Search NASA⌕ Search

SEARCH · Search NASA

Results for “care”

Search indexed NASA NTRS and DOE OSTI research on propulsion, heat transfer, battery materials and energy systems. Follow report and document links to the original sources.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16

The use of teledentistry in facilitating oral health for older adults: A scoping review

Teledentistry is used in many countries to provide oral health care services. However, using teledentistry to provide oral health care services for older adults is not well documented. This knowledge gap needs to be addressed, especially when accessing a dental clinic is not possible and teledentistry might be the only way for many older adults to receive oral health care services. Nine databases were searched and 3,396 studies were screened using established eligibility criteria. Included studies were original research or review articles in which the intervention of interest was delivered to an older adult population (≥ 60 years) via teledentistry. The authors followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Review criteria. Nineteen studies were identified that met the criteria for inclusion. Only 1 study was from the United States. Seven studies had results focusing on older adult participants only, with most of those conducted in elder care facilities. The remainder consisted of studies with mixed-age populations reporting distinct results or information for older adults. The included studies used teledentistry, in both synchronous and asynchronous modes, to provide services such as diagnosis, oral hygiene promotion, assessment and referral of oral emergencies, and postintervention follow-up. Teledentistry comprises a variety of promising apps. Lastly, the authors identified and described uses, promising possibilities, and limitations of teledentistry to improve the oral health of older adults.

60 APPLIED LIFE SCIENCES↗

Efficient Nighttime Biogenic SOA Formation in a Polluted Residual Layer

Abstract Organic nitrates formed from nighttime reaction between anthropogenic nitrate radicals (NO3) and biogenic volatile organic compounds (BVOCs) are potentially an important but highly uncertain source of secondary organic aerosol (SOA). Here we report on the enhanced nighttime biogenic SOA formation observed in a polluted residual layer over Sacramento, California, the morning of 15 June 2010 during the Carbonaceous Aerosols and Radiative Effects Study (CARES). Trajectory analysis showed that the residual layer air, containing trace amounts of isoprene and monoterpenes left over after nighttime oxidation, was influenced by the San Francisco Bay Area emissions the previous evening. The residual layer aerosol was also enriched in nitrate, with about 64% of it estimated to be in the form of organic nitrates. The nitrate:organic mass ratio of the SOA was about 0.47±0.044, which corresponds to the range typically found in isoprene mononitrates. Assuming the SOA was composed of organic mononitrates, its nominal molecular weight was estimated at 186±11 g mol-1, consistent with the highly functionalized isoprene hydroxynitrates that have been observed in the particle phase in the southeast United States. Overall, our findings show that the efficiency of nighttime biogenic SOA formation, expressed as the change in organic aerosol mass relative to carbon monoxide (?OA/?CO), was about 100 µg m-3 ppmv, which falls in the range 77-157 µg m-3 ppmv previously estimated for enhanced daytime SOA formation from mixed anthropogenic and biogenic emissions during CARES.

Zaveri, Rahul A.↗

Examining Perceptions of Spanish Language Health Information Among Hispanics Living in the United States: A Qualitative Study Assessing Videos, Brochures, and Websites

Background Nationally, Hispanics experience health disparities manifested as a higher prevalence of chronic diseases in comparison to non-Hispanic Whites. Factors that influence health disparities in this population include inadequate dissemination of culturally and linguistically appropriate health information. Method Our qualitative analysis is based on data obtained from three focus groups with Spanish-speaking Hispanic adults conducted at a clinic in Nebraska. Participants were asked about their perceptions of health information in the form of videos, brochures, and websites. We followed the consolidated criteria for reporting qualitative research and used the theoretical framework of content analysis. Results For videos, attributes associated with higher levels of trust included a friendly health professional, the logo or name of a health care institute, and a reference specifying “se habla Español.” For brochures, attributes associated with trust included use of visual aids, use of numerous colors and big font sizes, the year of printing, and a health care agency logo. For websites, characteristics associated with trust were inclusion of plain language, use of pictures and videos, and date of last update. In all focus groups, participants perceived the use of mixed English/Spanish language in health information from pamphlets and websites as unprofessional. The use of unknown governmental logos in health promotional videos and websites was perceived as untrustworthy information. Conclusions Spanish-speaking Hispanics prefer health information supported by a health care agency or delivered by a health care professional. Health communication strategies should avoid the use of mixed English/Spanish language in sensitive information especially when combined with governmental logos.

