Why primary health care offers a more comprehensive approach to tackling health inequities than primary care.

As governments attempt to focus more intently on how to deal with alarming measures of health disadvantage and inequities, a reformist gaze seems to have settled on the primary care sector. Simultaneously, in literature about this area, whether intended or not, primary health care and primary care are terms that are increasingly interchanged. This article argues that the slippage in language is counter-productive, first because it disguises the transformative potential of strategies and approaches that can make the fundamental changes necessary to improve health status, and second because the structures and practices of the primary care sector are not necessarily compatible with notions of comprehensive primary health care. There is much to be lost if primary health care and health promotion are disguised as primary care, and not understood for their capacity to make a difference to health inequities although of course in some circumstances, comprehensive primary health care is interdependent with services provided by primary care. In this article, characteristics of primary care and primary health care are juxtaposed to show that if the strengths and limitations of each model are understood, they can be mobilised in collaborative partnerships to deal more effectively with health inequities, than our system has so far been able to do.

Eccentric decline squat protocol offers superior results at 12 months compared with traditional eccentric protocol for patellar tendinopathy in volleyball players

Background: Conservative treatment of patellar tendinopathy has been minimally investigated. Effective validated treatment protocols are required.

Objectives: To investigate the immediate (12 weeks) and long term (12 months) efficacy of two eccentric exercise programmes for the treatment of patellar tendinopathy.

Methods: This was a prospective randomised controlled trial of 17 elite volleyball players with clinically diagnosed and imaging confirmed patellar tendinopathy. Participants were randomly assigned to one of two treatment groups: a decline group and a step group. The decline group were required to perform single leg squats on a 25° decline board, exercising into tendon pain and progressing their exercises with load. The step group performed single leg squats on a 10 cm step, exercising without tendon pain and progressing their exercises with speed then load. All participants completed a 12 week intervention programme during their preseason. Outcome measures used were the Victorian Institute of Sport Assessment (VISA) score for knee function and 100 mm visual analogue scale (VAS) for tendon pain with activity. Measures were taken throughout the intervention period and at 12 months.

Results: Both groups had improved significantly from baseline at 12 weeks and 12 months. Analysis of the likelihood of a 20 point improvement in VISA score at 12 months revealed a greater likelihood of clinical improvements in the decline group than the step group. VAS scores at 12 months did not differ between the groups.

Conclusions: Both exercise protocols improved pain and sporting function in volleyball players over 12 months. This study indicates that the decline squat protocol offers greater clinical gains during a rehabilitation programme for patellar tendinopathy in athletes who continue to train and play with pain.

Consumers' evaluation of free service trial offers

Largely unexplored, a free service trial may be defined as an offer to the consumer to experience, at no monetary cost, all or part of a core, augmented or facilitating service from a provider that the consumer does not currently use. Free service trials are worth studying for two reasons. First they are one of the important examples of inequitable exchange between supplier and purchaser – one that is likely to lead to a sense of obligation among those who adopt the trial offer. Second, they are a very common promotional device. This paper proposes that free service trials are more problematic than tangible product trials. The value of what is offered may be limited by time, the scope of trial, or because only a partial, facilitating or augmented service is offered. Judgments about the perceived value of the complete service in its paid form will also contribute to the evaluation of the trial offer. In deciding whether they accept the trial, the paper proposes that consumers make attributions about the motives of the service trial provider and the consumer’s consequent obligations if they accept it. Obligations are likely to be felt more acutely where the trial is interpersonal (e.g. a facial massage) rather than impersonal (e.g. anti-virus service). Such evaluations are also likely to be affected by past experience with the service category, consumer skepticism and personal norms of reciprocity. A program of research is proposed which would systematically examine the consumers’ evaluations of free trial offers.

