Clinical Characterization of Insomnia among Veterans with PTSD: Identifying Risk Factors for Diagnosis and Treatment with Sedative-Hypnotics

Abstract

Insomnia is prevalent among Veterans with post-traumatic stress disorder (PTSD), it exacerbates PTSD symptoms, and it contributes to impaired functioning and quality of life. To improve treatment outcomes, it is important to identify risk factors for insomnia and sedative-hypnotic use. Classification and regression trees and logistic regression models were used to identify variables associated with insomnia or sedative-hypnotic use. Key findings include low insomnia diagnosis rates (3.5–5.6%) and high rates of sedative-hypnotics (44.2–49.0%). Younger Veterans and those without a breathing-related sleep disorder (BRSD) were more likely to receive an insomnia diagnosis. Veterans with greater service connection and those with an alcohol/substance use disorder were more likely to be prescribed sedative-hypnotics. Interaction terms may have identified potential groups at risk of being under-diagnosed with insomnia (i.e. non-black Veterans with psychiatric co-morbidity, black Veterans without psychiatric co-morbidity) as well as groups at risk for sedative-hypnotic use (i.e. younger Veterans without BRSD). In sum, Veterans with PTSD have high rates of sedative-hypnotic use despite minimal evidence they are effective. This is counter to recommendations indicating behavioral interventions are the first-line treatment. Policy changes are needed to reduce use of sedative-hypnotics and increase access to behavioral insomnia interventions.     

What Is Known About Defence Research And Development Spill-Overs?

This article surveys the body of available evidence regarding the spill-over effects of defence R&D. It reviews the routes through which defence R&D spills over to the economy with positive externalities – in terms of new products, technologies or processes; the barriers that impede or block such a process; potential negative repercussions, and the measure of such effects. The main conclusion is that the uncertainty of these effects, and the inaccurate appraisal of their value, hardly supports informed decisions concerning defence R&D policies.     

军民融合产业概念及范畴研究

军民融合产业概念及范畴不明确一直是困扰决策部门和研究部门的问题,影响了军民融合发展的顺利推进。本文在梳理总结军民融合产业概念及范畴的研究现状以及政府文件表述的基础上,认为军民融合作为一种发展模式,定义军民融合产业概念并非易事,但出于当前工作要求,需要相关管理部门整合力量,加强研究,尽快明确军民融合产业概念和范畴,构建科学合理的军民融合产业统计体系。     

大力弘扬改革创新时代精神 加快建设世界一流高等教育院校

习主席在庆祝改革开放40周年大会上的重要讲话,是新时代改革开放再出发的宣言书和动员令。学习贯彻习主席重要讲话精神,关键要全面推进学校深化改革创新,深刻认清弘扬改革创新精神对于建设世界一流高等教育院校的重大意义,牢牢扭住全面深化改革创新的主攻方向,科学处理深化改革创新的重大关系,既以顽强的战略定力坚定不移深化改革,又运用科学的工作方法积极稳妥地推进改革。     

虚拟现实在心理战中的应用及展望

虚拟现实是用虚拟的情境模拟现实的世界,通过虚拟的多维空间,使用户体验到身临其境的感觉。文章通过深度剖析虚拟现实的历史沿革、发展现状与技术特点,结合其在军事中的运用以及发展前景,提出虚拟现实能够对心理战参战人员的心理训练、战场环境模拟和心理战效果评估提供借鉴和支持。     

基于ADAMS和Matlab的大口径舰炮发射系统动力学仿真

利用ADAMS和Matlab/Simulink两大软件的信息交互功能,将ADAMS中的全炮动力学仿真模型生成ADAMS_SUB模块,并将其嵌入联合后坐系统仿真模型中;通过ADAMS和 Matlab/Simulink同步运行对全炮进行发射动力学联合仿真,模拟大口径舰炮发射的全过程,分析全炮的动态响应.对全炮发射动力学联合仿真结果进行后处理分析,观察炮口扰动曲线,进行稳定性分析和炮口扰动分析.根据分析结果,对所建模型及仿真模块进行评价,结果表明,仿真结果与靶场试验数据基本吻合,为物理样机的研制提供了重要的理论参考依据.     

潜艇的承载力与水下动力抗沉

阐明了潜艇承载力图谱的一种新算法,分析了危险舵卡的基本挽回方法及其衡准,论述了当前水下动力抗沉的实用方法及评价指标.     

一种无人战斗机系统使用保障费用分析方法

基于无人战斗机系统在使用保障上的特点,通过对有人战斗机使用保障费用模型进行合理改造,使其能适用于无人战斗机的使用保障费用分析。经过改造的模型具有结构清晰、概念明确的特点。适合在飞机总体设计阶段用于全寿命周期的费用估算以及飞机的费效分析和综合优化设计。通过与有人战斗机的使用保障费用进行对比计算表明,无人战斗机系统的使用保障费用具有明显的经济优势。     

The multiplicative representation for multiple objectives optimization with an application for arms procurement

Multiple Objectives Optimization is much seen in combination with linear functions and even with linear programming, together with an adding of the objectives by using weights. With distance functions, normalization instead of weights is used. It is also possible that together with an additive direct influence of the objectives on the utility function a mutual utility of the objectives exists under the form of a multiplicative representation. A critical comment is brought on some representations of this kind. A full‐multiplicative form may offer other opportunities, which will be discussed at length in an effort to exclude weights and normalization. This theoretical approach is followed by an application for arms procurement. © 2002 Wiley Periodicals, Inc. Naval Research Logistics 49: 327–340, 2002; Published online in Wiley InterScience (www.interscience.wiley.com). DOI 10.1002/nav.10014     

藏区地基换填戈壁土处理的经济适用性评价

藏区地基处理中如果能采用戈壁土作为换填材料，可以较好的解决该地区地基加固费用高的问题。结合某新建工程，对换填戈壁土方法进行经济适用性评价，结果表明该方法经济合理，可以推广应用。