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This paper has three purposes: to identify and discuss values that should be promoted and respected in personal health monitoring, to formulate an ethical checklist that can be used by stakeholders, and to construct an ethical matrix that can be used for identifying values, among those in the ethical checklist, that are particularly important to various stakeholders.

On the basis of values that empirical studies have found important to various stakeholders in personal health monitoring, the author constructs an ethical checklist and an ethical matrix. The author carries out a brief conceptual analysis and discusses the implications.

The ethical checklist consists of three types of values: practical values that a technical product in personal health monitoring must have, quality of life values to be promoted by the development and use of the product, and moral values to be respected in this development and use. To give guidance in practice, the values in the checklist must be interpreted and balanced. The ethical matrix consists of the values in the checklist and a number of stakeholders.

The overall ambition is to suggest a way of categorizing values that can be useful for stakeholders in personal health monitoring. In order to achieve this, the study takes empirical studies as a starting-point and includes a conceptual analysis. This means that the proposals are founded on practice rather than mere abstract thinking, and this improves its usability.

The concept of user participation is well accepted internationally. Nevertheless, studies show that both patients and health professionals find it challenging to maintain patient-centred ideals in the context of severe mental illness. The purpose of this paper is to explore how professionals deal with the ideals in light of patients’ right to participate in planning and decision making regarding milieu therapeutic measures and activities.

This is a qualitative study with an interactionist approach based on fieldwork at three district psychiatric centres in Norway during 2011-2012. The observations focused on patient-staff interaction in milieu therapeutic activities. Interviews were based on observed situations.

Adherence to treatment, rules and routines restricted patient autonomy. The professionals’ practical orientation towards routines overrode the ideals of patients’ rights. The staff regarded user participation primarily as participation in organised and mandatory activities. Refusal to comply was met with different sanctions, e.g. the prospect of being discharged.

Although user participation calls for patient-centred approaches, there is some debate about the challenges and premises for cooperation with persons suffering from severe mental conditions. This study adds insight into the everyday organisational context that facilitates or impedes user participation. It helps to explain why the user perspective can be overlooked, thus providing important information to both clinicians and policy makers who aim to fulfil the patient’s right to participate in planning and decision making regarding treatment and care.

The study aims to guide private healthcare organizations to create value for patients through service encounters (SE) based on the value-in-use notion. It also intends to reveal whether SE experiences differ from reputation levels of hospitals.

Research embraces mixed methods for building theoretical construction and sampling, seven hospital managers and two private hospitals were interviewed and selected via analytical hierarchical process. A number of 1,023 valid data were obtained from patients through survey. Structural equation modeling, PROCESS macro and multigroup analysis were used to test for research model.

Call center experience among pre-core SE affected patient satisfaction positively and behavioral intention indirectly; however, online and social experiences did not. As core SE, physician and nursing interaction, trust, accessibility and perceived sufficient waiting positively influenced patient satisfaction and behavioral intention, though physical evidence and supportive staff interaction did not. In the post-core stage, patient satisfaction positively impacts behavioral intention. Additionally, those effects were equivalent for high and low reputations.

Study uniquely attempts to shift the paradigm from value-in-exchange to value-in-use in private healthcare context by embracing SE approach. Research differs from others by revealing the remarkable role of intangible assets instead of tangibles on holistic patient experience, essential for creating and managing value for patients.

Purpose – Objective measures of a new treatment's expected ability to improve patients’ health are presumed to be significant factors influencing physicians’ treatment decisions. Physicians’ behavior may also be influenced by their patients’ disease severity and insurance reimbursement policies, firm promotional activities and public media reports. This chapter examines how objective evidence of the incremental effectiveness of novel drugs to treat cancer (“chemotherapies”) impacts the rate at which physicians’ adopt these treatments into practice, holding constant other factors.

Design/methodology – The novelty of the analysis resides in the dataset and estimation strategy employed. Data is derived from a United States population-based chemotherapy order entry system, IntrinsiQ Intellidose. Quality/price endogeneity is overcome by employing sample selection methods and an estimation strategy that exploits quality variation at the molecule-indication level. Pooled diffusion rates across molecule-indication pairs are estimated using nonparametric hazard models.

