Stress Management in Low Intensity Conflict Operations

Stress Management in Low Intensity Conflict Operations CHAPTER I INTRODUCTION â€Å"Life is a long sequence of stressors† Mirza Galib General 1. Stress is an inescapable part of modern life. It is the psychological and physiological reaction that occurs when an individual perceives an imbalance between the level of demand placed upon him and his capability for meeting that demand. Stress affects individuals physiologically, emotionally and behaviourally and is linked to responses which in case of stress overloads, often results in rash or irrational behaviour. However, it is not always negative in fact, stress at optimum levels also produces a positive force or stimuli that is dynamic and often aids in tiding over difficult situations. 2. Officers, Junior Commissioned officers and men in the army are by no means insulated to the phenomenon of stress but in fact exposed to situations which tend to become stressful. Understanding of stress, therefore, plays an important role in management of personnel in the army, both in peace and in operational environments. 3. A rigid organizational structure, peculiar environmental factors, extended deployment in Counter Insurgency Operations and Combat situations often compound stress related problems in the army. These, if not tackled at an early stage results in cumulated stress effects which often surpass acceptable limits. The recent spate of suicides, fragging and fratricides provides an urgency to understand at the earliest, the maladies of stress and its effect on men officers of the army. 4. The Penguin Medical Encyclopaedia defines stress as any influence, which disturbs the natural equilibrium of the body and includes within its reference, physical injury, exposure, deprivation and all kinds of diseases and emotional disturbances. The word stress has been borrowed from Physics and Engineering where it has a precise meaning, a force sufficient enough in magnitude to distort or deform when applied to a system. For our studies the apt definition seems to be the rate of wear and tear of the mind. 5. To quote a formal definition, â€Å"Stress is defined as an adaptive response to an external situation that results in physical, psychological and / or behavioural deviations for organizational participants.[1]† It may also be defined as â€Å"failure to adapt†[2] 6. Most people view stress in a negative way but as mentioned in the previous paragraph it may be positive sometimes as it provides the extra energy to deal with tough or life threatening situations. Experts therefore agree that some stress is not only helpful but essential to keep it going for us without which we would be vegetables. Stress results from a stimulation of environment , the degree of this stimulation on the stress curve is positive to an extent but thereafter prolonged stimulations of the same kind, for example the operational environment experienced by the soldiers in Low Intensity Conflict Operations leads to manifestation of stress in the form of negative effects on the soldiers mind. High stress levels, besides manifesting in below-par performance standards during discharge of duties, are also the cause of incidents like running amok, fratricides and suicides. METHODOLOGY STATEMENT OF THE PROBLEM 7. To analyse the causes of stress in soldiers of Indian Army in the backdrop of its prolonged deployment in Low Intensity Conflict Operations, its manifestation in various forms and to suggest possible methods of stress management at the national, army, formation unit levels. HYPOTHESIS 8. Existing op environment in areas where the Indian Army is deployed for Low Intensity Conflict Operations coupled with prolonged deployment of troops in such areas is the main cause of stress in soldiers today which has led to an increased occurrence of stress related incidents amongst the soldiers. JUSTIFICATION OF STUDY 9. India has a 1.1 million-strong army and with 81 suicides[3] in the year 2006 stress has become one of its major worries. s given by The Indian Express show that the number of suicides per lakh personnel in the army stands at 10.8 though this is much lower than 17 for the US Army, 18 for the French and 14 of the Royal Army is still big enough to draw attention. The increasing numbers of suicide cases[4] are a cause of concern (See chart below).This fact has been proven adequately in the research carried out by Dr DS Goel of Ranchi institute of Neuropsychiatry in conjunction with command hospital northern command on â€Å"Psychological Effects of Low Intensity Operations†. Extract of the same is attached as appendix A. 10. Another alarming is the 23 cases of fratricide in 2006[5], of these 09cases were reported from Jammu and Kashmir and remaining 14 from the North East, both are areas where army is involved in Low Intensity Conflict Operations. Similar statistics also can be established in suicide cases. Why these cases did not occur in peace stations if the reasons for stress as propounded by some theories are economic growth and rising financial aspirations of the soldier is a moot question and does point to the operational environment of Low Intensity Conflict Operations as the prime reason of stress in soldiers and thus the prime nemesis to be tamed to get down the worrisome numbers of suicides and fratricides. However the effects of personal problems of the soldier causing such incidents is correct, but again if the soldier was located in a peace area he would have been in a better connected place as far as communication with his family is concerned whether it is a case of land dispute or mar ital discord or his wife not being treated well by her in laws. Most of such cases could be solved merely by the physical presence of the soldier along with his wife or parents as the case may be thus it connects to the prolonged deployment of troops in Low Intensity Conflict Operations which leads to increased domestic problems in a soldiers life. 11. In July 2009 the Honourable RM while answering to a question in the parliament stated that already 48 cases of suicides and one case of fratricide have been reported till June[6], its anybodys guess what the final for 2009 will be, whatever be the it cannot be denied that the Indian Army today is faced with the demon of stress in its soldiers. The good news is that the army has realised that this is a problem and cannot be wished away and a number of steps are being taken to tackle the issue but till such time the bigger demon of Low Intensity Conflict Operations exists and some holistic measures by the government and the army are undertaken, firstly to improve the operational environment and secondly to reduce or decrease the time which a soldier spends continuously in Low Intensity Conflict Operations areas, this demon will continue to feed on the strength of the Indian Army- the Indomitable spirit of the Indian soldier. SCOPE 12. The scope is limited to study the following aspects :- (a) Deployment pattern of Indian Army in Low Intensity Conflict Operations. (b) Operational Environment in Low Intensity Conflict Operations. (c) Manifestation of stress and its inter-relation with behaviour/performance. (d) Management of stress to include present approach its shortcomings and recommendations. OPERATIONAL DEFINITIONS 13. Some terms used in this dissertation are defined below:- (a) Combat Stress[7]. The stress experienced by the soldier during a combat situation. This is a complex form of stress resulting from all the physical and mental strain caused to the soldier during the combat mission, it is cumulative in nature and the number of times the soldier goes through the same situation it causes stress and is accumulated in the mind of the combatant. (b) Stressors. The factors that cause stress are called stressors; it can be an event or situation which requires a non routine change in the lifestyle or behaviour of a soldier. This causes a felling of conflict with the ideals and values of a person or it may pose a challenge or threat to an individuals sense of wellbeing or self esteem. (c) Eustress[8]. Stress may manifest sometimes in a positive way, this effect is known as Eustress, which is described by experts as a motivator which drives a person to achieve extraordinary feats under situations of pressure. It is obvious that Eustress is not harmful being occasional. METHODS OF DATA COLLECTION 14. The research work is mainly based on books, journals available in the library, thesis and dissertation work available on the internet as also the