Wendy Z. Thompson, EdD(c), MSN, BSBA, IBCLC
When alleles of two linked genes segregate erectile dysfunction treatment by homeopathy generic silvitra 120mg on-line, more than 50 percent of the gametes produced have parental combinations of the segregating alleles erectile dysfunction causes natural treatment purchase silvitra on line, and fewer than 50 percent have nonparental (recombinant) combinations of the alleles erectile dysfunction pills for diabetes purchase silvitra 120 mg online. The recombination of linked genes results from crossing-over impotence when trying to conceive purchase 120mg silvitra with mastercard, a process in which nonsister chromatids of the homologous chromosomes exchange corresponding segments in the first meiotic prophase. This model, although not correct in all its details, is nevertheless the basis on which more accurate and complex models of recombination have been developed. The frequency of recombination between different genes can be used to determine the relative order and locations of the genes in chromosomes. Distance between adjacent genes in such a Page 163 map (a genetic or linkage map) is defined to be proportional to the frequency of recombination between them; the unit of map distance (the map unit or centimorgan) is defined as 1 percent recombination. One map unit corresponds to a physical length of the chromosome in which a crossover event takes place, on the average, once in every 50 meiotic divisions. This discrepancy results from multiple crossover events, which yield either no recombinants or the same number produced by a single event. For example, two crossovers in the region between two genes may yield no recombinants, and three crossover events may yield recombinants of the same type as that from a single crossover. When many genes are mapped in a particular species, they form linkage groups equal in number to the haploid chromosome number of the species. The maximum frequency of recombination between any two genes in a cross is 50 percent; this happens when the genes are in nonhomologous chromosomes and assort independently or when the genes are sufficiently far apart in the same chromosome that at least one crossover is formed between them in every meiosis. The map distance between two genes may be considerably greater than 50 centimorgans because the map distance is equal to half of the average number of crossovers per chromosome times 100. A mapping function is the mathematical relation between the genetic map distance across an interval and the observed percent recombination in the interval. In many organisms, including model experimental organisms, agricultural animals and plants, and human beings, the genetic map includes hundreds or thousands of genetic markers distributed more or less uniformly throughout the euchromatin. Some of the most useful genetic markers are changes in base sequence present in wildtype organisms that are not associated with any phenotypic abnormalities. Prominent among these are nucleotide substitutions that create or destroy a particular cleavage site recognized by a restriction endonuclease. Such mutations can be detected because different chromosomes yield restriction fragments that differ in size according to the positions of the cleavage sites. The four haploid products of each of a series of meiotic divisions can be used to analyze linkage and recombination in some species of fungi and unicellular algae. In Neurospora and related fungi, the meiotic tetrads are contained in a tubular sac, or ascus, in a linear order, which makes it possible to determine whether a pair of alleles segregated in the first or the second meiotic division. With such asci, it is possible to use the centromere as a genetic marker; in fact, the centromere serves as a reference point to which all genes in the same chromosome can be mapped. The functional definition of a gene is therefore not based on mutation or on recombination but on complementation (by means of the complementation test). If two recessive mutations, a and b, are present in a cell or organism in the trans configuration and the phenotype is wildtype (complementation), the mutations are in different genes. If the phenotype is mutant (noncomplementation), the mutations are in the same gene. At the molecular level, lack of complementation implies that allelic mutations impair the function of the same protein molecule. The absence of crossing-over in males of Drosophila is a great convenience for detecting linkage. Make a diagram of the matings, indicating all genotypes and phenotypes and the numbers observed in each generation of progeny. The keyword Saccharomyces will connect you with the genome database of the yeast Saccharomyces cerevisiae. Select Maps for graphical views of yeast chromosomes and Genetic Map to access the linkage map of each chromosome individually. If assigned to do so, use the site to find the relation between map length (in centimorgans) and physical length (in base pairs) of each of the yeast chromososomes. Detecting genetic linkage in