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.     

A Question of ‘Government’ Control: Afghanistan DDR Programs Since 2001

Since the fall of the Taliban in late 2001, the Islamic Republic of Afghanistan (GIRoA), the United States, the United Nations, and the International Security Assistance Force (ISAF) have funded and led three different Disarmament, Demobilization, and Reintegration (DDR) programs. Despite a significant investment in time and treasure, all of them have failed to significantly reduce the number of insurgents or arbaki (militia). This article explores why these programs failed despite incorporating ideas from the prominent DDR schools of thought. Utilizing Stathis Kalyvas’ theory of The Logic of Violence in Civil War as a lens, this article argues that GIRoA and ISAF did not have sufficient control of territory to entice insurgents or arbaki to reconcile and/or reintegrate with the government. Further, in areas GIRoA nominally controlled in northern and western Afghanistan, regional powerbrokers who controlled these areas balked at these programs.     

COSMIC掩星电子密度廓线的质量检核

利用COSMIC掩星任务自2010年至2014年的电离层电子密度廓线,使用只考虑廓线自身特性的4种参数进行质量检核,并对廓线质量的时空分布进行分析。发现在廓线质量的空间分布上,廓线不合格率在高纬地区最高,其次是低纬地区,在中纬地区最低,这可能与电子密度分布在磁赤道附近存在赤道异常、两极地区的磁场强度最大有关。廓线质量的季节变化较明显,在南、北半球,冬、春两季的廓线不合格率均显著高于夏、秋两季。另外,廓线质量具有一定昼夜分布特性,不合格率白天明显较夜晚低,且在晨昏分界线上变化较大。合格廓线的电子密度峰值和峰值高度分布在磁赤道附近明显高于其他区域,呈现"双驼峰"现象。     

柔软物体力触觉形变模型验证系统

为了验证柔性物体力-形变模型的合理性,构建了基于CC2531芯片的无线数据收发平台、力传感器测量平台和FALCON手控器位移测量平台的力-形变模型验证系统。以新鲜猪肝脏为实验对象,研究了弹性形变实验和穿刺实验的作用力与位移之间的关系;以力-形变测量数据为基础,进行了参数验证校调。仿真实验结果表明:模型中力-形变特性与实际测量值保持一致。该系统能广泛应用于柔性物体力-形变模型验证,对于促进力触觉虚拟医学仿真系统的发展具有重要意义。     

满足大动压模拟要求的试验弹道优化设计

为了解决弹道导弹在高海拔发射场进行飞行试验时的大动压检验问题,提出一种模拟大动压条件的试验弹道设计方法。针对发射场的实际特点,建立残骸再入的动力学模型与落区边界模型;将大动压模拟条件转化为过程约束,提出一种主动段联合优化策略。基于自适应模拟退火算法,分别设计了三组满足不同大动压模拟条件和各项约束的试验弹道,并给出了对应的落区调整方案,验证了该方法的可行性。设计结果表明,最大动压主要出现在一级,一级最大负攻角增加,则最大动压也明显提高;同时调整发射方位角和二、三级程序角可以保证试验弹道满足弹头落点约束条件。     

掠飞末敏弹耦合运动动导数计算

以新型掠飞末敏弹为研究对象,提出了基于欧拉转动定理和滑移网格技术的复杂角运动模拟方法,利用著名的罗德里格斯转换矩阵插值求得弹箭在每个时间步的角速度修正值,并指定给球形滑移网格区。通过对非定常气动参数进行求解辨识,分析了不同马赫数下掠飞末敏弹滚转运动对其俯仰组合动导数和升力系数动导数的影响规律。结果表明:所提角运动模拟方法可有效消除姿态角计算的累积误差,实现对弹箭任意给定角运动的准确模拟;弹箭滚转运动对俯仰组合导数和升力系数动导数的辨识结果均存在显著影响,在进行弹箭动导数计算和稳定性分析时需充分考虑俯仰耦合效应的影响。     

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。