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At least 73 records · Page 4

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NASA NTRS1996

Distant Operational Care Centre: Design Project Report

The goal of this project is to outline the design of the Distant Operational Care Centre (DOCC), a modular medical facility to maintain human health and performance in space, that is adaptable to a range of remote human habitats. The purpose of this project is to outline a design, not to go into a complete technical specification of a medical facility for space. This project involves a process to produce a concise set of requirements, addressing the fundamental problems and issues regarding all aspects of a space medical facility for the future. The ideas presented here are at a high level, based on existing, researched, and hypothetical technologies. Given the long development times for space exploration, the outlined concepts from this project embodies a collection of identified problems, and corresponding proposed solutions and ideas, ready to contribute to future space exploration efforts. In order to provide a solid extrapolation and speculation in the context of the future of space medicine, the extent of this project's vision is roughly within the next two decades. The Distant Operational Care Centre (DOCC) is a modular medical facility for space. That is, its function is to maintain human health and performance in space environments, through prevention, diagnosis, and treatment. Furthermore, the DOCC must be adaptable to meet the environmental requirements of different remote human habitats, and support a high quality of human performance. To meet a diverse range of remote human habitats, the DOCC concentrates on a core medical capability that can then be adapted. Adaptation would make use of the DOCC's functional modularity, providing the ability to replace, add, and modify core functions of the DOCC by updating hardware, operations, and procedures. Some of the challenges to be addressed by this project include what constitutes the core medical capability in terms of hardware, operations, and procedures, and how DOCC can be adapted to different remote habitats.

Source record↗

NASA NTRS1990

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↗

NASA NTRS2001

Neocytolysis on descent from altitude: a newly recognized mechanism for the control of red cell mass

BACKGROUND: Studies of space-flight anemia have uncovered a physiologic process, neocytolysis, by which young red blood cells are selectively hemolyzed, allowing rapid adaptation when red cell mass is excessive for a new environment. OBJECTIVES: 1) To confirm that neocytolysis occurs in another situation of acute plethora-when high-altitude dwellers with polycythemia descend to sea level; and 2) to clarify the role of erythropoietin suppression. DESIGN: Prospective observational and interventional study. SETTING: Cerro de Pasco (4380 m) and Lima (sea level), Peru. PARTICIPANTS: Nine volunteers with polycythemia. INTERVENTIONS: Volunteers were transported to sea level; three received low-dose erythropoietin. MEASUREMENTS: Changes in red cell mass, hematocrit, hemoglobin concentration, reticulocyte count, ferritin level, serum erythropoietin, and enrichment of administered(13)C in heme. RESULTS: In six participants, red cell mass decreased by 7% to 10% within a few days of descent; this decrease was mirrored by a rapid increase in serum ferritin level. Reticulocyte production did not decrease, a finding that establishes a hemolytic mechanism.(13)C changes in circulating heme were consistent with hemolysis of young cells. Erythropoietin was suppressed, and administration of exogenous erythropoietin prevented the changes in red cell mass, serum ferritin level, and(13)C-heme. CONCLUSIONS: Neocytolysis and the role of erythropoietin are confirmed in persons with polycythemia who descend from high altitude. This may have implications that extend beyond space and altitude medicine to renal disease and other situations of erythropoietin suppression, hemolysis, and polycythemia.

Non-NASA Center↗

NASA NTRS1997

Automation-induced monitoring inefficiency: role of display location

Operators can be poor monitors of automation if they are engaged concurrently in other tasks. However, in previous studies of this phenomenon the automated task was always presented in the periphery, away from the primary manual tasks that were centrally displayed. In this study we examined whether centrally locating an automated task would boost monitoring performance during a flight-simulation task consisting of system monitoring, tracking and fuel resource management sub-tasks. Twelve nonpilot subjects were required to perform the tracking and fuel management tasks manually while watching the automated system monitoring task for occasional failures. The automation reliability was constant at 87.5% for six subjects and variable (alternating between 87.5% and 56.25%) for the other six subjects. Each subject completed four 30 min sessions over a period of 2 days. In each automation reliability condition the automation routine was disabled for the last 20 min of the fourth session in order to simulate catastrophic automation failure (0 % reliability). Monitoring for automation failure was inefficient when automation reliability was constant but not when it varied over time, replicating previous results. Furthermore, there was no evidence of resource or speed accuracy trade-off between tasks. Thus, automation-induced failures of monitoring cannot be prevented by centrally locating the automated task.

