Sustained Military Operations Research Articles

From trenches to technology: a narrative review of sleep medicine in the military.

Thomas CL, Carr K, Yang F, etal. From trenches to technology: a narrative review of sleep medicine in the military. J Clin Sleep Med. 2024;20(6):973-981.

Effects of testosterone enanthate on aggression, risk-taking, competition, mood, and other cognitive domains during 28 days of severe energy deprivation

RationaleBehavioral effects of testosterone depend on dose, acute versus sustained formulation, duration of administration, personality, genetics, and endogenous levels of testosterone. There are also considerable differences between effects of endogenous and exogenous testosterone.ObjectivesThis study was the secondary behavioral arm of a registered clinical trial designed to determine if testosterone protects against loss of lean body mass and lower-body muscle function induced by a severe energy deficit typical of sustained military operations.MethodsBehavioral effects of repeated doses of testosterone on healthy young men whose testosterone was reduced by severe energy deficit were examined. This was a double-blind, placebo-controlled, between-group study. Effects of four weekly intramuscular injections of testosterone enanthate (200 mg/week, N = 24) or matching placebo (N = 26) were evaluated. Determination of sample size was based on changes in lean body mass. Tasks assessing aggression, risk-taking, competition, social cognition, vigilance, memory, executive function, and mood were repeatedly administered.ResultsDuring a period of artificially induced, low testosterone levels, consistent behavioral effects of administration of exogenous testosterone were not observed.ConclusionsExogeneous testosterone enanthate (200 mg/week) during severe energy restriction did not reliably alter the measures of cognition. Study limitations include the relatively small sample size compared to many studies of acute testosterone administration. The findings are specific to healthy males experiencing severe energy deficit and should not be generalized to effects of other doses, formulations, or acute administration of endogenous testosterone or studies conducted with larger samples using tests of cognitive function designed to detect specific effects of testosterone.

The Grammar of Civil War: A Mexican Case Study, 1857–61 by Will Fowler

This book grows out of Fowler’s previous studies of the forceful negotiations that dominated the early political life of nineteenth-century Mexico. Known as pronunciamientos, these tense affairs usually ended without cataclysmic violence and led to concessions and agreement between the contending factions. In short, Fowler has already demonstrated how democracy by other means functioned in Mexico. Such was not the case with the War of Reform from 1857 to 1861, in which the fighting claimed approximately 200,000 lives. The Grammar of Civil War explores how and why this exceptional violence came to pass.But Fowler has more than the history of Mexico on his mind this time around. After all, his previous monograph, La Guerra de Tres Años, 1857–1861 (Mexico City, 2020) delves fully into that conflict as a singular military episode. The titular “grammar” of his present study amounts to an analytical framework that Fowler proposes for the study of any modern civil conflict around the world. He maintains that the deployment of this model can explicate even such far-flung events as the seventeenth-century English Civil War and the twenty-first-century Syrian civil war.Fowler begins by drawing from the contributions of political scientists like Kalyvas, Sambanis, and Conteh-Morgan to develop his definition of civil war.1 Crudely summarized, civil wars are conflicts located within the bounds of a nation-state that features a single government prior to the commencement of hostilities. They also involve at least two warring parties—one of which enjoys government sponsorship. Finally, civil wars require competing political factions that lay claim to national authority, sustained military operations, and a significant death toll of military and civilian lives on each side (7). Fowler closes his introduction by elucidating a tripartite framework for understanding how civil wars begin, the internal dynamics that compel people to continue fighting once war has begun, and the ways in which civil wars end.Each of these components receives consistent and clear explanation in a chapter of its own. To understand how civil wars begin, Fowler examines the macro-transnational sphere alongside the national-regional context, which encompasses structural contributing factors, social divides, ideological disputes, and cultural concerns. Amid these swirling forces, an activation period that is difficult to predict and even more challenging to defuse commences. He identifies eight unique but linked components that must become manifest before the preceding stress factors culminate in a civil war.Once it arrives at the actual fighting, the book explores how and why people decide to wield such brutality against others whom they might know intimately. Fowler’s model accounts for the tit-for-tat nature of violence and how it becomes justifiable to a range of participants, including those initially seeking to avoid it altogether. By examining evolving group dynamics and individual agency—everything from emotional grievance to economic gain—Fowler identifies multiple paths that generate a cold logic for waging total war against dehumanized opponents. The implications of this process are beyond sobering, and the third element of Fowler’s framework offers little solace. Although the fighting theoretically could end via exhaustion or negotiated resolution, he finds that, in most cases, the cycle of violence usually concludes where it began—at the business end of a rifle.Aside from the model building that sits at the center of the book, The Grammar of Civil War has much to offer scholars examining military conflict, civil war, and modern Latin America. Fowler draws deeply from primary sources to illustrate how violent conflict has unfolded in the past. The book’s second chapter provides a narrative of Mexico’s War of Reform as a stand-alone episode, with renewed emphasis on the critical roles played by the 1857 Plan de Tacubaya and the subsequent massacre of civilians at the same site in 1859. The war remains firmly in view, even as Fowler deploys that conflict in the service of his theoretical model in the chapters to follow. Although such an exercise potentially could dilute the history or the analytical framework, Fowler’s linguistic dexterity, respect for contingency, and clarity of vision hold the endeavor together.Along the way, Fowler compellingly examines why scholars and the reading public tend to overlook the War of Reform, especially in comparison with the U.S. Civil War. Fowler makes a convincing case for why the War of Reform deserves more consideration as a historical turning point. The book also effectively incorporates the perspectives of civil-war participants from a broad social and geographical swath of life. The ideological and religious imperatives guiding politicians, military leaders, and high clergy in Mexico City may dominate the proceedings, but Fowler does not neglect the imperatives of peripheral indigenous communities and regional bosses. Those seeking a better understanding of nineteenth-century Mexico or the cruel prerogatives of civil war elsewhere in the modern world will be well served by reading this book.

