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.     

舰艇编队作战系统的武器目标分配问题

设我方m艘战舰,对方n个来袭目标.运用灰色局势决策求得目标对各个战舰产生的威胁值排序;再用模拟退火算法,参考目标威胁,单舰根据自身装载的火力发射进行初步武器分配;最后将分配结果传送至融合中心,应用大系统理论的分解协调法,协调武器分配,使得我方武器对本批目标的打击概率最大.仿真基于VC++编程实现,具体分析了算法及思想的可行性.     

基于ACE Streams框架的舰船综合电子仿真系统设计

软件构件具有良好的功能封装性及接口规范性,在增强软件的可移植性和提高复用率等方面意义重大。在舰船综合电子仿真系统开发过程中,通过引入ACE Streams框架的技术,有效地降低了软件各层次间的耦合度,增强了数据的传输处理能力,固化了该系统的通信机制。     

模糊变权法在通信保障能力评估中的应用

分析了通信保障应注重提高的六种能力,给出了运用模糊变权法求变化权重的方法,并通过示例计算进行分析,得出结论,为通信保障能力评估提供了一定的理论依据。     

在交叉学科研究中创新指挥与控制

用辩证唯物论的观点,阐述了指挥与控制复杂科学的产生背景、研究对象与方法,以及在相关领域的应用前景,并就如何在学科交叉、渗透、融合中开展指挥与控制这一新兴学科研究提出了建议.     

基于等值线约束的地磁匹配定位技术

地磁匹配定位是利用地磁图进行定位的方法,位置输出可用于限制惯导系统的误差积累.介绍了地磁辅助导航的原理和发展现状,并重点研究了地磁匹配定位技术.提出了一种基于等值线约束的改进的相关匹配算法,能有效消除导航系统的初始位置误差并能限制匹配过程中惯导系统的积累误差.仿真实验证明该算法能有效地提高相关匹配的实时性,并能把定位精度控制在地磁数据网格间距以内.算法对航向误差具有一定的适应性.     

基于RTX的实时测控系统软件设计

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.     

一种嵌入式系统中软硬件故障的划分方法

软硬件故障是嵌入式系统可靠性的关键问题之一,如何划分软硬件故障对于整个系统的可靠性研究来说是至关重要的,也是最基本的一步.给出了软硬件故障的基本定义,并与单纯的软件故障和单纯的硬件故障进行了对比,总结了软硬件故障的基本特点.在此基础上,归纳了几条软硬件故障的划分原则,提出了一种软硬件故障的划分流程,并通过形式化方法对某装备的具体软硬件故障进行了划分,为进一步的研究提供了有力的依据.