De Alba Rosales, Armando↗

Hydropower Geotechnical Foundations: Current Practice and Innovation Opportunities for Low-Head Applications

Hydropower is a renewable energy resource that produces electricity from flowing water under pressure. Engineered hydropower structures, such as dams, are used to create a hydraulic head, enabling a turbinegenerator unit to convert pressurized flow into electricity. While hydropower has been a source of renewable energy since antiquity, new development in the United States has slowed in recent decades. Based on recent resource assessments, the largest opportunity to expand hydropower in the United States is from new stream-reach development (i.e., new hydropower development along stream-reaches that do not currently have hydroelectric facilities or other forms of infrastructure, such as dams). Roughly 75% of identified new stream-reach development potential is from low-head sites (less than 30 ft of head), which typically suffer from smaller power densities and higher normalized costs, given economies of scale. Hydropower developers and other stakeholders are thus interested in strategies to reduce initial capital costs while practicing sustainable development to maximize environmental compatibility with minimal disruption to natural aquatic life, sediment, and water flows. Historically, civil works have represented a significant cost driver for new hydropower development, with the foundation system representing a major cost component and source of uncertainty. The foundation system is the collection of engineered structural features (e.g. cutoff trenches, walls, grouting, anchors) constructed at or below the preconstruction ground surface that interfaces between the overlying structures (superstructures) and the bed material below (subsurface). Development of a hydropower foundation system must consider the various characteristics of the surrounding stream environment and subsurface while adhering to the engineering requirements of the superstructure that it supports. The care of water, excavation, and other construction activities are important features of foundation design and construction. The design and construction cost of the foundation system is largely dependent on the site geology and riverbed composition and is influenced by the level of geotechnical assessment required and conducted. Thus, a hydropower facility’s geotechnical foundation is often highly site-specific, with proper site selection and assessment being important to project success. The foundation system is designed to provide structural stability (of the foundation and dam), limit seepage, ensure public safety, and maintain functionality for the project life, during both construction and facility operations. Inadequate foundation or dam design can result in dam failure and the uncontrolled release of significant volumes of water, which could cause a high number of casualties and extensive property damage downstream of the failure. According to the Association of State Dam Safety Officials, approximately 30% of all historical dam failures in the United States are attributed to foundation or abutment defects, and another 20% are attributed to piping or seepage through the embankment, foundation, or abutment. To ameliorate these safety considerations, foundations often require massive amounts of construction material (e.g., grout, concrete, engineered dam fill) and long construction times. Foundation design also requires significant analysis prior to construction because the initial in-stream and abutment subsurface conditions are site-specific, and sufficient data for them often are lacking. Current practice requires on-site assessment, using expensive drilling and invasive and non-invasive investigation methods, to determine the expected cost of foundation material and treatment. Additionally, foundation construction often requires site dewatering (and other care of water activities), which involves constructing temporary diversion structures upstream and often downstream, called cofferdams, and water diversion systems that route water around the construction site. Cofferdams and water diversion systems can drastically increase construction costs and contribute to environmental disruption, including modification of flow patterns and benthic habitats. Given the technical, economic, and environmental challenges associated with hydropower foundations, opportunities exist to improve the current state of practice and to develop new and innovative solutions to Hydropower is a renewable energy resource that produces electricity from flowing water under pressure. Engineered hydropower structures, such as dams, are used to create a hydraulic head, enabling a turbinegenerator unit to convert pressurized flow into electricity. While hydropower has been a source of renewable energy since antiquity, new development in the United States has slowed in recent decades. Based on recent resource assessments, the largest opportunity to expand hydropower in the United States is from new stream-reach development (i.e., new hydropower development along stream-reaches that do not currently have hydroelectric facilities or other forms of infrastructure, such as dams). Roughly 75% of identified new stream-reach development potential is from low-head sites (less than 30 ft of head), which typically suffer from smaller power densities and higher normalized costs, given economies of scale. Hydropower developers and other stakeholders are thus interested in strategies to reduce initial capital costs while practicing sustainable development to maximize environmental compatibility with minimal disruption to natural aquatic life, sediment, and water flows. Historically, civil works have represented a significant cost driver for new hydropower development, with the foundation system representing a