Testosterone Undecanoate Administration Prevents Fat-Free Mass Loss During Strenuous Multi-Stressor Military Operations

PURPOSE: The efficacy of administering testosterone (T) to restore eugonadal concentrations during multi-stressor, sustained military operations (SUSOPS) that suppress endogenous T synthesis to prevent declines in lean mass and physical performance is not well described. Therefore, the objective of this study was to test the effects of T on androgen status, body composition, and physical performance during a simulated SUSOPS. METHODS: After a baseline phase (P1), 32 healthy young males (26.5 ± 4.4 y) received a single injection of either T undecanoate (750 mg; TEST) or placebo (PLA) before completing four consecutive, 5-d simulated SUSOPS cycles (P2). Each cycle consisted of two low-stress days (~1230 kcal/d exercise-induced energy deficit [EDef]; 8 h sleep/night) and three high-stress days (~2800 kcal/d EDef; 4 h sleep/night). P2 was followed by a 23-d recovery period (P3). Circulating hormones, 4-compartment measures of body composition, and physical performance (vertical jump, 3-repetition maximum [RM] deadlift, Wingate anaerobic test, treadmill VO2peak, and 2.5-mile weighted ruck march) were examined at the end of each phase. RESULTS: Total T in TEST was greater by the end of P2 than P1 (mean ± SE between group difference at the end of P2: 6.7 ± 2.6 nmol/L, p < 0.001), which returned to P1 values in P3, but total T did not change in PLA. Despite increases in free T in TEST throughout P2, free T at the end of P2 was not different from P1, but decreased from P1 to P2 in PLA (-1.2 ± 0.6 pmol/L, p = 0.04) and was greater at the end of P3 compared to P1 in PLA (p < 0.05). FFM was maintained across phases in TEST, but decreased from P1 to P2 in PLA (-2.3 ± 1.0 kg, p = 0.02) and recovered in P3. Total body mass and fat mass decreased from P1 to P2 (p < 0.05) and recovered by P3 regardless of treatment. Vertical jump height, 3-RM deadlift, and Wingate peak power decreased, and 2.5-mile ruck march time increased from P1 to P2 (all p < 0.05) and recovered by P3 regardless of treatment. CONCLUSION: Administering T before a 20-d, simulated SUSOPS maintained eugonadal T concentrations and prevented FFM loss without impacting androgen status in recovery. However, T use did not attenuate performance decrements in response to the multi-stressor SUSOPS.

