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Background Multi 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. Methods The 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 Discussion The 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. Conclusions The 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.

The relative contributions of health promotion programs and services to the improvement of community health is the subject of long-standing debate. Critics of health promotion have argued that it does not save costs, has low cost-effectiveness compared to treatment services, does not attract strong community support and may be inequitable. The arguments and counter-arguments that form the basis of this debate are canvassed in this paper. This is done by applying these various claims not to health promotion in isolation, but in comparison with treatment and care services. The special problems for health promotion—namely that its benefits are often considerably delayed and only uncertainly apply to a particular individual and are less in demand than services with more immediate benefits-are examined. Demand for health promotion and other programs is considered from a political perspective. The relative importance of equity and effectiveness as program goals is an important consideration for program and service managers, not only for health promotion but all health care programs. To address further these issues, evaluation of health promotion programs is urgently needed to establish which programs should be expanded or contracted. These evaluations need to incorporate economic appraisal techniques and to assess program demand and equity. The two latter themes can most appropriately occur as part of process and impact evaluation studies. Implications for the evaluation of different types of health promotion programs are explored. Even if health promotion programs can be demonstrated to justify support on cost, effectiveness and equity grounds, they will face continued political obstacles to their funding.

Yesterday morning, as they and their forefathers have done for more than 60 years, the footballers of Croftfoot on the southside of Glasgow convened for their weekend sport, oblivious to the winter's mud and glaur. These premises are the home of Croftfoot Amateurs and Kings' Park Rangers, both of whom compete in the Scottish Amateur League and have run first and second teams on a regular basis for as long as most of the residents can remember. Other groups use these facilities as well, including Celtic Boys Club and a number of children's and youth organisations. But after May 31, every single one of them will be forced to look elsewhere. Older readers may recall that in 1995 we chronicled the activities of one David Peek, a Tunbridge Wells-based businessman who, in his capacity as a consultant to the Western Heritable Investment Company, the firm which owns the land at Croftfoot, was even then putting pressure on the sports organisations. When we initially contacted Peek to ask him why he was intending to increase the annual rent for the footballers from nil (this land was originally a gift to the community from the late Sir John McTaggart) to GBP 1,500 a year, he replied: \"Life is tough, so I don't see what the fuss is about. I am sorry the football people can't seem to get their act together, but I am confident you'll see excellent sports facilities at Croftfoot by the end of the century.\" (My italics).

Conservatives viewed Mr. [Edward G. Rendell] as a big-city, big-spending Democrat. But some members of his own party see him as pro-business, which resulted in only lukewarm labor backing. His popularity stems from his ebullient campaign style and his reputation for turning around the city of Philadelphia. Voters are hoping Mr. Rendell will do the same for the state.

Mr. [George E. Pataki], a Republican, drew support from nearly 50 percent of the voters, leaving the Democratic challenger, H. Carl McCall with 33 percent of the vote. Tom Golisano, the Rochester businessman who was the candidate of the Independence Party, received more than 14 percent of the vote, and analysts said he drew only slightly more from the governor than from Mr. McCall, the state comptroller.

Given the broad, bipartisan support that carried him to a second term, Gov. Kenny Guinn might consider himself an honorary Democrat about now. Mr. Guinn swept to victory over Joe Neal, a Democrat, thanks in part to the support of traditionally Democratic union leaders. Guinn: 343,859 (68%)Neal: 110,930 (22%)

The Democratic candidate, Lt. Gov. Douglas A. Racine, conceded the race to the Republican, Jim Douglas, the state treasurer. Douglas: 101,912: 45%Racine: 95,599: 42%

The third upset was in the 12th Congressional District, which is heavily Democratic. Charles Walker Jr., a Democrat and the son of the highest-ranking black in the State Senate, lost a district that many lawmakers believed was built for his rise to the House of Representatives. Mr. Walker missed debates and never really connected with voters. Max Burns, a Republican, drew attention to Mr. Walker's arrest on shoplifting charges.

Voter discontent with the powerful Democratic Party propelled Ms. [Linda Lingle] past the Democrat, Mazie Hirono. Lingle: 194,338 (52%)Hirono: 177,186 (47%)