Automation↗

NASA NTRS1996

Musculoskeletal adaptations to weightlessness and development of effective countermeasures

A Research Roundtable, organized by the American College of Sports Medicine with sponsorship from the National Aeronautics and Space Administration, met in November 1995 to define research strategies for effective exercise countermeasures to weightlessness. Exercise was considered both independently of, and in conjunction with, other therapeutic modalities (e.g., pharmacological nutritional, hormonal, and growth-related factors) that could prevent or minimize the structural and functional deficits involving skeletal muscle and bone in response to chronic exposure to weightlessness, as well as return to Earth baseline function if a degree of loss is inevitable. Musculoskeletal deficits and countermeasures are described with respect to: 1) muscle and connective tissue atrophy and localized bone loss, 2) reductions in motor performance, 3) potential proneness to injury of hard and soft tissues, and 4) probable interaction between muscle atrophy and cardiovascular alterations that contribute to the postural hypotension observed immediately upon return from space flight. In spite of a variety of countermeasure protocols utilized previously involving largely endurance types of exercise, there is presently no activity-specific countermeasure(s) that adequately prevent or reduce musculoskeletal deficiencies. It seems apparent that countermeasure exercises that have a greater resistance element, as compared to endurance activities, may prove beneficial to the musculoskeletal system. Many questions remain for scientific investigation to identify efficacious countermeasure protocols, which will be imperative with the emerging era of long-term space flight.

Non-NASA Center↗

NASA NTRS2009

Behavioral Health and Performance Element: Tools and Technologies

This slide presentation reviews the research into the Behavioral Health and Performance (BHP) of the Human Research Program. The program element goal is to identify, characterize and prevent or reduce behavioral health and performance risks associated with space travel, exploration, and return to terrestrial life. To accomplish this goal the program focuses on applied research that is designed to yield deliverables that reduce risk. There are several different elements that are of particular interest: Behavioral Medicine, Sleep, and team composition, and team work. In order to assure success for NASA missions the Human Research Program develops and validate the standards for each of the areas of interest. There is discussion of the impact on BHP while astronauts are on Long Duration Missions. The effort in this research is to create tools to meet the BHP concerns, these prospective tools are reviewed.

Leveton, Lauren B.↗

NASA NTRS1987

The preservation of urine samples for determination of renal stone risk factors

A preservation technique for urine specimens before determination of stone risk factors was evaluated. The purpose of these experiments was to prove the effectiveness of the preservatives used to prevent changes in the concentrations of those constituents measured. Measured concentrations in fresh specimens were compared with those in the same specimens after storage with the preservatives. Refrigeration at 4 degrees C up to five days was appropriate in a laboratory setting, as no significant changes in urinary concentrations occurred. Refrigeration, however, did not offer a convenient method for shipping. Chemical preservation was found to be an effective alternative to refrigeration. Thymol prevented changes in concentration of pH, citrate, uric acid, sulfate, sodium, potassium, and cyclic AMP, while a mixture of hydrochloric (HCl) acid and boric acid prevented changes in calcium, magnesium, phosphorus, oxalate, ammonium, and creatinine. Thus, the addition of thymol or HCl/boric acid to urine specimens will prevent significant changes in the concentrations of stone risk factors.

Non-NASA Center↗

NASA NTRS1988

An overview of the space medicine program and development of the Health Maintenance Facility for Space Station

Because the prolonged stay on board the Space Station will increase the risk of possible inflight medical problems from that on Skylab missions, the Health Maintenance Facility (HMF) planned for the Space Station is much more sophisticated than the small clinics of the Skylab missions. The development of the HMF is directed by the consideration of three primary factors: prevention, diagnosis, and treatment of injuries and illnesses that may occur in flight. The major components of the HMF include the clinical laboratory, pharmacy, imaging system, critical-care system, patient-restraint system, data-management system, exercise system, surgical system, electrophysiologic-monitoring system, introvenous-fluid system, dental system, and hyperbaric-treatment-support system.