study report of the Defence Institute of Psychological Research on the causes of inter-personal violence in the units deployed in counter insurgency areas and the study report of research carried out by Ranchi Institute of Neurosciences in collaboration with Armed Forces Medical Services, Command Hospital (Northern Command) and Director general Medical Services. Data of twenty units of infantry and artillery was also collected to prove that the existing deployment pattern and troop commitment to Rashtriya Rifles is resulting in prolonged exposure of approximately one percent of soldiers to higher stress prone areas. A detailed bibliography of sources is appended at the end of the dissertation. ORGANISATION OF THE DISSERTATION (CHAPTERISATION) 15. It is proposed to study the subject in the following manner :- (a) Chapter I Introduction. (b) Chapter II Deployment Pattern of Indian Army in Low Intensity Conflict Operations. (c) Chapter III Operational environment in Low Intensity Conflict Operations Areas. (d) Chapter IV Manifestation of Stress. (e) Chapter V Management of Stress. (f) Chapter VI Recommendations and Conclusion. CHAPTER II DEPLOYMENT PATTERN OF INDIAN ARMY IN LOW INTENSITY CONFLICT OPERATIONS â€Å"We live longer than our forefathers, but we suffer more from a thousand artificial anxieties and cares. They fatigued only muscles we exhaust the finer strength of our nerves† -Edward George Bulwer-Lytton 1. Infantry Battalions. The infantry battalions are deployed for Low Intensity Conflict Operations typically for a duration of two to three years during what is known as the field tenure, it can either be in the Northern sector (Jammu and Kashmir) or the North Eastern region. After tenure of aforesaid duration when the battalion is de-inducted from such areas to peace locations, a finite number of soldiers are sent to the affiliated Rashtriya Rifles (RR) Battalions to meet the requirement of troop commitment of Indian army to such units (Refer survey in following paragraphs). Thus a number of soldiers who have served for up to two to three years are again posted to operate in a Low Intensity Conflict Operations situation for a duration of two years and furthermore when these soldiers return from this stint it is again time for their battalion to move to field area for Low Intensity Conflict Operations, hence he again undergoes a tenure in high stress environment. In this way some sol diers end up spending up to six to seven years in Low Intensity Conflict Operations which anybody who has been there will agree is a long time. 2. Artillery Units. The case mentioned above is only slightly better for artillery, since the artillery units generally have longer peace tenures than the infantry battalions; hence a soldier after coming back, gets to spend some time in peace locations, however these personnel would have still undergone up to four years of continuous field area tenure. 3. Survey. To establish the facts mentioned in the previous paragraphs, data was collected from ten infantry battalions and ten artillery regiments. The results of the survey are given in succeeding paragraphs. 4. Infantry Battalions. Number of personnel who were dispatched to RR Battalions within one year are given as under, due to security reasons the exact identity of the units is not being revealed:- Serial Number Battalion Number of Personnel Junior Commissioned Officers Other Ranks (i) A Battalion 04 53 (ii) B Battalion 05 52 (iii) C Battalion 03 54 (iv) D Battalion 04 51 (v) E Battalion 04 52 (vi) F Battalion 04 55 (vii) G Battalion 04 52 (viii) H Battalion 04 55 (ix) J Battalion 04 51 (x) K Battalion 04 56 9 5. Artillery Regiments. A similar survey of artillery units revealed the following s:- Serial Number Regiment Number of Personnel Junior Commissioned Officers Other Ranks (i) No 1 Regiment 01 59 (ii) No 2 Regiment 02 58 (iii) No 3 Regiment 02 61 (iv) No 4 Regiment 03 58 (v) No 5 Regiment 01 56 (vi) No 6 Regiment 02 57 (vii) No 7 Regiment 03 59 (viii) No 8 Regiment 03 58 (ix) No 9 Regiment 02 57 (x) No 10 Regiment 01 60 Analysis of Data. 6. An analysis of the survey reveals the following:- (a) In the case of infantry battalions, on an average a total of four junior commissioned officers and fifty three soldiers were found who have had to undergo extended field tenure in excess of six years. (b) In case of artillery units, it can be seen from the data shown in the, table above that number of such personnel on an average is about is about fifty nine other ranks. Though artillery units are relatively better off due to reasons mentioned earlier, still these individuals still undergo an extended tenure in a Low Intensity Conflict Operations situation, and hence are over exposed to the stressful operational environment of Low Intensity Conflict Operations. 7. A further analysis reveals this to be a repetitive affair since each unit or battalion is responsible for providing relief of its personnel in Rashtriya Rifles (RR) thus when these personnel are reverted a set of similar strength is dispatched, therefore the fifty three soldiers in case of infantry battalions who were sent in the second year of the battalions peace tenure also have an extended tenure in Low Intensity Conflict Operations area, extending up to an year with Rashtriya Rifles and up to three years with their respective battalions. 8. One more interesting which emerges from the statistics[9] that the number of suicides and fratricides were much higher in Jammu and Kashmir than in the North-East. Why so? There could be number of reasons for this like intensity of operational environment, troop commitment of Army to Assam Rifles (AR) as compared to RR, better management of Low Intensity Conflict Operations due to longer experience of the Indian Army in the North East etc but the operational environment factor emerges as the singular, most differentiating aspects between the two regions. Report of study of Defence Institute of Psychological Research refers as attached as appendix B[10] also corroborates the same. CHAPTER III OPERATIONAL ENVIRONMENT IN LOW INTENSITY CONFLICT OPERATIONS â€Å"It is the man trained to recognize the dangers of the battlefield, understand his fears without surrendering to them and equipped with skills he must have to carryout his task, who can endure the prolonged stress of modern war† -Shelford Bidwell 1. In conventional operations battle lines are clearly drawn, one can identify the enemy easily and thus aggression can be directed unequivocally in his direction. The situation in Low Intensity Conflict Operations is quite the opposite. These are often characterised by limitations of armament being used, Tactics and levels of force applied. They are often protracted and involve military, diplomatic, economic and psychological pressure through terrorism and insurgency. Troops trained in conventional warfare experience significant stress in such operations. Conventional military training makes the soldier think in clear cut extremes of black and white, friend and foe. This tendency often leads to problems in Low Intensity Conflict Operations where the concept of ‘enemy cannot be applied to ones own population. The contributory factors, which increase the stress level on soldiers participating in Low Intensity Conflict Operations, are the product of complex interplay of the three elements involved the terrorist, the local population and the soldier. 2. Low Intensity Conflict Operations are continuous; there are no pauses and no time outs or half times. Frustrations mount when there is no breakthrough for months together and while the expectation to perform and produce results are high. The soldiers are caught in the cross fire moral Vs the immoral and the dividing lines are blurred. In sum, insurgency imposes severe stress and strain on those engaged in it[11]. 3. The operational environment in Low Intensity Conflict Operations is an ideal cauldron for manifestation of stress related problems. Some other factors which affect the soldier in such a situation are discussed in succeeding paragraphs. 4. Boredom and Isolation. The operational environment is characterised by long drawn intense activity. During the periods of lull and inactivity there are times when the imagination could run wild and seriously affect the individuals capacity to think rationally. 