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。     

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。     

认知建模及其心理战

认知建模以神经科学、计算机科学和认知心理学为依托,深入研究人类的思维模式。心理战作为认知科学领域的研究范畴,其内在运行机制就是通过特定的手段传播特定的信息影响作战对象的认知,达到精神上影响甚至瓦解作战对象的目的。由此,认知建模的不断完善和发展能够为心理战的理论研究、实际训练和效果评估等提供理论支持和借鉴启示。     

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。     

Resequencing with parallel queues to minimize the maximum number of items in the overflow area

This article treats an elementary optimization problem, where an inbound stream of successive items is to be resequenced with the help of multiple parallel queues in order to restore an intended target sequence. Whenever early items block the one item to be currently released into the target sequence, they are withdrawn from their queue and intermediately stored in an overflow area until their actual release is reached. We aim to minimize the maximum number of items simultaneously stored in the overflow area during the complete resequencing process. We met this problem in industry practice at a large German automobile producer, who has to resequence containers with car seats prior to the assembly process. We formalize the resulting resequencing problem and provide suited exact and heuristic solution algorithms. In our computational study, we also address managerial aspects such as how to properly avoid the negative effects of sequence alterations. © 2016 Wiley Periodicals, Inc. Naval Research Logistics 63: 401–415, 2016