3 4 An evaluation of caesarean sections by the American College of Obstetricians and Gynecologists reported that first time mothers with term singleton cephalic pregnancies and women with a previous caesarean section account for the greatest increase in rates of caesarean section and much of the variation between institutions.5 Higher rates of caesarean delivery are associated with increased maternal and neonatal morbidity. 6 Rising rates of caesarean deliveries are assumed to have been driven by obstetricians, reflecting medicolegal concerns about vaginal birth after previous caesarean section (VBAC), vaginal breech delivery, and fetal distress in labour. In contrast, over a similar time period there has been increased emphasis on involvement of patients in making medical decisions.7-9 The traditional paternalistic model of care is based on the premise that the obstetrician knows best and by taking the lead on decisions could reduce anxiety and risk for the mother and her baby. 10 The shared model of medical decision making, in which clinician and patient exchange information, reveal preferences for treatment, and jointly come to a decision, is now promoted in preference to other models. [10][11][12] Decision aids are designed to help people select between various treatment strategies by providing information on the options and outcomes relevant to a person's health. A Cochrane review has reported that decision aids can improve knowledge and realistic expectations, reduce decisional conflict, and increase active participation in decision making. 13 A recent consensus process identified key aspects of quality of patients' decision aids relating to content, development, and effectiveness. 14 Determining the optimal mode of delivery for a woman who has experienced a previous caesarean section requires consideration of the risks and benefits of

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A theoretically based text-messaging intervention aimed at reducing binge drinking in disadvantaged men was not found to reduce prevalence of binge drinking at 12-month follow-up.

It is widely accepted that rigorous rehabilitation exercises after a stroke can help restore some functionality. However for many patients, this means exercises at home with minimal, if any, clinician support. Technologies that help motivate and promote good exercises offer significant potential but need to be designed to realistically take account of real homes and real lives of the people who have had a stroke. As part of the Motivating Mobility project, we carried out a series of visits to homes of people living with stroke and photographed their homes. In contrast to many utopian smart home scenarios, the elderly of today live in homes that were built as homes fit for heroes' but have been evolved and adapted over time and present significant challenges for the design of in‐home rehabilitation technologies. These challenges include the uses and repurposing of use of rooms, attitudes to and uses of existing technologies, space available in the home, feelings about different spaces within homes and individual preferences and interests. The findings provide a set of sensitivities that will help shape and frame ongoing design work for the successful deployment of rehabilitation technologies in real homes.

The use of computer decision support software that implements guidelines during patient consultations may improve clinical outcomes for patients with asthma.