5. Hostile Local Population. One of the key factors for fighting and restricting insurgencies is the local populace. Due to a number of reasons such as fear of retribution by terrorists or negative propaganda against the army, the attitude of the locals towards the army is hostile. This causes considerable strain in the minds of the soldier who cant understand as to why the same people are against him to save whom he is risking his life. 6. Long Drawn Operations. These type of operations are long prolonged affair in which the inability to see the end of the tunnel is in itself quite stressful. Fatigue in such situations may be of two types. Firstly, tiring operational work in the form of sitting in long ambushes etc leads to physical exhaustion. Secondly, mental fatigue is caused by the repetitive nature of such physically exhausting missions over a long period of time, with little hope of relief. This condition can result in breakdown or even burning out. Prolonged spells of stress punctuated by quantitatively and qualitatively inadequate opportunities 7. Guilt. In Low Intensity Conflict Operations, the soldier is at a loss to understand the rationale of killing own countrymen, and hence is faced with a factor of guilt, even though he may not accept it openly for the fear of being ridiculed by peers but he sub-consciously feels a sense of guilt. 8. Human Rights Factor. The fear of being prosecuted for Human Rights violations, is always at the back of the minds of commanders at levels and thus percolates down to the soldiers in the form of unrealistic restraints and restrictions while operating in such environment. This too adds its share as stress. 9. Adverse Media Influence. The media in many cases blames the army for any collateral damage caused during an operation or sometimes blows a wrong accusation of Human rights violation against the security forces out of proportion to sell news, this is especially true for local vernacular media. They never highlight the gains of the army but would jump at a single violation, though army is now addressing this issue with its proactive media policy. 10. Separation From Families. Loneliness, domestic worries and a long wait for leave are not singular but inter-related issues all these have mutually related effects on the psyche of the soldier. Domestic worries have an adverse impact, especially so in low intensity situations wherein the soldier is as it is stressed out and is further frustrated since he cannot attend to his family problems in person. 11. Unrealistic Goals and Demands. The matters are made worse when senior commanders lay down unrealistic targets to be met in terms of terrorists killed or captured and weapons captured. The results in low intensity situations are not corporate targets to be met in a month or a quarter or a financial year they come by fits and starts and are not routine, a good month may see a good haul of Kills and there could be a lean period extending months together sometimes. The pressure to achieve results day after day in the end manifests as stress on the soldier. 12. Low intensity conflict operations are full of ambiguity and uncertainty. It should be realized by the government in general and the army hierarchy in particular that prolonged exposure to such situations is likely to make everyone, be it officers or soldiers, susceptible to stress because they are not only surviving there but are working at a faster pace everyday to deal with the uncertainty and constantly changing dynamic situations. STRESSORS PECULIAR TO LOW INTENSITY CONFLICT OPERATIONS 13. Inhospitable Terrain and Climate. The terrain and climate in which the troops are deployed in low intensity conflicts are mountainous terrain sometimes with secondary jungles and have harsh climatic conditions. The cold climate in J K and the heavy monsoons in North East make normal living in temporary habitats difficult[12]. Under such working conditions whenever there is a lack of motivation due to any reason, there is bound to be general deterioration of morale and discipline amongst the soldiers, thus this factor is an important stressor as far as the soldier is concerned. 14. Fear of Unknown. All soldiers who have been in life threatening soldiers are familiar with this phenomenon. It is the possibility of getting killed which puts a soldier under immense pressure it is omnipresent whether on duty within the company post or on operations outside the company post. It is primarily the fear of death or injury, which makes the low intensity scenario so stressful for the soldier in fact a harassing experience. The soldiers are thus living under tremendous psychological pressure constant fear of losing life does take its toll[13]. 15. Lack of Mental Respite. This is not a nine to five job it is continues twenty four by seven days. The terrorists in some way have initiative and can strike at the time of their choosing but the soldier has to be alert at all times, thus requiring a high state of alertness always. This leads to mental and physical fatigue and exhaustion and has a telling effect on his psyche. It is a campaign in which the regular army is pitted against the irregulars or guerrillas[14]. 16. Use of Improvised Explosive Devices (IEDs), By Terrorists. Use of IEDs gives the terrorists the ability to strike at the soldier without being seen and makes the army deploy a large number of troops for road santisation duties. This is frustrating for the soldier when he is unable to strike back at his attacker and leads to a constant fear of IEDs in the soldiers mind. 17. Constant Re-deployment. Counter insurgency operations demand a dynamic deployment depending upon militant activity and intelligence. Any person after spending some time in a place gets comfortable and starts to feel comfortable there his mind accepts the place as his home, but constant changing of bases as done in dynamic counter insurgency deployment adversely affects the soldiers mind. 18. Inadequacy of Equipment. Lack of special equipment to combat militancy has a demoralising effect on the troops. At times it gives a feeling of being pushed into ‘Counter Insurgency (CI) operations without being adequately equipped. 19. Prolonged Deployment/Change in Duration of Tenure. Many a times, move is delayed due to local operations causing uncertainties and resulting in building up of stress. 20. Break up of Joint Family System. There has been erosion in this time-tested system and more and more soldiers have now to fend for themselves. 21. Declining Discipline and Values. There has been a recent tendency among officers to over look major breaches of discipline in counter insurgency areas. Such an attitude breeds indiscipline leading to an overall discontentment among the disciplined soldiers. 22. Individual Psyche. The mental makeup of soldiers is different and their adaptability varies. A few individuals are weak and have a very low breaking point. Such persons soon become liability to the unit and are easy victims of stress related incidents. 23. Pressures of Human Rights Violations. The fear of perpetuating a human right violation and judicial harassment puts restrictions on the actions of the men and also make them vulnerable to militants during operations. 24. Lack of Recognition. There is a general feeling that due recognition is not being given for the services rendered by the soldiers in CI operations. The soldier feels that he is giving everything for the integrity of the country, but once he steps in to the civil street, no one has a word of praise for him. 25. Frustration Due to No Results (Numbers Game). The effect of operating in CI operations areas for months without any tangible results is frustrating. No amount of hard work is recognised in these operations unless accompanied by a few dead bodies of militants and some weapons. 26. Conviction towards the Cause. Most of the soldiers deployed in these operations are fighting militancy with no clear conviction towards the cause. In sum, insurgency imposes severe stress and strain on those engaged in it[15]. CHAPTER IV MANIFESTATION OF STRESS General 1. Stress can have serious consequences for both health and performance. In terms of health, the current belief is that 50-70 percent of all physical illness is related to stress. Stress is associated with heart disease, diabetes, ulcers, depression, irritation, anxiety, fatigue, lowered self-esteem, and reduced job satisfaction. Sustained over a long period, stress can lead to attempts to escape through the use of drugs or alcohol and may lead to burn out. 2. The most serious consequence of stress relates to performance. In order to take timely steps to ameliorate stress, it is imperative that commanders at all levels know the symptoms in detail. It should be the endeavour of every leader to ensure that the level of stress in the men under his commands remains within the optimum stress level (OSL) zone. Some individuals are more prone to stress than others. The reason lies in demographic differences and type of personality. 