Pool, Sam Lee↗

NASA NTRS2003

Physiology, medicine, long-duration space flight and the NSBRI

The hazards of long-duration space flight are real and unacceptable. In order for humans to participate effectively in long-duration orbital missions or continue the exploration of space, we must first secure the health of the astronaut and the success of such missions by assessing in detail the biomedical risks of space flight and developing countermeasures to these hazards. Acquiring the understanding necessary for building a sound foundation for countermeasure development requires an integrated approach to research in physiology and medicine and a level of cooperative action uncommon in the biomedical sciences. The research program of the National Space Biomedical Research Institute (NSBRI) was designed to accomplish just such an integrated research goal, ameliorating or eliminating the biomedical risks of long-duration space flight and enabling safe and productive exploration of space. The fruits of these labors are not limited to the space program. We can also use the gained understanding of the effects and mechanisms of the physiological changes engendered in space and the applied preventive and rehabilitative methods developed to combat these changes to the benefit of those on Earth who are facing similar physiological and psychological difficulties. This paper will discuss the innovative approach the NSBRI has taken to integrated research management and will present some of the successes of this approach. c2003 International Astronautical Federation. Published by Elsevier Science Ltd. All rights reserved.

NASA Discipline General Space Life Sciences↗

NASA NTRS1988

Space medicine

This paper attempts to underscore the importance of continued studies on the effects of space on human physiology. With particular reference to the Space Station, it is pointed out that there are two aspects which are challenging to life scientists: first is the development of a research capability for the life sciences which will be used to conduct investigations necessary to extend the time humans can remain in space; second is the challenge to develop a medical capability to provide prevention, diagnosis, and therapy. A discussion of physiological changes that have been observed in spacecrews follows along the lines of the two aspects mentioned.

Pool, Sam L.↗

NASA NTRS2018

Defining Medical Capabilities for Exploration Missions

Exploration-class missions to the moon, Mars and beyond will require a significant change in medical capability from today's low earth orbit centric paradigm. Significant increases in autonomy will be required due to differences in duration, distance and orbital mechanics. Aerospace medicine and systems engineering teams are working together within ExMC to meet these challenges. Identifying exploration medical system needs requires accounting for planned and unplanned medical care as defined in the concept of operations. In 2017, the ExMC Clinicians group identified medical capabilities to feed into the Systems Engineering process, including: determining what and how to address planned and preventive medical care; defining an Accepted Medical Condition List (AMCL) of conditions that may occur and a subset of those that can be treated effectively within the exploration environment; and listing the medical capabilities needed to treat those conditions in the AMCL. This presentation will discuss the team's approach to addressing these issues, as well as how the outputs of the clinical process impact the systems engineering effort.

Hailey, M.↗

NASA NTRS1992

Medicine on Mars: Remote medical care and the space exploration initiative

Mars exploration missions as described in the Synthesis Group report will involve extended exposures of crew members to remote, hazardous environments for up to 100 days. Maintenance of crew health and performance will be critical to ensure mission success. Because of the great distances between the Earth and Mars, round trip telecommunication will take from seven to forty minutes and immediate return to Earth will not be feasible: an autonomous medical care system that integrates preventive, occupational, and environmental aspects of health care and provides diagnostic and treatment capabilities will be necessary. Providing medical care for Mars explorers will pose some unique technical and engineering challenges. Medical care equipment will need to be designed to be modular and portable to ensure that it is interchangeable between vehicle and planetary surface elements. Miniaturization will be necessary to reduce mass and volume. Computerized systems that automatically acquire and manage medical information and provide medical references (literature), decision support, and automated medical record keeping will be a crucial part of a Martian medical care system. Medical care will also rely on remote consultation with Earth-based specialists. This presentation will provide an overview of the health and medical concerns associated with Mars exploration missions and will describe some specific concepts for Mars medical care systems.