Effects of post short nap sleep inertia on cognitive and psychomotor task performance

Introduction: Sleep inertia, a detrimental effect of daytime nap, may affect cognitive functions following awakening. The present study aimed to assess the effects of sleep inertia on cognitive and psychomotor tasks following short nap of 30 min taken in the afternoon hours, a realistic probability in the aerospace operational environment. Material and Methods: In a repetitive measure design, 30 healthy male volunteers having adequate sleep the previous night, were tested for changes in cognitive and psychomotor performance following 30 min of nap after lunch at the Sleep-cum-Group confinement lab. Post nap longitudinal testing for dual task (DT) test and Stroop test was carried out in periodic intervals for 40 min. DT response time (DTRT), DT lag error (DTLE), DT correct clicks (DTCC) and response time difference (Stroop Effect [SE]) were analyzed as performance measures. Results: There was a significant increase in DTRT (χ2 =11.13, P = 0.011) in the post-nap period as compared to pre-nap baseline values. No significant changes were observed in other parameters vis DTLE, DTCC, and SE. Post-hoc analysis revealed that the increase of DTRT was significant at 6 min post-nap session; following which the changes were not statistically significant. Conclusion: Sleep inertia was found to affect speed component of the task rather than accuracy in a post-nap period of 30 min. The effect was significant at 6 min following awakening and after that, the effects got dissipated. Although nap can be an effective strategy for sleep-alertness management, the effects of sleep inertia have to be borne in mind, especially during sustained military operations.

Effects of testosterone undecanoate on performance during multi-stressor military operations: A trial protocol for the Optimizing Performance for Soldiers II study

BackgroundPreviously, young males administered 200 mg/week of testosterone enanthate during 28 days of energy deficit (EDef) gained lean mass and lost less total mass than controls (Optimizing Performance for Soldiers I study, OPS I). Despite that benefit, physical performance deteriorated similarly in both groups. However, some experimental limitations may have precluded detection of performance benefits, as performance measures employed lacked military relevance, and the EDef employed did not elicit the magnitude of stress typically experienced by Soldiers conducting operations. Additionally, the testosterone administered required weekly injections, elicited supra-physiological concentrations, and marked suppression of endogenous testosterone upon cessation. Therefore, this follow-on study will address those limitations and examine testosterone's efficacy for preserving Solder performance during strenuous operations. MethodsIn OPS II, 32 males will participate in a randomized, placebo-controlled, double-blind trial. After baseline testing, participants will be administered either testosterone undecanoate (750 mg) or placebo before completing four consecutive, 5-day cycles simulating a multi-stressor, sustained military operation (SUSOPS). SUSOPS will consist of two low-stress days (1000 kcal/day exercise-induced EDef; 8 h/night sleep), followed by three high-stress days (3000 kcal/day and 4 h/night). A 23-day recovery period will follow SUSOPS. Military relevant physical performance is the primary outcome. Secondary outcomes include 4-comparment body composition, muscle and whole-body protein turnover, intramuscular mechanisms, biochemistries, and cognitive function/mood. ConclusionsOPS II will determine if testosterone undecanoate safely enhances performance, while attenuating muscle and total mass loss, without impairing cognitive function, during and in recovery from SUSOPS. Trial RegistrationClinicalTrials.gov Identifier: NCT04120363.

Effects of Energy Deficit on Secretory IgA During a Simulated Multi-Stressor Military Operation

ObjectivesSecretory IgA (SIgA) is a critical component of mucosal immunity and a first line of defense against pathogens. Intense physical exercise, lack of sleep, and inadequate energy intake are frequently observed during military training and operations. These factors are associated with a decline in SIgA and may increase the risk of infection; however, to what degree each of these factors contributes to immune dysfunction is unclear. This study aimed to determine the effect of severe energy deficit on mucosal immunity (SIgA) during a multi-day period of intense training. MethodsThe parent study was a randomized, crossover trial in healthy males (n = 10, 22.4 ± 5.4 y, 87.3 ± 10.9 kg) to assess the effect of severe negative energy balance on inflammation, iron absorption, and other physiological and cognitive outcomes during a simulated sustained military operation (SUSOPS; high energy expenditure with repeated bouts of intense exercise). Participants completed two SUSOPS trials and were randomized to consume ± 10% of estimated total daily energy expenditure (TDEE, energy balance) or 45% of TDEE (energy deficit). At 0500 on each SUSOPS day (D1: baseline, D2:24 h, D3:48 h), participants placed polyester oral swabs under their tongue for 3-mins. A second swab was collected (i.e., placed under the tongue until saturation) to ensure adequate sample volume. SIgA secretion rate (μg/min) was calculated from SIgA concentration (μg/mL; enzyme-linked immunosorbent assay) and salivary flow rate (mL/min). Dependent variables were log10 transformed due to non-normal distribution and data were analyzed using linear mixed models. ResultsIndependent of treatment, a main effect of time (P = 0.01) was observed where SIgA secretion rate declined by 20% from D2 [1.77 ± 0.34 μg/min] to D3 [1.41 ± 0.51 μg/min], P = 0.001, with no significant treatment by time interactions. A main effect of time (P = 0.01) was also found wherein SIgA concentration declined by 13% from D2 [2.67 ± 0.32 μg/mL] to D3 [2.33 ± 0.37 μg/mL], P = 0.001. There were no main or treatment effects with regard to SIgA flow rate. ConclusionsMucosal immune response, as measured by SIgA, declined in response to SUSOPS. Severe energy deficit did not exacerbate the decline in SIgA secretion rate observed in response to the high intensity, multi-stressor training scenario. Funding SourcesUS Army Medical Research and Development Command.

