Missionaries, music and method - dissemination of tonic sol-fa in Asia-Pacific countries during the nineteenth century

The Tonic Sol-fa method of teaching choral singing and its system of music notation was developed in England by John Curwen and propagated throughout the British Isles as a means of both enhancing Christian worship and achieving social reform. Tonic Sol-fa may be identified as an entirely foreign musical practice introduced to indigenous people in many British colonies and in other overseas countries during the nineteenth century as an instrument of Christian evangelism as well as of European cultural imposition. Nevertheless, indigenous communities were introduced to other aspects of European musical culture including a choral repertoire consisting of four-part hymnody and masterworks by Handel, Bach, Mozart, etc which sometimes resulted in the emergence of a school of indigenous composers writing in Tonic Sol-fa notation and using the tonal harmonic style. The result has been that in several countries-such as South Africa and Fiji for example-Tonic Sol-fa has been so fully assimilated into the ethnic culture that it has been "indigenized" and may now be said to represent a significant exogenous aspect of the musical culture in these countries.

Tonic Sol-fa was most commonly introduced to countries in the Asia-Pacific Region -as in Africa - by Christian missionaries who sought to exploit the attraction of hymns, particularly when sung in four-part harmony, as a means of evangelizing indigenous people who frequently regarded this aspect of missionary activity as a form of "magic". In particular, the Tonic Sol-fa method and notation gained a significant foothold in what were referred to as the South Sea Islands--especially in Fiji where today, the Fijian Hymn Book (1985 edition) is notated exclusively in Tonic Sol-fa. The vast majority of the Fijians are literate in Tonic Sol-fa notation and congregational singing in four parts is the norm in Fijian churches.

This paper will draw on data from nineteenth century journal sources, particularly The Tonic Sol-fa Reporter (1853-1888) and The Musical Herald (1889-1920), and will document the introduction and dissemination of Tonic Sol-fa in several Asia-Pacific countries where, unlike Australia and New Zealand, the indigenous population has maintained its own cultural and demographic predominance. Countries to be considered will include India, China (including Hong Kong), and Pacific Island nations. There will also be a consideration of the contemporary usage and applications of Tonic Sol-fa in the region, with specific reference to Fiji. It will be argued that countries where Tonic Sol-fa notation has become the norm should resist any external pressure to transfer to the standard staff notation merely for the sake of conformity. In the case of Fiji, almost universal music literacy has been achieved through Tonic Sol-fa and this should be recognized as an enviable social and cultural asset.

Perceptions of multiculturalism in music education: what matters and why

Pre-service teacher education students from two Australian universities were interviewed about their understandings of cultural diversity in music education. These initial findings revealed varied but generally consistent enthusiasm about including music from different cultures in teaching. However comments revealed an almost haphazard exposure to other musics. These were generally informal rather than learned in their formal education. Interviewees recognised the training that they had received in their tertiary studies in other cultures (both Western and non-Western) and expressed the intention to pursue professional development in their future careers. Engaging with the music of other cultures allows teachers and students to develop understanding and empathy with others. This is in line with current governmental initiatives on values that states that values education is intended to 'inspire and educate the next generation to see their world through the eyes of others. We want children to become adults who are caring, tolerant, fair and compassionate' (Department of Education, Science and Training, n.d., p. 2). Comments from the interviewees illustrate just such attitudes and understandings. It behoves us as educators to prepare students for teaching in multicultural classrooms that reflect the wider Australian society.

Validity of the assessment of quality of life (AQoL) utility instrument in patients with operable and inoperable lung cancer

