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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.

An emerging evidence base, and increased awareness of the effects of trauma on the body, advocates a sensory-based approach to treatment with posttraumatic stress and complex trauma survivors. This paper aims to identify, analyse and summarise the empirical evidence for the sensory-based interventions, which occupational therapists are using in the treatment of adult and adolescent trauma survivors.

An integrative review of the literature was undertaken. Both empirical and conceptual papers were included. An inductive approach and constant comparative method were used to understand and synthesise the research.

The literature search yielded 18 papers describing the types of sensory-based interventions used, sensory processing (SP) patterns and the context and evidence for sensory-based occupational therapy practice with trauma survivors. Nine of the studies were empirical and nine were conceptual and review papers. Themes identified included: atypical SP patterns; type of sensory-based intervention used with trauma survivors; and transdisciplinary treatment programmes can reduce the symptoms of trauma.

Sensory-based interventions with adult and adolescent trauma survivors are emerging as promising areas of practice and research in the literature. Although empirical data is limited, the sensory needs of the body in processing trauma experiences is becoming more recognised and are supported by the atypical SP patterns identified in survivors. A sensory-based, transdisciplinary approach to treatment has the potential to be effective in treating the trauma survivor.

With a skill base in sensory integration and occupational analysis, occupational therapists have much to offer the field of trauma studies. This review begins to address the gap in the literature, recommending more rigorous controlled outcome research with larger sample sizes, person-centred studies focussing on the trauma survivor’s perspective and continuing professional development and mentorship for occupational therapists working with this population.

Similar to religion, spirituality is considered a private affair along with issues of faith, hope, and love (Palmer, 1998). American public education has been reluctant to address such issues due to our cultural norm of “separation of church and state” (Love and Talbot, 2000, p. 1) yet the American Council for Education calls upon higher education to provide students ways to explore their personal values, world beliefs, and spirituality (Chickering et al., 2006; Dalton and Crosby, 2006). As such, the purpose of this paper is to explore student leaders’ perspectives on how leadership development activities influenced their sense of spirituality.

A qualitative case study design was used to explore responses from ten student leaders who completed a leadership development program in the Spring 2015 at a public four-year institution. As part of the leadership development program, students were paired a peer mentor while they completed leadership workshops, a reflection paper, self-assessment, and an ongoing community service project painting murals with individuals who have intellectual disabilities. Participants were from various majors and religious backgrounds and had completed the leadership development program two months prior to their participation in this study.

Findings revealed that leadership workshops, self-assessment, reflections, peer-to-peer mentorship, and an ongoing shared community service project, influenced students’ perspectives of spirituality and their leadership identity. Student leaders both did and did not differentiate the developmental process of leadership from the spiritual development process, defining both as cognitive and emotional development deeply grounded in self-awareness. Study participants shared that through self-reflection, developing their inter and intra personal skills through conducting service, shaped their understanding of their spiritual identity and developed their sense of self.

Study results are not generalizable but provide insight into the experiences and perceptions of student leaders on two hard-to-define topics: spirituality and leadership. The order of the interview questions may have influenced the thought process leading up to student’s responses connecting spirituality and leadership concepts. Another limitation is that the leadership activities were designed and coordinated by the lead investigator. Hence, there may be findings that were influenced by the investigators’ personal beliefs about leadership. Study participants may have also felt more comfortable discussing their beliefs about spirituality because of their familiarity with the lead investigator.

Results support the notion that non-faith based public institutions may intentionally support the spiritual development of students through the context of leadership development program activities. Approaching spiritual and leadership development through Baxter Magolda’s (2009) theory of self-authorship allows students to experience new activities coupled with personal self-reflection, to deepen their self-understanding, compassion for others, and self-awareness. This learning is an ongoing process that expands as students engage in contemplative practices such as mindfulness training provided through leadership workshops, self-reflection, and peer-to-peer interactions and self-assessment.

This case study illustrates that intentionally designed and implemented leadership development programs may cultivate both the spiritual and leadership identities and behaviors of students. Also, this study reveals that spirituality and leadership are not mutually exclusive processes because both are deeply rooted in connecting to our community, connecting to our greater purpose and our higher consciousness about who we are and how we treat others. Hence, this work may support educators develop more compassionate and empathetic students who are agents of positive social change.

This qualitative case study suggests a new framework for public institutions to support students’ leadership and spiritual development through the theoretical framework of self-authorship. As such, educators can stop being fearful about discussing religion, spirituality, and matters of the heart if they use this framework to design leadership developmental activities.

There is a mental health crisis, particularly among young people. Despite many young people living in urban settings, reviews about the association between exposure to green or natural environments and mental health tend to focus on either children or adults. The aim of this review is to examine the scope of the global literature for this age group, to inform a systematic review on the role of exposure to green space in preventing anxiety and depression amongst young people aged 14–24 years.

Seven databases were searched for quantitative and qualitative sources published from January 2000 to June 2020. This identified 201 sources and their characteristics are described here. Gaps in the literature are also highlighted.

The number of relevant studies published per year has increased over time. Most studies are set in North America (28%) or Europe (39%). The most common study designs were observational (34%) or experimental (28%). A wide range of exposures and interventions are described.

This review included literature from predominantly high-income countries and has shown the under-representation of low-middle income countries and lack of ethnic diversity in study populations. It has also highlighted the lack of clinical measures of anxiety and depression as outcomes.

This inter-disciplinary review has contributed to the field by describing the geographic distribution of the literature and the broad range of exposures to green spaces being reported. Unlike previous scoping reviews, this review focused specifically on young people and on measures of anxiety and depression and their pre-cursers.