Energy deficit increases hepcidin and exacerbates declines in dietary iron absorption following strenuous physical activity: a randomized-controlled cross-over trial

Strenuous physical activity promotes inflammation and depletes muscle glycogen, which may increase the iron regulatory hormone hepcidin. Hepcidin reduces dietary iron absorption and may contribute to declines in iron status frequently observed following strenuous physical activity. To determine the effects of strenuous physical activity on hepcidin and dietary iron absorption and whether energy deficit compared with energy balance modifies those effects. This was a randomized, cross-over, controlled-feeding trial in healthy male subjects (n=10, mean±SD age: 22.4±5.4 y, weight: 87.3±10.9 kg) with sufficient iron status (serum ferritin 77.0±36.7 ng/mL). Rest measurements were collected before participants began a 72-h simulated sustained military operation (SUSOPS), designed to elicit high energy expenditure, glycogen depletion, and inflammation, followed by a 7-d recovery period. Two 72-h SUSOPS trials were performed where participants were randomly assigned to consume either energy matched (±10%) to their individual estimated total daily energy expenditure (BAL) or energy at 45% of total daily energy expenditure to induce energy deficit (DEF). On the rest day and at the completion of BAL and DEF, participants consumed a beverage containing 3.8 mg of a stable iron isotope, and plasma isotope appearance was measured over 6 h. Muscle glycogen declined during DEF and was preserved during BAL (-188±179 mmol/kg, P-adjusted<0.01). Despite similar increases in interleukin-6, plasma hepcidin increased during DEF but not BAL, such that hepcidin was 108% greater during DEF compared with BAL (7.8±12.2 ng/mL, P-adjusted<0.0001). Peak plasma isotope appearance at 120 min was 74% lower with DEF (59±38% change from 0 min) and 49% lower with BAL (117±81%) compared with rest (230±97%, P-adjusted<0.01 for all comparisons). Strenuous physical activity decreases dietary iron absorption compared with rest. Energy deficit exacerbates both the hepcidin response to physical activity and declines in dietary iron absorption compared with energy balance. This trial was registered at clinicaltrials.gov as NCT03524690.

Additional Protocol II: Elevating the minimum threshold of intensity?

AbstractThis paper examines the notion of intensity in the context of common Article 3 and Additional Protocol II (AP II) to the Geneva Conventions in order to establish whether AP II demands a different intensity threshold from the minimum threshold of intensity contemplated in common Article 3. The paper considers the question of whether the inclusion of the term “sustained” in the phrase “sustained and concerted military operations” intrinsic to the threshold in Article 1(1) of AP II introduces a temporal requirement in addition to mere protracted armed violence. The paper argues that the inclusion of the term “sustained” in Article 1(1) of AP II potentially demands prolonged protracted armed violence. The research aims to contribute to the existing literature on the notion of intensity demanded by the scope of application inherent in AP II through an interrogation of the phrase “sustained” military operations by employing the rules of treaty interpretation and by examining relevant case law and scholarly debate. In this way, the author hopes to contribute towards filling a lacuna with regard to the minimum threshold for intensity in the context of treaty law concerned with the classification of non-international armed conflicts.

