For infantry units of the Dutch Ministry of Defence, high attrition rates (varying from 42 to 68%) during initial training are a persisting problem. The reasons for this attrition are diverse. Having better insight into the causes of attrition is a prerequisite for implementing preventive measures. To achieve this, a monitoring assessment system was developed that integrated the effects of physical, mental, and organizational determinants on operational readiness. The aim of this study was to implement the monitoring tools and to establish the set of determinants that best predicted attrition during infantry training of new recruits. Eighty-five recruits were monitored over a 24-week infantry training course. Before the training, recruits were screened for medical, psychological, and physical wellness. During the monitoring phase, mental, physiological, and organizational indicants were obtained using an array of tools such as questionnaires, chest belt monitors (for heart rate, acceleration, and skin temperature measurements), and computerized tests (e.g., vigilance, long-term memory). Survival analyses were used to tease out the determinants of individual and grouped predictors of attrition. Nearly half the recruits (47%) failed the training. Attrition was predicted by both physiological and mental determinants. However, the organizational determinant "trainers' judgment" on the "recruits' military quality" dominated the physiological and mental determinants. It was concluded that the monitoring system was successfully implemented during infantry training, and that the survival analysis method emphasized on single effects and interactions between the different determinants. Based on the current findings, we recommend several steps to successfully implement a monitoring method in settings with high demands.

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Bilastine 20 mg did not cause sleepiness or impaired performance on tasks related to flying. It is anticipated that a single dose of bilastine 20 mg will not affect flying performance. Bilastine may provide a safe therapeutic alternative for pilots suffering from allergic rhinitis or urticaria. Our findings might also have implications for the treatment of allergic disorders of personnel involved in other safety-sensitive jobs. Valk PJL, Simons R, Jetten AM, Valiente R, Labeaga L. Cognitive performance effects of bilastine 20 mg during 6 hours at 8000 ft cabin altitude. Aerosp Med Hum Perform. 2016; 87(7):622-627.

In-flight performance and alertness of aircrew will not be affected by the prophylactic use of A/P during a period of 14 days.

Pilots with allergic diseases, who need antihistaminic drug therapy, have to be grounded temporarily because this therapy is considered to interfere with flight safety due to its sedative effects. There is evidence that loratadine is practically void of these sedative effects, and therefore might be prescribed to pilots. A study was conducted to determine the effects of loratadine on performance and alertness. In a randomized, double-blind, within subjects design, 18 male subjects were studied, employing loratadine 10 mg, triprolidine hydrochloride 5 mg, and placebo. Objective (vigilance, complex tasks) and subjective tests, tailored to the specific tasks of aircrew, were applied under hypobaric conditions that prevail in an intact cockpit. With respect to alertness and performance, the results of this study showed no significant differences between loratadine and placebo during a period of 1 to 6 hours after drug ingestion. Triprolidine, used as a positive control, showed significant detrimental effects on both subjective and objective measures. It is anticipated that a single dose of loratadine 10 mg will not affect flying performance. This finding might also have implications for the treatment of allergic disorders of personnel involved in other highly skilled jobs.