There have been few longitudinal studies of quality of life in patients with all stages of lung cancer, particularly those that have included measures of utility. The purpose of this study was to examine the psychometric properties of the Assessment of Quality of Life instrument (AQoL) in patients with lung cancer. The AQoL is a health-related quality of life questionnaire and provides a descriptive system for a multi-attribute utility instrument (MAU), so that scores can be used in cost-utility evaluations. In the present study the reliability (internal consistency) of the AQoL was examined and the concurrent validity was assessed using the Medical Outcomes 36-item Short Form Health Survey (SF-36) as the comparator instrument. The sensitivity to different health states of the AQoL and the responsiveness to change over time was also examined. A prospective, non-experimental cohort study was undertaken. Ninety-two participants with all stages of lung cancer were recruited from a tertiary multi-disciplinary lung cancer clinic. Ninety participants had non-small cell lung cancer (NSCLC) and two had limited stage small cell lung cancer. The AQOL and SF-36 surveys were administered concurrently at baseline. In patients with NSCLC the surveys were then repeated 3 and 6 months later. Correlations between the baseline AQoL summary scales and SF-36 summary scales support the divergent and convergent validity of the AQoL. Reliability was also found to be sufficient (Cronbach's Alpha = 0.76). In addition, in patients with inoperable NSCLC, baseline AQoL scores were found to be predictive of survival at 6 months in Cox proportional hazards multivariate analysis. However, the physical components summary score of the SF-36 was more sensitive to differences in health states between patients with different stages of NSCLC at 6 months of follow-up and more responsive to change over time in both operable and inoperable patients with NSCLC than the AQoL. The findings support the construct validity and reliability of the AQoL in this population. However, there remains some uncertainty about whether the AQoL has sufficient sensitivity to different health states in this population. Further studies using other MAU instruments may determine whether alternative instruments are more sensitive to different health states in individuals with lung cancer.

The performance of solarscan : an automated dermoscopy image analysis instrument for the diagnosis of primary melanoma

Objective To describe the diagnostic performance of SolarScan (Polartechnics Ltd, Sydney, Australia), an automated instrument for the diagnosis of primary melanoma.

Design Images from a data set of 2430 lesions (382 were melanomas; median Breslow thickness, 0.36 mm) were divided into a training set and an independent test set at a ratio of approximately 2:1. A diagnostic algorithm (absolute diagnosis of melanoma vs benign lesion and estimated probability of melanoma) was developed and its performance described on the test set. High-quality clinical and dermoscopy images with a detailed patient history for 78 lesions (13 of which were melanomas) from the test set were given to various clinicians to compare their diagnostic accuracy with that of SolarScan.

Setting Seven specialist referral centers and 2 general practice skin cancer clinics from 3 continents. Comparison between clinician diagnosis and SolarScan diagnosis was by 3 dermoscopy experts, 4 dermatologists, 3 trainee dermatologists, and 3 general practitioners.

Patients Images of the melanocytic lesions were obtained from patients who required either excision or digital monitoring to exclude malignancy.

Main Outcome Measures Sensitivity, specificity, the area under the receiver operator characteristic curve, median probability for the diagnosis of melanoma, a direct comparison of SolarScan with diagnoses performed by humans, and interinstrument and intrainstrument reproducibility.

Results The melanocytic-only diagnostic model was highly reproducible in the test set and gave a sensitivity of 91% (95% confidence interval [CI], 86%-96%) and specificity of 68% (95% CI, 64%-72%) for melanoma. SolarScan had comparable or superior sensitivity and specificity (85% vs 65%) compared with those of experts (90% vs 59%), dermatologists (81% vs 60%), trainees (85% vs 36%; P =.06), and general practitioners (62% vs 63%). The intraclass correlation coefficient of intrainstrument repeatability was 0.86 (95% CI, 0.83-0.88), indicating an excellent repeatability. There was no significant interinstrument variation (P = .80).

Conclusions SolarScan is a robust diagnostic instrument for pigmented or partially pigmented melanocytic lesions of the skin. Preliminary data suggest that its performance is comparable or superior to that of a range of clinician groups. However, these findings should be confirmed in a formal clinical trial.

Nutrition screening in long-term care facilities : an evaluation of the methodological quality of available instruments

A variety of nutrition screening instruments have been developed and implemented for identifying the risk of undernutrition among community and hospitalized older adults. Despite the high prevalence of undernutrition amongst older adults in long-term care, few screening instruments have been developed or evaluated in this setting. This review aims to evaluate the validity, reproducibility and feasibility of nutrition screening instruments developed for use, or described as being used, with older adults in long-term care. Ten publications encompassing nine independent nutrition screening tools were identified using electronic databases and manual searches of reference lists. The Mini Nutritional Assessment-Short Form (MNA-SF) was the most widely evaluated nutrition screening instrument and met the requirements for a valid instrument (sensitivity and specificity >0.9) for use in the long-term care setting. Modified versions of the MNA for use in China and South Africa also demonstrated acceptable levels of sensitivity and specificity. Other nutrition screening instruments were found to have variable levels of sensitivity and specificity and while some demonstrated levels consistent with the MNA-SF, only two were evaluated across more than one study population, Body Mass Index (BMI)+weight loss and BMI+albumin. These same instruments reported the highest levels of inter-rater and test-retest reproducibility, although this was only tested in one other instrument (Chinese Nutrition Screen -modified MNA). In conclusion, it is evident from this review that further work in this area is needed. Based on validity, reproducibility and feasibility it appears that BMI+weight loss is the most suitable nutrition screening instrument for use in the long-term care setting at this time. MNA-SF is promising; however, there is currently no data for inter-rater or test-retest reproducibility in the long-term care setting.