major cost component and source of uncertainty. The foundation system is the collection of engineered structural features (e.g. cutoff trenches, walls, grouting, anchors) constructed at or below the preconstruction ground surface that interfaces between the overlying structures (superstructures) and the bed material below (subsurface). Development of a hydropower foundation system must consider the various characteristics of the surrounding stream environment and subsurface while adhering to the engineering requirements of the superstructure that it supports. The care of water, excavation, and other construction activities are important features of foundation design and construction. The design and construction cost of the foundation system is largely dependent on the site geology and riverbed composition and is influenced by the level of geotechnical assessment required and conducted. Thus, a hydropower facility’s geotechnical foundation is often highly site-specific, with proper site selection and assessment being important to project success. The foundation system is designed to provide structural stability (of the foundation and dam), limit seepage, ensure public safety, and maintain functionality for the project life, during both construction and facility operations. Inadequate foundation or dam design can result in dam failure and the uncontrolled release of significant volumes of water, which could cause a high number of casualties and extensive property damage downstream of the failure. According to the Association of State Dam Safety Officials, approximately 30% of all historical dam failures in the United States are attributed to foundation or abutment defects, and another 20% are attributed to piping or seepage through the embankment, foundation, or abutment. To ameliorate these safety considerations, foundations often require massive amounts of construction material (e.g., grout, concrete, engineered dam fill) and long construction times. Foundation design also requires significant analysis prior to construction because the initial in-stream and abutment subsurface conditions are site-specific, and sufficient data for them often are lacking. Current practice requires on-site assessment, using expensive drilling and invasive and non-invasive investigation methods, to determine the expected cost of foundation material and treatment. Additionally, foundation construction often requires site dewatering (and other care of water activities), which involves constructing temporary diversion structures upstream and often downstream, called cofferdams, and water diversion systems that route water around the construction site. Cofferdams and water diversion systems can drastically increase construction costs and contribute to environmental disruption, including modification of flow patterns and benthic habitats. Given the technical, economic, and environmental challenges associated with hydropower foundations, opportunities exist to improve the current state of practice and to develop new and innovative solutions to challenges frequently encountered with traditional approaches. With this understanding, it is critically important to understand and document the current state of practice for hydropower geotechnical foundations, identify key challenges, and define opportunities for innovative solutions. To this end, this report documents the current state of practice across the three main phases of geotechnical foundation development: (1) geotechnical site assessment, (2) design, and (3) construction for hydropower systems. It also describes the major challenges with conventional approaches and identifies opportunities for innovation to reduce hydropower foundations costs, timelines, and risks. Key takeaways from this report include the following: Approximately 80% of available low-head sites are expected to have foundations on soil beds rather than rock beds, suggesting that rockfill and earthfill dams may be the most cost-effective conventional dam type for new projects.; Geotechnical and geologic investigation activities are time-consuming and expensive but are essential to define the parameters and criteria needed for foundation design.; Certain riverbed soil and bedrock types present significant technical challenges or require expensive foundation construction, which can prove financially prohibitive for low-head project development.; Modular hydropower design and prefabricated modular foundations represent a promising but unproven paradigm for new hydropower development. Design and construction approaches using optimized and highly repeatable, reliable components would benefit project cost, time, and risk but require additional research and development.; Temporary construction features for foundations, including cofferdams, water diversion, and water control systems, can prove costly and have inherent construction risk.; For economically viable development, hydropower geotechnical foundations should be limited to 4 to 15% of the project’s total initial capital costs. Many proposed projects have experienced cost overruns attributable to foundation difficulties or surprises during construction. These overruns may have been due to inadequate investigations, lack of adequate engineering effort to tailor the structures to site geology and topography, and/or contractual terms, among other considerations.; Challenges for hydropower foundations and opportunities for innovative technology solutions are identified in the following areas (consistent with the three main phases of foundation development): Geotechnical site assessment, Foundation design and materials, Construction methods and technology. Ultimately, this report aims to provide information about geotechnical foundations for low-head hydropower and to motivate transformative technologies to support hydropower growth.

