main causes of death in Dande, Angola: results from verbal autopsies of deaths occurring during 2009–2012

bACKGROUND - The Dande Health and Demographic Surveillance System (HDSS) located in Bengo province, Angola, covers nearly 65,500 residents living in approximately 19,800 households. This study aims to describe the main causes of deaths (CoD) occurred within the HDSS, from 2009 to 2012, and to explore associations between demographic or socioeconomic factors and broad mortality groups (Group I-Communicable diseases, maternal, perinatal and nutritional conditions; Group II-Non-communicable diseases; Group III-Injuries; IND-Indeterminate). Methods - Verbal Autopsies (VA) were performed after death identification during routine HDSS visits. Associations between broad groups of CoD and sex, age, education, socioeconomic position, place of residence and place of death, were explored using chi-square tests and fitting logistic regression models. Results - From a total of 1488 deaths registered, 1009 verbal autopsies were performed and 798 of these were assigned a CoD based on the 10th revision of the International Classification of Diseases (ICD-10). Mortality was led by CD (61.0%), followed by IND (18.3%), NCD (11.6%) and INJ (9.1%). Intestinal infectious diseases, malnutrition and acute respiratory infections were the main contributors to under-five mortality (44.2%). Malaria was the most common CoD among children under 15 years old (38.6%). Tuberculosis, traffic accidents and malaria led the CoD among adults aged 15–49 (13.5%, 10.5 % and 8.0% respectively). Among adults aged 50 or more, diseases of the circulatory system (23.2%) were the major CoD, followed by tuberculosis (8.2%) and malaria (7.7%). CD were more frequent CoD among less educated people (adjusted odds ratio, 95% confidence interval for none vs. 5 or more years of school: 1.68, 1.04–2.72). Conclusion - Infectious diseases were the leading CoD in this region. Verbal autopsies proved useful to identify the main CoD, being an important tool in settings where vital statistics are scarce and death registration systems have limitations.

Photo-excess : two paradigms of archaeological photography

Discovering ‘photo-excess’: what difference does digital photography bring to the archaeological process, and does this difference constitute a paradigm shift from the traditional film model? Using reflexive practice, the contribution that digital photography has made to the archaeological process is explored. The themes presented in the photographs and exegesis combine visual exploration and original research to examine the role and place of archaeological photography in both a contemporary and an historical context. In contrasting the development of film-based photography of archaeology undertaken in the Eastern Mediterranean during the early 1900s with contemporary digital photography, this exegesis and creative work explores both the synergies and differences of the two photographic methods in archaeology. I introduce the term ‘photo-excess’ to describe the new role that digital photography plays in archaeological practice as compared to film, and demonstrate this difference through my creative work. At the turn of the 20th century, photography was affirmed as the major instrument for visual recording of an archaeological excavation. The combination of archaeological methods and photographic techniques from that era formed an approach to archaeological documentation and recording that was formalised by William Matthews Flinders Petrie in 1904. In this thesis I propose that Petrie became the father of modern archaeological photography through his work, and in recognition of his contribution I refer to his method as the ‘Petrie Paradigm’. Digital photography has made possible a quantum leap in the volume, quality and immediacy of visual data available to the user. Further, through the creative process, digital archaeological photography may provide visual information that exceeds the archaeologist’s original research questions, so that the digital image may sometimes exceed its primary role as a recording device. In such cases it may become the starting point for new research due to its potential photo-excess. I propose this as an emerging paradigm for archaeological photography.

Twins prematurity--the influence of prenatal surveillance

OBJECTIVE: To evaluate the influence of the local prenatal surveillance of twin pregnancies in the obstetrical results. METHODS: A prospective cohort study of multiple pregnancies delivered over a period of 16 years in a tertiary centre was conducted. In this study 861 twin pregnancies were included. They were compared for obstetric complications, gestational age at delivery, mode of delivery and birthweight, according to the place of the surveillance. RESULTS: Of the 861 cases examined, the following obstetric complications were significantly different: metrorrhagia (p = 0.039), infections (p < 0.001), HELLP (p = 0.007), PROMPT (p < 0.001) and fetal death (p = 0.024). The mode of delivery was similar but occurred mostly ≤32 weeks (p < 0.001), the birthweight was mostly <2000 g and occurred more NICU admission (p < 0.001) when surveillance was outside the MPC-MDM. CONCLUSION: Our results demonstrate the crucial importance of prenatal surveillance be carried in a differentiated referral centers with specific/strict protocols or the urgent implementation of same protocols in all other places of surveillance, since this straight surveillance greatly reduces the occurrence of prenatal complications, mainly PROMPT, PTD.