Findings – Results suggest incremental effectiveness is negatively and nonsignificantly associated with the diffusion of new chemotherapies; faster rates of diffusion are positively and significantly related to low five-year survival probabilities and measures of perceived clinical significance. Results are robust to numerous specification checks, including a measure of alternative therapeutic availability. We discuss the magnitude and potential direction of bias introduced by several threats to internal validity. Evidence of incremental effectiveness does not appear to motivate the rate of specialty physician diffusion of new medical treatment; in all models high risk of disease mortality and perceptions of therapeutic quality are significant drivers of physician use of novel chemotherapies.

Value/originality – Understanding the rate of technological advance across different clinical settings, as well as the product-, provider-, and patient-level determinants of this rate, is an important subject for future research.

This paper describes the social circumstances report, written for the MHRT in an historical setting, and incorporates a small‐scale audit to determine the effect of implementing national guidelines in July 2002. Sixty reports were audited ‐ thirty in the period immediately before the introduction of national guidelines, and thirty immediately following the introduction of national guidelines. These reports concerned only patients subject to a hospital order with restriction under Section 37/41 of the Mental Health Act 1983. National guidelines comprised 102 individual sub‐headings within 17 main headings. Each report was scored using these guidelines as a checklist. Results show that compliance as measured by the national guidelines significantly improved following their circulation.Very little previous research has been undertaken in this area and only by researchers from the legal profession. Further research may need to be undertaken by social work professionals themselves, and by local authorities, which may encourage others in the profession to build on this knowledge. At present the process appears to be exclusively a legal interest rather than a joint interest with social care.

Emergency care delivery is a process requiring input from various healthcare professionals within the hospital. To deliver efficient and effective emergency care, professionals must integrate rapidly at multiple interfaces, working across functional, spatial and professional boundaries. Yet, the interdisciplinary nature of emergency care presents a challenge to the optimization of patient flow, as specialization and functional differentiation restrict integration efforts. This study aims to question what boundaries exist at the level of professionals and explores how these boundaries may come to influence integration and operational performance.

To provide a more holistic understanding of the inherent challenges to integration at the level of professionals and in contexts where professionals play a key role in determining operational performance, the authors carried out an in-depth case study at a busy, Level 1 trauma center in The Netherlands. In total, 28 interviews were conducted over an 18-month period.

The authors reveal the existence of structural, relational and cultural barriers between (medical) professionals from different disciplines. The study findings demonstrate how relational and cultural boundaries between professionals interrupt flows and delay service processes.

This study highlights the importance of interpersonal and cultural dynamics for internal integration and operational performance in emergency care processes. The authors unveil how the presence of professional boundaries creates opportunity for conflict and delays at important interfaces within the emergency care process, and can ultimately accumulate, disrupting patient flow and increasing lead times.

Patients in secure units are at high risk of obesity because of antipsychotic medication, restrictions on freedom, and poor motivation to eat healthily and exercise. The aim of this paper is to investigate how consultant forensic psychiatrists address weight management, particularly with respect to inpatients.

Based on a review of the literature, a structured questionnaire was developed and piloted locally. After revising the questionnaire, it was sent to all 442 consultant psychiatrists listed by the Royal College of Psychiatrists as having a special interest in forensic psychiatry.

A total of 183 usable questionnaires were returned (response rate 45.9 per cent). Most respondents monitored patients' weight and had some access to a dietitian. Respondents rated a median of 40 per cent of their inpatients as obese. A total of 68.9 per cent said their patients did not have unrestricted access to food. Use of weight loss drugs such as orlistat was infrequent. A few patients had been referred for bariatric surgery but most had been judged unsuitable.

The responses reported in this paper are based on participants' self‐report and have not been confirmed by independent observation. Further research is needed to determine which weight loss measures are effective for psychiatric patients in real‐life situations.

Obesity appears to be common among forensic inpatients despite weight monitoring, dietetic interventions and exercise programmes. Comprehensive and continuing efforts are needed to help patients lose weight and lead healthier lifestyles.

This survey reports on clinicians' views and clinical practice.

An audit of the 12 adult protection cases arising in a south London hospice during 2004 is reported, including case studies illustrating issues arising and information about the introduction of a new policy and procedure following No Secrets guidance (Home Office/Department of Health, 2000). Introducing reporting to local authority social services and adult protection co‐ordination raised various issues.