3. Demographic Differences. Demographic differences include age, health, education and profession/occupation. Age affects stress because most people go through life stages during which certain things are expected of them. As one grows in age, the expectations increases and so does the pressure. Thus age does create stress[16]. 4 Type of Personality. These are psychological in nature. These include need satisfaction, locus of control and type of personality. People, who have strong urge for need satisfaction, work hard and tend to excel others. This attribute can be basis for overwork and burnout. Locus of control refers to ones feeling of the extent to which one is able to control surrounding world. Greater an individuals perception of control over the environment, lesser is the person prone to stress, and vice versa[17]. Chronic Stress 5. Chronic stress is the outcome of prolonged exposure to stressful situation, as prevalent in the CI operations. It is not so perceptible in the initial stages, but in the longer run it causes lasting and grave damage to the physiology and psyche of the soldiers. It distorts perception and behavioural responses, and slowly but steadily wears down the stress tolerance capacity of individuals, bringing them to a state where they may break down at a critical juncture. The effects of chronic stress generally manifest themselves in the form of psychosomatic disorders, and later in the form of inappropriate behavioural responses[18]. 6. Psychosomatic Manifestations. Prolonged exposure to stress results in many psychological/physiological ailments such as headache, insomnia, fatigue, lack of appetite, duodenal ulcers, depression, diarrhoea, dizziness and fainting are some of the symptoms of a person being under chronic stress. Psychosomatic symptoms occur when thoughts and emotional reactions maintain the body in a state of physiological arousal. If this arousal is prolonged, it can lead to pain, infection, and organ breakdown[19]. 7. Behavioural Manifestations. Behavioural manifestations of chronic stress are generally in the form of defence-oriented responses. Common behavioural manifestations of chronic stress are as follows: (a) Apathy. This is the task oriented compromise reaction of an individual, wherein he shows lack of interest towards his primary role and shows great interest in secondary or mundane duties. (b) Isolation and Withdrawal. The individual under stress may reduce communicating with others or may totally stop it. The greater inclination towards the religious activities, most commonly displayed in CI environment, is also a withdrawal reaction due to internalisation of stress experienced by an individual. (c) Leave Requests. Absence without Leave and Malingering incidents are the outcome of unconscious or at times sub-conscious efforts of the mind to avoid facing the dangers of CI environment. (d) Rationalisation and Interjection. Giving logical and rational sounding excuses for own or sub units failure to perform up to the desired level, is in itself a defence oriented manifestation of stress. One form of this stress manifestation is comparing own performance with that of the others, who are not doing well enough, to justify own failures or except lower norms and standards of performance. (e) Projection. Another form of manifestation of stress is projection of blame for own shortcomings and failures on other colleagues and blaming them, their actions /advice, for own unjustifiable performance or actions. Cribbing and grumbling are also manifestation of stress. (f) Failures. Frequent failures to perform up to the desired level by same person or a sub unit reflect that the individual or the sub unit as such may be suffering from chronic stress. (g) Violence and Aggression. Violence against suspects and insurgents and aggressive attitude towards own colleagues are another form of stress expression. Under stress, individual and specially leaders, tend to displace there feeling of chronic stress by arbitrary rudeness towards their colleagues and juniors, suspects and civilian population. Excessive use of violence against captured or trapped insurgents is a common manifestation of stress. It is also believed that the passive and timid person who cannot mobilise and externalise his anger is more vulnerable to external fear because of his impaired ability to react aggressively towards the enemy and thus discharge tension. 8. Post -Traumatic Stress Reactions Post-traumatic stress disorder is a state of anxiety, depression and physiological ‘numbing that follows exposure to a severe trauma, such as warfare, militant killings, a catastrophe or violent death of a loved one. This appears as a recurrent dream or nightmare in slow motion. Victims complain of tension, insomnia and trouble in concentrating, a feeling of remoteness from others an Stress Management in Low Intensity Conflict Operations Stress Management in Low Intensity Conflict Operations CHAPTER I INTRODUCTION â€Å"Life is a long sequence of stressors† Mirza Galib General 1. Stress is an inescapable part of modern life. It is the psychological and physiological reaction that occurs when an individual perceives an imbalance between the level of demand placed upon him and his capability for meeting that demand. Stress affects individuals physiologically, emotionally and behaviourally and is linked to responses which in case of stress overloads, often results in rash or irrational behaviour. However, it is not always negative in fact, stress at optimum levels also produces a positive force or stimuli that is dynamic and often aids in tiding over difficult situations. 2. Officers, Junior Commissioned officers and men in the army are by no means insulated to the phenomenon of stress but in fact exposed to situations which tend to become stressful. Understanding of stress, therefore, plays an important role in management of personnel in the army, both in peace and in operational environments. 3. A rigid organizational structure, peculiar environmental factors, extended deployment in Counter Insurgency Operations and Combat situations often compound stress related problems in the army. These, if not tackled at an early stage results in cumulated stress effects which often surpass acceptable limits. The recent spate of suicides, fragging and fratricides provides an urgency to understand at the earliest, the maladies of stress and its effect on men officers of the army. 4. The Penguin Medical Encyclopaedia defines stress as any influence, which disturbs the natural equilibrium of the body and includes within its reference, physical injury, exposure, deprivation and all kinds of diseases and emotional disturbances. The word stress has been borrowed from Physics and Engineering where it has a precise meaning, a force sufficient enough in magnitude to distort or deform when applied to a system. For our studies the apt definition seems to be the rate of wear and tear of the mind. 5. To quote a formal definition, â€Å"Stress is defined as an adaptive response to an external situation that results in physical, psychological and / or behavioural deviations for organizational participants.