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There is neither doubt nor debate that career decision-making is essential and has long-term effects on the lives of individuals, families and communities. Despite the utmost significance of career decision-making, it is well acknowledged in the literature that it remains difficult for young people in many countries worldwide to make informed and meaningful career decisions. Concerning this difficulty, this chapter presents findings from a small-scale doctoral research project investigating what influences students’ career decision-making at one public technical and vocational education and training (TVET) college in the Eastern Cape Province of South Africa. The doctoral study on which this paper reports was framed within an interpretive framework and used focus groups and individual interviews to generate data. Following the original research project, we frame this chapter within the sociological perspective, thereby focusing on the notions of careership (Hodkinson & Sparkes, 1997) and navigational capacity (Appadurai, 2004). Also, the sociological perspective reveals the tension and relation between structure and agency. Several factors influence young people’s career decision-making, for example, socio-economic status and capacity to aspire, life turning points, and horizons of action and possibility. The findings show that the participants operate from a position of disadvantage and lack; hence, career decision-making is more of a mission than a natural step in education and training. The chapter concludes that educational institutions should expand the horizon for action and improve the navigational maps of young people as they move through education and career paths.

The purpose of this paper is to explore the changes in gender‐biased employment practices that it is perceived have occurred in New Zealand accountancy workplaces over the last 30 years, using Oliver's model of deinstitutionalization.

Sequential interviewing was carried out with 69 experienced chartered accountants and three human resource managers, and at a later date with nine young female accountants.

Evidence is presented of perceived political, functional and social pressures cumulatively contributing to deinstitutionalization of overt gender‐biased employment practices, with social and legislative changes being the most influential. Deinstitutionalization appears incomplete as some more subtle gender‐biased practices still remain in New Zealand's accountancy workplaces, relating particularly to senior‐level positions.

This study adds to understanding of how professions evolve. The purposeful bias in the sample selection, the small size of two of the interviewee groups, and the diversity in the interviewees' workplaces are recognized limitations.

Identification of further cultural change is required to deinstitutionalize the more subtle gender‐biased practices in accountancy organizations. This could help to avoid a serious deficiency of senior chartered accountants in practice in the future.

This paper represents one of a limited number of empirical applications of the deinstitutionalization model to organizational change and is the first to address the issue of gender‐biased practices in a profession. The use of sequential interviewing of different age groups, in order to identify and corroborate perceptions of organizational change is a novel approach.

Despite the recent growing interest in user‐led organisations (ULOs), they remain an under‐researched area of volunteer sector activity, with the majority of the literature emanating from North America. This article attempts to redress this imbalance by reporting on the innovatory features and challenges facing mental health ULOs in England, particularly in light of recent government policy prioritising generic pandisability ULOs. In‐depth qualitative interviews were undertaken with a purposive sample of 48 service users and staff from four geographically dispersed mental health ULOs in England. Innovatory features identified by staff running and service users attending mental health ULOs were: being user‐led; their non‐hierarchical organisational structures; and community‐inclusive activities. The challenges identified were: maintaining a user‐led ethos; managing the tension between being user‐led or user‐managed; and relationships with funders. Recent policies that recognise and promote the development of ULOs are encouraging, although the emphasis on generic, pan‐disability ULOs may impede the innovatory ethos and development of mental health ULOs.

Successive governments have called for greater “empowerment” of the patient, reflected in the chief medical officer's call for more patient‐related outcome measures (PROM). This paper aims to bring together three‐linked studies.

First study: in 1999, the neurosurgical patient was seen as “expert” to identify PROM outcomes, based upon a patient and carer‐designed self‐administered postal questionnaire in a regional two‐year retrospective survey of subarachnoid haemorrhage (SAH) patients with a 77 per cent response rate, designated treatment‐as‐usual (TAU) cohort (n=142).Second study: in the same region, following the implementing of the specialist neuro‐vascular nurse (SNVN), the SNVN recommendation was evaluated in a two‐year prospective study (n=184) that provided family‐specific psychosocial support and a continuity of care linking hospital and community; the response rate was 87 per cent. Third study: A re‐analysis of the national SAH study (n=2,380), by projecting the TAU and SNVN results onto clinically matched patients within the National cohort to estimate the potential “savings” if all 34 neurosurgical units had an SNVN type service.

First study: respondents identified many psychosocial and fiscal problems but recommended a SNVN to reduce these difficulties. Second study: the TAU and SNVN patient's were a close clinical match and using the TAU as a control group, it was found that there were major psychosocial and fiscal benefits for SNVN patients and carers, who more speedily re‐established their lives.Third study: it was estimated that this would have produced major financial benefits, e.g. 4,165 fewer bed occupancy days, saving £2.5million; reduced time‐off work for patients and carers, saving £8.1million; and, after deducting cost of a national SNVN service, a combined saving for the service and families of an estimated £9.83 million p.a. Thus, addressing PROM outcomes, through an integrated psychosocial service in neurosurgery was cost‐effective, benefited families, the service, and the wider economy and should be a factor when considering pressurised departmental budgets.

