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There is growing evidence to suggest that childhood deprivation is linked to social inequalities and has important consequences for health in later life. Past studies tend to focus on the influence of cumulative deprivation on the risk of developing a particular disease. This study adds to the literature by exploring how deprivation in childhood may be linked to how people (who already have a disease) self-manage their condition in later life. Questionnaires and focus groups were analysed to explore this relationship (n=91) among coronary heart disease patients living in a deprived urban area of Northern England. The results suggest that childhood deprivation may influence health behaviours and lifestyle in later life especially with regard to diet, health locus of control and doctor visits.

Although much is known about inequalities in the prevalence of CHD, less is known about the barriers experienced in self-managing it. Questionnaires, focus groups, and Internet forums were analyzed to explore obstacles in self-managing CHD. Most people found it difficult and costly to maintain a healthy lifestyle. Gender inequalities included women being more likely to live on their own and with a lower income. Marital status was an issue as several were either caring for an ill spouse or were coping with their recent death. Socio-demographic factors played a key role in influencing people's ability to manage their CHD.

Digital transformation (DT) is a priority for the healthcare sector. In many countries, it is still considered in the early stages with an underestimation of its benefits and potentiality. Especially in Italy, little is known about the impact of digitalization – particularly of the Internet of Things (IoT) – on the healthcare sector, for example, in terms of clinician's jobs and patient's experience. Drawing from such premises, the paper aims to focus on an overlooked healthcare area related to the chronic heart diseases field and its relationship with DT. The authors aim at exploring and framing the main variables of remote Monitoring (RM) adoption as a specific archetype of healthcare digitalization, both on patients and medical staff level, by shedding some lights on its overall implementation.

The authors empirically inquiry the RM adoption within the context of the Cardiology Department of the Casilino General Hospital of Rome. To answer our research question, the authors reconstruct the salient information by using induction-type reasoning, direct observation and interviewees with 12 key informants, as well as secondary sources analysis related to the hospital (internal documentation, presentations and technical reports).

According to a socio-technical framework, the authors build a model composed of five main variables related to medical staff and patients. The authors classify such variables into an input-process-output (I-P-O) model. RM adoption driver represents the input; cultural digital divide, structure flexibility and reaction to change serve the process and finally, RM outcome stands for the output. All these factors, interacting together, contribute to understanding the RM adoption process for chronic disease management.

The authors' research presents two main limitations. The first one is related to using a qualitative method, which is less reliable in terms of replication and the interpretive role of researchers. The second limitation, connected to the first one, is related to the study's scale level, which focuses on a mono-centric consistent level of analysis.

The paper offers a clear understanding of the RM attributes and a comprehensive view for improving the overall quality management of chronic diseases by suggesting that clinicians carefully evaluate both hard and soft variables when undertaking RM adoption decisions.

RM technologies could impact on society both in ordinary situations, by preventing patient mobility issues and transport costs, and in extraordinary times (such as a pandemic), where telemedicine contributes to supporting hospitals in swapping in-person visits with remote controls, in order to minimize the risk of coronavirus disease (COVID-19) contagion or the spread of the virus.

The study enriches the knowledge and understanding of RM adoption within the healthcare sector. From a theoretical perspective, the authors contribute to the healthcare DT adoption debate by focusing on the main variables contributing to the DT process by considering both medical staff and patient's role. From a managerial perspective, the authors highlight the main issues for RM of chronic disease management to enable the transition toward its adoption. Such issues range from the need for awareness of the medical staff about RM advantages to the need for adapting the organizational structure and the training and education process of the patients.

The East London Clinical Guidelines Project aims to improve clinical effectiveness by disseminating locally developed guidelines linked to research evidence to inner city primary health care teams. Practice‐based educational sessions combined with audit are offered to help practices implement the guidelines. This paper reports on the baseline and one‐year audit results following facilitation and implementation of coronary heart disease guidelines.

The aim of this paper is to link complexity theory to the intentional change process by examining the role of emotional attraction. A research study currently underway on intentional change theory (ICT) in a healthcare context is presented.

This paper uses the concept of “attractors” from complexity theory to suggest that emotion affects the process of intentional change in different ways dependent upon whether the emotion is positive or negative. Determination of the emotion in this way proposes the existence of either a positive emotional attractor (PEA) or a negative emotional attractor (NEA). The paper discusses positive psychology's perspective on the differential impacts of positive and negative emotion. The paper also outlines an ongoing research project at a Veterans Affairs Medical Center which examines the concept of PEA and its effect on diabetes self‐management as well as its consequent role in improved health.

A review of the literature and subsequent development of hypotheses and the conceptual model, indicate education for chronically ill adults must be purposeful and directed toward a self‐perceived need for personal change; include their own disease experience; allow them to become active participants in learning; and lastly, the learning process should be considerate of individual cognitive ability.

ICT could address the needs of chronically ill patients as its focus is a self‐directed journey to personal change and learning. The potential of ICT is enormous given that diabetes is a national problem that has reached epidemic proportions.

The paper seeks to show that the new General Medical Services (GMS) contract will provide opportunities for NHS staff to enhance their roles, so it is important that adequate training assessment and quality control systems are set in place. This paper assesses the implications for NHS staff in primary care.

In this paper a review of policy documents was undertaken.

The paper finds that enhanced services set out in the new GMS contract may be provided by primary care organisations and healthcare professionals other than those located in general practitioner (GP) practices. As nurses and other healthcare professionals take on tasks previously conducted by GPs, so GPs will take on more consultant tasks previously confined to secondary care. Personal Medical Services (PMS) and GMS are converging in their contractual obligations and the opportunities offered to staff. As well as General Practitioners with Special Interests (GPwSIs), Practitioners with Special Interests (PwSIs) are important developments, which could promote recruitment and retention in the nursing and allied health professional workforce. Nurses and other healthcare professionals will be the main source of staffing for services shifted from secondary care.

The paper shows that it will be important to identify whether these professionals can substitute for GPs, the boundaries to that substitution, and whether recruitment and retention are enhanced. Training for GPwSIs and PwSIs will be introduced or expanded but also needs accreditation and validation.

The paper provides an overview of the implications of the new GMS contract for nurses and other NHS professionals.