human pedigrees requires special methods because human sibships are typically quite small. What does it mean to say that two genes have a recombination frequency of 12 percent? Explain why the factor of one-half occurs when we compare recombination frequency to chiasma frequency. Draw a diagram of each kind of double crossover in a bivalent in a region between two genes, each heterozygous. In a region of high interference, would you observe more or fewer double crossovers? Guide to Problem Solving Problem 1: In Drosophila, the genes cn (cinnabar eyes) and bw (brown eyes) are located in the same chromosome but so far apart that they appear unlinked. Compare the possible offspring produced by the cross and the cross the + symbols denote the wildtype alleles. Flies with the genotype cn cn have cinnabar Page 165 (text box continued from previous page) genetic marker in a pedigree in which a trait, for example, a genetic disease, is present, the likelihood of linkage is assessed by a "lod score. Use the keyword to learn more about this approach and examine the sample lod score calculation for a simple pedigree. If assigned to do so, write a 250-word summary of the method and the logic on which it is based. Select the Mutable Site for Chapter 4, and you will be linked to the current exercise that relates to the material presented in the chapter. Answer: the key to this problem is to remember that crossing-over does not take place in Drosophila males. When the male is cn bw/++, his gametes are 1/2 cn bw and 1/2 + +, so the progeny are cn bw/cn bw (white eyes) and + +/cn bw (wildtype eyes) in equal proportions. Crossing-over does happen in female Drosophila, but cn and bw are so far apart that they undergo independent assortment. When the female is cn bw/+ +, her gametes are 1/4 cn bw, 1/4 cn +, 1/4 + bw, and 1/4 + +, so the progeny are cn bw/cn bw (white eyes), cn +/cn bw (bright red), + bw/cn bw (brown), and + +/cn bw (wildtype) in equal proportions. Problem 2: One of the earliest reported cases of linkage was in peas in the year 1905 between the gene for purple versus red flowers and the gene for elongate versus round pollen. Plants of genotype B have purple flowers, and plants of the genotype bb have red flowers. Plants of genotype E have elongate pollen, and those of genotype ee have round pollen. Determine what genotypes and phenotypes among the progeny would be expected from crosses of F1 hybrids × red, round when the F1 hybrids are obtained as follows (a) purple, elongate × red, round purple, elongate F1 (b) purple, round × red, elongate purple, elongate F1 Answer: the red, round parents have genotype b e/b. Although both F1 hybrids have the dominant purple, elongate phenotype, they are different kinds of double heterozygotes. To calculate the types of progeny expected, use the fact that 1 map unit corresponds to 1 percent recombination: Because the genes are 12 map units apart, 12 percent of the gametes will be recombinant (6 percent of each of the reciprocal classes) and 88 percent will be nonrecombinant (44 percent of each of the reciprocal classes). Problem 3: In Drosophila, the genes ct (cut wing margin), y (yellow body), and v (vermilion eye color) are X linked. Females heterozygous for all three markers were mated with wildtype males, and the following male progeny were obtained. As is conventional in Drosophila genetics, the wildtype allele of each gene is designated by a + sign in the appropriate column. The way to solve it is to start by deducing the genotype of the triply heterozygous parent. This is done by noting that the most common classes of offspring are the nonrecombinants, in this case ct+ + and +y v. This is done by noting that the least common classes of offspring are the double recombinants, in this case ct y v and + + +. Moreover, each class of double recombinants will be identical with one of the nonrecombinants except for the marker that is in the middle. In this case, comparing ct y v with + y v and + + + with ct + + shows that ct is in the middle. In fact, the double recombinants are recombinant in both regions and so must be counted twice—once in calculating the recombination frequency in region 1 and again in calculating the recombination frequency in region 2. To calculate the interference, note that the expected number of double recombinants is 0. Students can prepare a class graph refecting their conclusions about the efects of environmental variables on the rate of transpiration in plants erectile dysfunction doctors in maine order 120mg silvitra overnight delivery. Based on the students’ product erectile dysfunction drugs covered by insurance discount silvitra 120mg otc, do you think students have met the learning objectives of the investigation? Have the students prepare a lesson on transpiration for younger students at the school best erectile dysfunction pills for diabetes discount 120mg silvitra amex, following the adage that “you can’t really learn something until you have to teach it erectile dysfunction at age 35 buy silvitra 120 mg. Did the students