Simmons, S. C.↗

NASA NTRS1994

Electrical stimulation in exercise training

Electrical stimulation has a long history of use in medicine dating back to 46 A.D. when the Roman physician Largus found the electrical discharge of torpedo fishes useful in the treatment of pain produced by headache and gout. A rival Greek physician, Dioscorides, discounted the value of the torpedo fish for headache relief but did recommend its use in the treatment of hemorrhoids. In 1745, the Leyden jar and various sized electrostatic generators were used to treat angina pectoris, epilepsy, hemiplegia, kidney stones, and sciatica. Benjamin Franklin used an electrical device to treat successfully a young woman suffering from convulsive fits. In the late 1800's battery powered hydroelectric baths were used to treat chronic inflammation of the uterus while electrified athletic supporters were advertised for the treatment of male problems. Fortunately, such an amusing early history of the simple beginnings of electrical stimulation did not prevent eventual development of a variety of useful therapeutic and rehabilitative applications of electrical stimulation. Over the centuries electrical stimulation has survived as a modality in the treatment of various medical disorders with its primary application being in the rehabilitation area. Recently, a surge of new interest in electrical stimulation has been kindled by the work of a Russian sport scientist who reported remarkable muscle strength and endurance improvements in elite athletes. Yakov Kots reported his research on electric stimulation and strength improvements in 1977 at a Canadian-Soviet Exchange Symposium held at Concordia University in Montreal. Since then an explosion of new studies has been seen in both sport science and in medicine. Based upon the reported works of Kots and the present surge of new investigations, one could be misled as to the origin of electrical stimulation as a technique to increase muscle strength. As a matter of fact, electric stimulation has been used as a technique to improve muscle strength for over a century. Bigelow reported in 1894, for example, the use of electrical stimulation on a young man for the purpose of increasing muscle strength. Employing a rapidly alternating sinusoidal induced current and a dynamometer for strength testing, Bigelow reported that the total lifting capacity of a patient increased from 4328 pounds to 4639 pounds after only 25 minutes of stimulation. In 1965, Massey et al. reported on the use of an Isotron electrical stimulator that emitted a high frequency current. Interestingly enough, the frequencies used by Massey et al. and the frequencies used by Bigelow in 1894 were in the same range of frequencies reported by Kots as being the most effective in strength development. It would seem the Russian secret of high frequency electrical stimulation for strength development, then, is not a modern development at all.

Kroll, Walter↗

NASA NTRS2001

Psychosocial issues in long-term space flight: overview

Anecdotal evidence of the individual and interpersonal problems that occurred during the Shuttle-Mir Space Program (SMSP) and other long-duration Russian/Soviet missions, and studies of personnel in other isolated and confined extreme (ICE) environments suggest that psychosocial elements of behavior and performance are likely to have a significant impact on the outcome of long-duration missions in space. This impact may range from individual decrements in performance, health and well being, to catastrophic mission failure. This paper reviews our current understanding of the psychosocial issues related to long duration space missions according to three different domains of behavior: the individual domain, the interpersonal domain and the organizational domain. Individual issues include: personality characteristics that predict successful performance, stress due to isolation and confinement and its effect on emotions and cognitive performance, adaptive and maladaptive coping styles and strategies, and requirements for the psychological support of astronauts and their families during the mission. Interpersonal issues include: impact of crew diversity and leadership styles on small group dynamics, adaptive and maladaptive features of ground-crew interactions, and processes of crew cohesion, tension and conflict. Organizational issues include: the influence of organizational culture and mission duration on individual and group performance, and managerial requirements for long duration missions. Improved screening and selection of astronaut candidates, leadership, coping and interpersonal skills training of personnel, and organizational change are key elements in the prevention of performance decrements on long-duration missions.

Review, Tutorial↗

NASA NTRS2001

Proceedings from the 2001 NASA Occupational Health Conference: Risk Assessment and Management in 2001

This Conference convened approximately 86 registered participants of invited guest speakers, NASA presenters, and a broad spectrum of the Occupational Health disciplines representing NASA Headquarters and all NASA Field Centers. Two days' Professional Development Courses on Exposure Assessment Strategies and Statistics and on Advanced Cardiac Life Support training and recertification preceded the Conference. With the theme, 'Risk Assessment and Management in 2001,' conferees were first provided updates from the Program Principal Center Office and the Headquarters Office. Plenary sessions elaborated on several topics: biological terrorism, OSHA recordability, Workers' Compensation issues, Federal ergonomic standards, bridging aerospace medicine and occupational health-especially in management of risk in spaceflight, and EAP operations with mission failures. A keynote address dealt with resiliency skills for 21st century workers and two NASA astronaut speakers highlighted a tour of the Johnson Space Center. During discipline specific breakout sessions, current issues in occupational health management and policy, credentialing and privileging, health risk assessment, measurement and standardization, audits, database development, prevention and rehabilitation, international travel and infection control, employee assistance, nursing process, and environmental health were presented.