[1]† It may also be defined as â€Å"failure to adapt†[2] 6. Most people view stress in a negative way but as mentioned in the previous paragraph it may be positive sometimes as it provides the extra energy to deal with tough or life threatening situations. Experts therefore agree that some stress is not only helpful but essential to keep it going for us without which we would be vegetables. Stress results from a stimulation of environment , the degree of this stimulation on the stress curve is positive to an extent but thereafter prolonged stimulations of the same kind, for example the operational environment experienced by the soldiers in Low Intensity Conflict Operations leads to manifestation of stress in the form of negative effects on the soldiers mind. High stress levels, besides manifesting in below-par performance standards during discharge of duties, are also the cause of incidents like running amok, fratricides and suicides. METHODOLOGY STATEMENT OF THE PROBLEM 7. To analyse the causes of stress in soldiers of Indian Army in the backdrop of its prolonged deployment in Low Intensity Conflict Operations, its manifestation in various forms and to suggest possible methods of stress management at the national, army, formation unit levels. HYPOTHESIS 8. Existing op environment in areas where the Indian Army is deployed for Low Intensity Conflict Operations coupled with prolonged deployment of troops in such areas is the main cause of stress in soldiers today which has led to an increased occurrence of stress related incidents amongst the soldiers. JUSTIFICATION OF STUDY 9. India has a 1.1 million-strong army and with 81 suicides[3] in the year 2006 stress has become one of its major worries. s given by The Indian Express show that the number of suicides per lakh personnel in the army stands at 10.8 though this is much lower than 17 for the US Army, 18 for the French and 14 of the Royal Army is still big enough to draw attention. The increasing numbers of suicide cases[4] are a cause of concern (See chart below).This fact has been proven adequately in the research carried out by Dr DS Goel of Ranchi institute of Neuropsychiatry in conjunction with command hospital northern command on â€Å"Psychological Effects of Low Intensity Operations†. Extract of the same is attached as appendix A. 10. Another alarming is the 23 cases of fratricide in 2006[5], of these 09cases were reported from Jammu and Kashmir and remaining 14 from the North East, both are areas where army is involved in Low Intensity Conflict Operations. Similar statistics also can be established in suicide cases. Why these cases did not occur in peace stations if the reasons for stress as propounded by some theories are economic growth and rising financial aspirations of the soldier is a moot question and does point to the operational environment of Low Intensity Conflict Operations as the prime reason of stress in soldiers and thus the prime nemesis to be tamed to get down the worrisome numbers of suicides and fratricides. However the effects of personal problems of the soldier causing such incidents is correct, but again if the soldier was located in a peace area he would have been in a better connected place as far as communication with his family is concerned whether it is a case of land dispute or mar ital discord or his wife not being treated well by her in laws. Most of such cases could be solved merely by the physical presence of the soldier along with his wife or parents as the case may be thus it connects to the prolonged deployment of troops in Low Intensity Conflict Operations which leads to increased domestic problems in a soldiers life. 11. In July 2009 the Honourable RM while answering to a question in the parliament stated that already 48 cases of suicides and one case of fratricide have been reported till June[6], its anybodys guess what the final for 2009 will be, whatever be the it cannot be denied that the Indian Army today is faced with the demon of stress in its soldiers. The good news is that the army has realised that this is a problem and cannot be wished away and a number of steps are being taken to tackle the issue but till such time the bigger demon of Low Intensity Conflict Operations exists and some holistic measures by the government and the army are undertaken, firstly to improve the operational environment and secondly to reduce or decrease the time which a soldier spends continuously in Low Intensity Conflict Operations areas, this demon will continue to feed on the strength of the Indian Army- the Indomitable spirit of the Indian soldier. SCOPE 12. The scope is limited to study the following aspects :- (a) Deployment pattern of Indian Army in Low Intensity Conflict Operations. (b) Operational Environment in Low Intensity Conflict Operations. (c) Manifestation of stress and its inter-relation with behaviour/performance. (d) Management of stress to include present approach its shortcomings and recommendations. OPERATIONAL DEFINITIONS 13. Some terms used in this dissertation are defined below:- (a) Combat Stress[7]. The stress experienced by the soldier during a combat situation. This is a complex form of stress resulting from all the physical and mental strain caused to the soldier during the combat mission, it is cumulative in nature and the number of times the soldier goes through the same situation it causes stress and is accumulated in the mind of the combatant. (b) Stressors. The factors that cause stress are called stressors; it can be an event or situation which requires a non routine change in the lifestyle or behaviour of a soldier. This causes a felling of conflict with the ideals and values of a person or it may pose a challenge or threat to an individuals sense of wellbeing or self esteem. (c) Eustress[8]. Stress may manifest sometimes in a positive way, this effect is known as Eustress, which is described by experts as a motivator which drives a person to achieve extraordinary feats under situations of pressure. It is obvious that Eustress is not harmful being occasional. METHODS OF DATA COLLECTION 14. The research work is mainly based on books, journals available in the library, thesis and dissertation work available on the internet as also the study report of the Defence Institute of Psychological Research on the causes of inter-personal violence in the units deployed in counter insurgency areas and the study report of research carried out by Ranchi Institute of Neurosciences in collaboration with Armed Forces Medical Services, Command Hospital (Northern Command) and Director general Medical Services. Data of twenty units of infantry and artillery was also collected to prove that the existing deployment pattern and troop commitment to Rashtriya Rifles is resulting in prolonged exposure of approximately one percent of soldiers to higher stress prone areas. A detailed bibliography of sources is appended at the end of the dissertation. ORGANISATION OF THE DISSERTATION (CHAPTERISATION) 15. It is proposed to study the subject in the following manner :- (a) Chapter I Introduction. (b) Chapter II Deployment Pattern of Indian Army in Low Intensity Conflict Operations. (c) Chapter III Operational environment in Low Intensity Conflict Operations Areas. (d) Chapter IV Manifestation of Stress. (e) Chapter V Management of Stress. (f) Chapter VI Recommendations and Conclusion. CHAPTER II DEPLOYMENT PATTERN OF INDIAN ARMY IN LOW INTENSITY CONFLICT OPERATIONS â€Å"We live longer than our forefathers, but we suffer more from a thousand artificial anxieties and cares. They fatigued only muscles we exhaust the finer strength of our nerves† -Edward George Bulwer-Lytton 1. Infantry Battalions. The infantry battalions are deployed for Low Intensity Conflict Operations typically for a duration of two to three years during what is known as the field tenure, it can either be in the Northern sector (Jammu and Kashmir) or the North Eastern region. After tenure of aforesaid duration when the battalion is de-inducted from such areas to peace locations, a finite number of soldiers are sent to the affiliated Rashtriya Rifles (RR) Battalions to meet the requirement of troop commitment of Indian army to such units (Refer survey in following paragraphs). Thus a number of soldiers who have served for up to two to three years are again posted to operate in a Low Intensity Conflict Operations situation for a duration of two years and furthermore when these soldiers return from this stint it is again time for their battalion to move to field area for Low Intensity Conflict Operations, hence he again undergoes a tenure in high stress environment. In this way some sol diers end up spending up to six to seven years in Low Intensity Conflict Operations which anybody who has been there will agree is a long time. 2. Artillery Units. The case mentioned above is only slightly better for artillery, since the artillery units generally have longer peace tenures than the infantry battalions; hence a soldier after coming back, gets to spend some time in peace locations, however these personnel would have still undergone up to four years of continuous field area tenure. 3. Survey. To establish the facts mentioned in the previous paragraphs, data was collected from ten infantry battalions and ten artillery regiments. The results of the survey are given in succeeding paragraphs. 