13 HYDRO ENERGY↗

Health Management Clinic Report FY18

The Health Management Clinic (HMC) is a worksite specialty clinic designed to provide an exceptional level of health care for Sandia employees with diabetes, cholesterol and blood pressure disorders, and for those employees that need help with smoking cessation, depression, anxiety, sleep disorders, or weight management. With a unified commitment to the best care practices available, the HMC is Sandia’s interface to workplace healthcare and health plan services. The HMC provides Sandia employees access to onsite screenings, health care exams, preventative health education, disease management education, care management, periodic laboratory testing, immunizations, podiatry services, and behavioral, fitness, and nutrition counseling/education. Our multidisciplinary team of health professionals consists of physicians, nurses, medical assistants, certified diabetes educators, dietitians, health educators, and exercise specialists. Services offered by the Health Management clinic have been designed to reduce further complications from disease states and promote healthy behavior changes for Sandia employees.

60 APPLIED LIFE SCIENCES↗

Natural Gas Community of the Future (Final Report)

Nicor Gas, a subsidiary of Southern Company Gas and its parent company Southern Company, is developing the concept of the Carbon-neutral, Affordable, Resilient, and Equitable Community ("CARE Community") to address the challenges of accessibility and affordability of grid-interactive efficient buildings in historically disadvantaged communities. The CARE Community is a new construction net-zero energy and carbon neutral residential neighborhood consisting of 50 homes with electricity and natural gas services in South Suburban Chicago, built as low-income affordable housing. The National Renewable Energy Laboratory (NREL) is assisting Southern Company to explore how energy efficiency, renewable technologies, and the reliability and resilience of natural gas can be combined and optimized in an islandable energy system as part of a broader effort to understand the role natural gas plays in future communities integrated with renewable energy and improved energy efficiency. The CARE Community will demonstrate how energy efficiency, distributed energy resources (DERs), and advanced controls can be combined with existing natural gas infrastructure to serve historically disadvantaged communities in a cold climate with low energy cost for affordable housing programs and enhanced resilience to withstand extreme weather. Homes will be a part of an islandable energy system, integrating multiple DER technologies such as solar panels, natural gas fuel cells, reciprocating natural gas engines, and battery storage. The CARE Community will provide a replicable template that affordable housing developers and energy companies can adopt throughout the United States. In this report, we present the design and modeling of the community and potential approaches for integrating DERs. We analyze and discuss annual simulations under normal operating conditions and week-long simulations under electric power grid outage conditions.

03 NATURAL GAS↗

Commitment to Hypertension Control During the COVID-19 Pandemic: Million Hearts Initiative Exemplars

Hypertension is a major risk factor for cardiovascular diseases, but 3 of 4 US adults do not have their blood pressure adequately controlled. Million Hearts (US Department of Health and Human Services) is a national initiative that promotes a set of priorities and interventions to optimize delivery of evidence-based strategies to manage cardiovascular disease, including hypertension. The COVID-19 pandemic, however, has disrupted routine care and preventive service delivery. We identified examples of clinical and health organizations that adapted services and care processes to continue a focus on monitoring and controlling hypertension during the pandemic. Eight Hypertension Control Exemplars were identified and interviewed. They reported various adapted care strategies including telemedicine, engaging patients in self-measured blood pressure monitoring, adapting or implementing medication management services, activating partnerships to respond to patient needs or expand services, and implementing unique patient outreach approaches. Documenting these hypertension control strategies can help increase adoption of adaptive approaches during public health emergencies and routine care.

59 BASIC BIOLOGICAL SCIENCES↗

STARPAHC systems report. Volume 1: Executive summary

A joint NASA and Department of Health, Education, and Welfare/Indian Health Services demonstration project entitled Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) was conducted to develop a solution for delivering quality health care to people in remote geographical areas. The STARPAHC concept verified the feasibility of telemedicine plus physician assistant - under the direction of a physician as a means of delivering quality health care. The two years of operational evaluation have provided considerable medical and engineering data which will be valuable to the designers and planners of future health care systems on earth and in space.