have an adequate understanding of the physical and chemical properties of water before investigating transpiration? Were the students able to determine leaf surface by using appropriate mathematical skills? If you used the suggested gas pressure sensor protocol, were the students able to navigate through the computer interface to the lab investigation without much difculty? If the students had difculty, ask them to teach other students how to use the equipment. Many factors influence a person’s chance of developing a mental and/or substance use disorder. Effective prevention focuses on reducing those risk factors, and strengthening protective factors, that are most closely related to the problem being addressed. Risk factors are characteristics at the biological, psychological, family, community, or cultural level that precede and are associated with a higher likelihood of negative outcomes. Protective factors are characteristics associated with a lower likelihood of negative outcomes or that reduce a risk factor’s impact. Other risk and protective factors are considered variable and can change over time. Individual-level risk factors may include a person’s genetic predisposition to addiction or exposure to alcohol prenatally. Individual-level protective factors might include positive self-image, self-control, or social competence. Key Features of Risk and Protective Factors Prevention professionals should consider these key features of risk and protective factors when designing and evaluating prevention interventions. Risk and Protective Factors Exist in Multiple Contexts All people have biological and psychological characteristics that make them vulnerable to , or resilient in the face of, potential behavioral health issues. Because people have relationships within their communities and larger society, each person’s biological and psychological characteristics exist in multiple contexts. Targeting only one context when addressing a person’s risk or protective factors is unlikely to be successful, because people don’t exist in isolation. In relationships, risk factors include parents who use drugs and alcohol or who suffer from mental illness, child abuse and maltreatment, and inadequate supervision. Here, protective factors could include the availability of faith-based resources and after-school activities. Protective factors in this context would include hate crime laws or policies limiting the availability of alcohol. Risk and Protective Factors Are Correlated and Cumulative Risk factors tend to be positively correlated with one another and negatively correlated to protective factors. In other words, people with some risk factors have a greater chance of experiencing even more risk factors, and they are less likely to have protective factors. Risk and protective factors also tend to have a cumulative effect on the development—or reduced development—of behavioral health issues. Young people with multiple risk factors have a greater likelihood of developing a condition that impacts their physical or mental health; young people with multiple protective factors are at a reduced risk. Interventions that target multiple, not single, factors Individual Factors Can Be Associated With Multiple Outcomes Though preventive interventions are often designed to produce a single outcome, both risk and protective factors can be associated with multiple outcomes. For example, negative life events are associated with substance use as well as anxiety, depression, and other behavioral health issues. Prevention efforts targeting a set of risk or protective factors have the potential to produce positive effects in multiple areas. Risk and Protective Factors Are Influential Over Time Risk and protective factors can have influence throughout a person’s entire lifespan. For example, risk factors such as poverty and family dysfunction can contribute to the development of mental and/or substance use disorders later in life. Risk and protective factors within one particular context—such as the family—may also influence or be influenced by factors in another context. Effective parenting has been shown to mediate the effects of multiple risk factors, including poverty, divorce, parental bereavement, and parental mental illness. The more we understand how risk and protective factors interact, the better prepared we will be to develop appropriate interventions. Universal, Selective, and Indicated Prevention Interventions Not all people or populations are at the same risk of developing behavioral health problems. Prevention interventions are most effective when they are matched to their target population’s level of risk. Universal preventive interventions take the broadest approach and are designed to reach entire groups or populations. Universal prevention interventions might target schools, whole communities, or workplaces. Examples include prevention education for immigrant families with young children or peer support groups for adults with a family history of substance use disorders. These types of interventions