Operational Tempo Research Articles

TBICoE approach to concussion rehabilitation in service members and veterans.

Concussion, also known as mild traumatic brain injury (mTBI), is a condition with unique ties to military service. Service members (SMs) are inherently at a higher risk for concussive injuries due to the intense physical training environment and combat operational tempo required to serve. The Traumatic Brain Injury Center of Excellence (TBICoE) is the US Department of Defense authority on this condition and provides a thorough approach to management of concussion and associated symptom sequela. This article seeks to review the TBICoE approach to the management and rehabilitation of military SMs with mTBI, and highlight resources available to military medical providers. The authors reviewed evidence and TBICoE resources to provide this comprehensive overview of the TBICoE approach to management and rehabilitation of concussion in military SMs. A progressive return to activity protocol in conjunction with symptom-guided management of common post-concussive sequelae, including headache, vestibular and oculomotor issues, sleep dysfunction, cognitive rehabilitation, and behavioral health comorbidities are essential for concussion management in the acute, post-acute and chronic phases of injury. The TBICoE approach to the rehabilitation of military SMs is comprehensive, and includes initial management with a stepwise return to duty protocol and an objective return to duty screening. The mainstays of treatment for SMs with post-acute and chronic post-concussion symptoms are headache management, vestibular and oculomotor rehabilitation, sleep interventions, cognitive rehabilitation, and early intervention for behavioral health comorbidities. These evidence-based strategies may be applied in the treatment of SMs in the US and internationally.

A qualitative study of special operations forces chaplaincy teams' relationship building for suicide prevention, intervention, and postvention.

The U.S. special operations forces (SOF) contribute to a range of complex missions and experience high operational tempo, which may result in heightened professional and personal stressors. Those who are experiencing stressors may be reluctant to seek professional mental health services due to career concerns. The chaplaincy community is at the forefront of bearing and responding to the pain of others including those at risk for suicide. As a formative step to developing a tailored suicide prevention curriculum for the U.S. SOF religious support teams (RSTs), we sought to understand SOF RSTs' common strategies for suicide prevention, intervention, and postvention. We conducted confidential interviews with SOF RSTs via telephone and in person. We used an inductive thematic analysis to code a total of 57 transcripts. SOF RSTs prominently expressed that building relationships with SOF community members was foundational to their suicide prevention, intervention, and postvention practices: (a) Suicide prevention involved being available and cultivating a community of insiders who can provide resources as needed prior to crisis escalation; (b) Suicide intervention involved listening and responding to suicide risk and building autonomy for a suicidal SOF member to seek outside help; (c) Suicide postvention involved reaching out to suicide-loss survivors and grieving together through memorial services. The salient theme of building relationships points to opportunities to capitalize on RSTs' social connections and to enhance skills and resources for military suicide prevention, intervention, and postvention practices. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Network analysis of PTSD, depression, and anxiety symptom Co-occurrence among U.S. veterans seeking treatment

BackgroundFor the past twenty years, veterans have sustained an unprecedented operational tempo, which can lead to co-occurring mental health disorders. When veterans present for clinical services, the symptom constellation can be challenging to treat due to the overlap of posttraumatic stress, depression, and generalized anxiety symptoms. With limitations, researchers have traditionally used latent variable models to investigate the association between these constructs, whereas network analysis provides a novel approach to study symptom- and disorder-level associations. MethodIn our evaluation of symptom co-occurrence among veterans, we used a sample of treatment-seeking veterans (N = 591) who completed self-report measures of PTSD, depression, and generalized anxiety. ResultsOur cross-sectional network analysis yielded five empirically distinct communities: intrusion and avoidance, hyperarousal and numbing, negative alterations, depression, and generalized anxiety symptoms. LimitationsThe data is cross-sectional and should be modeled in longitudinal networks. ConclusionsNetwork associations underscore the heterogeneity of PTSD and also highlight overlapping and diverging symptoms of depression and generalized anxiety. These findings are discussed within the context of existing research on veterans, and recommendations for further study and treatment interventions are provided.

