Page 99 - Journal of Special Operations Medicine - Summer 2014

Figure 4 The OODA loop: Observe, Orient, Decide, and Act. resources cannot be quantified, sensed, or assessed at
this time. Therefore, those resources over which we have
active control must be considered first. In the future, spe-
cific aspects of HPO independent of technology will be
addressed as determined by the Consortium for Health
and Military Performance (CHAMP) and the readers.

Conclusion and Summary
The concept of HPO is not new and is essential to per-
sonal, family, unit, and organizational success. Of note
is a statement by Civil War physician Dr. Jonathan Let-
terman, who sought to focus all medical providers on
HPO; he believed the leading mission of the military
styles, beliefs and values, engagement, perceived threat, medical corps was “to strengthen the hands of the Com-
conscientiousness, anticipatory anxiety, and the like. 17–22 manding General by keeping his Army in the most vig-
How do we enhance the human ability of observation orous health, thus rendering it, in the highest degree,
and perception to serve as a beneficial resource for fu- efficient for enduring fatigue and privation, and for
ture events? How can the “observed and perceived” fighting.” The model presented captures the complex-
39
information be processed independently of our arma- ity of HPO, as it shows that a change in any one of
mentarium of negative resources—and critically deci- the multiple, intertwined parts can serve to optimize or
phered? These are questions without scientifically based compromise performance. Letters to the editor are wel-
answers, but they must be considered. come and topics for future issues are desired. A group
of experts will be working together to ensure the latest
Scientific evidence supporting a multitude of simple ap- information is provided but in terms of science and ap-
proaches for mediating/mitigating negative resources plication to Special Operations Medicine.
and/or minimizing excessive demand is emerging. For ex-
ample, several studies have shown that both mindfulness Disclaimer
and meditation may 23–25 positively impact perception,
attention, and consciousness, as well as help to mini- The views expressed are those of the authors and do not
mize stress and anxiety during periods of extreme stress. reflect the official policy or position of the Uniformed
Other modalities for stress release and promoting health Services University of the Health Sciences, the Depart-
and well-being may involve spending time outdoors in ment of Defense, or the United States Government.
a natural environment and listening to music or the
26
sounds of nature. 27–29 Interestingly, data are emerging Disclosures
that simply chewing gum may improve performance by The authors declare no conflicts of interest and have no
minimizing the body’s response to stress. 30–32 In addition financial disclosures.
to self-care skills and activities, nutrients and other com-
pounds may prove to be important for HPO. What is the
evidence behind nicotine as a performance enhancer ? References
33
Which nutritional interventions are available to optimize 1. Patton GS. Mechanized forces. Cavalry J. 1933;42:5–8.
performance during or enhance recovery after various 2. Eisenhower DD. Speech to Economic Club of New York.
cognitive challenges or environmental extremes 8,34–37 ? Paper presented at: Economic Club of New York, 1946,
When used appropriately, caffeine is well accepted as a New York, NY.
performance enhancer, but other nutrients are emerg- 3. Burgess L. “Humans are more important than hardware,”
13
ing as possibilities. One question that emerges is, “How says Army chief of staff. 2003. http://www.stripes.com/
do we know when we need assistance?” news/humans-are-more-important-than-hardware
-says-army-chief-of-staff-1.12477.
The science and technology of today and the future 4. Committee on Assessing Foreign Technology Development
should allow us to optimize at least selected resources. in Human Performance Modification, National Research
A 2012 article by Blackhurst et al. published in the Council. Human performance modification: Review of
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worldwide research with a view to the future. Washington,
Armed Forces Journal notes the importance of sensing DC: National Academies Press; 2012.
through physiological monitoring; assessing through in- 5. Bakker AB, Van Emmerik H, Van Riet P. How job de-
terpretation of sensed data into actionable information, mands, resources, and burnout predict objective perfor-
and then augmenting the data to optimize human per- mance: a constructive replication. Anxiety Stress Coping.
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An Integrated Approach for Special Operations 89