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.     

基于Bayes理论的航空电子设备可靠性评估

针对航空电子设备无失效数据可靠性分析问题,提出了weibull分布下基于Bayes理论的无失效数据分析方法,基于分层Bayes思想建立了模型,推导出可靠性参数后验分布计算公式,结合实例,验证了方法的有效性,结果表明,此方法计算结果符合工程实际,在其他电子设备可靠性分析中,有一定的借鉴意义.     

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。     

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.     

基于数字地图的威胁空间建模与仿真

利用雷达地形遮蔽盲区进行低空突防对敌人地面目标进行攻击是航迹规划关键技术之一.在综合考虑作战区域地形、敌方防空力量等因素条件下,应用人工势场理论对威胁空间的威胁级别进行量化处理,建立了战区势场模型.通过仿真证明,该模型更加符合真实的战场环境,为战斗机任务规划特别是航迹规划提供了参考依据.     

孔子道德教育思想与当代公民道德建设

孔子重视道德教育,提出了以“仁”为核心的道德教育思想,他把道德教育放在教育的突出位置,在道德教育中注重贯彻因材施教原则,重视道德实践的训练,强调发挥领导者的模范带头作用。当代公民道德建设,应该营造相互关心、团结互助、讲究制度和规范的良好氛围,应该重视公民行为规范的训练和习惯的养成,要构建家庭、学校、社会“三位一体”的道德教育模式。     

用科学发展观引领高校建设发展的几点思考

科学发展观是中国特色社会主义建设和党的建设的根本指导方针。高校落实科学发展观,涉及到办学的各个领域。概括地讲：在思想认识和宏观战略层面,包括办学理念、办学定位、发展规划、舆论导向等;在工作实践和微观操作层面,包括正确处理学校内部各个业务领域的关系、优化工作系统,如何使得学校各方面工作协调、全面、和谐发展等。