A Sensemaking Framework for Defensive Cyber Operations: Filling the Void in Leadership Discourse

In the realm of contemporary warfare dominated by cyber threats, Defensive Cyber Operations (DCO) serve as a linchpin for mitigating risks and ensuring mission assurance. This article delves into the intricate landscape of DCO, focusing on the critical role played by Defensive Cyberspace Forces (DCFs). Despite their significance, the absence of a unified sensemaking framework poses a challenge for leaders responsible for the nuanced development and strategic employment of DCFs. The lacuna in the existing literature revolves around the lack of a comprehensive sensemaking framework tailored for operational and DCF leaders. The inadequacies of current frameworks, either overly broad or excessively specific, hinder effective dialogue and understanding. This deficiency not only obstructs the planning efforts and operational tempo of DCO but also restrains the maturation of DCFs, amplifying residual risks faced by commanders. This paper endeavours to present a purpose-built sensemaking framework crafted for leaders engaged in the dynamic realms of DCF development. Integrating well-established risk mitigation principles with the unique organizational structures and missions of DCFs, the framework fills a crucial void in the literature. Beyond being a decision-support tool, it strives to foster a shared mental model, providing a nuanced lens for leaders to contextualize and prioritize their efforts in the complex landscape of DCO. Through a meticulous critique of existing frameworks, this article introduces a tailored model designed to address identified shortcomings. Emphasizing the practical utility of the proposed framework, the discussion unfolds to elucidate how it not only facilitates the development and employment of DCF but also contributes to organizational resilience and risk mitigation. This article contributes a novel sensemaking framework to the academic discourse on DCO. While acknowledging limitations imposed by an unclassified context, the framework provides valuable insights into the strategic dimensions of DCF development and employment, DCO planning intricacies, and organizational analyses. Future avenues for research include the integration of classified information to refine the framework, ensuring its applicability across diverse DCO mission types and aligning DCF core functions with specific threats, thereby enhancing the efficacy of defensive cyber strategies.

Resilience through appropriate response: a simulation study of disruptions and response strategies – case COVID-19 and the grocery supply chain

In the wake of disruptions such as the COVID-19 pandemic, supply chains (SCs) face unprecedented levels of uncertainty, underscoring the critical need for resilience capabilities. We study how the operational dynamics of SCs influence the efficacy of key resilience capabilities, specifically flexibility and visibility. Utilizing a system dynamics simulation model, we analyze the contingency effects within Finnish grocery SCs, examining how the operational tempo—characterized by lead times, inventory buffers, information updating—affects the efficiency of resilience strategies in response to diverse disruption scenarios. Our model, informed by real-world disruption events and responses, reveals distinct preferences for resilience capabilities based on SC operational dynamics. For fast-moving SCs, flexibility in ramping up capacity emerges as paramount, whereas for slower SCs, enhanced visibility becomes crucial. We contribute to the contingent Resource-Based View (RBV) on SC resilience by proposing that responsiveness is important moderator of flexibility and visibility as resilience capabilities. We highlight the importance of prevention of phantom ordering through improved visibility and caution against destocking following sudden demand declines. By aligning operational dynamics with tailored resilience strategies, our research offers actionable insights for SC managers aiming to navigate future disruptions more effectively.

A brief mindfulness-based intervention for stress, pain, emotion and attention regulation in military service members with mild traumatic brain injury.