Recognizing and celebrating Xhosa traditional music in South Africa

The recognition and celebration of Indigenous Knowledge Systems (IKS) as a way forward to promote democracy and inclusivity continues to be part of South Africa's nation building process. One effective platform for this to take place is through community music making as music making in Africa is a way of life. Since democracy in 1994 many initiatives were set up to explore and foster traditional music. This paper presents a brief contextualization of IKS, identity and community music making. It reports on the a Xhosa music research project (2004-2006) as an ethnographic study which is descriptive and interpretive as a holistic cultural portrait. Participants in the project included post-graduate music students, community culture bearers and academics. Only some significant aspects of the Xhose music project at the University of Fort Hare will be reported on. We contextualize the recognition and celebration of IKS within the parameters of the music and the culture of the amaMpondo within the Xhosa people. The paper specifically focuses on the ritual life of the amaMpondo. It also describes the indigenous bow instruments of the Uhadi and Umrhubhe as unique examples of South Africa's traditional music. As this initiative proved a worthy undertaking, we challenge whether such a project could strengthen local IKS elsewhere and be a pathway for tertiary institutions to engage effectively with local community music practitioners in order to prepare students effectively as holistic music educators.

A new instrument for targeting falls prevention interventions was accurate and clinically applicable in a hospital setting

Background and Objective: To describe the diagnostic accuracy and practical application of the Peter James Centre Falls Risk Assessment Tool (PJC-FRAT), a multidisciplinary falls risk screening and intervention deployment instrument.

Methods: In phase 1, the accuracy of the PJC-FRAT was prospectively compared to a gold standard (the STRATIFY) on a cohort of subacute hospital patients (n = 122). In phase 2, the PJC-FRAT was temporally reassessed using a subsequent cohort (n = 316), with results compared to those of phase 1. Primary outcomes were falls (events), fallers (patients who fell), and hospital completion rates of the PJC-FRAT.

Results: In phase 1, PJC-FRAT accuracy of identifying fallers showed  sensitivity of 73% (bootstrap 95% confidence interval CI = 55, 90) and specificity of 75% (95% CI = 66, 83), compared with the STRATIFY (cutoff ≥ 2/5) sensitivity of 77% (95% CI = 59, 92) and specificity of 51% (95% CI = 41, 61). This difference was not significant. In phase 2, accuracy of nursing staff using the PJC-FRAT was lower. PJC-FRAT completion rates varied among disciplines over both phases: nurses and physiotherapists, ≥90%; occupational therapists, ≥82%; and medical officers, ≥57%.

Conclusion: The PJC-FRAT was practical and relatively accurate as a predictor of falls and a deployment instrument for falls prevention interventions, although continued staff education may be necessary to maintain its accuracy.

Parsimonious and efficient assessment of health-related quality of life in osteoarthritis research: validation of the Assessment of Quality of Life (AQoL) instrument

Background: The Assessment of Quality of Life (AQoL) utility instrument was psychometrically developed for the general population. This study aimed to explore its potential as an osteoarthritis (OA) outcome measure.

Methods: WOMAC, Lequesne index, SF-36, Visual analogue scales and the AQoL were administered to 222 people with OA. The ability of each questionnaire to detect differences between groups was based on (i) self-rated health (SRH) and, (ii) differences between people on an orthopedic waiting list (WL) vs people with OA in the community (C). Comparisons included effect size, relative efficiency and receiver operator characteristic curves.

Results: All instruments detected differences between groups; however no one instrument exhibited superior efficiency. The AQoL demonstrated strong psychometric properties.

Conclusion: The AQoL has equivalent performance to comparator questionnaires commonly used in OA research and would be a useful adjunct to well-established disease specific scales. The AQoL has important advantages; brevity (12 items), facilitates comparisons between disease groups, and delivers a utility score that can be used in health economic evaluations.