Consumer responses to free service trial offers

Consumers find it difficult to evaluate services they have not previously used, especially where these services have high experience or credence properties (Mittal 2002, 2004). A frequent promotional strategy used by marketers is to offer a free trial, such as a free brake check on cars or a free session at a new gym. While there is extensive literature on product trials, very little research has been conducted on free service trial offers. This led the researchers to undertake preliminary content analysis and qualitative interviews and ultimately to develop a comprehensive model of consumer evaluations of these offers. The model takes account of the type of service on offer, the manner in which it is offered and the pricing mechanism used (free versus discounted). It also characterizes the cognitive and emotional evaluations consumers make in response to these offers and how these contribute to trial and purchase propensity. Individual characteristics of consumers, such as deal proneness, were also incorporated into the model. The current study reports an experiment where the model was systematically tested among groups of male and female consumers (in total 400) who varied by age group and service experience. The research indicated that a free trial offer operated rather differently from a discount, inducing a sense of obligation which motivated some people to adopt the trial and subsequent full service offer. Traditional trial-cognition-evaluation models (e.g. Smith and Swinyard, 1983) are not sufficient to explain the phenomena uncovered by this research.

No limits : exploring the psychology of unsolicited credit card limit increase offers

The issue of credit card debt has become an increasing concern in recent years. In Australia, for example, there is currently $42.5 billion worth of outstanding debt on credit cards, with $30 billion (over 70 per cent) bearing interest. Further, in 2001, Visa reported that 32 per cent of consumers had not paid their card off in the previous 12 months, which suggests that interest-bearing debt in Australia is held by approximately only 113 of credit card borrowers. An important element of credit card marketing is the use of psychological manipulations to encourage consumers to take-up credit. In this article, we examine the use of language and imagery in unsolicited credit card limit increase offers, and how these might influence consumers' decisions to increase their credit card limit. The analysis found that the use of terms that focused on the benefits of credit card use, such as "choice", "freedom", and "peace of mind" were used consistently to convince consumers to increase their credit card limit, whereas the use the of terms that could be considered more pragmatic and with direct reference to the nature of the product, such as "debt", "repayment" and "loan", were rarely used. Similarly, the use of colour, text changes, and images, were used which may have an influence over a consumer's ability to rationally consider whether the increase is appropriate for them. The paper concludes by recommending that government and representative bodies need to take into account the psychological manipulations used by credit card providers when developing consumer policy and codes of ethics.

Power ultrasound offers an environmentally friendly approach to cleaning dairy UF membranes

Flat sheet polymeric UF membranes of 30000 MWCO were obtained from Millipore Inc. Polypropylene spacers of a 50 mil (1.3 mm) thickness were obtained from KOCH membrane systems. A single 30 cm^sup 2^ membrane sheet was sandwiched with a spacer on the feed side of a cross flow Minitan S unit (Millipore Inc). The unit was immersed in a 50 kHz ultrasonic bath that was switched on as required. All experiments used re-constituted spray-dried whey powder to foul the membrane.

Mitochondrial DNA offers unique insights into invasion history of the common starling

Mitochondrial DNA (mtDNA) can be a powerful genetic marker for tracing origins and history of invasive populations. Here, we use mtDNA to address questions relevant to the understanding of invasion pathways of common starlings (Sturnus vulgaris) into Western Australia (WA) and discuss the utility of this marker to provide information useful to invasive species management. Mitochondrial sequence data indicate two geographically restricted genetic groups within Australia. Evidence of dispersal from genetically distinct sources outside the sampled range of starlings in Australia suggests increased vigilance by management agencies may be required to prevent further incursions from widely separated localities. Overall, genetic diversity in Australia was lower than in samples from the native range. Within Australia, genetic diversity was lowest in the most recently colonized area in the west, indicating that demographic bottlenecks have occurred in this area. Evidence of restricted dispersal between localities on the edge of the range expansion (ERE) in WA and other Australian sampling localities suggests that localized control within the ERE may be effective in preventing further range expansion. Signatures of spatial and demographic expansion are present in mismatch analyses from sampling localities located at the ERE, but neutrality indices did not support this finding, suggesting that the former may be more sensitive to recent expansion. Additionally, mismatch analyses support the presence of admixture, which is likely to have occurred pre-introduction. We compare our findings with those from a microsatellite study of the same samples and discuss how the mtDNA analyses used here offer valuable and unique insights into the invasion history of introduced species.