The primary aim of this study was to conduct an open pilot clinical trial of a brief mindfulness-based intervention for persistent postconcussion symptoms that occur after mild traumatic brain injury in military service members. For many service members, operational tempo and other time constraints may prevent them from completing a standard mindfulness-based stress reduction course. Thus, this study sought to examine the effectiveness of a five-session intervention called mindfulness-based stress, pain, emotion, and attention regulation (MSPEAR). Participants were active duty service members with a history of mild traumatic brain injury (TBI) and persisting postconcussion symptoms, all of whom were recruited from an outpatient TBI rehabilitation program at a military treatment facility. Of the 38 service members that were initially enrolled, 25 completed the 5-session MSPEAR intervention, and 20 returned for a 5-week follow-up evaluation. Questionnaires assessing perceived stress, positive affect, pain interference and catastrophizing, sleep disturbances, perceived behavioral and attention regulation, self-efficacy and satisfaction with life were administered at preintervention, postintervention, and at 5-week follow-up intervals. Neuropsychological testing at preintervention and 5-week follow-up included performance validity measures, attention, working memory, and executive function measures. T-tests were run to compare for questionnaire measures at preintervention (Time 1) to postintervention (Time 2). Repeated analysis of variances were conducted to compare questionnaire and neuropsychological measures at Time 1, Time 2, and at Time 3 which is the 5-week follow-up. Improvements in perceived stress, positive affect, behavioral regulation, metacognition, sleep disturbance, self-efficacy, and satisfaction with life were found immediately after the MSPEAR intervention and were maintained at the 5-week follow-up. Magnification and helplessness aspects of pain catastrophizing improved when comparing preintervention to the 5-week follow-up. Pain interference was not significantly different across study assessment times. Neuropsychological testing revealed improvements in sustained attention, working memory, cognitive flexibility, and inhibitory control when comparing preintervention to the 5-week follow-up assessment. The MSPEAR intervention appears to show promise as a brief and effective therapy for specific postconcussion symptoms after mild traumatic brain injury in military service members. Each of the components of MSPEAR including stress, pain catastrophizing, emotion and attention regulation showed improvements in this study, and bears further investigation in a larger scale, preferably randomized controlled trial in those active duty military service members who experience persisting symptoms after a mild traumatic brain injury.

Experiences and challenges of emergency medical services in Incheon, South Korea: Implications for disaster risk reduction

Emergency Medical Services (EMS) in South Korea were formally established in 1982 meaning that they are relatively young in comparison to western counterparts. The handling of the 1988 Seoul Olympics earned widespread global support. Recent disasters have, however, brought the nation's preparedness into question. EMS provides life-critical pre-hospital emergency care. In South Korea, services are free at point-of-use, and, like several other countries, they are experiencing ever higher levels of stress. Budget cuts, personnel shortages, and increasing operational tempo are known stressors that cause individual and organizational harm which compromises disaster preparedness. Interestingly, EMS in South Korea suffer from poor social acknowledgement within a rank-based society that venerates firefighting and specialist rescue units. EMS are deemed less prestigious; this constrains their organizational voice, minimizes leadership representation, and reduces morale. Recent visceral disaster experience and the limited research focused expressly on the socio-cultural context of EMS provision in South Korea constitute a pertinent research gap. Accordingly, this study critically evaluated perceptions of the experiences and challenges faced by EMS crews in Incheon, South Korea.Constructivist grounded theory, semi-structured interviewing, and induction underpin 24 interviews that address the experiences and challenges faced by EMS. The resultant 24 codes, eight categories, and three themes drawn from 253 quotations are presented within a comprehensive network diagram that provides the building blocks of a new tentative theory. The posited EMS organizational efficiency model is, therefore, grounded within empirical data and is designed to mitigate chronic stressors and enhance disaster preparedness.

Managing Shortage: The role of Centre Bases of the NKO in overcoming supply constraints in the Red Army, 1941–1945

ABSTRACT In the winter of 1941, the Red Army faced a shell crisis brought on by the loss of its pre-war stocks due to the rapidity of the German advance that summer, the dislocation of industry due to evacuation to the Urals, and the large expansion in the size of the army. Materiel shortages during the battle for Moscow forced reform in both the approach to and administration of handling all manner of supplies. This saw the introduction of strict rationing of munitions supplies at the Front level, and the centralization of munitions distribution and stocks by the Rear in the Centre Bases of the NKO. 1 1 NKO refers to both to the department, the People’s Commissariat of Defense, and the office of the Commissar of Defense, held for most of the war by Jospeh Stalin. This use of a centralized supply system allowed the Red Army to use a ‘just in time’ approach to supplying the Fronts that enabled it to make maximum use of a limited number of supplies and to maintain a high tempo of operations.