Source record↗

Evaluation of reliability modeling tools for advanced fault tolerant systems

The Computer Aided Reliability Estimation (CARE III) and Automated Reliability Interactice Estimation System (ARIES 82) reliability tools for application to advanced fault tolerance aerospace systems were evaluated. To determine reliability modeling requirements, the evaluation focused on the Draper Laboratories' Advanced Information Processing System (AIPS) architecture as an example architecture for fault tolerance aerospace systems. Advantages and limitations were identified for each reliability evaluation tool. The CARE III program was designed primarily for analyzing ultrareliable flight control systems. The ARIES 82 program's primary use was to support university research and teaching. Both CARE III and ARIES 82 were not suited for determining the reliability of complex nodal networks of the type used to interconnect processing sites in the AIPS architecture. It was concluded that ARIES was not suitable for modeling advanced fault tolerant systems. It was further concluded that subject to some limitations (the difficulty in modeling systems with unpowered spare modules, systems where equipment maintenance must be considered, systems where failure depends on the sequence in which faults occurred, and systems where multiple faults greater than a double near coincident faults must be considered), CARE III is best suited for evaluating the reliability of advanced tolerant systems for air transport.

Baker, Robert↗

Design of ceramic components with the NASA/CARES computer program

The ceramics analysis and reliability evaluation of structures (CARES) computer program is described. The primary function of the code is to calculate the fast-fracture reliability or failure probability of macro-scopically isotropic ceramic components. These components may be subjected to complex thermomechanical loadings, such as those found in heat engine applications. CARES uses results from MSC/NASTRAN or ANSYS finite-element analysis programs to evaluate how inherent surface and/or volume type flaws component reliability. CARES utilizes the Batdorf model and the two-parameter Weibull cumulative distribution function to describe the effects of multiaxial stress states on material strength. The principle of independent action (PIA) and the Weibull normal stress averaging models are also included. Weibull material strength parameters, the Batdorf crack density coefficient, and other related statistical quantities are estimated from four-point bend bar or uniform uniaxial tensile specimen fracture strength data. Parameter estimation can be performed for a single or multiple failure modes by using a least-squares analysis or a maximum likelihood method. Kolmogorov-Smirnov and Anderson-Darling goodness-to-fit-tests, 90 percent confidence intervals on the Weibull parameters, and Kanofsky-Srinivasan 90 percent confidence band values are also provided. Examples are provided to illustrate the various features of CARES.

Nemeth, Noel N.↗

Earth benefits from space life sciences

Contributions of space exploration which are widely recognized are those dealing with the impact of space technology on public health and medical services in both urban and remote rural areas. Telecommunications, image enhancement, 3-dimensional image reconstructions, miniaturization, automation, and data analysis, have transformed the delivery of medical care and have brought about a new impetus to the field of biomedicine. Many areas of medical care and biological research have been affected. These include technological breakthroughs in such areas as: (1) diagnosis, treatment, and prevention of cardiovascular diseases, (2) new approaches to the understanding of osteoporosis, (3) early detection of genetic birth defects, (4) emergency medical care, and (5) treatment of chronic metabolic disorders. These are but a few examples where technology originally developed to support space medicine or space research has been applied to solving medical and health care delivery problems on Earth.

NASA Center HQS↗

Eccentric loading of microtensile specimens

Ceramic materials have a lower density than most metals and are capable of performing at extremely high temperatures. The utility of these materials is obvious; however, the fracture strength of brittle materials is not easily predicted and often varies greatly. Characteristically, brittle materials lack ductility and do not yield as other materials. Ceramics materials are naturally populated with microscopic cracks due to fabrication techniques. Upon application of a load, stress concentration occurs at the root of these cracks and fracture will eventually occur at some not easily predicted strength. In order to use ceramics in any application some design methodology must exist from which a component can be placed into service. This design methodology is CARES/LIFE (Ceramics Analysis and Reliability Evaluation of Structures) which has been developed and refined at NASA over the last several decades. The CARES/LIFE computer program predicts the probability of failure of a ceramic component over its service life. CARES combines finite element results from a commercial FE (finite element) package such as ANSYS and experimental results to compute the abovementioned probability of failure. Over the course of several tests CARES has had great success in predicting the life of various ceramic components and has been used throughout industry. The latest challenge is to verify that CARES is valid for MEMS (Micro-Electro Mechanical Systems). To investigate a series of microtensile specimens were fractured in the laboratory. From this data, material parameters were determined and used to predict a distribution of strength for other specimens that exhibit a known stress concentration. If the prediction matches the experimental results then these parameters can be applied to a desired component outside of the laboratory. During testing nearly half of the tensile Specimens fractured at a location that was not expected and hence not captured in the FE model. It has been my duty to investigate the nature of this phenomenon in hopes of finding a better correlation between theory and empirical results. To investigate I built complete FE models of all of the tensile specimens using ANSYS. It is suspected that some misalignment naturally occurs during testing and thus additional bending stresses are present in the specimens. I modeled this eccentric loading and ran several FE trials using ANSYS/PDS (a probabilistic design system in ANSYS). My objective this summer has been familiarize myself with the CARES/LIFE program in hopes of using it in conjunction with ANSYS to help verify that CARES is applicable to MEMS-scale (greater that 1 micron, less than 1 millimeter) components.