The SF36 Version 2: critical analyses of population weights, scoring algorithms and population norms

Background: The SF36 Version 2 (SF36V2) is a revision of the SF36 Version 1, and is a widely used health status measure. It is important that guidelines for interpreting scores are available.

Method: A population sample of Australians (n = 3015) weighted to achieve representativeness was administered the SF36V2. Comparisons between published US weights and sample derived weights were made, and Australian population norms computed and presented.

Major findings: Significant differences were observed on 7/8 scales and on the mental health summary scale. Possible causes of these findings may include different sampling and data collection procedures, demographic characteristics, differences in data collection time (1998 vs. 2004), differences in health status or differences in cultural perception of the meaning of health. Australian population norms by age cohort, gender and health status are reported by T-score as recommended by the instrument developers. Additionally, the proportions of cases within T-score deciles are presented and show there are important data distribution issues.

Principal conclusions: The procedures reported here may be used by other researchers where local effects are suspected. The population norms presented may be of interest. There are statistical artefacts associated with T-scores that have implications for how SF36V2 data are analysed and interpreted.

Sharing music and culture through singing in Australia

This article discusses the notion of sharing music and culture as an effective platform to celebrate diversity in Melbourne, Australia. My research project ‘Celebrating Music Making and Finding Meaning’ investigates and illustrates a context of diversity, one that promotes respect in a multicultural society sharing music and culture of a minority group. In 2007, I interviewed members of the South African choir in Melbourne; here I report on some data regarding why members sing in the choir, what are their understandings of a so-called South African identity and what they would like to share with the wider Australian community. I present some theoretical perspectives focusing on the notion of cultural and musical identity within a multicultural society. Such findings may have similar implications for other multicultural educational settings exploring the possibilities of valuing cultural diversity and making music across ages through a choir where difference can be shared and celebrated.

The validity and reliability of an instrument to assess children's outdoor play in various locations

The aim of this study was to develop and test the reliability and validity of survey items that examine the frequency with which primary school-aged children play in particular outdoor locations. Parents reported the number of days their child spent playing in specified outdoor locations (i.e., yard at home, own street/court/footpath, and park/playground) out-of-school hours on weekdays and weekend days during a typical week. To test the reliability of these items, the survey was administered on two occasions, 2 weeks apart, to a sample of 53 parents of children attending primary schools located in metropolitan Melbourne. The validity study involved the completion of a log book by 46 parents of primary school children over a 1-week period. Two weeks later, the same sample of parents completed the survey items. The test–retest reliability of individual items was determined using intra-class correlation coefficients (ICC). The kappa statistic and percent agreement between responses were used to assess validity by comparing the information provided in the log book with that provided in the survey. Results from the two studies suggest that the survey was generally a reliable and valid instrument for assessing the frequency with which children play in particular locations especially at home or in the street. Evidence of the reliability and validity of items assessing where children play is novel and important considering the need to promote children's physical activity in a variety of settings.

The impact of study design on prevalence estimates of female sexual dysfunction

Introduction, objectives Despite increasing research, the true prevalence of Female Sexual Dysfunction (FSD) remains a contentious issue. Previous research suggests that aspects of study design affect the reported prevalence of FSD. We compare commonly used instruments for assessing FSD. Methods A random sample of 240 Australian women aged 20-70 participated in this population based, cross-sectional study. A questionnaire mailed to women across Australia included four instruments for assessing FSD. The Sexual Function Questionnaire combined with the Female Sexual Distress Scale (SFQ-FSDS) was employed as a standard, validated instrument. Alternative instruments were the SFQ alone and two modified versions of a set of questions originally developed by Laumann et al. Results When assessed by the SFQ-FSDS, prevalence estimates (and 95% confidence intervals) of Hypoactive Sexual Desire Disorder, Female Sexual Arousal Disorder (genital subtype), Female Orgasmic Disorder, and Dysparunia were 16%(11-20%), 8%(4-11%), 9%(6-13%), 2%(0.1-3%) respectively. The prevalence estimates of these same disorders obtained using alternative instruments were 32-55%, 17-35%, 17-33% and 3-25% respectively. The sensitivity of alternative instruments varied widely (0 to 1.0). Specificities ranged from 0.51 to 0.99. Positive predictive values ranged from 0 to 0.57. Negative predictive values were all above 0.90. Changing the time span for recalling sexual experiences in an instrument altered the prevalence estimates, sensitivity and specificity. 32% of women with low desire, 31% with low genital arousal, 36% with orgasm difficulty and 57% with sexual pain were sexually distressed. Conclusion Over a third of women who were classified as suffering FSD by alternative instruments did not have FSD when assessed by SFQ-FSDS. Alternative instruments produced substantially higher prevalence estimates of FSD and identified different groups of women. Consequently, the instruments researchers choose to assess FSD may affect both the prevalence estimates and risk factors they report.