4. Infantry Battalions. Number of personnel who were dispatched to RR Battalions within one year are given as under, due to security reasons the exact identity of the units is not being revealed:- Serial Number Battalion Number of Personnel Junior Commissioned Officers Other Ranks (i) A Battalion 04 53 (ii) B Battalion 05 52 (iii) C Battalion 03 54 (iv) D Battalion 04 51 (v) E Battalion 04 52 (vi) F Battalion 04 55 (vii) G Battalion 04 52 (viii) H Battalion 04 55 (ix) J Battalion 04 51 (x) K Battalion 04 56 9 5. Artillery Regiments. A similar survey of artillery units revealed the following s:- Serial Number Regiment Number of Personnel Junior Commissioned Officers Other Ranks (i) No 1 Regiment 01 59 (ii) No 2 Regiment 02 58 (iii) No 3 Regiment 02 61 (iv) No 4 Regiment 03 58 (v) No 5 Regiment 01 56 (vi) No 6 Regiment 02 57 (vii) No 7 Regiment 03 59 (viii) No 8 Regiment 03 58 (ix) No 9 Regiment 02 57 (x) No 10 Regiment 01 60 Analysis of Data. 6. An analysis of the survey reveals the following:- (a) In the case of infantry battalions, on an average a total of four junior commissioned officers and fifty three soldiers were found who have had to undergo extended field tenure in excess of six years. (b) In case of artillery units, it can be seen from the data shown in the, table above that number of such personnel on an average is about is about fifty nine other ranks. Though artillery units are relatively better off due to reasons mentioned earlier, still these individuals still undergo an extended tenure in a Low Intensity Conflict Operations situation, and hence are over exposed to the stressful operational environment of Low Intensity Conflict Operations. 7. A further analysis reveals this to be a repetitive affair since each unit or battalion is responsible for providing relief of its personnel in Rashtriya Rifles (RR) thus when these personnel are reverted a set of similar strength is dispatched, therefore the fifty three soldiers in case of infantry battalions who were sent in the second year of the battalions peace tenure also have an extended tenure in Low Intensity Conflict Operations area, extending up to an year with Rashtriya Rifles and up to three years with their respective battalions. 8. One more interesting which emerges from the statistics[9] that the number of suicides and fratricides were much higher in Jammu and Kashmir than in the North-East. Why so? There could be number of reasons for this like intensity of operational environment, troop commitment of Army to Assam Rifles (AR) as compared to RR, better management of Low Intensity Conflict Operations due to longer experience of the Indian Army in the North East etc but the operational environment factor emerges as the singular, most differentiating aspects between the two regions. Report of study of Defence Institute of Psychological Research refers as attached as appendix B[10] also corroborates the same. CHAPTER III OPERATIONAL ENVIRONMENT IN LOW INTENSITY CONFLICT OPERATIONS â€Å"It is the man trained to recognize the dangers of the battlefield, understand his fears without surrendering to them and equipped with skills he must have to carryout his task, who can endure the prolonged stress of modern war† -Shelford Bidwell 1. In conventional operations battle lines are clearly drawn, one can identify the enemy easily and thus aggression can be directed unequivocally in his direction. The situation in Low Intensity Conflict Operations is quite the opposite. These are often characterised by limitations of armament being used, Tactics and levels of force applied. They are often protracted and involve military, diplomatic, economic and psychological pressure through terrorism and insurgency. Troops trained in conventional warfare experience significant stress in such operations. Conventional military training makes the soldier think in clear cut extremes of black and white, friend and foe. This tendency often leads to problems in Low Intensity Conflict Operations where the concept of ‘enemy cannot be applied to ones own population. The contributory factors, which increase the stress level on soldiers participating in Low Intensity Conflict Operations, are the product of complex interplay of the three elements involved the terrorist, the local population and the soldier. 2. Low Intensity Conflict Operations are continuous; there are no pauses and no time outs or half times. Frustrations mount when there is no breakthrough for months together and while the expectation to perform and produce results are high. The soldiers are caught in the cross fire moral Vs the immoral and the dividing lines are blurred. In sum, insurgency imposes severe stress and strain on those engaged in it[11]. 3. The operational environment in Low Intensity Conflict Operations is an ideal cauldron for manifestation of stress related problems. Some other factors which affect the soldier in such a situation are discussed in succeeding paragraphs. 4. Boredom and Isolation. The operational environment is characterised by long drawn intense activity. During the periods of lull and inactivity there are times when the imagination could run wild and seriously affect the individuals capacity to think rationally. 5. Hostile Local Population. One of the key factors for fighting and restricting insurgencies is the local populace. Due to a number of reasons such as fear of retribution by terrorists or negative propaganda against the army, the attitude of the locals towards the army is hostile. This causes considerable strain in the minds of the soldier who cant understand as to why the same people are against him to save whom he is risking his life. 6. Long Drawn Operations. These type of operations are long prolonged affair in which the inability to see the end of the tunnel is in itself quite stressful. Fatigue in such situations may be of two types. Firstly, tiring operational work in the form of sitting in long ambushes etc leads to physical exhaustion. Secondly, mental fatigue is caused by the repetitive nature of such physically exhausting missions over a long period of time, with little hope of relief. This condition can result in breakdown or even burning out. Prolonged spells of stress punctuated by quantitatively and qualitatively inadequate opportunities 7. Guilt. In Low Intensity Conflict Operations, the soldier is at a loss to understand the rationale of killing own countrymen, and hence is faced with a factor of guilt, even though he may not accept it openly for the fear of being ridiculed by peers but he sub-consciously feels a sense of guilt. 8. Human Rights Factor. The fear of being prosecuted for Human Rights violations, is always at the back of the minds of commanders at levels and thus percolates down to the soldiers in the form of unrealistic restraints and restrictions while operating in such environment. This too adds its share as stress. 9. Adverse Media Influence. The media in many cases blames the army for any collateral damage caused during an operation or sometimes blows a wrong accusation of Human rights violation against the security forces out of proportion to sell news, this is especially true for local vernacular media. They never highlight the gains of the army but would jump at a single violation, though army is now addressing this issue with its proactive media policy. 10. Separation From Families. Loneliness, domestic worries and a long wait for leave are not singular but inter-related issues all these have mutually related effects on the psyche of the soldier. Domestic worries have an adverse impact, especially so in low intensity situations wherein the soldier is as it is stressed out and is further frustrated since he cannot attend to his family problems in person. 11. Unrealistic Goals and Demands. The matters are made worse when senior commanders lay down unrealistic targets to be met in terms of terrorists killed or captured and weapons captured. The results in low intensity situations are not corporate targets to be met in a month or a quarter or a financial year they come by fits and starts and are not routine, a good month may see a good haul of Kills and there could be a lean period extending months together sometimes. The pressure to achieve results day after day in the end manifests as stress on the soldier. 12. Low intensity conflict operations are full of ambiguity and uncertainty. It should be realized by the government in general and the army hierarchy in particular that prolonged exposure to such situations is likely to make everyone, be it officers or soldiers, susceptible to stress because they are not only surviving there but are working at a faster pace everyday to deal with the uncertainty and constantly changing dynamic situations. STRESSORS PECULIAR TO LOW INTENSITY CONFLICT OPERATIONS 13. Inhospitable Terrain and Climate. The terrain and climate in which the troops are deployed in low intensity conflicts are mountainous terrain sometimes with secondary jungles and have harsh climatic conditions. The cold climate in J K and the heavy monsoons in North East make normal living in temporary habitats difficult[12]. Under such working conditions whenever there is a lack of motivation due to any reason, there is bound to be general deterioration of morale and discipline amongst the soldiers, thus this factor is an important stressor as far as the soldier is concerned. 