Analysis of factors influencing the physical, chemical and sensorial properties of Serra da Estrela cheeses

The objective of this study was to evaluate the chemical, color, textural, and sensorial characteristics of Serra da Estrela cheese and also to identity the factors affecting these properties, namely thistle ecotype, place of production, dairy and maturation. The results demon- strated that the cheeses lost weight mostly during the first stage of maturation, which was negatively correlated with moisture content, being this also observed for fat and protein contents. During maturation the cheeses became darker and with a yellowish coloration. A strong corre- lation was found between ash and chlorides contents, being the last directly related to the added salt in the manufacturing process. The flesh firmness showed a strong positive correlation with the rind harness and the firmness of inner paste. Stickiness was strongly related with all the other textural properties being indicative of the creamy nature of the paste. Adhesiveness was posi- tively correlated with moisture content and negatively correlated with maturation time. The trained panelists liked the cheeses, giving high overall assessment scores, but these were not significantly correlated with the physicochemical properties. The salt differences between cheeses were not evident for the panelists, which was corroborated by the absence of correlation between the perception of saltiness and the analyzed chlorides con- tents. The Factorial Analysis of the chemical and physical properties evidenced that they could be explained by two factors, one associated to the texture and the color and the other associated with the chemical properties. Finally, there was a clear influence of the thistle ecotype, place of production and dairy factors in the analyzed properties.

DOCUMENTS ANALYSIS DATABASE ON ETHNIC GROUPS CONTROL OF INDIGENOUS DOCUMENTARY OF COSTA RICA 1979-2003

One way to do a bibliometric study is to examine each of the records that make up a database, each record and extract key areas that may disclose relevant information about the use of the database and documents in the collection . This article shows how a reference database allows to obtain important data that can reach conclusions that in some cases surprising. For this study we used the following fields of Database Control Documentary Indigenous Nationalities of Costa Rica 1979-2003: author, place of publication, publisher, year, language and support. The database analyzed has two thousand records and was developed in the Winisis. Moreover, analysis of documents was made after processing of the data, which was to export records to Excel software Winisis. After this information extracted from their chosen fields and are held by their respective separate chart or graph to present the results obtained. Furthermore, we show the application of different methods to learn more about the scientific aspects as: the Price Index, the Index of Collaboration This contribution will, first, for (as) students in the course of the race Metric Studies of Library and Information Science, National University, demonstrate and practice what you learned in this area. They may also benefit the (as) professionals from different areas, such as anthropologists (as), sociologists (as), linguists and librarians (as), among others (as).

Managing university records and documents in the world of governance, audit and risk: Case studies from South Africa and Malawi

There are enormous benefits for any organisation from practising sound records management. In the context of a public university, the importance of good records management includes: facilitating the achievement the university’s mandate; enhancing efficiency of the university; maintaining a reliable institutional memory; promoting trust; responding to an audit culture; enhancing university competitiveness; supporting the university’s fiduciary duty; demonstrating transparency and accountability; and fighting corruption. Records scholars and commentators posit that effective recordkeeping is an essential underpinning of good governance. Although there is a portrayal of positive correlation, recordkeeping struggles to get the same attention as that given to the governance. Evidence abounds of cases of neglect of recordkeeping in universities and other institutions in Sub-Saharan Africa. The apparent absence of sound recordkeeping provided a rationale for revisiting some universities in South Africa and Malawi in order to critically explore the place of recordkeeping in an organisation’s strategy in order to develop an alternative framework for managing records and documents in an era where good governance is a global agenda. The research is a collective case study in which multiple cases are used to critically explore the relationship between recordkeeping and governance. As qualitative research that belongs in the interpretive tradition of enquiry, it is not meant to suggest prescriptive solutions to general recordkeeping problems but rather to provide an understanding of the challenges and opportunities that arise in managing records and documents in the world of governance, audit and risk. That is: what goes on in the workplace; what are the problems; and what alternative approaches might address any existing problem situations. Research findings show that some institutions are making good use of their governance structures and other drivers for recordkeeping to put in place sound recordkeeping systems. Key governance structures and other drivers for recordkeeping identified include: laws and regulations; governing bodies; audit; risk; technology; reforms; and workplace culture. Other institutions are not managing their records and documents well despite efforts to improve their governance systems. They lack recordkeeping capacity. Areas that determine recordkeeping capacity include: availability of records management policy; capacity for digital records; availability of a records management unit; senior management support; level of education and training of records management staff; and systems and procedures for storage, retrieval and dispositions of records. Although this research reveals that the overall recordkeeping in the selected countries has slightly improved compared with the situation other researchers found a decade ago, it remains unsatisfactory and disjointed from governance. The study therefore proposes governance recordkeeping as an approach to managing records and documents in the world of governance, audit and risk. The governance recordkeeping viewpoint considers recordkeeping as a governance function that should be treated in the same manner as other governance functions such as audit and risk management. Additionally, recordkeeping and governance should be considered as symbiotic elements of a strategy. A strategy that neglects recordkeeping may not fulfil the organisation’s objectives effectively.

