Winning wars in the future will not be about who has the best technology or the latest weapons.The difference between success and failure will be the "human dimension."That was the message from the Institute of Land Warfare panel at the Association of the United States Army Annual Meeting in Washington.The panel was chaired by Lt. Gen. Robert Brown, commanding general of the U.S. Army Combined Arms Center.The human dimension concept developed by the Army provides a framework to help leaders focus on human development.It includes the mental, physical, and social components of soldiers and leaders and focuses on organizational development and performance to ensure success on the battlefield."Fewer people can have a larger impact [in battle] than ever before," said Brown.Equipment can be adapted to changing situations, he said, but not as quickly as the soldier.As a result, how soldiers are educated, trained, organized, and developed as leaders are all critical to the future of the Army.Future challenges require the Army to invest significantly in the human dimension to maximize individual and team performance, creating soldiers who can adapt, think clearly in chaotic situations, and keep themselves healthy, fit, and resilient.The panel included Lt. Gen. Patricia Horoho, the Army surgeon general, who reported that Army Medicine is a significant part of the culture change needed to strengthen the human dimension.She emphasized the need for brain health, optimizing physical capabilities, and the Performance Triad.Horoho said, "We have to focus on the healthy brain" as part of the overall health of the soldier."It is unknown how powerful our Army can be if we start off with a healthy brain," she said.Army Medicine has studies, she said, that are focusing on mindfulness to help recover from PTSD and the day-to-day stressors faced by soldiers.Mindfulness also has the potential to help soldiers unwind from the hyper-vigilant state they are often in after they return from deployment.She discussed tailoring nutrition for soldiers in environmental extremes, such as high altitude.Weight loss and fatigue can often be an issue for those individuals."What fuels the body also fuels the brain," she said. We have to enable the soldier to "be agile and flexible in split second decision making."Army Medicine is helping to evaluate physical fatigue and how combating fatigue might require changes in the design of boots and body armor.In order for soldiers to operate at the highest mental and physical level, reducing fatigue is critical, Horoho said.The Performance Triad – sleep, activity, nutrition – is the "culture change" that can enhance mission performance.The use of sleep as a tool to enhance performance in particular requires a change in thinking.Part of the Army culture is the mindset that, even though you give up sleep, you can still operate effectively, Horoho said.Less than six hours sleep for six days in a row, she said, leads to a cognitive impairment of 20 percent. That’s about the same as a blood alcohol level of 0.08 percent."We would never allow a soldier in formation with a 0.08 blood alcohol level," Horoho told the audience.But we allow the equivalent every day when the Army has sleep-deprived soldiers, she said.She also pointed out that the brain recovers and restores function while the soldier sleeps.Sleep optimizes soldier performance and can even reduce the potential for injuries, she said.The second component of the Performance Triad – activity – is just as important.New research suggests that exercise contributes to the development of new brain cells in the hippocampus, the area of the brain where new memories are formed, which is critical for learning new tasks.The Army continually learns and adapts. Anything that enhances cognitive ability is an advantage, she said.Finally, nutrition is critical as part of the Performance Triad.Nutrition is medicine and it fuels the brain, she said. "We have to put the right nutritional ingredients into our soldiers." The right nutrition will optimize performance.In the spring, Horoho said, Army Medicine will have available a predictive tool that correlates missing a primary care appointment while in garrison with a significant higher possibility that the soldier will be non-deployable.Other panelists included Brad Carson, under secretary of the Army; Maj. Gen. Eric Wendt, commander of the John F. Kennedy Special Warfare Center and School; Michelle Sams, director of the Army Research Institute for the Behavioral and Social Sciences; and Ori Brafman, co-author of "The Starfish and the Spider."