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Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons?

An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above.

The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways.

This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations.

Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary.

Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.

Young people’s involvement should lead to research, and ultimately services, that better reflect young people’s priorities and concerns. Young people with a history of treatment for alcohol and/or drug problems were actively involved in the youth social behaviour and network therapy study. The purpose of this paper is to explore the impact of that involvement on the study and what was learnt about involving young people in drug and alcohol research.

The initial plan was to form a young people’s advisory group (YPAG), but when this proved problematic the study explored alternative approaches in collaboration with researchers and young people. Input from 17 young people informed all key elements of the study.

Involvement of young people needs to be dynamic and flexible, with sensitivity to their personal experiences. Engagement with services was crucial both in recruiting young people and supporting their ongoing engagement. This research identified a need to critically reflect on the extent to which rhetorics of participation and involvement give rise to effective and meaningful involvement for young service users. It also highlights the need for researchers to be more flexible in response to young people’s personal circumstances, particularly when those young people are “less frequently heard”.

This research highlights the need for researchers to be more flexible in response to young people’s personal circumstances, particularly when those young people are “less frequently heard”. It highlights the danger of young people in drug and alcohol research being unintentionally disaffected from involvement through conventional approaches and instead suggests ways in which young people could be involved in influencing if and how they participate in research.

There is an apparent contradiction between dominant discourses and cultures of health services research (including patient and public involvement) that often do not sit easily with ideas of co-production and young people-centred involvement. This paper provides an alternative approach to involvement of young people that can help to enable more meaningful and effective involvement.

The flexible and young people-centred model for involvement which emerged from this work provides a template for a different approach. This may be particularly useful for those who find current practice, such as YPAG, inaccessible.

This paper aims to investigate three promotional publications produced by the Postum Cereal Company – A Trip Through Postumville (1920), How I Make Postum (1924) and The Wonderful Lunch Boxes (1925) – with the aim of understanding how language and other semiotic resources are used to promote its products as good and healthy choices.

The three publications were collected from the HathiTrust Digital Library and University of South Florida Tampa Special Collections. They were subjected to multimodal critical discourse analysis to tease out their subtle characteristics and how a combination of language, image, colour, typography and composition are used to represent certain ideas and values related to health and well-being.

The publications subscribe to three distinct genres – “inside the factory”, “friendly spokesperson” and “fictional world” – each of which are aimed at different target audiences. The first seeks to promote Postum as an open and transparent company; the second to promote Postum as a company that cares about its consumers; and the third to promote the health benefits of Postum in a fun and accessible manner. Nonetheless, they are united in their overall objective to link the regular consumption of Postum as essential for good health.

To date, few studies have been conducted on the Postum Cereal Company, while the limited research conducted on promotional publications has tended to overlook discourses of health and well-being. The three genres outlined in this study, thus, have the potential to foster a reappraisal of promotional publications and showcase their ability to offer new understandings on historical approaches to marketing, particularly the link with health and science.

This research aimed to fill several gaps in the tipping literature which has overlooked the server's perspective in identifying and understanding variables that influence a tip amount and therefore where they concentrate their efforts during the service encounter. Furthermore, the extant literature has theorized how or why certain variables influence the tip amount, but these studies fail to capture insight from server's which would supplement the theory and provide a more in-depth understanding of the mechanisms at play.

This study adopts a grounded theory approach using semi-structured one-on-one interviews with tipped restaurant employees who were identified and selected using snowball sampling. Content analysis is employed to code and categorize the data.

The content analysis revealed five categories where servers focus their time and effort to earn tips: service quality, connection, personal factors, expertise and food quality. The server's personality was identified as a variable the tipping literature has largely ignored as a determinant of the tip amount. Server's shift their style of service for groups of eight or more people, and for regular customers, who must dine in the restaurant at least once per week. Lastly, despite the many drawbacks associated with working for tips, servers would not want to replace it with any other method of compensation.

This is the first qualitative study focused on understanding the server's role in the service exchange relationship since McCarty et al. (1990) study. The results provide new insights on the often-studied variables from the tipping literature.