Beyond the Battlefield: the Impact of United Nations and African-Led Peacekeeping on Enhancing Capabilities of African Armies

Abstract The character of conflicts across Africa has evolved, necessitating the United Nations Peacekeeping Operations (UN pko), African-led Peace Support Operations (pso) and African states to adapt their approach to dealing with emerging insecurities. As a response, African states have deployed their armies to UN pko, African-led pso s and other peace operations to not only support these missions’ objectives and receive training for their forces but also to develop security and military capacities to deal with emerging and existing threats. Drawing on the cases of Chad and Ghana, the paper explores the formation of the respective armies, their influence on their political systems and how the respective armies have been influenced by their participation in peacekeeping operations. The analysis finds that despite being under-equipped and working in challenging environments. Both forces influence and shape the mission’s tempo and style of operations by adapting to regional challenges, which is a consequence of the historical and strategic style of the respective militaries but are also capitalised on by the UN pko and African-led pso. Finally, the paper finds that dissimilar environments where the armies are deployed contribute to shaping and supporting both armies’ evolution, increasing their overall agency and legitimacy in peacekeeping.

The Potential of an Embedded Mental Health Services Program Toward Increasing Health Care-Seeking Behaviors Among U.S. Air Force Aircrew: A Mixed-Methods Study.

The U.S. Air Force implemented the Integrated Operational Support model, which involves embedding health care professionals within operational units to meet the health needs of the airmen. This study assessed the extent to which airmen sought out both traditional and embedded mental health services, as well as perceptions of factors that hinder or encourage health care-seeking behaviors. A mixed-methods approach including a web-based occupational psychological health assessment and semi-structured interviews was used to assess airmen's experiences with seeking mental health care services. A total of 447 Remotely Piloted Aircraft operators participated in an occupational psychological health assessment (42% response rate) in 2018, and 15 airmen across five high operational tempo, restricted-access installations completed a semi-structured interview (60% participation rate) in 2021. From the occupational assessment, females (33%) sought care from the traditional mental health clinic significantly more than males (21%; χ2 = 5.10, P = .02). However, there were no significant gender differences in seeking embedded mental health services. Respondents who had not sought out help from either the traditional clinic or embedded services were significantly more likely to seek assistance from embedded mental health services (M = 4.29, SD = 2.09) over the traditional clinic (M = 3.92, SD = 1.90), t(205) = 4.94, P < .001. A resounding interview theme was the deep appreciation that airmen expressed for the availability of embedded mental health professionals. Airmen also discussed factors that hinder health care-seeking behaviors with the top-reported factor being the stigma associated with seeking mental health. The top three reported factors that encourage health care-seeking behaviors included leadership and mental health professionals normalizing care, trust in embedded mental health professionals, and ease of access to care. Findings suggest that having mental health professionals integrated within the unit brings the care straight to the airmen and may reduce the stigma associated with airmen asking for help.

Silver Lining Study: Missileer Fatigue Mitigation During 2020 Coronavirus Pandemic.

