Abstract--Anaphylaxis is an increasingly prevalent lifethreatening allergic condition that requires people with anaphylaxis and their caregivers to be trained in the avoidance of allergen triggers and in the administration of adrenaline autoinjectors. The prompt and correct administration of autoinjectors in the event of an anaphylactic reaction is a significant challenge in the management of anaphylaxis. Unfortunately, many people do not know how to use auto-injectors and either fail to use them or fail to use them correctly. This is due in part to deficiencies in training and also to the lack of a system encouraging continuous practice with feedback. Assistive smartphone healthcare technologies have demonstrated potential to support the management of chronic conditions such as diabetes and cardiovascular disease, but there have been deficiencies in their evaluation and there has been a lack of application to anaphylaxis. This paper describes AllergiSense, a smartphone app and sensing system for anaphylaxis management, and presents the results of a randomized, controlled, pre-post evaluation of AllergiSense injection training and feedback tools with healthy participants. Participants whose training was supplemented with AllergiSense injection feedback achieved significantly better practiced injections with 90.5% performing correct injections compared to only 28.6% in the paper-only control group. In addition, the results provide insights into possible self-efficacy failings in traditional training and the benefits of embedding self-efficacy theory into the technology design process.

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In 2005, a 13-year-old child presented with a 1-day history of fever and encephalopathy and later, abdominal pain. We report a case of strongyloides, one of only 17 cases reported in the UK that year. The presentation was consistent with a heavy strongyloides infection, seen occasionally with a high nematode load, in this case Enterobius vermicularis. It is an illness of the tropics and rare in an indigenous setting. We suggest that the diagnosis should be considered in children presenting with signs of sepsis.