iMStrong: Deployment of a Biosensor System to Detect Cocaine Use.

Biosensor systems are increasingly promoted for use in behavioral interventions. Portable biosensors might offer advancement over self-report use and can provide improved opportunity for detection and intervention in patients undergoing drug treatment programs. Fifteen participants wore a biosensor wristband capable of detecting multiple physiologic markers of sympathetic nervous system (SNS) arousal for 30 days. Urine drug screening and drug use self-report were obtained twice per week. A parameter trajectory description method was applied to capture abrupt changes in magnitude of three measures of SNS activity: Electrodermal activity (EDA), skin temperature and motion. Drug use events detected by the biosensor were verified using a triad of parameters: the biosensor data, urine drug screens, and patient self-report of substance use. Twelve positive cocaine urine screens were identified. Thirteen self-reported episodes of cocaine use were recorded. Distinct episodes with biometric parameters consistent with cocaine use were identified on biosensor data. Eleven potential cocaine use episodes were identified by biosensors that were missed by both self-report and drug screening. Study participants found mobile biosensors to be acceptable, and compliance with the protocol was high. Episodes of cocaine use, as measured by supraphysiologic changes in biophysiometric parameters, were detected by analysis of biosensor data in instances when self-report or drug screening or both failed. Biosensors have substantial potential in detecting substance abuse, in understanding the context of use in real time, and in evaluating the efficacy of behavioral interventions for drug abuse.

Guillain-Barré syndrome patient's satisfaction with physiotherapy: A two-part observational study.

The purpose of this observational study was to assess Guillain-Barre´ syndrome (GBS) patients' satisfaction with physiotherapy in the acute and sub-acute setting, and provide an overview of inpatient case management, including the number of complications. Twenty-seven patients admitted to Sir Charles Gairdner Hospital (SCGH) with GBS between 1 May 2005 and 30 April 2010 were considered for inclusion. Nineteen patients consented and a waiver of consent was granted for four other patients. Data were collected from case-note audit (n = 23) and telephone survey (n = 19) during June and July 2011. Participants receiving physiotherapy (n = 16) reported they were satisfied with management (87%), treatment frequency (88%), duration (94%), and timetabling (81%) of treatment and the professionalism and rapport (100%) of physiotherapists. Median length of hospital stay was 20 days (range 5-198) for 23 participants. Physiotherapists documented patient assessment within 2 days from admission (range 1-5). First functional improvements were documented on day 6 (median, range 2-34). Physiotherapists were most commonly first to mobilize patients to sit, stand, transfer, and walk (83%, 82%, 81%, and 90%, respectively). Twenty patients (87%) developed complications during their hospital stay, the most common being low back pain (61%). This study has demonstrated that GBS patients were satisfied with care provided by physiotherapy.