Assessing the special need for protection of vulnerable refugees: testing the applicability of a screening method (RHS-15) to detect traumatic disorders in a refugee sample in Germany.

Objectives: Although EU member states are obligated to take special account of the situation of particularly vulnerable refugees, appropriate and specific measures to detect affected asylum seekers are not yet available. This study tries to pave the way for the implementation of an adequate instrument which at the same time assesses these needs of suffering people whilst responding to the need for mental health assessments specifically designed for refugees. This was done by testing the implementation of a screening method (Refugee Health Screener RHS-15) for trauma related mental health problems in refugees. Design: Two refugee samples in Germany (differing in arrival time: 126 applicants for asylum residing in the initial reception center and 116 living in long term communal accommodations) were assessed with the culturally sensitive Refugee Health Screener (RHS-15) to detect the incidence of mental health problems amongst them. Test fairness, reasonableness, susceptibility, transparency, acceptance, external design, utility and economy of the instrument were examined to check the applicability of the RHS-15 standardization test. Results: The RHS-15 indicates a good practical feasibility as the examination of the focused psychometric characteristics suggests. It became apparent, that implementing a screening procedure depends on political, legal and medical context factors that need to be considered. 2/3 of the participants had a positive screening result, which needs further diagnostic clarification in a second step. Conclusion: The RHS-15 seems to be practicable, economical, and rapidly deployable for the widespread detection of traumatic disorders in refugees living in Europe. The tool proved useful to aid diagnostic assessments and provide treatment to individuals in need, however the time of examination (resp. the duration of staying in the target land) influences the results.

Making Strides Toward Health Equity: The Experiences of Public Health Departments.

OBJECTIVES: We explored the definition of health equity being used by public health departments and the extent of engagement of public health departments in activities to improve health equity, as well as facilitators and barriers to this work. DESIGN: We conducted 25 semistructured qualitative interviews with lead public health officials (n = 20) and their designees (n = 5). All interviews were transcribed and thematically analyzed. SETTING: We conducted interviews with respondents from local public health departments in the United States (April 2017-June 2017). PARTICIPANTS: Respondents were from local or state public health departments that were members of the Big Cities Health Coalition, accredited or both. RESULTS: Many departments were using a definition of health equity that emphasized an equal opportunity to improve health for all, with a special emphasis on socially disadvantaged populations. Improving health equity was a high priority for most departments and targeting the social determinants of health was viewed as the optimal approach for improving health equity. Having the capacity to frame issues of health equity in ways that resonated with sectors outside of public health was seen as a particularly valuable skill for facilitating cross-sector collaborations and promoting work to improve health equity. Barriers to engaging in work to improve health equity included lack of flexible and sustainable funding sources as well as limited training and guidance on how to conduct this type of work. CONCLUSIONS: Work to improve health equity among public health departments can be fostered and strengthened by building capacity among them to do more targeted framing of health equity issues and by providing more flexible and sustained funding sources. In addition, supporting peer networks that will allow for the exchange of resources, ideas, and best practices will likely build capacity among public health departments to effectively do this work.

When Parents and Adolescents Disagree About Disagreeing: Observed Parent-Adolescent Communication Predicts Informant Discrepancies About Conflict.

Adolescence is accompanied by increased stress in the parent-adolescent relationship, which frequently results in conflict. Researchers often rely on self-reports to measure conflict, but these reports are frequently discrepant from one another. In two studies, we examined the extent to which communication observed during parent-adolescent discussions of conflict were associated with discrepancies in reports about conflict. We also examined links between informant depressive symptoms and discrepancies. Across studies, observed parent-adolescent conflict behaviors consistently predicted absolute discrepancies in reports of conflict. Informant depressive symptoms sometimes predicted directional discrepancies in reports. Results suggest that informant discrepancies about conflict may stem, in part, from a lack of open communication in the relationship.

One-Year Test-Retest Reliability of the Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS).

The Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS) is a novel behavioral task designed to measure individual differences in negative reinforcement-based risk taking propensity. Performance on the MRBURNS has been linked with alcohol-related problems and negative reinforcement-based drinking motives, as well as symptoms of anxiety and depression; however, it is unclear if performance on the task represents a stable measure of negative reinforcement-based risk taking over time. As such, the current study aimed to examine the test-retest reliability of the MRBURNS over a period of one year. Results indicate that the correlation between year 1 and year 2 risk behavior (average number of pumps) on the MRBURNS was .43 across all trials. With the one year test-retest reliability of the MRBURNS established, the MRBURNS may be a useful approach to measuring the relative contribution of negative reinforcement-based risk taking in the development of risky behaviors over time, and may be used to monitor the effects of novel interventions that aim to reduce negative reinforcement based risk taking in the real world.

