Why do some people involve themselves in politics and others not? Which issues are they concerned with? What do they get out of it? Answering such questions is fundamental to understanding political life and the workings of liberal democracies. This book presents the results of one of the most extensive surveys ever undertaken on the levels and patterns of political involvement in Britain. It is based on the findings of a sample survey of nearly 1,600 people across England, Scotland and Wales as well as a further 1,600 men and women and nearly 300 leaders in six specially selected and contrasting communities. These people were asked about the extent to which they had taken political action, particularly at a local level, and the authors found higher levels of participation than previous research has revealed. They analyse these findings in terms of age, gender, social class and education and look at the reactions of local leaders to the efforts people make to influence them.

As part of the validation of the Assessment of Quality of Life (AQoL) instrument comparisons were made between five multiattribute utility (MAU) instruments, each purporting to measure health-related quality of life (HRQoL). These were the AQoL, the Canadian Health Utilities Index (HUI) 3, the Finnish 15D, the EQ-5D (formerly the EuroQoL) and the SF6D (derived from the SF-36). The paper compares absolute utility scores, instrument sensitivity, and incremental differences in measured utility between different instruments predicted by different individuals. The AQoL predicted utilities are similar to those from the HUI3 and EQ-5D. By contrast the 15D and SF6D predict systematically higher utilities, and the differences between individuals are significantly smaller. There is some evidence that the AQoL has greater sensitivity to health states than other instruments. It is concluded that at present no single MAU instrument can claim to be the 'gold standard', and that researchers should select an instrument sensitive to the health states they are investigating. Caution should be exercised in treating any of the instrument scores as representing a trade-off between length of life and HRQoL.

BackgroundMulti attribute utility (MAU) instruments are used to include the health related quality of life (HRQoL) in economic evaluations of health programs. Comparative studies suggest different MAU instruments measure related but different constructs. The objective of this paper is to describe the methods employed to achieve content validity in the descriptive system of the Assessment of Quality of Life (AQoL)-6D, MAU instrument.MethodsThe AQoL program introduced the use of psychometric methods in the construction of health related MAU instruments. To develop the AQoL-6D we selected 112 items from previous research, focus groups and expert judgment and administered them to 316 members of the public and 302 hospital patients. The search for content validity across a broad spectrum of health states required both formative and reflective modelling. We employed Exploratory Factor Analysis and Structural Equation Modelling (SEM) to meet these dual requirements.Results and DiscussionThe resulting instrument employs 20 items in a multi-tier descriptive system. Latent dimension variables achieve sensitive descriptions of 6 dimensions which, in turn, combine to form a single latent QoL variable. Diagnostic statistics from the SEM analysis are exceptionally good and confirm the hypothesised structure of the model.ConclusionsThe AQoL-6D descriptive system has good psychometric properties. They imply that the instrument has achieved construct validity and provides a sensitive description of HRQoL. This means that it may be used with confidence for measuring health related quality of life and that it is a suitable basis for modelling utilities for inclusion in the economic evaluation of health programs.

Including the quality of life in the economic assessment of health and medical services is well established in the literature and a number of multi-attribute utility (MAU) instruments are available which purport to measure health state utilities. One of these, the Assessment of Quality of Life (AQoL) instrument was developed in Australia and uses Australian importance weights. The present article discusses some of the methodological problems encountered by existing instruments. It outlines the construction of the AQoL Mark 2 and the methodological innovations which have attempted to overcome some of these problems.Technical and other details may be obtained in Richardson et al. (

We developed a tele-education programme in child mental health for rural allied health workers. The programme was delivered in two parts, each consisting of six sessions. Videoconferencing at 384 kbit/s was used. Satisfactory retention rates were maintained throughout. Participants consistently reported increases in knowledge and skills as a result of attending the programme. The project resulted in a high rate of reported changes to practice. An unanticipated outcome was the value placed on the opportunities for local networking provided by the project for participants. Videoconferencing can deliver effective professional development to allied health workers in child mental health.