14. Fear of Unknown. All soldiers who have been in life threatening soldiers are familiar with this phenomenon. It is the possibility of getting killed which puts a soldier under immense pressure it is omnipresent whether on duty within the company post or on operations outside the company post. It is primarily the fear of death or injury, which makes the low intensity scenario so stressful for the soldier in fact a harassing experience. The soldiers are thus living under tremendous psychological pressure constant fear of losing life does take its toll[13]. 15. Lack of Mental Respite. This is not a nine to five job it is continues twenty four by seven days. The terrorists in some way have initiative and can strike at the time of their choosing but the soldier has to be alert at all times, thus requiring a high state of alertness always. This leads to mental and physical fatigue and exhaustion and has a telling effect on his psyche. It is a campaign in which the regular army is pitted against the irregulars or guerrillas[14]. 16. Use of Improvised Explosive Devices (IEDs), By Terrorists. Use of IEDs gives the terrorists the ability to strike at the soldier without being seen and makes the army deploy a large number of troops for road santisation duties. This is frustrating for the soldier when he is unable to strike back at his attacker and leads to a constant fear of IEDs in the soldiers mind. 17. Constant Re-deployment. Counter insurgency operations demand a dynamic deployment depending upon militant activity and intelligence. Any person after spending some time in a place gets comfortable and starts to feel comfortable there his mind accepts the place as his home, but constant changing of bases as done in dynamic counter insurgency deployment adversely affects the soldiers mind. 18. Inadequacy of Equipment. Lack of special equipment to combat militancy has a demoralising effect on the troops. At times it gives a feeling of being pushed into ‘Counter Insurgency (CI) operations without being adequately equipped. 19. Prolonged Deployment/Change in Duration of Tenure. Many a times, move is delayed due to local operations causing uncertainties and resulting in building up of stress. 20. Break up of Joint Family System. There has been erosion in this time-tested system and more and more soldiers have now to fend for themselves. 21. Declining Discipline and Values. There has been a recent tendency among officers to over look major breaches of discipline in counter insurgency areas. Such an attitude breeds indiscipline leading to an overall discontentment among the disciplined soldiers. 22. Individual Psyche. The mental makeup of soldiers is different and their adaptability varies. A few individuals are weak and have a very low breaking point. Such persons soon become liability to the unit and are easy victims of stress related incidents. 23. Pressures of Human Rights Violations. The fear of perpetuating a human right violation and judicial harassment puts restrictions on the actions of the men and also make them vulnerable to militants during operations. 24. Lack of Recognition. There is a general feeling that due recognition is not being given for the services rendered by the soldiers in CI operations. The soldier feels that he is giving everything for the integrity of the country, but once he steps in to the civil street, no one has a word of praise for him. 25. Frustration Due to No Results (Numbers Game). The effect of operating in CI operations areas for months without any tangible results is frustrating. No amount of hard work is recognised in these operations unless accompanied by a few dead bodies of militants and some weapons. 26. Conviction towards the Cause. Most of the soldiers deployed in these operations are fighting militancy with no clear conviction towards the cause. In sum, insurgency imposes severe stress and strain on those engaged in it[15]. CHAPTER IV MANIFESTATION OF STRESS General 1. Stress can have serious consequences for both health and performance. In terms of health, the current belief is that 50-70 percent of all physical illness is related to stress. Stress is associated with heart disease, diabetes, ulcers, depression, irritation, anxiety, fatigue, lowered self-esteem, and reduced job satisfaction. Sustained over a long period, stress can lead to attempts to escape through the use of drugs or alcohol and may lead to burn out. 2. The most serious consequence of stress relates to performance. In order to take timely steps to ameliorate stress, it is imperative that commanders at all levels know the symptoms in detail. It should be the endeavour of every leader to ensure that the level of stress in the men under his commands remains within the optimum stress level (OSL) zone. Some individuals are more prone to stress than others. The reason lies in demographic differences and type of personality. 3. Demographic Differences. Demographic differences include age, health, education and profession/occupation. Age affects stress because most people go through life stages during which certain things are expected of them. As one grows in age, the expectations increases and so does the pressure. Thus age does create stress[16]. 4 Type of Personality. These are psychological in nature. These include need satisfaction, locus of control and type of personality. People, who have strong urge for need satisfaction, work hard and tend to excel others. This attribute can be basis for overwork and burnout. Locus of control refers to ones feeling of the extent to which one is able to control surrounding world. Greater an individuals perception of control over the environment, lesser is the person prone to stress, and vice versa[17]. Chronic Stress 5. Chronic stress is the outcome of prolonged exposure to stressful situation, as prevalent in the CI operations. It is not so perceptible in the initial stages, but in the longer run it causes lasting and grave damage to the physiology and psyche of the soldiers. It distorts perception and behavioural responses, and slowly but steadily wears down the stress tolerance capacity of individuals, bringing them to a state where they may break down at a critical juncture. The effects of chronic stress generally manifest themselves in the form of psychosomatic disorders, and later in the form of inappropriate behavioural responses[18]. 6. Psychosomatic Manifestations. Prolonged exposure to stress results in many psychological/physiological ailments such as headache, insomnia, fatigue, lack of appetite, duodenal ulcers, depression, diarrhoea, dizziness and fainting are some of the symptoms of a person being under chronic stress. Psychosomatic symptoms occur when thoughts and emotional reactions maintain the body in a state of physiological arousal. If this arousal is prolonged, it can lead to pain, infection, and organ breakdown[19]. 