The U.S. Air Force's Intercontinental Ballistic Missile (ICBM) force stands ready to launch weapons 365 days per year. Since its inception, missileers vigilantly operate launch consoles on a 3-day cycle: minimum 24-hour alert-shift/24-hour travel-admin/24-hour off, leading to concerns that health, morale, and alertness are chronically impacted. In 2020, a Missileer Occupational Health Assessment (OHA) revealed 76% of respondents struggle with being rested for duty and 29% of respondents never feel adequately rested for duty. Later that year, 20th Air Force initiated long-duration operations to safeguard from the SARS CoV-2 (COVID-19) Pandemic, resulting in increased operations tempo, and exacerbating crew fatigue.341st Operations Group and 341st Medical Group at Malmstrom Air Force Base enacted interventions to mitigate crew fatigue and support continued readiness during pandemic operations. They recorded, analyzed, and compiled findings in this report, including recommendations for long-term ICBM operations at Missile Wings. All participants were Nuclear and Missile Operations Officers, or missileers, were continuously evaluated with qualitative and quantitative measures to ensure safety of the force during a period of unprecedented change. Interventions implemented and evaluated during the 9-month period included: environmental modifications, scheduling changes, and crew education on fatigue management, nutrition, anticipatory sleep preparation, and fitness. Most notably, the 341st Operations Group examined various 3-person and 4-person shift-length and alert duration schedules. Psychomotor vigilance testing results validated safety of operators and delta between pre- and post-shift measurements. Crew force readiness trends were analyzed for force-health awareness. Pre- and post-OHA results were compared for subjective changes. Fatigue and health-related outcomes were collected from a safety monitoring effort during standard and COVID-19 operations at 341st Missile Wing. Findings from qualitative and quantitative data indicate the optimal schedule is a 3-week cycle:7-day alert/7-day recovery/7-day training-administrative utilizing 4-member or 3-member crews for low tempo operations. Crews experimented with shift-lengths of 24hrs-on/24hrs-off, 16hrs-on/8hrs-off, and 12hrs-on/12hrs-off. Maximum safe alert duration is 7 days due to task fatigue onset between 8 and 10 days. Short and long duration Duties Not to Include Flight (DNIF) (also known as Duties Not to Include Alert (DNIA) among missileers) rates decreased from the first to last month of the period by 74.6% and 79.2%, respectively. The number of alerts missed per month decreased 86% from baseline. The 2021 OHA found a 7% decline in members seeking separation, and absence of sleep, fatigue, and physical or mental health as missileer concerns. This analysis has identified a sustainable alert rotation of 7/7/7 with emphasis on protected recovery and training time and has been continued after concluding pandemic operations, creating consistent schedule stability where there once was none. If executed properly, this alert rotation, regardless of shift-length selected, has potential to improve trust between crews and leadership, provides adequate recovery time between alerts to maintain health, and improves wellness, family stability, morale, unit cohesion, and crew force retention. Notably, all Air Force Global Strike Missile Operations Groups adjusted scheduling practices to align with these findings.

When Military Interventions Decrease Military Power. Evidence from the French Case

ABSTRACT Military interventions create dilemmas for military organizations which must balance security-related tasks (such as peacekeeping or crisis management operations) and defense-related tasks involving deterrence and the preparation for high-intensity operations. This article specifically examines the trade-off between security and defense tasks through an original analysis of the impact of the intensification of the French armed forces’ operational tempo on the overall availability of military equipment. We argue that the intensification of military interventions generates gaps in a country’s military capabilities. More precisely, an excessive operational tempo, understood as an unsustainable level of deployment given regeneration capabilities, can reduce the ability of military organizations to generate operationally effective forces. Through an original methodological approach, using a multilevel econometric model that estimates a specific dimension of military power applied to the French case, this article contributes to the literature on the strategic utility of military interventions by examining their structural impact on the armed forces.

Prototyping Apps for the Management of Sleep, Fatigue, and Behavioral Health in Austere Far-Forward Environments: Development Study.