include referral to support services for young adults who violate drug policies or screening and consultation for families of older adults admitted to hospitals with potential alcohol-related injuries. The following are prohibited by law: •any public performance or display, including transmission of any image over a network; •preparation of any derivative work, including extraction, in whole or in part, of any images; •any rental, lease, or lending of the program. Copyright 2001 by Allyn & Bacon Sleep n Sleep is a behavior and an altered state of consciousness l Sleep is associated with an urge to lie down for several hours in a quiet environment u Few movement occur during sleep (eye movements) l the nature of consciousness is changed during sleep u We experience some dreaming during sleep u We may recall very little of the mental activity that occurred during sleep n We spend about a third of our lives in sleep l A basic issue is to understand the function of sleep 9. These treatments are called biologics because, unlike chemical medications, they are made out of materials found in life. Biologics are antibodies created in the laboratory that stop certain proteins in the body from causing inflammation. For example, unlike corticosteroids, which affect the whole body and may produce major side effects, biologic agents act more selectively. While it is not possible to determine which biologic will work best for an individual patient, your physician will present you with various effective options and work with you until you reach remission. Adalimumab is given as a subcutaneous injection under the skin of the abdomen or thigh. Once instructed by a healthcare professional, the patient or family member can administer it at home. Typically, when starting adalimumab, patients will perform four injections for their first dose (four pens, 160mg), and then two weeks later they will perform two injections (two pens, 80mg). It is a prescription medicine shown to induce and maintain clinical remission in patients with moderate to severe Crohn’s disease in (adults and children) and ulcerative colitis (in adults). Adalimumab-atto is given as a subcutaneous injection under the skin of the abdomen or thigh. Typically, when starting adalimumab-atto patients will perform four injections for their first dose (four pens, 160mg), then two weeks later they will perform two injections (two pens, 80mg). It has been approved for the treatment of adult patients with moderately to severely active Crohn’s disease or ulcerative colitis who have had an inadequate response to conventional therapy. Adalimumab-adbm is given as a subcutaneous injection under the skin of the abdomen or thigh. Typically, when starting adalimumab-adbm, patients will perform four injections for their first dose (four pens, 160mg), then two weeks later they will perform two injections (two pens, 80mg). Patients treated with certolizumab pegol usually receive an injection every two weeks for the first three injections. Depending on the physician’s orders, it is injected under the skin by either a health care professional (typically a nurse) or the patient. Once instructed by a health care professional, the patient or family member can administer it at home. It has been approved for the treatment and maintenance of remission of moderate to severe Crohn’s disease (in adults and children) and ulcerative colitis (in adults). Order silvitra discount. 3 Home Remedies for Erectile Dysfunction - Cure ED without drugs.
Throughout erectile dysfunction causes ppt purchase genuine silvitra on line, a particular recommendation will imply an esti mation of average benefit/risk erectile dysfunction caused by herniated disc purchase 120 mg silvitra fast delivery. In fact erectile dysfunction zurich cheap silvitra 120 mg overnight delivery, the estimation of potential benefits and harms is not a widely understood science erectile dysfunction pill identifier cheap 120 mg silvitra overnight delivery. This approach explicitly downgrades non-experimental titative models (Mt-Isa et al. For example, based on research evidence, the decisions of regulators to approve weight may be given to positive findings from small, inconclu particular medicines and clinical experience. Like others (Kessing, 2015), we have been impressed by new observa Methodology tional data linking treatment exposures with clinical outcome. A narrative literature review was assembled to illus Grade of Underlying methodology Symbol recommendation trate the consensus points. Finally, in Part 1, we identified a list of quality standards for uk/guidance/cg185). Additional publications were identified audit based on our most important recommendations. Nomenclature Strengths of evidence and In this manuscript, we will avoid, where possible, the use of recommendations for guidelines generic terms for drugs based on indication and instead prefer Strengths of recommendation to use descriptions of mode of action. The Neuroscience-based Nomenclature (NbN) is a new system to promote the descrip Grading of