Assessment of fatigue in personnel during sustained operations using ‘SOAP’ – Sustained Operational Assessment Profile

Introduction: Sustained operations are the future of any advanced Air Force, which involve round the clock flying operations over a prolonged period. Such operations have the potential of disrupting normal sleep cycle and may cause fatigue among aircrew and ground duty personnel. It is well known that fatigue among crew member is a significant risk to aerospace safety. The present study was hence undertaken to quantify the subjective fatigue and its effects, among the personnel involved in a simulated exercise using Sustained Operations Assessment Profile (SOAP). Material and Methods: SOAP questionnaire, a validated tool, was used for data collection. In the first phase, 1521 personnel involved in the exercise, including aircrew as well as ground duty tradesmen completed the SOAP questionnaires twice during the simulated sustained military operation. The subjective ratings were statistically analyzed using the Wilcoxon matched paired test. The two levels of repeated measures being mean SOAP scores on day 2 and that on day 5. In the second phase, to ascertain differences in the subjective ratings of SOAP among different streams of pilots, data were recorded during another simulated sustained operation after 6 months. A total of 140 aircrew responded to the SOAP questionnaire during 6 days of sustained operations. SOAP score was acquired on day 1 and day 6 of the operations in the second phase. Results: A total of 3042 completed SOAP responses were analyzed. There was a significant increase in ratings of the three cardinal dimensions of SOAP among all personnel. The aircrew rated the subjective effects higher than maintenance or administrative support group. Among the aircrew, the fighter pilots rated significantly higher as compared to transport or helicopter aircrew. Conclusion: The study revealed significant changes in the cardinal dimensions of SOAP among the aircrew who were routinely not involved in shift work (especially fighter pilots). Scientifically designed “shift work” may be an effective strategy to mitigate effects of fatigue during sustained operations, hence, needs to be practiced as a routine by combat Air Force units.

Hard Versus Soft Measures to Security: Explaining the Failure of Counter-Terrorism Strategy in Nigeria

Nigeria continues to face the challenge of containing terrorism despite adopting diverse counter-terrorism measures. While extant literature has evaluated the impacts of these measures, explaining why terrorist attacks in Nigeria persist despite a robust hard approach through the traditional use of force is still lacking. Thus, this article raises a fundamental question of: why has Boko Haram terrorism persisted in Nigeria despite sustained military operations against it? In this article, we argued that because counter-terrorism in Nigeria is lacking in soft approach, it will be difficult for the Nigerian state to defeat Boko Haram insurgency even with military force.

Changes In Cognition During A 24-h Simulated Military Operation. Role Of Classical Monocytes And Beta-alanine.

Cognitive dysfunction during sustained military operations (SUSOP’s) may be related to the recruitment and infiltration of classical monocytes into the brain. Beta-alanine (BA) supplementation may attenuate cognitive dysfunction and improve resilience to stress exposure, which may be relevant during a SUSOP. PURPOSE: To examine the effect of BA on serum monocyte chemoattractant protein-1 (MCP1), C-C chemokine receptor 2 (CCR2), macrophage-1-antigen (CD11b) and cognition (COG), and to examine the relationships between these variables during a SUSOP. METHODS: Nineteen recreationally active men ingested 12g·day-1 BA (n = 10) or placebo (PL; n = 9) for 14-days prior to completing a simulated 24-h SUSOP. MCP1 was assessed via multiplex assay. Classical monocyte CCR2 and CD11b expression were assessed via flow cytometry. Throughput (TP) scores were extracted from seven cognitive subtests administered via Automated Neuropsychological Assessment Metric (ANAM) software. The relative weight of each ANAM subtest was determined by dividing its outer weight by the standard deviation of all TP scores for that subtest. TP scores were multiplied by their relative weights, and the values summed to provide a value for COG. Assessments occurred at baseline (0H), 12-hours (12H), 18-hours (18H) and 24-hours (24H). A two-way mixed ANOVA was used to assess differences between BA and PL. The statistical significance of pathway (β) coefficients derived from partial least squares structural equation modeling were used to evaluate relationships between MCP1, CCR2, CD11b and COG. RESULTS: MCP1 was significantly greater at 12H, 18H and 24H relative to 0H (p’s < 0.001). CCR2 expression was significantly lower at 12H (p = 0.031), 18H and 24H (p’s < 0.001), while CD11b expression was significantly greater at 12H (p = 0.039) and 24H (p = 0.003) relative to 0H. COG was significantly lower at 18H and 24H compared to 0H and 12H (p’s ≤ 0.001). No significant differences were noted between BA and PL for any variable (p’s > 0.05). MCP1 had a direct negative relationship with cognition (β = -0.395, p = 0.002). CCR2 and CD11b were not directly related to cognition (p’s > 0.50). CONCLUSIONS: Greater serum MCP1 concentrations were associated with increased cognitive dysfunction during the SUSOP. BA did not affect MCP1, CCR2, CD11b or COG compared to placebo.