Military service inherently includes frequent periods of high-stress training, operational tempo, and sustained deployments to austere far-forward environments. These occupational requirements can contribute to acute and chronic sleep disruption, fatigue, and behavioral health challenges related to acute and chronic stress and disruption of team dynamics. To date, there is no centralized mobile health platform that supports self- and supervised detection, monitoring, and management of sleep and behavioral health issues in garrison and during and after deployments. The objective of this study was to adapt a clinical decision support platform for use outside clinical settings, in garrison, and during field exercises by medics and soldiers to monitor and manage sleep and behavioral health in operational settings. To adapt an existing clinical decision support digital health platform, we first gathered system, content, and context-related requirements for a sleep and behavioral health management system from experts. Sleep and behavioral health assessments were then adapted for prospective digital data capture. Evidence-based and operationally relevant educational and interventional modules were formatted for digital delivery. These modules addressed the management and mitigation of sleep, circadian challenges, fatigue, stress responses, and team communication. Connectivity protocols were adapted to accommodate the absence of cellular or Wi-Fi access in deployed settings. The resulting apps were then tested in garrison and during 2 separate field exercises. Based on identified requirements, 2 Android smartphone apps were adapted for self-monitoring and management for soldiers (Soldier app) and team supervision and intervention by medics (Medic app). A total of 246 soldiers, including 28 medics, received training on how to use the apps. Both apps function as expected under conditions of limited connectivity during field exercises. Areas for future technology enhancement were also identified. We demonstrated the feasibility of adapting a clinical decision support platform into Android smartphone-based apps to collect, save, and synthesize sleep and behavioral health data, as well as share data using adaptive data transfer protocols when Wi-Fi or cellular data are unavailable. The AIRE (Autonomous Connectivity Independent System for Remote Environments) prototype offers a novel self-management and supervised tool to augment capabilities for prospective monitoring, detection, and intervention for emerging sleep, fatigue, and behavioral health issues that are common in military and nonmilitary high-tempo occupations (eg, submarines, long-haul flights, space stations, and oil rigs) where medical expertise is limited.

The Effect ofConcussion Mechanism ofInjury onSleep Problems inActive Duty Service Members Following Deployment.

Sleep disruption is pervasive in the military and is generally exacerbated during deployment, partially due to increases in operational tempo and exposure to stressors and/or trauma. In particular, sleep disruption is a commonly reported symptom following deployment-related traumatic brain injury (TBI), though less is known about the prevalence of sleep disturbance as a function of whether the TBI was induced by high-level blast (HLB) or direct impact to the head. TBI assessment, treatment, and prognosis are further complicated by comorbidity with posttraumatic stress disorder (PTSD), depression, and alcohol misuse. Here, we examine whether concussion mechanism of injury is associated with differences in the prevalence of self-reported sleep disturbance following deployment in a large sample of U.S. Marines while accounting for probable PTSD, depression, and alcohol misuse. This was a retrospective cohort study of active duty enlisted Marines with a probable concussion (N = 5757) who completed the Post-Deployment Health Assessment between 2008 and 2012. Probable concussion was defined as endorsement of a potentially concussive event with corresponding loss or alteration of consciousness. The presence of concussion-related sleep problems was assessed with a dichotomous item. Probable PTSD, depression, and alcohol misuse were assessed using the Primary Care PTSD Screen, the Patient Health Questionnaire-2, and the Alcohol Use Identification Test-Concise, respectively. Logistic regression models investigated the effects of mechanism of injury (HLB vs. impact), PTSD, depression, and alcohol misuse on the presence of sleep problems, adjusting for sex and pay grade. The study was approved by the Naval Health Research Center Institutional Review Board. Approximately 41% of individuals with a probable deployment-related concussion reported sleep problems following the event; 79% of concussed individuals reporting both HLB and probable PTSD reported sleep problems. All main effects were significantly associated with sleep disturbance in adjusted models. PTSD showed the strongest association with sleep disturbance (adjusted odds ratio [AOR] = 2.84), followed by depression (AOR = 2.43), HLB exposure (AOR = 2.00), female sex (AOR = 1.63), alcohol misuse (AOR = 1.14), and pay grade (AOR = 1.10). A significant HLB × PTSD interaction emerged (AOR = 1.58), which suggests that sleep disturbance was elevated among those with both HLB-induced (vs. impact-induced) concussions and presence (vs. absence) of PTSD. No other significant interactions emerged. To our knowledge, this is the first study to examine the prevalence of concussion-related sleep complaints following deployment as a function of the mechanism of injury in individuals with and without probable PTSD and depression. Individuals with HLB-induced concussion were twice as likely to report sleep problems as those with an impact-induced concussion. Future work should examine these effects longitudinally with validated measures that assess greater precision of exposure and outcome assessment (e.g., blast intensity and type of sleep disturbance).

Stretching and Self-Myofascial Release in Helicopter Aircrew to Reduce Neck and Back Pain (Phase 1).

