Extent of the problemThat large numbers of legal abortions take place is well known; indeed the Soviet health service holds an unenviable record for terminating far more pregnancies than it welcomes babies into this world. The balance has been changing for the better, however, from the pronatalist viewpoint; when scattered data are pieced together a substantial improvement can be seen to have occurred in the ratio of live births to terminations ofpregnancy. Two decades ago, according to sample surveys, the ratios were as follows:

INTRODUCTION While promising evidence from trials of social-media-based stop smoking support informs service-planning, there is a need for more prospective, observational studies of smoking cessation interventions to build 'real-world' evidence. Specifically, user experiences have been under-explored with qualitative methods to date. This mixed-method evaluation of a closed Facebook group-based behavioral stop smoking support program, which was conducted in Ireland in 2018, aimed to address these issues. METHODS Pre-and post-program surveys measured smoking abstinence (selfreported 7-day point prevalence), changes in smoking attitudes and behavior, and participant experiences. Engagement with Facebook was measured through counting 'likes' and comments, and was used to categorize groups as 'more active' and 'less active' over a 12-week period of support. Thematic content analysis of semi-structured participant interviews explored program experience in depth. RESULTS In total, 13 of 52 participants reported smoking abstinence post-program (25.0%, 95% CI: 14.0-39.0). Participant engagement with Facebook was variable and decreased over the program. Membership of a 'more active' group was associated with better reported participant experience (e.g. 90.9% agreeing 'Facebook group helped me to quit or reduce smoking', versus 33.3% in the 'less active' group, p<0.05). Qualitative analysis identified three over-arching themes: importance of social interactions; perception of health information; and appeal of online support. CONCLUSIONS Facebook can be used to deliver group-based behavioral stop smoking support in the real world. In Ireland, the one-month post-program abstinence outcomes achieved by other stop smoking services is approximately 50%, and while the outcomes for this service was lower (25%), it is still better than outcomes estimated for unassisted quitting. Engagement and peer-to-peer interactivity should be maximized to support positive participant experience.

Empowering and engaging people with diabetes in their self-management journey through innovative digital channels.

back with persuasion. Where there were persistent and clear-cut demands to leave the hospital, civil rights were protected by appropriate use of the Mental Health Act.Being selective, the device does not mean there is an all-seeing monitor such as CCTV, and there is the added advantage that no one has constantly to monitor a receiving screen. Some staff training is required so that nurses understand the attachment procedures, and x-ray and laundry staff are warned to watch for tags inadvertently leaving the ward.The final test is whether people on the spot are convinced in practice and that is certainly so at the Hallett Clinic.I am grateful to the following people at Exe Vale Hospital: Charge nurses S Braunton and R Adams, Sister Julie Bloom, and the nursing staff of the Hallett Clinic for their work with the patients and on the ratings; the engineering staff for help with the installation; Dr N N

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