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.     

Single‐machine scheduling with deadlines to minimize the total weighted late work

We consider scheduling a set of jobs with deadlines to minimize the total weighted late work on a single machine, where the late work of a job is the amount of processing of the job that is scheduled after its due date and before its deadline. This is the first study on scheduling with the late work criterion under the deadline restriction. In this paper, we show that (i) the problem is unary NP‐hard even if all the jobs have a unit weight, (ii) the problem is binary NP‐hard and admits a pseudo‐polynomial‐time algorithm and a fully polynomial‐time approximation scheme if all the jobs have a common due date, and (iii) some special cases of the problem are polynomially solvable.     

基于结构光的柱体工件直径测量

为实现柱状工件直径的实时快速非接触测量,利用结构光原理,对柱体直径的视觉测量方法进行了研究.详细介绍了结构光法测直径的原理和步骤,以及激光平面的标定和坐标变换求解空间二次曲线方程及特征参数的方法.实验证明该方法测量速度快,精度适中的特点,适用于大批量产品在线测量,亦适用于恶劣环境下的测量.     

多级抽样折合的小子样计数抽样方法

高价值、小批量产品要求小子样抽样,传统的计数抽样方法不能很好地解决这一问题.提出了一种基于多级抽样的综合抽样方法,将子系统或组件、零部件抽样折合为全系统抽样,增加全系统样本量,从而达到减少全系统抽样量,降低试验成本的目的.实例表明,该抽样方法具有较好的工程使用价值.     

A decision support system for the procurement of military equipment

The use of life-cycle costs in procurement is limited by the accuracy of cost estimates and assessments of availability risks under the conditions generating costs. Critical to these problems are the needs and responses of equipment to maintenance and repair. Using transition probabilities to define the relationships between serviceability and maintenance and repairs, this article develops a comprehensive decision support system for military procurement. It uses a dynamic programming model to determine the least-cost set of maintenance and repair decisions, where adjustments are included for warranty conditions, time value of money, the opportunity costs of equipment failure, and the end-of-cycle salvage values or disposal costs. The system allows users to define working and failed states, create their own rules or indicators of availability from estimates of state probabilities and establish thresholds of risk acceptability.     

同步电机卦限识别技术及轴角数字转换器设计

根据同步电机工作原理提出了一种新的同步电机卦限划分及轴角识别技术,并据此技术,完成了同步电机轴角-数字转换器设计.     

(Re-)emergent orders: understanding the negotiation(s) of rebel governance

Abstract

The concept of order is often neglected in the study of conflict – seemingly such a ‘disordering’ process. With the recent increase in the examination of rebel governance however, bringing order back into our understanding of rebel and insurgent groups has much to offer in exploring the everyday politics which connect authorities, rebel movements and the population itself, in a complex mass of intersubjective and power-based interactions and negotiations. Rebels both shape and are shaped by existing forms of order in complex and ongoing ways. This article explores how varying elements interact in the negotiation, framing and enforcement of order and develops an original analytical framework to examine the perpetual negotiations of rebel movements in their attempts to cement their control.