This prospective intervention study was designed to determine the efficacy of a standardized Preflight/Postflight Stretches (PPS) protocol to reduce subjective neck and back pain scores in helicopter aircrew. Aircrew transient back and neck pain is well documented, and there is currently no standardized preflight and postflight stretching protocol for Naval Aviation. Subjects were recruited from two carrier air wing MH-60R squadrons at Naval Air Station Jacksonville. These carrier air wing squadrons were selected to control for size (number of aircrew), age, and operational tempo (number of flight hours). Subjects consisted of both pilots and enlisted aircrew. One squadron was designated as the control group, although the second squadron served as the intervention group. Subjects from both groups filled out the questionnaire. Only the intervention group completed the PPS protocol immediately after completing the questionnaire and before departing the squadron spaces for the aircraft outside. Upon landing, the aircrew completed a postflight debrief. Only the intervention group completed the PPS protocol after debrief. Both the intervention and control groups once again completed the questionnaire. Questionnaires were matched by using a generated anonymous subject ID. The amounts of change and pain levels were then compared using the Mann-Whitney test and the Fisher's exact test, respectively. The Kolmogorov-Smirnov test found the data to be nonparametric. The preflight and postflight overall (P ≤ .001), cervical (P ≤ .001), thoracic (P = .006), and lumbar (P = .004) differences between the control and intervention groups were found to be statistically significant when using the Mann-Whitney test. Preflight and postflight pain differences in the sacral region and "other" section were not found to be statistically significant (sacral, P = .618; others, P = .182). When evaluating the worsening of the pain level, 50 (92%) of the control flights in which PPS was not performed reported worse pain, compared to 21 (61.8%) in the intervention group where PPS was performed. The Fisher's exact test found the association between performing PPS and the worsening in pain to be statistically significant (P = .001) in the overall, cervical, thoracic, and lumbar regions. Therefore, the hypothesis was accepted in regard to overall pain, as well as in the cervical, thoracic, and lumbar regions. Aircrew back and neck pain because of flying is well documented. However, there is no standardized stretching protocol for aircrew to perform immediately preflight or postflight in U.S. Naval Aviation. This study demonstrated that PPS, a simple 5- to 7-min stretching routine, gives aircrew structure and can reduce postflight cervical, thoracic, lumbar, and overall pain. This phase proved to be safe as no adverse events were reported. The prehabilitation aspect could reduce conventional medical intervention, costly pharmacological management of neck and back pain, and be applied to other aviation populations in military and civilian communities.

Enabling civil–military collaboration for disaster relief operations in smart city environments

To address the aftermath of ever more frequent natural disasters striking highly-populated urban areas, Humanitarian Assistance and Disaster Relief (HADR) operations increasingly involve the coordinated efforts of multiple agencies and in particular Civil–Military Cooperation (CIMIC). In such scenarios, rescuers operate in a disrupted environment, must maintain a high operational tempo, and need to quickly make high-impact decisions. Effectively supporting emergency responders through IT services that implement accurate situation awareness presents a formidable set of challenges, including the discovery and integration of surviving IT assets with purposely deployed ones; effective information prioritization; resilient communications; and secure information sharing. We believe that in the highly digital modern urban environment, often referred to as smart cities, these challenges can be effectively addressed only by integrating by design HADR support into the smart city middleware. This paper presents Aceso — a proof-of-concept smart city middleware that provides location- and context-sensitive services with full support for HADR operations. Aceso provides a set of functions, ranging from resource discovery to secure information sharing, that can be quickly activated in case of unpredictable and adverse events to facilitate HADR operations. Furthermore, Aceso leverages the Value-of-Information (VoI) methodology to handle the processing and dissemination of mission-critical information. To validate the capabilities of Aceso, we devised a fictional HADR scenario, set in the city of Helsinki, Finland, that involves the collaboration of multiple responder teams with different roles. The validation results confirm Aceso’s usefulness in prioritizing the processing and dispatching of critical information and in realizing federation-wide sharing of this information among HADR teams.

