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.     

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针对半主动雷达中制导的远距空空导弹在制导过程中对载机的强依赖性问题,提出了双机协同制导的概念;首次给出了双机协同制导的过程描述.分析了长、僚机制导过程中对导弹导引和目标跟踪过程中的各计算要素;提出了长机对目标预测并进行数据传递,僚机再通过预测值对目标实施机动和照射的协同制导思想.     

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从无人机半物理仿真试验的整体结构出发,针对实时测控系统的需求,采用了一种较为新颖的Windows+RTX实时性方案,完成了无人机半物理仿真试验中实时测控系统的研制.既满足了试验的实时性要求,又具有很好的用户交互特性,对测控技术的发展及其在国防科技等相关领域中的应用均有重要的参考价值.     

GPS欺骗干扰原理研究与建模仿真

针对GPS欺骗干扰,分析了自主式与转发式干扰相关技术特点,重点研究了GPS转发式欺骗干扰的原理及实现方法,建立了GPS欺骗干扰对抗系统的主要数学模型,利用SYSTEMVIEW平台设计开发了GPS欺骗干扰仿真系统,通过仿真,验证了转发式欺骗干扰原理,给出了在一定干扰功率条件下转发误码率与干性比的关系,得到了各个转发信号的延迟量.所阐述的原理及仿真技术对于GPS欺骗干扰的分析与实现具有重要的参考作用.     

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总结分析了近年国内外重大隧道火灾事故,简述了隧道火灾的特点、危害性及其烟气控制方法,回顾了国内外对隧道火灾的研究现状。着重介绍了计算流体动力学（CFD）在隧道通风安全中的应用。同时总结了国内外在研究隧道火灾方面应用CFD模拟所作的一些基本工作,并描述近来在隧道安全工程的一些典型应用。     

论建设城市消防远程监控系统的必要性

目前,我国城市消防远程监控系统建设工作已经全面推广,该系统在运用市场手段推进消防工作社会化,提高城市预防和抵御火灾综合能力,提高消防部队快速反应能力、单位消防安全管理水平、消防监督执法效率和消防社会化水平等方面具有十分重要的意义和作用。由于系统主要由中介组织运营,进一步规范中介组织的法律地位和责任,引入市场竞争机制,逐步拓展其服务项目,不断研发新技术从而提高系统的可靠性是当前面临和亟待解决的问题。     

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