Declines in Dietary Iron Absorption Following Simulated Military Operations Are Exacerbated by Energy Deficit

Abstract Objectives Iron status declines with military training; however, the reason for the decline is not known. The objective of this study was to determine whether dietary iron absorption is reduced following military training and whether energy deficit during training modifies the effect. Methods This was a randomized, cross-over, controlled-feeding trial in healthy, active duty military males (n = 10, age 22.4 ± 5.4 y, weight 87.3 ± 10.9 kg) with normal iron status (serum ferritin 77.0 ± 36.7 ng/mL). Following a rest day (no exercise), participants completed a 72-h simulated sustained military operations (SUSOPS) followed by a 7-d recovery period. SUSOPS was comprised of military tasks designed to elicit high energy expenditures, muscle damage, and sleep deprivation. During SUSOPS, participants were randomized to consume ± 10% of estimated total daily energy expenditure (BAL) or 45% of total daily energy expenditure to induce severe negative energy balance (NEG BAL), but an equivalent amount of dietary iron. Two hours after rest, BAL, and NEG BAL participants consumed a beverage containing 3.8 mg of a stable iron isotope and plasma isotope appearance and hepcidin were determined 0, 20, 40, 60, 120, 240, and 360 min later. Results BAL maintained weight (−0.03 ± 0.8 kg) and muscle glycogen (4.1 ± 68.1% change), while NEG BAL lost weight (−2.38 ± 1.7 kg, P &amp;lt; 0.01) and muscle glycogen (−47.6 ± 17.8% change, P = 0.08) during SUSOPS. C-reactive protein (rest 1.2 ± 0.9, BAL 4.7 ± 3.6, NEG BAL 4.8 ± 3.5 mg/L, Pphase &amp;lt; 0.001) increased with SUSOPS compared to rest regardless of energy balance. Peak plasma isotope appearance at 120 min was 49% lower with BAL (116.9 ± 81.4% change from 0 min) and 74% lower with NEG BAL (58.9 ± 38.1%) compared to rest (229.7 ± 97.3%, P &amp;lt; 0.01 for all comparisons). Plasma hepcidin was not different at 0 min (rest 7.2 ± 1.6, BAL 6.7 ± 2.4, NEG BAL 6.8 ± 1.7 ng/mL, P = 0.79) and peaked at 360 min (rest 19.4 ± 9.5, BAL 9.5 ± 4.7, NEG BAL 13.7 ± 8.9 ng/mL, P = 0.03). Conclusions Dietary iron absorption is reduced following SUSOPS in healthy males with normal iron status and the reduction is exacerbated with energy deficit. Circulating concentrations of hepcidin following 72-h SUSOPS do not appear to mediate the reduction in dietary iron absorption. Funding Sources The views expressed are those of the authors and do not reflect official policy of the Army, DoD, or US Government. Supported by MRDC.

Effects of β-alanine supplementation on physical performance, cognition, endocrine function, and inflammation during a 24h simulated military operation.

Sustained military operations (SUSOPs) are associated with performance decrements and cognitive dysfunction. β‐Alanine (BA) supplementation may have a role in increasing soldier resiliency by enhancing muscle‐buffering capacity and reducing oxidative stress. The purpose of this study was to examine the effects of BA on physical performance, cognition, endocrine function, and inflammation during a 24 h simulated SUSOP. Nineteen males were randomized into one of two groups: BA (n = 10) or placebo (n = 9; PLA) (12 g/day) for 14 days preceding the 24 h SUSOP. Assessments were performed at 0 h (0H), 12 h (12H), and 24 h (24H) during the SUSOP. No changes in visual tracking ability, jump power, or upper‐body muscular endurance were observed between groups or time points (P's > 0.05). Increases in subjective feelings of soreness and fatigue were noted at 12H compared to 0H (P < 0.05) in PLA, but not in BA. Visual reaction time for PLA was slower at 24H compared to 0H (P = 0.035), and PLA made more errors on reaction time testing at 12H compared to BA (P = 0.048), but motor reaction time was faster (P = 0.016) for PLA. Simulated litter carry and 1 km run completion times increased at 24H compared to 0H in both groups (P < 0.05), however, PLA had a longer 1 km time compared to BA at 24H (P = 0.050). Increases in inflammatory and endocrine markers were observed over the SUSOP, with no differences between groups. BA supplementation appears to maintain some aspects of cognition and physical performance during a 24 h SUSOP, with no effects on endocrine function or inflammation.