Gender and social rejection as risk factors for engaging in risky sexual behavior among crack/cocaine users.

Crack/cocaine and engagement in risky sexual behavior represent important contributors to the escalation of the HIV infection among women. Several lines of research have emphasized the role of social factors in women's vulnerability for such practices and stressed the importance of understanding such factors to better inform prevention efforts and improve their effectiveness and efficiency. However, few studies have attempted to pinpoint specific social/contextual factors particularly relevant to high-risk populations such as female crack/cocaine users. Extensive previous research has related the experience of social rejection to a variety of negative outcomes including, but not limited to, various forms of psychopathology, self-defeating, and self-harm behavior. Motivated by this research, the current study explored the role of laboratory-induced social rejection in moderating the relationship between gender and risky sexual behavior among a sample of crack/cocaine users (n = 211) at high risk for HIV. The results showed that among women, but not among men, experiencing social rejection was significantly associated with a greater number of sexual partners. Further, experiencing social rejection was not related to the frequency of condom use. Implications for future research, prevention, and treatment are discussed.

Maternal and infant health of Eastern Europeans in Bradford, UK: a qualitative study.

This qualitative study aimed to investigate maternal and infant health needs within Eastern European populations in Bradford. Evidence suggested that migrants from Eastern Europe had poor maternal and child health and increased rates of infant mortality. Health visitors, community midwives and specialist voluntary workers were involved. Eleven interviews took place. They were semi-structured and analysed using a thematic approach. A number of health needs were identified in Eastern European populations, including high rates of smoking and poor diet. Wider determinants of health such as poverty and poor housing were cited as commonplace for Eastern European migrants. There were numerous cultural barriers to health, such as discrimination, mobility, cultural practices regarding age at pregnancy, and disempowerment of women. Lastly, access to health services was identified as a significant issue and this was impacting on staff working with this population. This study demonstrated the complexity and interaction of health and social factors and their influence on utilisation of health services.

Unsheltered Homelessness and Health: A Literature Review.

Context: In recent years, cities across the world have seen widespread growth in unsheltered homelessness, in which a person sleeps in a place not meant for human habitation such as cars, parks, sidewalks, and abandoned buildings. It is widely understood that people experiencing homelessness have poorer health outcomes than the general population. Less is known about the health of people who are unsheltered, yet they may be exposed to greater health risks than their sheltered counterparts. The purpose of this literature review is to evaluate and summarize the evidence on unsheltered homelessness and health. Evidence Acquisition: A literature search was conducted using PubMed to identify publications on unsheltered homelessness and health. A total of 42 studies were included for review. Evidence Synthesis: Unsheltered populations experience higher rates of chronic disease, serious mental illness, and substance abuse than sheltered populations. Unsheltered homelessness is strongly associated with chronic homelessness that exacerbates serious mental illness and substance use, which is often co-occurring. Despite having large unmet health needs, unsheltered populations have lower healthcare utilization and often lack health insurance. Conclusions: Evaluating the impact of shelter status on health outcomes has important implications for the allocation of housing and health services. Longitudinal studies are needed to examine the relationship between the duration of sheltered and unsheltered homelessness and health outcomes and explore the mediating mechanisms that lead to poor health among unsheltered populations. Despite these limitations, our results also suggest an urgent need to address the unique and severe challenges facing unsheltered populations and the need for intervention approaches that are sensitive to these unique disease burdens.

Examining the Role of Duration and Frequency of Homelessness on Health Outcomes Among Unsheltered Young Adults.