Roberson, Sheri↗

NASA NTRS1994

Physiological Adaptations and Countermeasures Associated with Long-Duration Space Flights

On earth, the presence of gravity imposes weight-bearing gradients on tissues which influence the functions of multiple integrative systems. On the other hand, conditions of actual or simulated microgravity can modify and/or nullify these gradients and subsequently alter structure and function. The purpose of this symposium is to discuss the results from short-term Shuttle flights, long term Skylab or Mir missions, or long-term ground based experiments which indicate or suggest that performance has been or could be compromised in space missions of long durations (>one year) or with space tasks (e.g. building space stations) with the goal of identifying countermeasures that could minimize or eliminate the expected anatomical and physiological consequences. After an overview by C. Tipton from the U. Arizona, the countermeasures necessary for the fluid shifts and select functions of the cardiovascular system will be discussed by A. Hargens from NASA Ames Research Center. He will be followed by K. Baldwin of the U. California at Irvine who will discuss the countermeasures needed to prevent the changes that alter the structure, function and control of skeletal muscles. Since changes in bone mass with microgravity are a major concern of NASA, V. Schneider from NASA Headquarters will present data and the countermeasures for bone. Although the results are limited, the changes in the endocrine and immune system deserve mentioning and C. Tipton will assume this responsibility. V. Convertino from the Air Force School of Aerospace Medicine has the challenge of discussing the role, importance, and the specificity of exercise as an effective countermeasure while I. Kozlovskaya from Moscow will elaborate on the Russian experiences with past countermeasures and provide a viewpoint on future ones. After the brief (25 min.) presentations, the speakers will assemble as a panel to discuss the issues raised and the concerns of the audience.

Tipton, C. M.↗

NASA NTRS1989

Medical care delivery in space

Consideration is given to the delivery of medical care in space. The history of aviation medicine is reviewed. Medical support for the early space programs is discussed, including the Mercury, Gemini, Apollo, and Skylab programs. The process of training crew members for basic medical procedures for the Space Shuttle program is briefly described and medical problems during the Shuttle program are noted. Plans for inflight medical care on the Space Station are examined, including the equipment planned for the Health Maintenance Facility, the use of exercise to help prevent medical problems.

Stewart, Don F.↗

NASA NTRS2010

Managing the Risk for Early Onset Osteoporosis in Long-Duration Astronauts Due to Spaceflight

Early Onset Osteoporosis is probably the most recognized but poorly understood long-term health risk due to spaceflight. Osteoporosis management is primarily prophylactic and clinical interventions rely upon the ability to predict fractures which is currently determined by surrogate measures of bone strength. The RMAT for Early Onset Osteoporosis identified some open issues related to the fact that long-duration astronauts compose a unique group of subjects for which clinical approaches for osteoporosis management do not apply. Long-duration astronauts are healthy, young (25 to 55 years of age), predominantly male, and physical fit relative to the typical osteoporosis patient. Moreover, during prolonged space missions (typically 6-month missions) the skeleton not only adapts to weightlessness, but is influenced by numerous risk factors induced by operational constraints, e.g., inability to maintain preflight weight-bearing and aerobic activities, sub-optimal dietary intake (e.g., high sodium content for food stability, lack of fresh fruit and vegetables), suppression of vitamin D metabolism by uv shielding, and remote medicine care. Moreover, adaptation results in novel changes to astronauts bones that cannot be detected by current medically-useful measures. Consequently, a panel of clinicians (recognized leaders and policy-makers in osteoporosis) was convened to review the dataset of bone measures and bone loss risk factors in long-duration astronauts. Driven by the queries in the RMAT, the panel was charged to determine 1) if an intervention is required to prevent this risk, 2) what type and at what time would intervention be optimal, 3) what is the clinical trigger that would require a medical response from flight surgeons and 4) how should research data be used in the clinical care of astronauts. Hence, the RMAT determined that a bone health policy need to be formulated specific for this unique cohort subjected to a novel skeletal condition

Sibonga, Jean D.↗