At the age of thirty, supported employment has given rise to significant accomplishments, but much of its promise remains unfulfilled. Wolfensberger's Social Role Valorization (SRV) theory offers a substantive method for analyzing and strengthening supported employment practices while describing principles for addressing patterns of social devaluation imposed on people with disabilities. Using formal SRV theory, this paper will explore the power of the employee role. Improved clarity about the role of employee, when it exists and when it does not (i.e., "my employee" versus "your client") represents one way to bolster supported employment and increase positive possibilities in life for people with disabilities.

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Scheme (NDIS) provides a once-in-ageneration opportunity to transform how people with a disability are served. Similar to the enactment of the Disability Services Act 1986, which challenged the segregation and supported the integration of people with a disability into community settings, the National Disability Insurance Scheme Act 2013 is expected to fundamentally disrupt traditional service practice and improve disabled people's lives. This paper identifies some lessons from the previous reform of 1986 to guide policy makers, people with a disability, their families and service-providers, as they implement the NDIS now. It reflects on what it takes to make change and what can be expected to remain essentially the same regardless of the disruption that the NDIS will bring. It concludes that if the lessons of the past hold true, the NDIS will require several decades of intentional leadership and capacity-building to achieve enduring, positive change.

The International Initiative for Mental Health Leadership (IIMHL) is a joint endeavour involving eight countries, and aims to facilitate the sharing of best practices and to provide support and collaboration for leaders of mental health services to develop robust and effective managerial and operational practices. The ultimate aim is to improve services for people who use them. An article from the IIMHL is included in every issue of The International Journal of Leadership in Public Services. This paper describes the key learning outcomes that came from the examination of the experience of eight American community-based agencies that altered their service practices from an exclusive reliance on group and fixed models of service, to models of service that were exclusively individualised for the entirety of the people they served. It examines the key lessons learned as to what drove this process and what did not, as well as what some of the critical comparative outcomes were. A significant core factor cited repeatedly was valuesbased leadership from within the agency concerned and a key result was that individualised services for every person served were very cost competitive in the systems they were in.

We report a case of chyloperitoneum and chylothorax 5 weeks after retroperitoneal lymphadenectomy and radiotherapy for embryonal cell carcinoma of the testis. To our knowledge, this is the second reported case of this rare combined complication. The patient was treated successfully with an alimental dietary regimen (medium chain triglycerides and Vivonex), coupled with thoracenteses and paracenteses.