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At least 163 records · Page 9

Johnson Space Center Flight Medicine Clinic Experience

Being a member of the Flight Medicine Clinic (FMC) Staff is a great experience. I joined the FMC staff 2 years ago when I became part of the Kelsey-Seybold team. The FMC staff consists of Flight Surgeons, Family Clinic Physician, Nursing staff, Wellness Coordinator and Support staff. We serve as the Primary Care Physicians for the astronauts and their families and provide annual physicals for the retired astronauts. We have approximately 800 patients in the FMC. As the Family Clinic Physician, I care for the astronaut spouses and children and provide annual physicals for the retired astronauts. Since we have a small patient population, we have the opportunity to spend increased personal time with our patients, which I enjoy. We have a pretty healthy patient population, who are very interested in their overall health and preventive care. In preparation for a shuttle launch, our nursing staff assists the flight surgeons with the astronaut physical exams, which occur 10 days prior to launch and again 3 days after their return. We also provide Primary Contact physicals for the families and guests, who will be in close contact with shuttle crew members. During these physicals, we provide education, emphasizing the importance of preventing the spread of communicable diseases to shuttle crew members. Being a part of the Space Medicine Program is an honor. To know that you contribute in some way to our nation s Space Program is very special. (This article was prepared by Dr. Trela Landry, M.D. for inclusion in a Kelsey-Seybold newsletter on 25 OCT 2006.)

Landry, Trela↗

USSR Space Life Sciences Digest

Research in exobiology, life sciences technology, space biology, and space medicine and physiology, primarily using data gathered on the Salyut 6 orbital space station, is reported. Methods for predicting, diagnosing, and preventing the effects of weightlessness are discussed. Psychological factors are discussed. The effects of space flight on plants and animals are reported. Bioinstrumentation advances are noted.

Lewis, C. S.↗

Psychological and Behavioral Health Issues of Long-Duration Space Missions

It will be the responsibility of the long-duration space flight crew to take the actions necessary to maintain their health and well-being and to cope with medical emergencies without direct assistance from support personnel, including maintaining mental health and managing physiological and psychological changes that may impair decision making and performance. The Behavior and Performance Integrated Product Team at Johnson Space Center, working, within the Space Medicine, Monitoring, and Countermeasures Program, has identified critical questions pertaining to long-duration space crew behavioral health, psychological adaptation, human factors and habitability, and sleep and circadian rhythms. Among the projects addressing these questions are: the development of tools to assess cognitive functions during space missions; the development of a model of psychological adaptation in isolated and confined environments; tools and methods for selecting individuals and teams well-suited for long-duration missions; identification of mission-critical tasks and performance evaluation; and measures of sleep quality and correlation to mission performance.

Eksuzian, Daniel J.↗

Significant Incidents in Extravehicular Activity

Dr. Jonathan B. Clark is an adjunct associate professor of Neurology and Space Medicine at Baylor College of Medicine. From 1997 to 2005, he worked at NASA as a six-time Space Shuttle crew surgeon and was chief of the Medical Operations Branch at the Johnson Space Center. During this event, Dr. Clark delivered a historic review of Extravehicular Activity (EVA) events with an emphasis on EVA system hazards. This is one event of a medical series delivered to the SKC Program by Dr. Clark. This series focuses on spacesuit medical lessons learned and medical safety aspects of the suit.

Jonathan B. Clark↗

Gas Related Problems Related to Spacesuits

Dr. Jonathan B. Clark is an adjunct Associate Professor of Neurology and Space Medicine at Baylor College of Medicine. From 1997 to 2005, he worked at NASA as a six-time Space Shuttle crew surgeon and was chief of the Medical Operations Branch at the Johnson Space Center. During this event, Dr. Clark discussed the hazards of low oxygen partial pressure (hypoxia) and high CO2 concentration (hypercarbia). This is one event of a medical series delivered to the SKC Program by Dr. Clark. This series focuses on spacesuit medical lessons learned and medical safety aspects of the suit.