Variable Recruitment in Bundles of Miniature Pneumatic Artificial Muscles and Space Qualified Pneumatic Artificial Muscles

The natural compliance and force generation properties of pneumatic artificial muscles (PAMs) allow them to operate like human muscles in anthropomorphic robotic manipulators. Traditionally, manipulators use a single PAM or multiple PAMs actuated in unison in place of a human muscle. However, these manipulators experience efficiency losses when operated outside their target performance ranges. The unidirectional actuation behavior of a miniature PAM bundle and bidirectional actuation behavior of an antagonistic pair of miniature PAM bundles are characterized and modeled. The results are used to motivate the application of a variable recruitment control strategy to a parallel bundle of miniature PAMs as an attempt to mimic the selective recruitment of motor units in a human muscle to improve the operating efficiency of the actuator. Additionally, the fabrication and quasi-static testing results for PAMs assembled from candidate space qualified bladder and braided sleeve materials for use in space robotics are assessed.

THE ETHICS OF READER

We have long been critics of the creative work of philosophers and culture at the tender touch of his words, written or verbal, are both with the "hammer" that whoever owns the Ethics in writer-reader relationship is the first, called "comprehensive architect of the word" but inveterate dominant ideals of multiple anonymous.With this statement suggests that the second of this connection is nothing but a later, perhaps a "so and so" incognito benefits from its "home on earth", and who succeeds, after a long journey "cognitive "the privilege of reading. This old argument raised from ancient tradition, makes the reader a living subject-receptor but without providing the bulk of responsibility quantitative space offered by the marketing and consumption.Distrust of the concepts that attempt to establish a definition coldly detached from a bandage dressing, and the reader has not been imposed by the consumer society. In the sixteenth century came the paperback version, the books of Erasmus of Rotterdam were bestsellers in their time. The Praise of Folly and the political writings of Marthin Luther read at a time when the religious world was incorruptible, were read more than the Bible. Imitation of Christ by Thomas a Kempis in the 1300's, that is, before you discover Gutenberg printing circulated throughout Europe in the Latin language, and even in the inscrutable rock monasteries under his cassock, in the secret place of the monk carrying the book. Accepting that the reader is a result of the market, is to bring the book to reified object category and inapreciar history book.

Using an end-of-life care pathway in acute stroke: a mixed methods study of decision-making and care experiences

Background: The evidence base on end-of-life care in acute stroke is limited, particularly with regard to recognising dying and related decision-making. There is also limited evidence to support the use of end-of-life care pathways (standardised care plans) for patients who are dying after stroke. Aim: This study aimed to explore the clinical decision-making involved in placing patients on an end-of-life care pathway, evaluate predictors of care pathway use, and investigate the role of families in decision-making. The study also aimed to examine experiences of end-of-life care pathway use for stroke patients, their relatives and the multi-disciplinary health care team. Methods: A mixed methods design was adopted. Data were collected in four Scottish acute stroke units. Case-notes were identified prospectively from 100 consecutive stroke deaths and reviewed. Multivariate analysis was performed on case-note data. Semi-structured interviews were conducted with 17 relatives of stroke decedents and 23 healthcare professionals, using a modified grounded theory approach to collect and analyse data. The VOICES survey tool was also administered to the bereaved relatives and data were analysed using descriptive statistics and thematic analysis of free-text responses. Results: Relatives often played an important role in influencing aspects of end-of-life care, including decisions to use an end-of-life care pathway. Some relatives experienced enduring distress with their perceived responsibility for care decisions. Relatives felt unprepared for and were distressed by prolonged dying processes, which were often associated with severe dysphagia. Pro-active information-giving by staff was reported as supportive by relatives. Healthcare professionals generally avoided discussing place of care with families. Decisions to use an end-of-life care pathway were not predicted by patients’ demographic characteristics; decisions were generally made in consultation with families and the extended health care team, and were made within regular working hours. Conclusion: Distressing stroke-related issues were more prominent in participants’ accounts than concerns with the end-of-life care pathway used. Relatives sometimes perceived themselves as responsible for important clinical decisions. Witnessing prolonged dying processes was difficult for healthcare professionals and families, particularly in relation to the management of persistent major swallowing difficulties.