recommendations is shown in Table 2. It aims allows for judgement to be made that downgrades some evidence to provide an app-based update of relevant and specific scien. Where evidence is sparse, it has been necessary ture, which highlights pharmacological targets and modes of to extrapolate from relevant evidence where it is available. It is a work in progress, and the voluntary sup pression of the familiar terms antipsychotic, antidepressant and anticonvulsant can only be partial. When we use the term anti Scope and target of the guidelines depressant, for example, it should be understood that we are the content of the guidelines is relevant for all doctors treating referring to drugs used in the treatment of unipolar depression. We hope that in most cases these the problem is, of course, that not all the drugs used for unipo will be doctors who are specialists in psychiatry. However, we lar depression are currently described as antidepressants, and have also written the guidelines to help inform general practi antidepressants are not active specifically in depression. Thus, tioners, patients and their families, and other health care pro antipsychotics are effective in psychosis, mania and, in some fessionals involved in the management of patients with bipolar cases, depression, and anticonvulsants are effective in epilepsy disorder. NbN will give us a larger vocab Clinical psychologists and other colleagues providing psy ulary and a better grasp of what our medicines actually do if we chotherapy to patients with bipolar disorder are a particularly make the necessary effort. However, we We are committed to the principle of basing recommendations on could not review all the relevant literature in the detail required to the best possible evidence and, for treatment efficacy, this will give a fully comprehensive text. However, there are important summarizing points of consensus, relating mainly to medical limitations to such evidence. We highlight these limitations here, management of bipolar disorder, does not result in a format that so what follows is informed by this perspective. Part 1 abstracts the key recommendations (and some of the key points of evidence) and can inform every Drug treatment trials day practice. Part 2 indicates consensus points that emerged and briefly summarizes the evidence. The structure and content are Drug trials are usually conducted by companies seeking to reg broadly but not precisely aligned between Parts 1 and 2. Such trials are now usually of 498 Journal of Psychopharmacology 30(6) good quality: matched placebo medication, randomized and (Yatham et al. In addition, many acute treatment studies concealed allocation, blinded treatment and pre-specified analy in psychiatry are only 6–8 weeks in duration, and the artificial sis plans. Nevertheless, it is often stated that sponsor (allegiance) nature of clinical trial procedures and the difficulties of recruit bias influences the outcome of clinical trials of new medicines ment mean drop-out rates are high. One important explanation power to detect effects, so trial methodology is probably as likely for this global conclusion is that company-sponsored studies to under-estimate drug effect as to magnify it. The right to drop out of studies is actually empha for dopamine antagonists and serotonin re-uptake inhibitors sized in the information given to participants in trials! However, there were no differences in effect size between industry high attrition rates have negative consequences for the power to supported and non-industry-supported trials when the designs detect effects and obviously defeat the purpose of longer-term were similar (Lundh et al. Finally, outcomes in acute treatment studies are often rating Unblinding could lead to inflation of effect sizes by biasing scale scores, which are arbitrary counts of symptoms and their assessment. These are measures rarely used by clinicians because studies for patients and raters, but are often omitted or not they are tedious to obtain by interview. This potential problem should be kept in mind when measures suspended between biomarkers, which can prove a examining the coherence of network meta-analyses which drug has had the predicted pharmacological effect, and real include placebo as the main comparator. The reporting of adverse reactions in clinical trials is also less Real outcomes are too distal to provide sensitivity in a short systematic than it could be, and has often relied on ambiguous clinical trial. The For all these reasons, caution is required in extrapolating the controversy arising from how self-harm or suicidality should be results of such trials to practice, whether or not presented as a identified as an adverse reaction has been particularly problem meta-analysis. This means that Independent trials have often been less well resourced and the balance between benefits and harms can be difficult to assess smaller scale, but may lack the stigma attaching to industry spon from trial data. The results of such trials have the potential to be very