Sustained Military Operations and Cognitive Performance.

Cognitive performance is crucial during military operations. It is suggested that impaired cognitive performance accounts for most of the accidents during training courses and actual battle. There is a need to define when soldiers' operational readiness becomes impaired. The objective of this systematic review was to investigate the effects of sustained military operations (SUSOPS) on vigilance, reaction time, working memory, and reasoning in order to select good indicators for performance impairment. A systematic literature search was performed using publicly accessible databases (IngentaConnect, PubMed, Science Direct, and Defense Technical Information Center online) that were screened until July 2015. Keywords were military, sustained operations, (cognitive) performance, soldier, and training. Only 7 out of 589 studies met the inclusion criteria. Selected studies were difficult to compare due to different methodologies, cognitive tasks, and military courses. Vigilance, reaction time, and working memory were affected after only a few hours, showing severe impairment. They are linearly related to military stress up to 80 h of SUSOPS. These three indicators needed little recovery time to return to baseline levels. After more than 80 h of SUSOPS, no significant impairments of those indicators were observed. Reasoning becomes impaired after high stress levels of relatively short duration and can remain affected after more than 80 h of SUSOPS. Vigilance, reaction time, and working memory are affected after only a few hours while little recovery time is needed. For reasoning to return to baseline values, longer recovery is needed than the time available during SUSOPS. Vrijkotte S, Roelands B, Meeusen R, Pattyn N. Sustained military operations and cognitive performance. Aerosp Med Hum Perform. 2016; 87(8):718-727.

Introduction to Working with Military Families

After the 9/11/2001 terrorist attacks in New York, the United States engaged in the global war on terror with two wars, primarily in Iraq and Afghanistan, leading to sustained military operations that lasted for over a decade. Service members deployed to dangerous combat locations, and their families who remained home juggled the numerous demands of daily life. The deployment/s of a service member and subsequent reintegration represents a period of sustained stress for these families and everyone in the system is affected, sometimes negatively, and personal and family change and growth always result from the experience. There has been a large and growing body of literature related to families and military deployment, especially over the last decade. Deployment is an essential and noble component of life in the military. Service members risk their lives and make great sacrifices to defend the freedoms of citizens at home. Yet, deployment and related events represent a crisis for members of families who face many changes and transitions during this time. Post deployment, family members are faced with getting to know each other again, a process made more difficult if the deployment was difficult and family life now includes variables such as poor mental health, financial strain, or recovery from injury. These changes, no matter how big or small, represent losses and additions to daily life and require many skills and qualities including adaptability, communication, patience, understanding, conflict resolution, anxiety management, boundary negotiation, co-parenting, building connection, and acceptance, to name just a few. Effective interventions for military families have the potential to result in changes that have long-lasting consequences across generations. From a military perspective, service members are more content and able to focus more easily on their work when things are going well at home. From a family perspective, children are better off when parents get along, for example, when they are communicating well, agree on family rules and routines, and show positive examples of love. From an individual perspective, life is easier to cope with when things run smoothly on the home front. When relationships are working well, family is the best support system, the finest motivator, and the most prized team. Positive family support makes it easier to face mental health concerns, employment difficulties, and the aftermath of war. Conversely, negative family relationships add to stress, exacerbate mental health problems, and can lead to detrimental outcomes including suicide, interpersonal violence, and other regrettable life-altering decisions. In this special issue focused on military families, twelve articles, authored by a diverse array of scholars, provide insight into the wellbeing of these families, and interventions to strengthen family functioning. Two articles focus on helping children who are dealing with the deployment of a parent in the military. Two articles describe prevention approaches for couples and interventions aimed at educating couples before, during, and after deployment, in a way that addresses problems before they even start. One paper focuses on an intervention for military spouses, a group who have needs for added supports and understanding during a difficult time. Four papers describe different interventions for couples including those dealing with PTSD, intimate partner violence, and sexual trauma. One of these papers includes an innovative description on & Adrian Blow blowa@msu.edu

β-alanine supplementation improves tactical performance but not cognitive function in combat soldiers