A critical study of John Hick's religious pluralism

This study examines the pluralistic hypothesis advanced by the late Professor John Hick viz. that all religious faiths provide equally salvific pathways to God, irrespective of their theological and doctrinal differences. The central focus of the study is a critical examination of (a) the epistemology of religious experience as advanced by Professor Hick, (b) the ontological status of the being he understands to be God, and further asks (c) to what extent can the pluralistic view of religious experience be harmonised with the experience with which the Christian life is understood to begin viz. regeneration. Tracing the theological journey of Professor Hick from fundamentalist Christian to religious pluralist, the study notes the reasons given for Hick’s gradual disengagement from the Christian faith. In addition to his belief that the pre-scientific worldview of the Bible was obsolete and passé, Hick took the view that modern biblical scholarship could not accommodate traditionally held Christian beliefs. He conceded that the Incarnation, if true, would be decisive evidence for the uniqueness of Christianity, but rejected the same on the grounds of logical incoherence. This study affirms the view that the doctrine of the Incarnation occupies a place of crucial importance within world religion, but rejects the claim of incoherence. Professor Hick believed that God’s Spirit was at work in all religions, producing a common religious experience, or spiritual awakening to God. The soteriological dimension of this spiritual awakening, he suggests, finds expression as the worshipper turns away from self-centredness to the giving of themselves to God and others. At the level of epistemology he further argued that religious experience itself provided the rational basis for belief in God. The study supports the assertion by Professor Hick that religious experience itself ought to be trusted as a source of knowledge and this on the principle of credulity, which states that a person’s claim to perceive or experience something is prima facie justified, unless there are compelling reasons to the contrary. Hick’s argument has been extensively developed and defended by philosophers such as Alvin Plantinga and William Alston. This confirms the importance of Hick’s contribution to the philosophy of religion, and further establishes his reputation within the field as an original thinker. It is recognised in this thesis, however, that in affirming only the rationality of belief, but not the obligation to believe, Professor Hick’s epistemology is not fully consistent with a Christian theology of revelation. Christian theology views the created order as pre-interpreted and unambiguous in its testimony to God’s existence. To disbelieve in God’s existence is to violate one’s epistemic duty by suppressing the truth. Professor Hick’s critical realist principle, which he regards as the key to understanding what is happening in the different forms of religious experience, is examined within this thesis. According to the critical realist principle, there are realities external to us, yet we are never aware of them as they are in themselves, but only as they appear to us within our particular cognitive machinery and conceptual resources. All awareness of God is interpreted through the lens of pre-existing, culturally relative religious forms, which in turn explains the differing theologies within the world of religion. The critical realist principle views God as unknowable, in the sense that his inner nature is beyond the reach of human conceptual categories and linguistic systems. Professor Hick thus endorses and develops the view of God as ineffable, but employs the term transcategorial when speaking of God’s ineffability. The study takes the view that the notion of transcategoriality as developed by Professor Hick appears to deny any ontological status to God, effectively arguing him out of existence. Furthermore, in attributing the notion of transcategoriality to God, Professor Hick would appear to render incoherent his own fundamental assertion that we can know nothing of God that is either true or false. The claim that the experience of regeneration with which the Christian life begins can be classed as a mere species of the genus common throughout all faiths, is rejected within this thesis. Instead it is argued that Christian regeneration is a distinctive experience that cannot be reduced to a salvific experience, defined merely as an awareness of, or awakening to, God, followed by a turning away from self to others. Professor Hick argued against any notion that the Christian community was the social grouping through which God’s Spirit was working in an exclusively redemptive manner. He supported his view by drawing attention to (a) the presence, at times, of comparable or higher levels of morality in world religion, when contrasted with that evidenced by the followers of Christ, and (b) the presence, at times, of demonstrably lower levels of morality in the followers of Christ, when contrasted with the lives of other religious devotees. These observations are fully supported, but the conclusion reached is rejected, on the grounds that according to Christian theology the saving work of God’s Spirit is evidenced in a life that is changing from what it was before. Christian theology does not suggest or demand that such lives at every stage be demonstrably superior, when contrasted with other virtuous or morally upright members of society. The study concludes by paying tribute to the contribution Professor Hick has made to the field of the epistemology of religious experience.