Jonathan B. Clark↗

Astronaut Medical Selection and Flight Medicine Care During the Shuttle ERA 1981 to 2011

The NASA Shuttle Program began with congressional budget approval in January 5, 1972 and the launch of STS-1 on April 12, 1981 and recently concluded with the landing of STS-135 on July 21, 2011. The evolution of the medical standards and care of the Shuttle Era Astronauts began in 1959 with the first Astronaut selection. The first set of NASA minimal medical standards were documented in 1977 and based on Air Force, Navy, Department of Defense, and the Federal Aviation Administration standards. Many milestones were achieved over the 30 years from 1977 to 2007 and the subsequent 13 Astronaut selections and 4 major expert panel reviews performed by the NASA Flight Medicine Clinic, Aerospace Medicine Board, and Medical Policy Board. These milestones of aerospace medicine standards, evaluations, and clinical care encompassed the disciplines of preventive, occupational, and primary care medicine and will be presented. The screening and retention standards, testing, and specialist evaluations evolved through periodic expert reviews, evidence based medicine, and Astronaut medical care experience. The last decade of the Shuttle Program saw the development of the International Space Station (ISS) with further Space medicine collaboration and knowledge gained from our International Partners (IP) from Russia, Canada, Japan, and the European Space Agencies. The Shuttle Program contribution to the development and implementation of NASA and IP standards and waiver guide documents, longitudinal data collection, and occupational surveillance models will be presented along with lessons learned and recommendations for future vehicles and missions.

Johnston, S.↗

Management of Service Projects in Support of Space Flight Research

Goal:To provide human health and performance countermeasures, knowledge, technologies, and tools to enable safe, reliable, and productive human space exploration . [HRP-47051] Specific Objectives: 1) Develop capabilities, necessary countermeasures, and technologies in support of human space exploration, focusing on mitigating the highest risks to human health and performance. 2) Define and improve human spaceflight medical, environmental, and human factors standards. 3) Develop technologies that serve to reduce medical and environmental risks, to reduce human systems resource requirements (mass, volume, power, data, etc.) and to ensure effective human-system integration across exploration systems. 4) Ensure maintenance of Agency core competencies necessary to enable risk reduction in the following areas: A. Space medicine B. Physiological and behavioral effects of long duration spaceflight on the human body C. Space environmental effects, including radiation, on human health and performance D. Space "human factors" [HRP-47051]. Service projects can form integral parts of research-based project-focused programs to provide specialized functions. Traditional/classic project management methodologies and agile approaches are not mutually exclusive paradigms. Agile strategies can be combined with traditional methods and applied in the management of service projects functioning in changing environments. Creative collaborations afford a mechanism for mitigation of constrained resource limitations.

Love, J.↗

Exploration Laboratory Analysis FY13

The Exploration Laboratory Analysis (ELA) project supports the Exploration Medical Capability (ExMC) risk, which is stated as the Risk of Inability to Adequately Treat an Ill or Injured Crew Member, and ExMC Gap 4.05: Lack of minimally invasive in-flight laboratory capabilities with limited consumables required for diagnosing identified Exploration Medical Conditions. To mitigate this risk, the availability of inflight laboratory analysis instrumentation has been identified as an essential capability in future exploration missions. Mission architecture poses constraints on equipment and procedures that will be available to treat evidence-based medical conditions according to the Space Medicine Exploration Medical Conditions List (SMEMCL), and to perform human research studies on the International Space Station (ISS) that are supported by the Human Health and Countermeasures (HHC) element. Since there are significant similarities in the research and medical operational requirements, ELA hardware development has emerged as a joint effort between ExMC and HHC. In 2012, four significant accomplishments were achieved towards the development of exploration laboratory analysis for medical diagnostics. These achievements included (i) the development of high priority analytes for research and medical operations, (ii) the development of Level 1 functional requirements and concept of operations documentation, (iii) the selection and head-to-head competition of in-flight laboratory analysis instrumentation, and (iv) the phase one completion of the Small Business Innovation Research (SBIR) projects under the topic Smart Phone Driven Blood-Based Diagnostics. To utilize resources efficiently, the associated documentation and advanced technologies were integrated into a single ELA plan that encompasses ExMC and HHC development efforts. The requirements and high priority analytes was used in the selection of the four in-flight laboratory analysis performers. Based upon the competition results, a down select process will be performed in the upcoming year. Looking ahead, this unified effort has positioned each element for an in-flight lab analysis demonstration of select diagnostics measurements in the 2015 timeframe.