7. Behavioural Manifestations. Behavioural manifestations of chronic stress are generally in the form of defence-oriented responses. Common behavioural manifestations of chronic stress are as follows: (a) Apathy. This is the task oriented compromise reaction of an individual, wherein he shows lack of interest towards his primary role and shows great interest in secondary or mundane duties. (b) Isolation and Withdrawal. The individual under stress may reduce communicating with others or may totally stop it. The greater inclination towards the religious activities, most commonly displayed in CI environment, is also a withdrawal reaction due to internalisation of stress experienced by an individual. (c) Leave Requests. Absence without Leave and Malingering incidents are the outcome of unconscious or at times sub-conscious efforts of the mind to avoid facing the dangers of CI environment. (d) Rationalisation and Interjection. Giving logical and rational sounding excuses for own or sub units failure to perform up to the desired level, is in itself a defence oriented manifestation of stress. One form of this stress manifestation is comparing own performance with that of the others, who are not doing well enough, to justify own failures or except lower norms and standards of performance. (e) Projection. Another form of manifestation of stress is projection of blame for own shortcomings and failures on other colleagues and blaming them, their actions /advice, for own unjustifiable performance or actions. Cribbing and grumbling are also manifestation of stress. (f) Failures. Frequent failures to perform up to the desired level by same person or a sub unit reflect that the individual or the sub unit as such may be suffering from chronic stress. (g) Violence and Aggression. Violence against suspects and insurgents and aggressive attitude towards own colleagues are another form of stress expression. Under stress, individual and specially leaders, tend to displace there feeling of chronic stress by arbitrary rudeness towards their colleagues and juniors, suspects and civilian population. Excessive use of violence against captured or trapped insurgents is a common manifestation of stress. It is also believed that the passive and timid person who cannot mobilise and externalise his anger is more vulnerable to external fear because of his impaired ability to react aggressively towards the enemy and thus discharge tension. 8. Post -Traumatic Stress Reactions Post-traumatic stress disorder is a state of anxiety, depression and physiological ‘numbing that follows exposure to a severe trauma, such as warfare, militant killings, a catastrophe or violent death of a loved one. This appears as a recurrent dream or nightmare in slow motion. Victims complain of tension, insomnia and trouble in concentrating, a feeling of remoteness from others an

Muscle Contraction Steps

During a Muscle Contraction The muscle fiber is in a resting state. The resting state is slightly negative inside and slightly positive outside. It has to be in this state in order to receive a message. First the brain sends a message to the muscle using a neuron then reaches the axon terminal of the neuron. Calcium gates then open on the axon terminal allowing calcium to rush in. Ach release from axon terminals, diffuses across the synaptic clef and binds to (receptors) on motor end plate.Then Ach receptor channel opens and increases permeability of Na+ into karyoplasms. This allows sodium gates to open. Na+ enters muscle fiber, rapid depolarization of sarcolemma occurs. Voltage changes to a less negative charge. An increase of Na+ rushing into cell allows for more gates to open (depolarization wave). Acetylcholinesterase is an enzyme that resets and closes gates once Ach is removed from its receptor. Once sodium gates close it initiates K+ gates to open.K+ rushes out of the cell th is and once repolarized the gates closes by the use of a pump and return to a resting state. ATP powers the Ca++ active transport pumps. The action potential spreads away from the end plate in all directions and depolarizes the T-tubules and dips down into the SR and depolarizes it. Calcium gates on the SR return open and allows calcium to rush out into the sarcoplasm. Calcium gates close, when a gate opens it’s a one way movement.Ca++ combines with protien troponin and changes shape exposing the myosin binding sites on actin. This is the latent period, the lag time between stimulation and contraction. Myosin heads or cross bridges attach to actin binding sites on thin filaments. The sliding filament theory of a muscle contraction begins. When myosin binds to actin it pulls toward the m-line this is the â€Å"power stroke†. Once myosin head if flexed, ATP binding site is exposed and ATP binds to the head. Every single myosin head that attaches to actin has to have ATP. Now the myosin head detaches from actin binding sites in result of ATP binding. Energy from ATP returns the myosin head to cocked forward position and now attaches to a new binding site on actin. Ca++ is then removed from troponin and changes shape allowing tropomyosin to cover myosin binding sites on actin. ATP is required to assist with the active transport of Ca++ to the SR. This process is considered the contraction and is repeated over and over as long as ATP and Ca++ are available.

The Health Belief Model ( Hbm ) Essay - 1486 Words

Out of all the vaccine preventable diseases, pertussis challenges most infectious diseases in severity and importance in children. In 2014, the incidence rate of pertussis in the United States increased by 15%, with almost 33,000 cases reported (Centers for Disease Control, 2015). The bacterium that causes this illness attacks an unprotected immune by attaching to the lining of the respiratory system. After initial attack, begins the release of the toxins that prohibit the respiratory system from working functionally. Because of this, mucus builds up in the lungs, causing an uncontrollable cough that makes breathing difficult (Tan et al, 2005). This illness is very contagious and almost always deadly in children. However, it can be prevented with proper vaccination. This problem can be addressed with the Health Belief Model (HBM), which encourages preventive health actions in order to prevent unwanted adverse conditions, with the idea that action depends on the value and expectancy o f the behavior. The HBM attempts to explain and predict behaviors by focusing on attitudes and beliefs of individuals that are represented by six distinct constructs. These constructs include, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, and self-efficacy. In addition, these six constructs are modified by other variables including, age, gender, ethnicity, personality, socioeconomics, and knowledge (Sharma, 2017). 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What Is Isobaric Process

An isobaric process is a thermodynamic process in which the pressure remains constant. This is usually obtained by allowing the volume to expand or contract in such a way to neutralize any pressure changes that would be caused by heat transfer. The term isobaric comes from Greek iso, meaning equal, and baros, meaning weight. In an isobaric process, there are typically internal energy changes.  Work is done by the system, and heat is transferred, so none of the quantities in the first law of thermodynamics readily reduce to zero. However, the work at a constant pressure can be fairly easily calculated with the equation: W p * Δ V Since W is the work, p is the pressure (always positive) and ΔV is the change in volume, we can see that there are two possible outcomes to an isobaric process: If the system expands (ΔV is positive), then the system does positive work (and vice versa).If the system contracts (ΔV is negative), then the system does negative work (and vice versa). Examples of Isobaric Processes If you have a cylinder with a weighted piston and you heat the gas in it, the gas expands due to the increase in energy. This is in accordance with Charles law - the volume of a gas is proportional to its temperature. The weighted piston keeps the pressure constant. You can calculate the amount of work done by knowing the change of volume of the gas and the pressure. The piston is displaced by the change in volume of the gas while the pressure remains constant. If the piston was fixed and didnt move as the gas was heated, the pressure would rise rather than the volume of the gas. This would not be an isobaric process, as the pressure was not constant. The gas could not produce work to displace the piston. If you remove the heat source from the cylinder or even place it into a freezer so it lost heat to the environment, the gas would shrink in volume and draw the weighted piston down with it as it maintained constant pressure. This is negative work, the system contracts. Isobaric Process and Phase Diagrams In a  phase diagram, an isobaric process would show up as a horizontal line, since it takes place  under  a constant pressure. This diagram would show you at what temperatures a substance is solid, liquid, or vapor for a range of atmospheric pressures. Thermodynamic Processes In thermodynamic processes, a system has a change in energy and that results in changes in pressure, volume, internal energy, temperature, or heat transfer. In natural processes, often more than one of these types are at work at the same time. Also, natural systems most of these processes have a preferred direction and are not easily reversible. Adiabatic process - no heat transfer into or out of the system.Isochoric process - no change in volume, in which case the system does no work.Isobaric process - no change in pressure.Isothermal process - no change in temperature.