PURPOSE: We examined the impact of duration and number of homelessness episodes on health outcomes for unsheltered homeless young adults. METHODS: We analyzed the 2018/2019 Los Angeles County homeless youth demographic surveys. We addressed five summary health outcomes: physical health, mental health, substance use disorder, tri-morbidity, and any condition. Respondents were classified into three homeless trajectory groups: (1) short-term-homeless < 1 year in one episode, (2) episodic-homeless < 1 year and multiple episodes, and (3) long-term-homeless continuously for > 1 year. Weighted bivariate and multivariate logistic regression models tested the relationship between homeless trajectory group and health, with controls for sociodemographic factors and structural exposures. RESULTS: Mental health and substance use were high among unsheltered young adults compared to national rates. Long-term homeless respondents were significantly more likely than short-term to report a mental health condition (53.3% vs. 39.8%, p < .001), substance use disorder (25.5% vs. 18.3%, p < .001), and physical conditions (26.0% vs. 15.6%, p = .008). Episodic respondents were more likely to report a mental health condition (50.5%, p < .001). In multivariate models, long-term respondents had twice the odds of tri-morbidity (odds ratio [OR] = 2.14, p < .05) and any health condition (OR 2.00, p < .01) as short term and significantly higher odds of a physical health condition (OR = 1.64, p < .05). DISCUSSION: Youth with longer durations and more frequent episodes of homelessness have substantially poorer health outcomes. The association of longer duration to poorer health persisted in multivariate models. Longer duration of unsheltered homelessness may drive the onset of physical and mental health problems.

Development and preliminary validation of a behavioral task of negative reinforcement underlying risk-taking and its relation to problem alcohol use in college freshmen.

BACKGROUND: A long line of theoretical and empirical evidence implicates negative reinforcement as a process underlying the etiology and maintenance of risky alcohol use behaviors from adolescence through emerging adulthood. However, the bulk of this literature has relied on self-report measures, and there is a notable absence of behavioral modes of assessments of negative reinforcement-based alcohol-related risk-taking. To address this clear gap in the literature, the current study presents the first published data on the reliability and validity of the Maryland Resource for the Behavioral Utilization of the Reinforcement of Negative Stimuli (MRBURNS), which is a modified version of the positive reinforcement-based Balloon Analogue Risk Task (BART). METHODS: Participants included a convenience sample of 116 college freshmen ever regular drinkers (aged 18 to 19) who completed both behavioral tasks; self-report measures of negative reinforcement/avoidance constructs and of positive reinforcement/appetitive constructs to examine convergent validity and discriminant validity, respectively; and self-report measures of alcohol use, problems, and motives to examine criterion validity. RESULTS: The MRBURNS evidenced sound experimental properties and reliability across task trials. In support of convergent validity, risk-taking on the MRBURNS correlated significantly with negative urgency, difficulties in emotion regulation, and depressive and anxiety-related symptoms. In support of discriminant validity, performance on the MRBURNS was unrelated to risk-taking on the BART, sensation seeking, and trait impulsivity. Finally, pertaining to criterion validity, risk-taking on the MRBURNS was related to alcohol-related problems but not heavy episodic alcohol use. Notably, risk-taking on the MRBURNS was associated with negative reinforcement-based but not with positive reinforcement-based drinking motives. CONCLUSIONS: Data from this initial investigation suggest the utility of the MRBURNS as a behavioral measure of negative reinforcement-based risk-taking that can provide a useful complement to existing self-report measures to improve our understanding of the relationship between avoidant reinforcement processes and risky alcohol use.

Neural systems underlying motivated behavior in adolescence: implications for preventive medicine.

OBJECTIVE: Although a time of increased independence and autonomy, adolescence is also a time of vulnerabilities, through increased risk-taking and the emergence of psychopathology. Neurodevelopmental changes during this period may provide a neurobiological basis for this normative rise in deleterious behaviors. Thus, the objective of this review was to identify neurodevelopmental processes underlying the emergence of risk-taking and psychopathology in adolescence, and discuss implications of these findings for prevention. METHOD: This article reviews literature examining developmental and contextual factors influencing neural functioning in systems mediating threat, reward, and cognitive control. This literature is discussed from the perspective of the Triadic Neural Systems Model of motivated behavior. RESULTS: Neuroimaging research suggests that neurodevelopmental and contextual factors both contribute to a shift in the functional equilibrium among the Triadic nodes. This equilibrium shift may contribute to negative outcomes of adolescent risk behavior. Most importantly, the balance of this equilibrium and its sensitivity to social and appetitive contexts may be exploited to facilitate prevention of deleterious outcomes. CONCLUSION: Understanding developmental and contextual factors that influence functioning in motivational neural circuits can inform research on adolescent risk-taking, and may provide targets for novel preventions, for example through the use of incentives to reduce deleterious outcomes.