Overall, what the two regional studies and the re‐analysis of the national study showed was that there are benefits from treating the “patient as expert” and taking on board their agendas. There is a need for a more integrated approach to treatment and care that is of value to the service, patients, families and the wider economy.

The purpose of this paper is to determine whether and how much patients would be willing to pay for diabetes disease state management (DSM) services in community pharmacies, and also to determine the relationships between willingness to pay (WTP) and different clinical/socio/demographic characteristics of patients.

A sample of 130 diabetic patients recruited from 14 pharmacies across Sydney, Australia completed self‐administered questionnaires. SPSS 16.0 was used to assess WTP in four scenarios (50 and 100 percent improvement in diabetes control after a 30 minute initial and 30 minute follow‐up consultation, respectively). Descriptive and inferential statistical techniques (regression) were used to analyse data.

Patients are willing to pay a median of AUS$30 for 50 percent improvement and AUS$40 for 100 percent improvement per 30 minute initial consultation, and AUS$20 for 50 percent improvement and AUS$30 for 100 percent improvement per 30 minute follow‐up consultation. Although results varied across scenarios, WTP generally increased when: patients' income is greater than AUS$150,000; frequency of patients' diabetes‐related hospitalizations is between 2 and 4; and patients' perceptions of pharmacists' ability are higher. The remainder of the variables tested are not significantly associated with WTP.

The findings demonstrate that most patients are willing to pay for diabetes DSM services in community pharmacies, and there is a great opportunity for pharmacies to expand their clinical services in this area.

The key contribution to the literature is the data relating to the willingness of Australian diabetic patients to pay for pharmacy‐delivered disease management support, and how this varies across people with different clinical/socio/demographic characteristics.

Several studies have related diagnostic information and adversity in childhood to criminal careers and risk of recidivism. Notably, ADHD and conduct disorder in childhood, schizophrenia, sexual abuse and physical abuse have been associated with offences in adulthood. This study investigates these variables in relation to large cohorts of offenders with learning disabilities. A case note review was undertaken for 126 individuals referred but not accepted into forensic learning disability services and 197 individuals accepted for such services. Results are reported on diagnostic information and experience of adversity in childhood. ADHD/conduct disorder featured prominently in both groups. Autistic spectrum disorders were not particularly over‐represented. For adversity in childhood, general socioeconomic deprivation featured prominently in both groups. This also increased significantly for those accepted into services. Sexual abuse and non‐accidental injury were featured at around 13‐20% for both groups. These results are broadly consistent with the mainstream literature on offending, ADHD/conduct disorder and general deprivation featuring significantly in all groups and rising for those accepted into offender services. It is important to deal with these aspects during assessment and to provide appropriate psychotherapeutic services for these individuals.

Maintaining the success of educational institutions largely depends on the teacher. It is the teacher whose main efforts and contribution help in achieving the goals in education. The purpose of this paper is to examine the current state of the programme delivery and how involving the active participation of the teacher will help enhance effective and efficient delivery of the school feeding programme at the school level.

A total of ten basic schools were purposefully selected for the study with the use of the case study method. Interviews and observations were made in all the selected schools using a semi-structured interview guide. It was also done for some selected stakeholders within the study area under the school feeding programme.

There is an indication that teachers as managers and administrators of the school system are not actively involved in the feeding programme leading to an ineffective and efficient delivery. The school children do not get the best from the programme. There is a need to put teachers in charge of operations at the school level. This will improve trust and cooperation between caterers, students and opinion leaders. The structure at the school level should be redesigned making caterers answerable to the teacher. Teachers as implementers in the case of the capitation grant will enhance efficiency leading to the achievement of the goal of the programme.

The study underlines the importance, efficiency and influence of the teacher within the school system, in the operations of the school feeding programme and in the Ghanaian society.

Meetings with colleagues are an essential activity in workplace collaboration. The iterative nature of collaborative work demands spaces that team members can access quickly and easily. Creating suitable meeting spaces will become more critical if the hybrid work model continues and the workplace environment becomes the hub for face-to-face collaborative time, learning and training. Workspace and fit-out is expensive so it is crucial that the investment in meeting spaces supports employees’ collaboration activities.

This paper presents a case study of a corporate organisation undertaken in New Zealand to investigate how employees from two business units use their workspace to collaborate within their own team and across other teams in their organisation. The study uses ethnographic techniques, including participant observation and in-depth face-to-face interviews.

The findings show that the frequency and nature of small group work in collaboration was underestimated in the initial planning of the new workspace. Although participants found the design and fit-out of the formal meeting rooms supportive of collaborative work, the meeting rooms were in high demand, and it was difficult to find a room at short notice. The breakout spaces were confusing because they lacked key design attributes identified by the participants as conducive to small group work. Design shortfalls together with fit-out features perceived as supportive of collaborative work are identified.

The research reports on employees’ perceptions and experiences across two functionally diverse business units, reflecting their different needs and concerns.