ence themselves or that may be detectable by observation we will misleading due to the whole range of potential biases. However, refer to “adverse reactions”; “adverse effects” are unwanted, where quality is maintained and sample size is reasonable, they measured consequences of drug treatment (Aronson, 2013). There is no may also recruit patients in a less distorted way than commercial doubt that the way industry-supported data was published has been clinical research organizations and so generalize more convinc a major problem in past decades. Positive studies of this kind have been particularly impor over-stating product advantages and cherry picking for publication tant in shaping some of our recommendations. This is One final consideration is that when small trials are negative, now partially corrected by trial registration and disclosure of ‘neg caution is required in claiming that the trial proves lack of effi ative’ studies by companies. Effect sizes in psychiatry, in common with As a rule, companies must convince regulators that new drugs are the rest of medicine, are moderate (Leucht et al. There are few examples of such trials in psychia most ill patients with multiple co-morbidities we actually see in try. The exclusion of patients with co-morbid substance ies using quasi-experimental designs. In such studies patients can misuse in trials of mania and of patients with suicidality in bipo act as their own controls before, during and after treatment, lar depression has the highest impact (Hoertel et al. This patient numbers can be very large and observation periods can be is compounded by heterogeneous rates of recruitment and associ long. Furthermore, the measured outcomes can be objective and ated with heterogeneous results across sites in multi-centre trials. Such studies are crucial in supporting our recom drown out efficacy signals at others with lower placebo responses mendations for the long-term use of drugs in bipolar disorder. The choice of a efficacy for drugs shown to be effective in short-term studies of fair comparison treatment is much more challenging than for acute illness. It is often simply ducked by using a poorly specified they take patients who have recovered while taking a particular ‘treatment as usual’ condition. While this may be defensible in active treatment and randomize to continue that treatment or be a pragmatic study of effectiveness, it creates problems of inter switched to placebo. If patients on placebo relapse to the same pretation for a proof-of-concept or efficacy study. If, as is com pole as the index episode, this is taken as further evidence that the monly the case, the active treatment is superior to treatment as drug worked acutely. The alterna If these studies are extended over 1 or even 2 years, there tive ‘waiting list’ control group is also problematic because any must be a point at which we can infer further that the drug–pla superiority for an active treatment may be due to (or amplified cebo difference represents prevention of new episodes. Hence, many posi there is no clear discontinuity in the boundary between prevent tive trials of particular therapies are pseudo-specific, in the ing relapse of the original episode and the prevention of new epi sense that we do not know what elements of the psychotherapy sodes, perhaps they are essentially different sides of the same are actually effective. However, it is recognized that ment also appears to be unsystematic and hence under-appreci much of the difference between active treatment arms and pla ated (Nutt and Sharpe, 2008). Retention of patients in a 1–2-year study may be as low as best practice based on meticulous trial design and execution 10%. Hence, interpretation of such studies, except in relation to and sequential refinement of the psychotherapy content.
Taken together erectile dysfunction treatment delhi purchase silvitra 120mg with amex, these cover the entire spectrum of contemporary confict operations and must be carefully studied to develop the appropriate strategy for the employment of air power—as well as all military forces—and the planning and execution of the air campaign erectile dysfunction treatment in egypt order silvitra 120 mg on line. Sun Tzu’s stanza could perhaps be interpreted in slightly diferent ways impotence when trying to conceive generic 120mg silvitra mastercard, but it is felt that the essence of the maxims has been explained correctly and interpolated metaphorically into the application of contemporary air power within the broader military capability development and employment erectile dysfunction nitric oxide cheapest silvitra. Air power capabilities are technologically sophisticated and have a very broad spread Air forces must be able to adapt their resident capabilities to suit the context of air power application Air power can control the tempo of a campaign by employing its high-end capabilities 246 Strategy for Confrontation the Force prefers high grounds to low; Values brightness and disparages darkness. When security is cultivated and