Effects of Temperature on Anoplophora chinensis (Coleoptera: Cerambycidae) Larvae and Pupae.

Anoplophora chinensis (Forster) is a xylophagous invasive cerambycid whose larvae feed on the lower bole and exposed roots of many tree species in orchard, urban, and forested habitats. Larval survival and development of A. chinensis from Italy and China were evaluated at eight constant temperatures (5, 10, 15, 20, 25, 30, 35, and 40°C). Development was slow or did not occur at temperatures ≤10 and >35°C. The TMin for the first six instars and the pupa was <10°C, while TMin for the higher instars was closer to 12°C. The ultimate instar for both populations was insensitive to temperature. When the TMax thresholds could be estimated they were between 31 and 41°C. Temperature also influenced larval weight gain; larvae held at 25-30°C generally weighed the most from the fourth instar on. The number of degree days for 50% of the population to molt to the next instar increased with increasing instar for both populations up through the sixth instar. Anoplophora chinensis may use wood moisture content in conjunction with temperature as a cue as to when to pupate. These responses of A. chinensis to temperature can be used for developing phenological models to predict timing of stages for management or eradication efforts.

Comparison of Survival and Development of Gypsy Moth Lymantria dispar L. (Lepidoptera: Erebidae) Populations from Different Geographic Areas on North American Conifers.

Host utilization information is critical to managers for estimating the hosts at risk and potential geographic range for gypsy moths from different geographic origins. In this study, the development and survival of gypsy moths from all three subspecies on 13 North American conifers and three broadleaf hosts were compared. There was variation in the ability of gypsy moth larvae from different geographic origins to utilize (survive and develop on) key North American conifers. However, that variation was not consistent within gypsy moth subspecies, but instead was more consistent with populations from different origins being preadapted to utilize different hosts and having different biologic traits. Some Asian populations developed and survived well on some conifers while populations from Europe and North America gained weight faster and/or survived better than some Asian populations. Although development was slower and survival poorer on several of the conifers, first instar larvae were able to utilize conifers unless the needles were tough or feeding deterrents were present. Host phenology was also critical since the early instars fed preferentially on new foliage or buds. Gypsy moth larvae can utilize many hosts, so this makes it a very adaptable invasive species that warrants taking measures to prevent its spread.

Effects of acute exercise on directed forgetting.

Background: The directed forgetting paradigm involves individuals encoding a list of words(List 1; L1) and then, prior to encoding a second list of words (List 2; L2), they are given specific instructions to either remember all the words from L1 or to try and forget these words. In this paradigm, after encoding L1, those who are given the directed forgetting (DF) instructions tend tore call more words for L2 when compared to those who were given the remember (R) instructions(DF benefit effect). Similarly, those given the DF instructions tend to recall fewer words from L1(DF cost effect). This DF phenomenon may, in part, occur via attentional inhibitory mechanisms, or mental context-change mechanisms, which may be influenced via acute exercise. Methods: The present experiment investigates if acute exercise can facilitate DF when exercise occurs after L1 forgetting instructions. Participants (N = 97; Mage = 21 years) were randomly assigned into either acute exercise (15-min high-intensity aerobic exercise) plus DF (EX + DF),2) DF (directed forgetting) only (DF) or 3) R (remember) only (R). A standard two list (L1 and L2)DF paradigm was employed. Results: We observed evidence of a DF cost effect, but not a DF benefit effect. For L1, although both EX + DF and DF differed from R, there was no difference between EX + DF and DF. Further, although for L2, EX + DF was different than DF, neither of these groups differed when compared to R. Conclusion: We reserve caution in suggesting that exercise had a DF effect.

Changes in Quality of Life Among Enrollees in Hennepin Health: A Medicaid Expansion ACO.

Despite limited program evaluations of Medicaid accountable care organizations (ACOs), no studies have examined if cost-saving goals negatively affect quality of life and health care experiences of low-income enrollees. The Hennepin Health ACO uses an integrated care model to address the physical, behavioral, and social needs of Medicaid expansion enrollees. As part of a larger evaluation, we conducted semistructured interviews with 35 primary care using Hennepin Health members enrolled for 2 or more years. Using fuzzy set qualitative comparative analysis, we assessed enrollee complexity and use of the care model and improvements in quality of life. We found improved quality of life was consistently associated with strong bonds to primary care, consistent mental health care, and support from extended care team members. Comprehensive, integrated care models within ACOs may improve quality of life for low-income Medicaid enrollees through coordinated primary and mental health care.