Trapp, Mark A.↗

Operational and Research Musculoskeletal Summit: Summit Recommendations

The Medical Informatics and Health Care Systems group in the Office of Space Medicine at NASA Johnson Space Center (JSC) has been tasked by NASA with improving overall medical care on the International Space Station (ISS) and providing insights for medical care for future exploration missions. To accomplish this task, a three day Operational and Research Musculoskeletal Summit was held on August 23-25th, 2005 at Space Center Houston. The purpose of the summit was to review NASA#s a) current strategy for preflight health maintenance and injury screening, b) current treatment methods in-flight, and c) risk mitigation strategy for musculoskeletal injuries or syndromes that could occur or impact the mission. Additionally, summit participants provided a list of research topics NASA should consider to mitigate risks to astronaut health. Prior to the summit, participants participated in a web-based pre-summit forum to review the NASA Space Medical Conditions List (SMCL) of musculoskeletal conditions that may occur on ISS as well as the resources currently available to treat them. Data from the participants were compiled and integrated with the summit proceedings. Summit participants included experts from the extramural physician and researcher communities, and representatives from NASA Headquarters, the astronaut corps, JSC Medical Operations and Human Adaptations and Countermeasures Offices, Glenn Research Center Human Research Office, and the Astronaut Strength, Conditioning, and Reconditioning (ASCR) group. The recommendations in this document are based on a summary of summit discussions and the best possible evidence-based recommendations for musculoskeletal care for astronauts while on the ISS, and include recommendati ons for exploration class missions.

Scheuring, Richard A.↗

Medical Grade Water Generation for Intravenous Fluid Production on Exploration Missions

This document describes the intravenous (IV) fluids requirements for medical care during NASA s future Exploration class missions. It further discusses potential methods for generating such fluids and the challenges associated with different fluid generation technologies. The current Exploration baseline mission profiles are introduced, potential medical conditions described and evaluated for fluidic needs, and operational issues assessed. Conclusions on the fluid volume requirements are presented, and the feasibility of various fluid generation options are discussed. A separate report will document a more complete trade study on the options to provide the required fluids.At the time this document was developed, NASA had not yet determined requirements for medical care during Exploration missions. As a result, this study was based on the current requirements for care onboard the International Space Station (ISS). While we expect that medical requirements will be different for Exploration missions, this document will provide a useful baseline for not only developing hardware to generate medical water for injection (WFI), but as a foundation for meeting future requirements. As a final note, we expect WFI requirements for Exploration will be higher than for ISS care, and system capacity may well need to be higher than currently specified.

Niederhaus, Charles E.↗

Pharmacy in a New Frontier - The First Five Years at the Johnson Space Center Pharmacy

A poster entitled "Space Medicine - A New Role for Clinical Pharmacists" was presented in December 2001 highlighting an up-and-coming role for pharmacists at the Johnson Space Center (JSC) in Houston, Texas. Since that time, the operational need for the pharmacy profession has expanded with the administration s decision to open a pharmacy on site at JSC to complement the care provided by the Flight Medicine and Occupational Medicine Clinics. The JSC Pharmacy is a hybrid of traditional retail and hospital pharmacy and is compliant with the ambulatory care standards set forth by the Joint Commission. The primary charge for the pharmacy is to provide medication management for JSC. In addition to providing ambulatory care for both clinics, the pharmacists also practice space medicine. A pharmacist had been involved in the packing of both the Space Shuttle and International Space Station Medical Kits before the JSC Pharmacy was established; however, the role of the pharmacist in packing medical kits has grown. The pharmacists are now full members of the operations team providing consultation for new drug delivery systems, regulations, and patient safety issues. As the space crews become more international, so does the drug information provided by the pharmacists. This presentation will review the journey of the JSC Pharmacy as it celebrated its five year anniversary in April of 2008. The implementation of the pharmacy, challenges to the incorporation of the pharmacy into an existing health-care system, and the current responsibilities of a pharmacist at the Johnson Space Center will be discussed.

