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How do the educational trajectories of young people develop differently at the transition between lower and upper secondary education and training--even amongst students labelled as disadvantaged with regard to social background, gender or ethnicity? The aim of the article is to understand the role of decision-making in the emergence of educational trajectories. Based on the analysis of qualitative interviews with students from schools in disadvantaged areas, patterns of educational trajectories are discerned with regard to the ruptures they involve, the destinations they take and the degree of choice young people have. The in-depth analysis of exemplary cases, however, reveals that even within similar patterns of trajectories decision-making processes occur in different ways. Therefore, constellations of decision-making are elaborated which cross-cut the patterns of educational trajectories. The fact that both institutional structures of different education systems and individual biographical orientations do make a difference reveals the complexity of educational trajectories in the interplay of structure and agency.

Purpose: This study investigated why some clinicians switched growth hormone (GH) brands in pediatric patients with GH-related disorders to Norditropin® since the start of the COVID-19 pandemic, the clinicians' perceptions of the results, and whether observations from this period of disruption could inform clinical practice in the future. Patients and Methods: Clinicians (N=106) from the UK, France, Italy, and Japan who had switched at least one patient to Norditropin® from a GH therapy manufactured by a different pharmaceutical company between February and November 2020 participated. They completed an online survey and submitted patient report forms for up to three switched patients. Results: Since the start of COVID-19, 39– 54% of the reported consultations were virtual (ie, via telephone or online means) in the UK, France, and Italy. Overall, 17% of patients seen by respondents in the survey were switched to a different GH brand; approximately two-thirds of switches were to Norditropin®. Clinicians' top considerations in choosing a GH brand were patient/carer feedback, patient support programs, and the need for easy-to-use therapies in the context of virtual consultations. The top reasons for switching patients to Norditropin® included ease of use, device features and benefits, better patient/carer feedback, and ease of training in device use via virtual consultations. Norditropin® was considered suitable for use in virtual or in-person consultations or a mixture of both. Based on patient/carer feedback, 66% of clinicians believed that patients preferred Norditropin® to their previous therapy in terms of overall satisfaction. Conclusion: In this survey, key considerations in prescribing GH therapy were ease of use and acceptability to patients and carers. If virtual consultations increasingly replace in-person ones, ease in training patients/carers in device use will be particularly important. A majority of clinicians considered that their patients preferred Norditropin® to their previous therapy. [ABSTRACT FROM AUTHOR]