Finishing what was started: an analysis of theater research conducted from 2010 to 2012.

The Joint Combat Casualty Research Team (JC2RT) is part of the human research protection regulatory system implemented in 2005 to oversee the conduct of research in a deployed military combatant command. In 2010, SharePoint, a web-based tool, was established to track study documents. This study conducted by JC2RT no. 13 describes characteristics of research studies under the purview of the JC2RT from 2010 through 2012. Of the 83 research studies reviewed, 34% were completed, 32% were not completed, and 34% were still in progress. Target sample sizes ranged from 12 to 70,000, with 96% of the research studying U.S. military members. The design of 61% of the studies was prospective, 20% surveys, and 14% retrospective reviews. Approximately one-half of the studies were conducted at single sites. Eighty-four percent of the studies that finished an institutional review board (IRB) were completed, whereas a large number of studies never made it to IRB approval. Even after studies have gone through the rigorous process of scientific review and IRB approval some continue to struggle for years to be completed in the theater of operations. The JC2RT is committed to helping facilitate the ethical conduct of research during war.

Restoration of risk-propensity during sleep deprivation: caffeine, dextroamphetamine, and modafinil.

INTRODUCTION: Sleep deprivation alters risk-related judgments, decision-making, and behavioral control. Stimulant medications are used to restore cognitive performance, but their effects on risk-taking and judgment in sleep-deprived subjects have not been explored. METHODS: There were 54 healthy adults (29 men, 25 women; age range 18 to 36) who completed a test of cognitive ability and daily measures of risk-taking propensity, including the Brief Sensation Seeking Scale (BSSS), Evaluation of Risks (EVAR) scale, and the Balloon Analog RiskTask (BART). Following 44 h of continuous wakefulness, participants ingested caffeine 600 mg (N = 12), dextroamphetamine 20 mg (N = 16), modafinil 400 mg (N = 12), or a placebo (N = 14) in a double blind manner, and completed risk-taking measures 2 h later (i.e., 0535). RESULTS: Relative to rested baseline, the placebo group showed a decline in risk-taking as measured by the BSSS (16% decline), EVAR Danger Seeking (32% decline) and Energy (22% decline), and BART (32% decline), consistent with previous reports of the effects of sleep deprivation. Comparisons among drug conditions showed that dextroamphetamine restored risk-taking propensity and risky behavior to baseline levels, an effect that was significantly greater than placebo or caffeine for several indices of risk-taking, but which did not differ from modafinil. Cognitive ability was significantly correlated with changes on some risk-taking indices following stimulant administration. CONCLUSIONS: Stimulant medications, particularly dextroamphetamine, sustained risk-related attitudes and behavior during continuous wakefulness. The extent to which stimulants restore other aspects of judgment during sleep loss remains to be determined.