BackgroundThere are no known studies that have examined β-alanine supplementation in military personnel. Considering the physiological and potential neurological effects that have been reported during sustained military operations, it appears that β-alanine supplementation may have a potential benefit in maintaining physical and cognitive performance during high-intensity military activity under stressful conditions. The purpose of this study was to examine the effect of 28 days of β-alanine ingestion in military personnel while fatigued on physical and cognitive performance.MethodsTwenty soldiers (20.1 ± 0.9 years) from an elite combat unit were randomly assigned to either a β-alanine (BA) or placebo (PL) group. Soldiers were involved in advanced military training, including combat skill development, navigational training, self-defense/hand-to-hand combat and conditioning. All participants performed a 4-km run, 5-countermovement jumps using a linear position transducer, 120-m sprint, a 10-shot shooting protocol with assault rifle, including overcoming a misfire, and a 2-min serial subtraction test to assess cognitive function before (Pre) and after (Post) 28 days of supplementation.ResultsThe training routine resulted in significant increases in 4-km run time for both groups, but no between group differences were seen (p = 0.597). Peak jump power at Post was greater for BA than PL (p = 0.034), while mean jump power for BA at Post was 10.2% greater (p = 0.139) than PL. BA had a significantly greater (p = 0.012) number of shots on target at Post (8.2 ± 1.0) than PL (6.5 ± 2.1), and their target engagement speed at Post was also significantly faster (p = 0.039). No difference in serial subtraction performance was seen between the groups (p = 0.844).ConclusionResults of this study indicate that 4-weeks of β-alanine ingestion in young, healthy soldiers did not impact cognitive performance, but did enhance power performance, marksmanship and target engagement speed from pre-ingestion levels.

β-Hydroxy-β-methylbutyrate improves bone properties and attenuates the depression of protein synthesis during a simulated sustained operation.

Soldiers lose muscle and bone density during sustained operations. We investigated the impact of β-hydroxy-β-methylbutyrate (HMB) on bone properties, muscle mass, and markers of skeletal muscle regeneration under simulated military sustained operations. Male mice were divided into four groups (10/group): (1) ALT = ad libitum + trained (1h/d for 3 d/wk); (2) ALTH = ALT + HMB (0.5 g/kg BW/d); (3) C = caloric restricted (-30%) + trained (6h/d, 6d/wk); and (4) CH = C + HMB. Assessments included bone mineral density/content by dual-energy X-ray absorptiometry, muscle wet weight (quadriceps) and expression of selected genes regulating muscle mass and protein turnover. Analysis of variances were used with significance set at p < 0.05. Bone mineral content increased in the ALT group (+16%) and decreased in the C group (-32%). Quadriceps muscle mass was lower in C (-27%) and CH (-19%) compared to ALT and ALTH. Myogenin mRNA expression was higher in C than ALT, ALTH and CH. Protein kinase B (Akt) mRNA expression was higher in both C and CH than ALT and ALTH. Mammalian target of rapamycin expression was higher in CH than ALT and ALTH. Muscle RING-finger protein-1 expression was higher in both C and CH than ALT and ALTH. HMB intake improved bone properties and attenuated the depression of protein synthesis during a simulated sustained military operation.

Family Systems and Ecological Perspectives on the Impact of Deployment on Military Families

The scope of sustained military operations in Iraq and Afghanistan has placed great demands on the Armed Forces of the United States, and accordingly, military families have been faced with deployments in more rapid succession than ever before. When military parents fulfill occupational duties during wartime, military children and families face multiple challenges, including extended separations, disruptions in family routines, and potentially compromised parenting related to traumatic exposure and subsequent mental health problems. Such challenges can begin to exert a significant toll on the well-being of both individuals and relationships (e.g., marital, parent-child) within military families. In order to respond more effectively to the needs of military families, it is essential that mental health clinicians and researchers have a better understanding of the challenges faced by military families throughout the entire deployment experience and the ways in which these challenges may have a cumulative impact over multiple deployments. Moreover, the mental health field must become better prepared to support service members and families across a rapidly evolving landscape of military operations around the world, including those who are making the transition from active duty to Veteran status and navigating a return to civilian life and those families in which parents will continue to actively serve and deploy in combat zones. In this article, we utilize family systems and ecological perspectives to advance our understanding of how military families negotiate repeated deployment experiences and how such experiences impact the well-being and adjustment of families at the individual, dyadic, and whole family level.

The effects of sustained military operations on cognitive performance a systematic review

The effects of sustained military operations on cognitive performance a systematic review