Krihak, Michael↗

Biennial Research and Technology Development Report: Johnson Space Center

The Biennial Research and Technology Development Report is a compilation of advances in research and technology accomplished by Johnson Space Center (JSC) engineers and scientists. The articles contained within this report further JSC's and NASA's historical tradition of working with colleges and universities, industry, federal laboratories, and other research and technology development organizations for the betterment of humankind. This report is organized into10 broad categories: Human Health, Life Support and Habitation Systems, and Space Medicine; Human Exploration Systems, Technologies for Extravehicular Activity and Harsh Environments; Environmental Technologies; Materials, Structures, Development and Testing; Space Power, Energy Storage, and Propulsion; Robotics, Tele-Robotics, Autonomous Systems, and Software; Exploration, Planetary Science, and Sensor Systems; Flammability and Explosive Technologies; Space and Ground Operations; and Education and Outreach.

Lulla, Kamlesh↗

Surveillance in a Telemedicine Setting: Application of Epidemiologic Methods at NASA Johnson Space Center Adriana

Space medicine presents unique challenges and opportunities for epidemiologists, such as the use of telemedicine during spaceflight. Medical capabilities aboard the International Space Station (ISS) are limited due to severe restrictions on power, volume, and mass. Consequently, inflight health information is based heavily on crewmember (CM) self-report of signs and symptoms, rather than formal diagnoses. While CM's are in flight, the primary source of crew health information is verbal communication between physicians and crewmembers. In 2010 NASA implemented the Lifetime Surveillance of Astronaut Health, an occupational surveillance program for the U.S. Astronaut corps. This has shifted the epidemiological paradigm from tracking diagnoses based on traditional terrestrial clinical practice to one that incorporates symptomatology and may gain a more population-based understanding of early detection of disease process.

Babiak-Vazquez, Adriana↗

Advanced Technology Applications for Combat Casualty Care

Exploration Medical Capability (ExMC) is an element of NASA s Human Research Program (HRP). ExMC s goal is to address the risk of the "Inability to Adequately Recognize or Treat an Ill or Injured Crewmember." This poster highlights the approach ExMC has taken to address this goal and our current areas of interest. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to identify medical conditions of concern during exploration missions. The list was derived from space flight medical incidents, the shuttle medical checklist, the International Space Station medical checklist, and expert opinion. The conditions on the list were prioritized according to mission type by a panel comprised of flight surgeons, physician astronauts, engineers, and scientists. From the prioritized list, the ExMC element determined the capabilities needed to address the medical conditions of concern. Where such capabilities were not currently available, a gap was identified. The element s research plan outlines these gaps and the tasks identified to achieve the desired capabilities for exploration missions.

Watkins, Sharmila↗

Exploration Medical Capability

Exploration Medical Capability (ExMC) is an element of NASA's Human Research Program (HRP). ExMC's goal is to address the risk of the Inability to Adequately Recognize or Treat an Ill or Injured Crewmember. This poster highlights the approach ExMC has taken to address this goal and our current areas of interest. The Space Medicine Exploration Medical Condition List (SMEMCL) was created to identify medical conditions of concern during exploration missions. The list was derived from space flight medical incidents, the shuttle medical checklist, the International Space Station medical checklist, and expert opinion. The conditions on the list were prioritized according to mission type by a panel comprised of flight surgeons, physician astronauts, engineers, and scientists. From the prioritized list, the ExMC element determined the capabilities needed to address the medical conditions of concern. Where such capabilities were not currently available, a gap was identified. The element s research plan outlines these gaps and the tasks identified to achieve the desired capabilities for exploration missions. This poster is being presented to inform the audience of the gaps and tasks being investigated by ExMC and to encourage discussions of shared interests and possible future collaborations.

Watkins, Sharmila↗

Assessment of programs in space biology and medicine

Over the past 30 or more years, the National Research Council Space Studies Board and its various committees have published hundreds of recommendations concerning life sciences research. Several particularly noteworthy themes appear consistently: (1) Balance - the need for a well-balanced research program in terms of ground versus flight, basic versus clinical, and internal versus extramural; (2) Excellence - because of the extremely limited number of flight opportunities (as well as their associated relative costs), the need for absolute excellence in the research that is conducted, in terms of topic, protocol, and investigator, and (3) Facilities - the single most important facility for life sciences research in space, an on-board, variable force centrifuge. In this first assessment report, the Committee on Space Biology and Medicine emphasizes that these long-standing themes remain as essential today as when first articulated. On the brink of the twenty-first century, the nation is contemplating the goal of human space exploration; consequently, the themes bear repeating. Each is a critical component of what will be necessary to successfully achieve such a goal.