Evidentiary needs of US public health departments with a mission to advance equity and health: a qualitative analysis.

OBJECTIVES: We sought the perspectives of lead public health officials working to improve health equity in the USA regarding the drivers of scientific evidence use, the supply of scientific evidence and the gap between their evidentiary needs and the available scientific evidence. DESIGN: We conducted 25 semistructured qualitative interviews (April 2017 to June 2017) with lead public health officials and their designees. All interviews were transcribed and thematically analysed. SETTING: Public health departments from all geographical regions in the USA. PARTICIPANTS: Participants included lead public health officials (20) and their designees (5) from public health departments that were either accredited or part of the Big Cities Health Coalition. RESULTS: Many respondents were using scientific evidence in the context of grant writing. Professional organisations and government agencies, rather than specific researchers or research journals, were the primary sources of scientific evidence. Respondents wanted to see more locally tailored cost-effectiveness research and often desired to participate in the planning phase of research projects. In addition to the scientific content recommendations, respondents felt the usefulness of scientific evidence could be improved by simplifying it and framing it for diverse audiences including elected officials and community stakeholders. CONCLUSIONS: Respondents are eager to use scientific evidence but also need to have it designed and packaged in ways that meet their needs.

#DocsOnTwitter: How Physicians use Social Media to Build Social Capital.

Using social capital theory, Augustana University healthcare marketing students examined how medical professionals utilize social media to further engage with their communities. The team selected Twitter as the social media network from which to collect data because of its popularity and ease of use. The sample was drawn from 1,000 Twitter profiles that were retrieved from 24 keywords such as MD. A total of 3,378,285 tweets from this sample were collected and analyzed for content, use of hashtags, mobile device use, frequency, longevity, medical relevance, medical specialty, gender, and approximate age. This is an important first look, using Big Data, at how physicians parlay the popularity of social media to build social capital through sharing research with colleagues, connecting with patients and prospective patients, and extending their personal and employer brands to increasingly information-hungry and interactive consumers.

Lack of degradation in visuospatial perception of line orientation after one night of sleep loss.

Sleep deprivation impairs a variety of cognitive abilities including vigilance, attention, and executive function. Although sleep loss has been shown to impair tasks requiring visual attention and spatial perception, it is not clear whether these deficits are exclusively a function of reduced attention and vigilance or if there are also alterations in visuospatial perception. Visuospatial perception and sustained vigilance performance were therefore examined in 54 healthy volunteers at rested baseline and again after one night of sleep deprivation using the Judgment of Line Orientation Test and a computerized test of psychomotor vigilance. Whereas psychomotor vigilance declined significantly from baseline to sleep-deprived testing, scores on the Judgment of Line Orientation did not change significantly. Results suggest that documented performance deficits associated with sleep loss are unlikely to be the result of dysfunction within systems of the brain responsible for simple visuospatial perception and processing of line angles.

Sex moderates the effects of positive and negative affect on clinical pain in patients with knee osteoarthritis.

BACKGROUND AND AIMS: Sex differences in clinical pain severity and response to experimental pain are commonly reported, with women generally showing greater vulnerability. Affect, including state (a single rating) and stable (average daily ratings over two weeks) positive affect and negative affect has also been found to impact pain sensitivity and severity, and research suggests that affect may modulate pain differentially as a function of sex. The current study aimed to examine sex as a moderator of the relationships between affect and pain-related outcomes among participants with knee osteoarthritis (KOA). METHODS: One hundred and seventy-nine participants (59 men) with KOA completed electronic diaries assessing clinical pain, positive affect, and negative affect. A subset of participants (n=120) underwent quantitative sensory testing, from which a single index of central sensitization to pain was derived. We used multiple regression models to test for the interactive effects of sex and affect (positive versus negative and stable versus state) on pain-related outcomes. We used mixed effects models to test for the moderating effects of sex on the relationships between state affect and pain over time. RESULTS: Sex differences in affect and pain were identified, with men reporting significantly higher stable positive affect and lower central sensitization to pain indexed by quantitative sensory testing, as well as marginally lower KOA-specific clinical pain compared to women. Moreover, there was an interaction between stable positive affect and sex on KOA-specific clinical pain and average daily non-specific pain ratings. Post hoc analyses revealed that men showed trends towards an inverse relationship between stable positive affect and pain outcomes, while women showed no relationship between positive affect and pain. There was also a significant interaction between sex and stable negative affect and sex on KOA-specific pain such that men showed a significantly stronger positive relationship between stable negative affect and KOA-specific pain than women. Sex did not interact with state affect on pain outcomes. CONCLUSIONS: Findings suggest that men may be particularly sensitive to the effects of stable positive affect and negative affect on clinical pain. Future work with larger samples is needed in order to identify potential mechanisms driving the sex-specific effects of affect on pain. IMPLICATIONS: The current study provides novel data that suggesting that the association of positive affect, negative affect, and pain are different in men versus women with KOA. Further understanding of the difference in affective expression between men and women may lead to the development of novel therapeutic interventions and help to identify additional modifiable factors in the prevention and management of pain.

