Sleep Validity of a Non-Contact Bedside Movement and Respiration-Sensing Device.

STUDY OBJECTIVES: To assess the sleep detection and staging validity of a non-contact, commercially available bedside bio-motion sensing device (S+, ResMed) and evaluate the impact of algorithm updates. METHODS: Polysomnography data from 27 healthy adult participants was compared epoch-by-epoch to synchronized data that were recorded and staged by actigraphy and S+. An update to the S+ algorithm (common in the rapidly evolving commercial sleep tracker industry) permitted comparison of the original (S+V1) and updated (S+V2) versions. RESULTS: Sleep detection accuracy by S+V1 (93.3%), S+V2 (93.8%), and actigraphy (96.0%) was high; wake detection accuracy by each (69.6%, 73.1%, and 47.9%, respectively) was low. Higher overall S+ specificity, compared to actigraphy, was driven by higher accuracy in detecting wake before sleep onset (WBSO), which differed between S+V2 (90.4%) and actigraphy (46.5%). Stage detection accuracy by the S+ did not exceed 67.6% (for stage N2 sleep, by S+V2) for any stage. Performance is compared to previously established variance in polysomnography scored by humans: a performance standard which commercial devices should ideally strive to reach. CONCLUSIONS: Similar limitations in detecting wake after sleep onset (WASO) were found for the S+ as have been previously reported for actigraphy and other commercial sleep tracking devices. S+ WBSO detection was higher than actigraphy, and S+V2 algorithm further improved WASO accuracy. Researchers and clinicians should remain aware of the potential for algorithm updates to impact validity. COMMENTARY: A commentary on this article appears in this issue on page 935.

An integrative review of promoting trust in the patient-primary care provider relationship.

AIM: An integrative review of empirical studies on factors promoting trust in the patient-primary care provider relationship. BACKGROUND: Trust is essential to the patient-provider relationship. Patients with high trust in their healthcare providers have been found to have improved outcomes, including improved chronic disease management, increased use of preventative services and satisfaction with care. Breaches of trust in the healthcare system threaten trust. Exploring factors that promote trust in the patient-provider relationship is warranted. DESIGN: Integrative literature review. DATA SOURCES: Electronic databases searched included CINAHL, MEDLINE and PsycARTICLES, using combinations of the key term 'trust' with: concept, practitioner, provider, physician, developing, creating, engendering, promoting and establishing. The results were limited to original publications in English, published between 1998-2013. REVIEW METHODS: A review of the literature was conducted by two independent reviewers based on the criteria established by Cooper; Whittemore and Knafl; and Polit and Beck. Methodological assessment tools were used to organize, evaluate the quality of and synthesize the data. RESULTS: A new conceptual definition of promoting trust is proposed that includes three core qualities: interpersonal and technical competence, moral comportment and vigilance. Gaps in the literature still exist related to rural, young adult, older adult and well patient populations. CONCLUSION: The core qualities could serve as target areas for the development of interventions aimed at modifying provider behaviours so that trust can be established, maintained or improved. Future prospective longitudinal research studies are needed that enhance understanding of trust with multiple primary care provider types.

Bedbugs: what nurses need to know from treating lesions to treating the home, management of an infestation is multifaceted.

I t could happen to anyone. A family is vacationing, and after checking into a hotel the kids and their mother go to bed. A short while later, the husband approaches the bed where his wife is sleeping; he notices something moving on the white sheet near her head. It's an insect. He catches it, places it on a tissue, and logs onto his computer to try to identify it. Soon he realizes it's a bedbug, wakes his wife and children, and calls the front desk. The hotel's pest manager comes up and confirms it: there's a bedbug infestation in the room, and the hotel moves the family to another part of the building.

Service-learning in baccalaureate nursing education: a literature review.

Service-learning is an educational pedagogy that provides students with an opportunity to apply classroom learning to real-world situations, while meeting a specific community need. The purpose of this literature review is to identify what type of baccalaureate nursing courses utilize service-learning, to determine the level at which baccalaureate nursing students are being engaged in service-learning, and to evaluate the efficacy of service-learning to meet curricular objectives. Suggestions are made for instructors who are considering integrating service-learning into their curriculum.