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Survey of On-Orbit Sleep Quality: Short-Duration Flyers

The NASA Human Research Program (HRP) Behavioral Health and Performance Element (BHP), in conjunction with the NASA Space Medicine Division, is currently completing the largest systematic, subjective assessment of shuttle astronauts sleep behaviors and sleep quality on Earth, during training periods, and during space flight missions. Since July 2009, a total of 66 astronauts have completed a secure online survey regarding specific sleep strategies, crew policies, and mitigation effectiveness. In addition to the survey, each astronaut participant met individually with trained BHP and SD representatives for a structured, follow-up interview. Data are currently being assessed and the study s principal investigator will be providing some preliminary findings at the Investigators Workshop. Additional analyses will be conducted in the following months to examine predictors of optimal sleep in space, and to evaluate the differences in countermeasure effectiveness between groups based on their sleep experience on the ground and on orbit. A revised survey for a subsequent investigation on the experiences of long-duration flyers will be developed in the Spring and implemented in the Summer of 2010. Findings from both of these investigations will inform countermeasure strategies for astronauts, medical operations, and habitat designers for future exploration missions, as well as upcoming shuttle and ISS missions.

Locke, J.↗

Integration of Optical Coherence Tomography Scan Patterns to Augment Clinical Data Suite

Vision changes identified in long duration spaceflight astronauts has led Space Medicine at NASA to adopt a more comprehensive clinical monitoring protocol. Optical Coherence Tomography (OCT) was recently implemented at NASA, including on board the International Space Station in 2013. NASA is collaborating with Heidelberg Engineering to increase the fidelity of the current OCT data set by integrating the traditional circumpapillary OCT image with radial and horizontal block images at the optic nerve head. The retinal nerve fiber layer was segmented by two experienced individuals. Intra-rater (N=4 subjects and 70 images) and inter-rater (N=4 subjects and 221 images) agreement was performed. The results of this analysis and the potential benefits will be presented.

Mason, S.↗

Space Flight-Induced Intracranial Hypertension: An Ophthalmic Review

Background: Although physiologic and pathologic changes associated with microgravity exposure have been studied extensively, the effect of this environment on the eye is largely unknown. Over the last several years, NASA s Space Medicine Division has documented astronauts presenting with varying degrees of disc edema, globe flattening, choroidal folds, cotton wool spots, and hyperopic shifts after long-duration space flight. Methods: Before and after long-duration space flight, six astronauts underwent complete eye examinations to include cycloplegic and/or manifest refraction and fundus photography. Five of these astronauts had Optical Coherence Tomography (OCT) and Magnetic Resonance Imaging (MRI) performed following their missions. Results: Following exposure to space flight of approximately 6-months duration, six astronauts had neuro-ophthalmic findings. These consisted of disc edema in four astronauts, globe flattening in four astronauts, choroidal folds in four astronauts, cotton wool spots in three astronauts, nerve fiber layer thickening by OCT in five astronauts, and decreased near vision in five astronauts. Four of the astronauts with near vision complaints had a hyperopic shift equal to or greater than + 0.50D between pre- and post-mission spherical equivalent refraction in one or both eyes (range +0.50D to +1.50D). These same four had globe flattening by MRI. Conclusions: The findings we describe may have resulted from a rise in intracranial pressure caused by microgravity fluid shifts, and could represent parts of a spectrum of ocular and cerebral responses to extended microgravity.

Gibson, Charles Robert↗

Certain peculiarities of the functioning of the cardiovascular system in bedrest conditions during horizontal and antiorthostatic body positions

The adequate modeling of physiological reactions inherent to the state of weightlessness has become a matter of particular urgency in space medicine. This modeling is necessary for studying the phenomenology and degree of disorders, prognostication of the crew's health, and developing the various preventive measures employed in space flights. A comparison is made of the physiological effects brought about by bed rest in a horizontal and antiorthostatic body position. A study is done of the influence of brief antiorthostatic hypokinesia, simulating the acute period of adaptation to weightlessness, on circulation and on a number of involved analytical systems. The basic model accepted is antiorthostatic hypokinesia with a body position declination angle of 4 deg (head lower than feet). The experiment's duration is dictated by the objectives of the research.

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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↗