Energy Factor-Based Blast Design in Large Opencast Coal Mines

Large surface coal mines in produce millions of tons of coal per annum, moving millions of cubic meters of overburden to mine the coal. Much of this volume is blasted in the form of benches, a common mining technique (Gustafsson, 1973). Blasting is a part of Large Opencast Coal Mine (LOCCM) operations, and is scheduled based on production requirements. With dragline pits, equipment size and operating parameters allow engineers to use tall benches and methods like cast blasting or production dozing to assist with moving blasted material. Changes in scale of equipment and speed of production scheduling have brought about a multi-dimensional shift in the planning process for drilling and blasting team at large surface coal mine operations. So, the problem is that while equipment scale and pace of planning have drastically changed over the last decade blast design and the explosive selection criteria has not changed significantly. Work done by eminent researchers such as Richard Ash and Calvin Konya set the standard for today’s scientific bench blast design practices. Recently, the explosive’s engineering community has largely occupied themselves with applying technology to subsets of the design problem – how to improve or measure fragmentation (M. Monjezi, 2009), how to use technologically advanced methods to design blasts (Y. Azimi, 2010) (P.D. Katsabani, 2005), the public’s perception of mining (Hoffman, 2013). Explosives research for surface coal mining has essentially ignored bench blasting; the industry has not notably recognized the fundamental differences in scale and operational tempo that separate large surface mine blast from regular quarry-scale bench blasting. There is a vast scope of research in the field for explosive energy-based design for better fragmentation with less risk.

Attachment-Based Relationship Satisfaction in Deployed and Non-Deployed Military Veterans with Prevalent PTSD, Anxiety, and Depression

After almost two decades of war, unprecedented operational tempos have remained high for the American military. This has left those on the home front (non-deploying veterans) a little behind since scholarship has mostly focused on veterans who have deployed. This study used a voluntary treatment-seeking sample of veterans who have not deployed (<em>n</em> = 49) and veterans who have deployed (<em>n</em> = 68) to address this gap in the literature. This study examines the associations between attachment avoidance, attachment anxiety, mental health constructs (i.e., generalized anxiety, depression, and posttraumatic stress disorder), and relationship satisfaction. Independent samples <em>t</em>-test comparisons, correlational analyses, and two hierarchical regressions were conducted. The variables that were significantly correlated with relationship satisfaction for both samples were attachment avoidance and attachment anxiety. In the non-deployed sample, the regression was not statistically significant. However, in the deployed sample the regression was statistically significant. In the final step of the hierarchical regression, only attachment avoidance and attachment anxiety were significant predictors of relationship satisfaction. Implications for social work and other behavioral health clinicians are highlighted, including the benefits of practitioners working to help veterans develop and maintain supportive partners and other relationships, particularly through using the attachment theory-based approach of Emotionally Focused Therapy.

The impact of work demands and operational tempo on safety Culture, motivation and perceived performance in safety critical systems

High reliability organizations (HROs) achieve high levels of safety performance through safety cultures grounded in trust and through reinforced norms and expectations that strengthen and motivate safety-related behaviors. Safety motivation and culture can be eroded by operational constraints, inadequate training, and job demands, but also mitigated by job resources such as adequate rest and preparation. Recent work has suggested that HROs can further enhance their reliability by marrying advanced analytical methods and diverse data sources and experiences. To that end, this work presents an exploratory partial least squares (PLS) model based on the Job Demands-Resources model that is used to consider the links between composite work demand factors and safety culture, safety motivation, and perceived safety performance in one HRO, the U.S. Navy. The model, based on 30 survey items (n = 3,803), suggests that attention to job resources that can bolster high levels of safety performance is important and consistent with safety practices in HROs. Job demands such as stress were found to be important safety motivators, as was sufficient rest. The results show the additive nature of job demands and resources, suggesting that they can support or diminish safety motivation and intent, consistent with previous studies.

Emergency Deep: Cold War Missions of a Submarine Commander

Emergency Deep: Cold War Missions of a Submarine Commander