solid ground occupied, the Force will thrive and triumph is certain. So on mound, hill or embankment, Occupy the light, with high ground to right and behind. When rains upstream have flooded the waterway, the Force wishing to cross waits for it to subside. When faced with isolating gorges Or natural hollows, cages, snares, traps and crevices: Quit with all speed and do not approach. The force should stay in high places and avoid the low, likewise it should stay in the light and avoid the dark. Take care of physical health, ensure the security of the encampment and stay close to natural resources—the force will be healthy and victory will be certain. All advantages that the ground afords must be carefully grasped—keep to the sunny side of foothills and embankments, if the river is in spate, wait for it to settle before crossing and keep away from hazardous obstacles like precipitous clifs and torrents. When own forces are distanced from these, the opponent will be near them; and when own forces face them, the opponent will be backed by them. This stanza covers two main points regarding positioning the force in order to triumph— gaining advantage from the operating area and dealing with extremely hazardous obstacles. In the original Chinese version Sun Tzu introduces the concept of yin and yang (roughly translated to male and female principles) in this passage. The frst part of the stanza deals with positioning the force to optimise the advantage that can be derived from the operating area through ensuring high visibility and providing adequate opportunities for forward movement. Sun Tzu advises to keep one’s own plans as secret and closely guarded as possible at all times. However, here a slight nuance has been added, in that he advocates openness and visibility to ensure freedom of manoeuvre while not revealing one’s plans so that the force is positioned to ensure victory. Hence his true aim is not so much to seek battle as to seek a strategic situation so advantageous that if it does not of itself produce the decision, its continuation by battle is sure to achieve this. Liddell Hart Metaphorically, ‘brightness’ or high visibility means adequate and contextual situational awareness as opposed to ‘darkness’ or ignorance of adversary manoeuvre that leads to uncertainty. By modern management practices, high visibility of probable obstacles is also one of the methods that can be used to solve it. Essentially, the advice is to position the force in such a way as to ensure that its vitality is nourished by being on ‘solid’ ground. The second aspect of positioning, with high ground behind the force, provides the opportunity to use the strategic advantages of being on high ground. High ground is also about the commander ensuring that the rank and fle of the force clearly understand the strategic aim of the campaign and thereby establishing the moral ground for the use of force. Once the soldiers understand what they are fghting for, they will not be susceptible to cynicism and the thirst for victory will be sharpened. Sun Tzu also alludes to high ground making it difcult for the adversary to initiate any severe action against one’s own forces. In combination, the metaphorical sense derived by these two factors— situational awareness and strong moral ground—about positioning the force is a very powerful one. It denotes a healthy and cohesive force with the moral authority to pursue its strategic goals by the application of force—lethal, nonlethal, kinetic or non-kinetic. The second part of the stanza deals with obstacles, frst water and then dangerous terrain. However, even at the metaphorical level, most of the axioms are common to the military forces as such with few very delicate nuances becoming apparent when they are applied to air power employment. Explanations of these nuances might, at a cursory analysis, seem to be laboured but they have to be indicated and explained for a holistic understanding of the application of air power and its impact on the conduct of the air campaign in a contemporary context. Rains can create a food in the river, which means that while rain by itself cannot be avoided, their after-efects can be managed if adequate and timely action is initiated. In combination, the essence is that change, by itself, is unavoidable in confict situations, but the impact of change can be managed by a fexible force without it having created any lasting impact. The commander needs to analyse and decide the time and place to initiate action and, therefore, patience becomes an absolutely essential virtue in these circumstances. Hence, Sun Tzu’s clear instruction to wait for the water to subside before attempting to cross—wait to discern and understand the dynamism of the battlespace before initiating action. When a rash movement leads to exposure of the shape of the army, it will fall victim to the enemy. Indeed, the army should not move without careful thought, much less take reckless action. Sun Haichen (Tr), 1991 the Wiles of War: 36 Military Strategies from Ancient China The second