Bayuse, Tina↗

Ventilator Technologies Sustain Critically Injured Patients

Consider this scenario: A soldier has been critically wounded in a sudden firefight in a remote region of Afghanistan. The soldier s comrades attend to him and radio for help, but the soldier needs immediate medical expertise and treatment that is currently miles away. The connection between medical support for soldiers on the battlefield and astronauts in space may not be immediately obvious. But when it comes to providing adequate critical care, NASA and the military have very similar operational challenges, says Shannon Melton of NASA contractor Wyle Integrated Science and Engineering. Melton works within Johnson Space Center s Space Medicine Division, which supports astronaut crew health before, during, and after flight. In space, we have a limited number of care providers, and those providers are not always clinicians with extensive medical training. We have limited room to provide care, limited consumables, and our environment is not like that of a hospital, she says. The Space Medicine Division s Advanced Projects Group works on combining the expertise of both clinicians and engineers to develop new capabilities that address the challenges of medical support in space, including providing care to distant patients. This field, called telemedicine, blends advanced communications practices and technologies with innovative medical devices and techniques to allow caregivers with limited or no medical experience to support a patient s needs. NASA, just by its nature, has been doing remote medicine since the beginning of the Space Program, says Melton, an engineer in the Advanced Projects Group. Since part of NASA s mandate is to transfer the results of its technological innovation for the benefit of the public, the Agency has worked with doctors and private industry to find ways to apply the benefits of space medicine on Earth. In one such case, a NASA partnership has resulted in new technologies that may improve the quality of emergency medicine for wounded soldiers on the battlefield and regular civilians.

Source record↗

Launch and Landing of Russian Soyuz - Medical Support for US and Partner Astronauts

Launching, landing, flight route, expeditions, Soyuz, near Kazakhstan USOS Crew Surgeon -Quarantine and direct care to crew before launch, then present in close proximity to launch for abort. IP Crew Surgeon -same Deputy Crew Surgeon -Back up for crew surgeon, care for immediate family, stationed at airport for helicopter abort response Russian based US doctor -Coordinate with SOS staff USOS Crew Surgeon -Nominal helicopter response and initial medical care and support during return on gulfstreamIPcenter dotP Crew Surgeon -same Deputy Crew Surgeon -Ballistic helicopter support Russian based US doctor -Coordinate with SOS staff Direct return doctor -Direct medical care on return flight

Menon, Anil↗

Medical System Concept of Operations for Mars Exploration Mission-11: Exploration Medical Capability (ExMC) Element - Human Research Program

NASA’s exploration missions to Mars will have durations of 2-3 years and will take humans farther away from Earth than ever before. This will result in a paradigm shift for mission planning, spacecraft design, human systems integration, and in-flight medical care. Constraints on real-time communication, resupply, and medical evacuation are major architectural drivers. These constraints require medical system development to be tightly integrated with mission and vehicle design to provide crew autonomy and enable mission success. This concept of operations provides a common vision of medical care for developing a medical system for Mars exploration missions. It documents an overview of the stakeholder needs and goals of a medical system and provides examples of the types of activities the system will be used for during the mission. Development of the concept of operations considers mission variables such as distance from Earth, duration of mission, time to definitive medical care, communication protocols between crewmembers and ground support, personnel capabilities and skill sets, medical hardware and software, and medical data management. The information provided in this document informs the ExMC Systems Engineering effort to define the functions to be provided by the medical system. In addition, this concept of operations will inform the subsequent systems engineering process of developing technical requirements, system architectures, interfaces, and verification and validation approaches for the medical system. This document supports the closure of ExMC Gap Med01: We do not have a concept of operations for medical care during exploration missions, corresponding to the ExMC-managed human system risk: Risk of Adverse Health Outcomes & Decrements in Performance due to Inflight Medical Conditions. This document is applicable to the ExMC Element Systems Engineering process and may be used for collaboration within the Human Research Program.

Urbina, Michelle↗