Investigations into the analytical applications and fundamental chemistry of the chemiluminescent reactions of Tris(2,2'-bipyridyl)ruthenium(III) with certain Papaver Somniferum alkaloids and other related compounds

The reaction of tris(2,2’-bipyridyl)ruthenium(III) (Ru(bipy) ₃³⁺) with various analytes to generate chemiluminescence has been well documented. This investigation sought to undertake a chemiluminometic study of the reactions of Ru(bipy) ₃³⁺ with selected Papaver Somniferum alkaloids and specifically synthesised phenethylamines. The investigation, based on a kinetic study, primarily addressed the effect of varying reaction conditions (pH) on Ru(bipy) ₃³⁺ chemiluminescence production. To monitor these reactions, a batch chemiluminometer was specifically designed, fabricated and automated to conduct an extensive study on the selected compounds of interest. The instrumentation incorporated a custom built reaction cell and comprised an ‘on-line’ sample preparation system with which calibration standards could be automatically prepared. The instrumentation provided both time-independent (peak area) and time-dependent (kinetic profile) information. A novel approach to the stabilisation of Ru(bipy) ₃³⁺ as a chemiluminescencent reagent was also investigated and a recirculating system was employed with the batch chemiluminometer to provide a stable supply of Ru(bipy) ₃³⁺. Codeine, thebaine and 6-methoxy-codeine were the Papaver Somniferum alkaloids selected for this study and several N-methylated and N,N-dimethylated phenethylamines and methoxy-substituted phenetheylamines were also synthesised to investigate the affect of pH on the chemiluminescence emission efficiency. The versatility of the batch chemiluminometer facilitated the kinetic study of numerous analytes over a broad pH range. The exemplary performance of the chemiluminometer as an analytical instrument, was demonstrated by the calibration functions, based on peak area data, which exhibited excellent linearity and sensitivity. The estimated detection limits (3s) for the selected alkaloids were in the range 2 x 10^-9 M to 7 x 10^-9 at pH 5.0 and above, which compared favourably to detection limits for the same compounds determined using FIA. Relative standard deviations (n=5) for peak areas ranged between 1% to 5% with a mean of 3.1% for all calibration standards above 2.5 x 10^-8 M. Correlation between concentration and peak area, irrespective of pH and analyte was excellent, with all but two calibration functions having r-squared values greater than 0.990. The analytical figures of merit exemplified the precision and robustness of the reagent delivery and ‘on-line’ sample preparation, as well as the sensitivity of the system. The employment of the chemiluminometer for the measurement of total chemiluminescence emission (peak area) was in itself a feasible analytical technique, which generated highly reproducible and consistent data. Excellent analytical figures of merit, based on peak area, were similarly achieved for the phenethylamines. The effects of analyte structure on chemiluminescence activity was also investigated for the alkaloids and the phenethylamines. Subtle structural variations between the three alkaloids resulted in either a moderately reduced or enhanced total emission that was two or three fold difference only. A significant difference in reaction kinetics was observed between thebaine and codeine/6-methoxy-codeine, which was dependent upon pH. The time-dependent data, namely the observed rate constants for the initial rise in intensity and for the subsequent decay rate, were obtained by fitting a mathematical function (based on the postulated reaction mechanism) to the raw data. The determination of these rate constants for chemiluminescence reactions highlighted the feasibility for utilising such measurements for quantitative analytical applications. The kinetic data were used to discriminate between analyte responses in order to determine the concentrations of individual analytes in a binary mixture. A preliminary, multi-component investigation performed on a binary mixture of codeine and 6-methoxy-codeine (1:1) successfully determined the concentrations of these individual components using such rate constant measurements. Consequently, variations in kinetics resulted in a significant difference between the relative chemiluminescence response based on peak area measurements and the relative response base on peak height measurements obtained using FIA. With regards to the observed reactivity of secondary amines and tertiary amines, chemiluminescence peak area determinations confirmed the vital role of pH on reaction efficiency, which was governed by structural features and kinetics. The tertiary amines investigated generally produced a greater emission under acidic conditions than the corresponding secondary amines. However, the measured chemiluminescence responses were highly dependent upon pH, with similar peak areas obtained for both amine groups under slightly alkaline conditions.