part of the stanza regarding overcoming obstacles also has a sub-element to it, where Sun Tzu points out that, while avoiding the obstacles, a clever commander will also try to direct—induce—the adversary to be trapped within the same obstacles. While manoeuvring the force it is possible to be led into a cul-de-sac situation wherein there are very limited options available to the commander to extricate the force from a weak position. While this is the physical aspect of manoeuvring a force, metaphorically this alludes to the need to retain as many options as possible at the strategic level of planning so that the fexibility of the force can be employed to the fullest. This will also facilitate denying the adversary cognitive fexibility to initiate any independent counter manoeuvres. The planning process must analyse strategic goals taking into account the possible risks involved in achieving them, which will permit the force to retain the necessary adaptability. The underlying assumption here is that every position that the force takes up is only the beginning of future manoeuvres. The crux of the matter is the art of military leadership and the perspicacity of the commander to have a broad vision of national goals and grand strategy so that superior operational skills can exercised appropriately in manoeuvring the forces optimally. The stanza is equally applicable to all military forces, in terms of the commander’s leadership capabilities. However, air power has the capacity to infict colossal damage 249 The Art of Air Power to life and property by the application of lethal force, through the employment of small elements of the force, even without sighting the adversary. Such application needs very clear thinking regarding the moral correctness of the actions being contemplated. This is not to suggest that the application of lethal force by either of the other forces does not need moral authority, but only indicates that, when air power is used to create catastrophic damage to the adversary, the moral and ethical dilemma in decision making could become extremely vexing for the commander. Air power transcends the physical realm of Sun Tzu’s treatise and has the ability to operate over long distances, create very high strategic damage and function at unparalleled tempo. However, this also creates a new environment of rapid change and enhanced awareness that may generate moral dilemmas, which in turn could degenerate into pitfalls—traps—in the conduct of a campaign. Decisions regarding the employment of air power at the strategic level, therefore, would have to be made at an unusually high level of the nation’s leadership, even while the military forces are prosecuting a successful campaign facilitated by a well developed air power strategy. Our evidence goes to show that it is not the way force is applied but its efectiveness that is feared and to that extent resented. Once force is actually applied, the tribesman probably dislike[s] land and air operations equally, except that in the latter his prized inaccessibility is taken from him and his opportunities for hitting back are far more limited. Rufus Isaacs, Lord Reading, 1925 While overcoming physical obstacles is not an issue for air power, the question of planning to ensure adequate fexibility to meet the demands to understand the emerging situation and manoeuvre for advantage needs to be considered. A joint approach to the overall campaign planning will be the best way to produce a viable strategic plan for the employment of military forces. In such an approach, the air campaign plan will be an integral part of the larger task force plan which will provide air commanders a sufciently adaptable strategic plan to employ their assets in the best possible manner to achieve the joint objective. The air campaign plan must have built-in adaptability to cater for possible changes that may become necessary to keep the broader military strategic plan aligned with the national grand strategy. The proper execution of the strategic plan will ensure centralised control and decentralised execution of the air campaign while retaining adequate fexibility within the force. Flexibility at the strategic and operational level of command and warfare is critical to the success of air power employment. When the force is near terrain that is impenetrable, the area must be carefully examined because the probability of an ambush or concealment of adversary forces is high in such places. The enemy should be studied by judging their reaction to encounters, by their irregular actions, by the disruption their activities cause and by their attempts at interaction. Reaction to encounters can be threefold—when the enemy is close but remains quiet, they are confdent in the natural strength of their position; when they are distant but challenging to battle, they are luring one to advance and when they are on easy ground they think they are in an advantageous position. In previous stanzas Sun Tzu has listed the factors that make a force believe that they are secure. |