Controlling Phlebotomy Volume Diminishes PICU Transfusion: Implementation Processes and Impact.

BACKGROUND AND OBJECTIVES: Phlebotomy excess contributes to anemia in PICU patients and increases the likelihood of red blood cell transfusion, which is associated with risk of adverse outcomes. Excessive phlebotomy reduction (EPR) strategies may reduce the need for transfusion, but have not been evaluated in a PICU population. We hypothesized that EPR strategies, facilitated by implementation science methods, would decrease excess blood drawn and reduce transfusion frequency. METHODS: Quantitative and qualitative methods were used. Patient and blood draw data were collected with survey and focus group data to evaluate knowledge and attitudes before and after EPR intervention. The Consolidated Framework for Implementation Research was used to interpret qualitative data. Multivariate regression was employed to adjust for potential confounders for blood overdraw volume and transfusion incidence. RESULTS: Populations were similar pre- and postintervention. EPR strategies decreased blood overdraw volumes 62% from 5.5 mL (interquartile range 1-23) preintervention to 2.1 mL (interquartile range 0-7.9 mL) postintervention (P < .001). Fewer patients received red blood cell transfusions postintervention (32.1% preintervention versus 20.7% postintervention, P = .04). Regression analyses showed that EPR strategies reduced blood overdraw volume (P < .001) and lowered transfusion frequency (P = .05). Postintervention surveys reflected a high degree of satisfaction (93%) with EPR strategies, and 97% agreed EPR was a priority postintervention. CONCLUSIONS: Implementation science methods aided in the selection of EPR strategies and enhanced acceptance which, in this cohort, reduced excessive overdraw volumes and transfusion frequency. Larger trials are needed to determine if this approach can be applied in broader PICU populations.

Validation of a Wireless, Self-Application, Ambulatory Electroencephalographic Sleep Monitoring Device in Healthy Volunteers.

STUDY OBJECTIVES: To evaluate the validity of an ambulatory electroencephalographic (EEG) monitor for the estimation of sleep continuity and architecture in healthy adults. METHODS: Healthy, good sleeping participants (n = 14) were fit with both an ambulatory EEG monitor (Sleep Profiler) and a full polysomnography (PSG) montage. EEG recordings were gathered from both devices on the same night, during which sleep was permitted uninterrupted for eight hours. The study was set in an inpatient clinical research suite. PSG and Sleep Profiler records were scored by a neurologist board certified in sleep medicine, blinded to record identification. Agreement between the scored PSG record, the physician-scored Sleep Profiler record, and the Sleep Profiler record scored by an automatic algorithm was evaluated for each sleep stage, with the PSG record serving as the reference. RESULTS: Results indicated strong percent agreement across stages. Kappa was strongest for Stage N3 and REM. Specificity was high for all stages; sensitivity was low for Wake and Stage N1, and high for Stage N2, Stage N3, and REM. Agreement indices improved for the manually scored Sleep Profiler record relative to the autoscore record. CONCLUSIONS: Overall, the Sleep Profiler yields an EEG record with comparable sleep architecture estimates to PSG. Future studies should evaluate agreement between devices with a clinical sample that has greater periods of wake in order to better understand utility of this device for estimating sleep continuity indices, such as sleep onset latency and wake after sleep onset.