Towards an integration of theories of achievement motivation

This thesis investigated children's school achievement in terms of an integration of three theories of achievement motivation. The three theoretical outlooks were expectancy-value theory (EVT), implicit theories of intelligence (ITI), and flow theory (FT). The first of two studies was an exploratory investigation of the effectiveness of each theory independently and combined to predict children's achievement in four school subjects. The subject areas were maths, reading, instrumental music and sport. Participants were 84 children (40 females and 44 males) aged 9 to 10 years, one of each child's parents, and school teachers of each child in the four subject areas. All data were collected through questionnaires based on the three models. The results indicated that EVT and FT but not ITI accounted for a significant amount of the variance in children's achievement, including effects for subject area and gender. A second confirmatory study tested EVT, FT and an integrated model for the prediction of achievement in maths, reading and instrumental music. The participants were a further 141 children (74 females and 67 males) aged 10 to 11 years, and a parent and teachers of each child. Data collection using questionnaires occurred early in the school year (Timel) and approximately five months later (Time2). For EVT, children and parents’ competence beliefs were significant predictors of children's achievement in each subject area. Females tended to believe themselves more competent at reading and instrumental music and also valued these subjects more highly than boys. Modeling results for flow theory indicated that children's emotional responses to classes (happiness and confusion) were significant predictors of achievement, the type of emotion varying between subject areas and time periods. Females generally had a more positive emotional reaction to reading and instrumental music classes than males did. The integrated model results indicated significant relationships between EVT and flow theories for each subject area, with EVT explaining most achievement variance in the integrated model. Children's and parents’ competence beliefs were the main predictors of achievement at Timel and 2, Subject area and gender differences were found which provide direction for future research. Anecdotal reports of parents and teachers often attest to individual differences in children's involvement in various school domains. Even among children of apparently similar intelligence, it is not uncommon to find one who likes nothing better than to work on a mathematics problem while another much prefers to read a novel or play a musical instrument Some children appear to achieve good results for most of the activities in which they are engaged while others achieve in a less consistent manner, sometimes particularly excelling in one activity. Some children respond to failure experiences with a determination to improve their performance in the future while others react with resignation and acceptance of their low ability. Some children appear to become totally absorbed in the activity of playing sport while others cannot wait for the game to end. The primary research objective guiding the current thesis is how children's thoughts and feelings about school subjects differ and are related to their school achievement. A perusal of the achievement motivation literature indicates several possible models and concepts that can be applied to explain individual differences in children's school achievement. Concepts such as academic self-concept, multiple intelligences, intrinsic and extrinsic motivation, self-beliefs, competence beliefs, subjective task values, mastery and performance goals, ‘Flow’ experiences and social motivation are just some of the constructs used to explain children's achievement motivation, both within and between various activity domains. These constructs are proposed by researchers from different theoretical perspectives to achievement motivation. Although there is much literature relevant to each perspective, there is little research indicating how the various perspectives may relate to each other. The current thesis will begin by reviewing three currently popular theoretical orientations cited in achievement motivation research: subjective beliefs and values; implicit theories of intelligence, and flow experience and family complexity. Following this review, a framework will be proposed for testing the determinants of children's school achievement, both within each of the three theoretical perspectives and also in combination.

Quality of life assessment in the community-dwelling elderly : validation of the Assessment of Quality of Life (AQoL) instrument and comparison with the SF-36

Measurement of Health-Related Quality of Life (HRQoL) of the elderly requires instruments with demonstrated sensitivity, reliability, and validity, particularly with the increasing proportion of older people entering the health care system. This article reports the psychometric properties of the 12-item Assessment of Quality of Life (AQoL) instrument in chronically ill community-dwelling elderly people with an 18-month follow-up. Comparator instruments included the SF-36 and the OARS. Construct validity of the AQoL was strong when examined via factor analysis and convergent and divergent validity against other scales. Receiver Operator Characteristic (ROC) curve analyses and relative efficiency estimates indicated the AQoL is sensitive, responsive, and had the strongest predicative validity for nursing home entry. It was also sensitive to economic prediction over the follow-up. Given these robust psychometric properties and the brevity of the scale, AQoL appears to be a suitable instrument for epidemiologic studies where HRQoL and utility data are required from elderly populations.