Results for “Medical requirements” — Page 4

NASA NTRS2011

Post Flight Reconditioning for US Astronauts Returning from the International Space Station

Prior to spaceflight, each astronaut undergoes medical requirement testing to establish a preflight baseline for physiologic functions. Astronauts returning from the International Space Station can experience deficits in all or some of the following areas: aerobic capacity, muscular strength, power, endurance, stamina, bone, balance, agility, coordination, orthostatic tolerances, proprioception, neurovestibular function and flexibility. These losses occur from living in microgravity and are consistent with deficits seen in terrestrial, de-conditioning individuals. Since 2001, the Astronaut Strength, Conditioning and Rehabilitation (ASCR) specialists have administered a reconditioning program, focusing on all deficits, which improves the physical condition of all returning astronauts. In most cases, astronauts have reached or surpassed their preflight physical condition. Purpose: This presentation will describe and explain the postflight reconditioning program for returning astronauts. Methods: The postflight reconditioning program is designed to stress the body systems that affect the following: aerobic capacity, muscular strength, power, endurance, stamina, bone, balance, agility, coordination, orthostatic tolerances, proprioception, neurovestibular function and flexibility. Postflight reconditioning begins on landing day, is scheduled for two hours per day, 7 days a week for 45 days and is tailored to the specific needs of the astronaut. Initially the program focuses on basic ambulation, cardiovascular endurance, strength, balance, flexibility and proprioception. The program advances through 45 days and specific attention is given to each astronaut s overall condition, testing results, medical status, and assigned duties after their mission. Conclusion: Astronauts will experience noticeable deficits in their physical condition after living in microgravity for an extended length of time. After completing postflight reconditioning, it is shown that astronauts have regained, and in most cases improved upon, their preflight baseline condition.

Nieschwitz, Bruce↗

NASA NTRS2016

Management of Asymptomatic Renal Stones in Astronauts

Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain significance. However, a small asymptomatic MRM or stone within the renal collecting system may become symptomatic, and so affect launch and flight schedules, cause incapacitation during flight, and ultimately require medical evacuation. For exploration class missions, evacuation is unlikely. The new screening and management algorithm allows better management of mission risks, and will define the true incidence of renal stones in U.S. astronauts. This information will be used to refine future screening, countermeasures and treatment methods; and will also inform the needed capabilities to be flown on exploration-class missions.

Reyes, David↗

NASA NTRS2016

Management of Asymptomatic Renal Stones in Astronauts

Introduction: Management guidelines were created to screen and manage asymptomatic renal stones in U.S. astronauts. The risks for renal stone formation in astronauts due to bone loss and hypercalcuria are unknown. Astronauts have a stone risk which is about the same as commercial aviation pilots, which is about half that of the general population. However, proper management of this condition is still crucial to mitigate health and mission risks in the spaceflight environment. Methods: An extensive review of the literature and current aeromedical standards for the monitoring and management of renal stones was done. The NASA Flight Medicine Clinic's electronic medical record and Longitudinal Survey of Astronaut Health were also reviewed. Using this work, a screening and management algorithm was created that takes into consideration the unique operational environment of spaceflight. Results: Renal stone screening and management guidelines for astronauts were created based on accepted standards of care, with consideration to the environment of spaceflight. In the proposed algorithm, all astronauts will receive a yearly screening ultrasound for renal calcifications, or mineralized renal material (MRM). Any areas of MRM, 3 millimeters or larger, are considered a positive finding. Three millimeters approaches the detection limit of standard ultrasound, and several studies have shown that any stone that is 3 millimeters or less has an approximately 95 percent chance of spontaneous passage. For mission-assigned astronauts, any positive ultrasound study is followed by low-dose renal computed tomography (CT) scan, and flexible ureteroscopy if CT is positive. Other specific guidelines were also created. Discussion: The term "MRM" is used to account for small areas of calcification that may be outside the renal collecting system, and allows objectivity without otherwise constraining the diagnostic and treatment process for potentially very small calcifications of uncertain significance. However, a small asymptomatic MRM or stone within the renal collecting system may become symptomatic, and so affect launch and flight schedules, cause incapacitation during flight, and ultimately require medical evacuation. For exploration class missions, evacuation is unlikely. The new screening and management algorithm allows better management of mission risks, and will define the true incidence of renal stones in U.S. astronauts. This information will be used to refine future screening, countermeasures and treatment methods; and will also inform the needed capabilities to be flown on exploration-class missions.

Reyes, David↗

NASA NTRS1971

NASA's contributions to patient monitoring, appendix

Health care problems, and markets for patient monitoring equipment are discussed along with contributions to all phases of patient monitoring, and technology transfer to nonaerospace problems. Health care medical requirements, and NASA achievements in patient monitoring are described, and a summary of the technology transfer is included.

Murray, D. M.↗

NASA NTRS1972

A narrowband, crystal controlled biomedical telemetry system.

A miniature, single-channel, crystal-controlled transmitter has been developed for biomedical applications. A narrow-band frequency modulation (plus or minus 7 kHz) of the RF is used to achieve maximum operating range with minimum transmitting power. The radiated power is limited to stay within the 50 microvolts/m at 15 m FCC requirement for low-power transmitters in the 88- to 108-MHz band. This technique offers a number of advantages. First only manufacturer's type approval is required for the device and the user does not need a license. Second maximum operating range can be achieved within the FCC power limitations by using a narrow-band that is consistent with the required medical information bandwidth. A third advantage in using the 88- to 108-MHz band is that the commercial FM stations are relatively widely spaced and carefully regulated so that by selecting the transmitter's frequency in the guard band between stations, minimum interference from other transmitter sources is encountered.

Westbrook, R. M.↗

NASA NTRSDate not supplied

The potable water system in Skylab

Description of the medical requirements, development, system operation, and in-flight performance of the Skylab potable water system. Emphasized is the description of the unique features involving new space-flight concepts, procedures, and design incorporated in Skylab. The water supplied to the three Skylab missions was preloaded in stainless-steel tanks. These tanks were fitted with positive expulsion stainless-steel bellows. In-flight iodination of the water, for bacterial control, was accomplished as required. An in-flight bactericide monitor was used periodically to determine the level of bactericide in the water. Prior to the delivery of the water to the crewmen for consumption, the water was passed through a cation exchange resin for metallic ion removal and then heated for food reconstitution or chilled for drinking.

R. L. Sauer↗

NASA NTRS1975

Medical suitability for Federal employment

The medical requirements of the Civil Service Commission in determining employability of applicants for Federal employment are presented.

Eck, R. L.↗

NASA NTRS1977

Space Shuttle - A personal view

A typical flight profile for the Space Shuttle is reviewed, and the operation of the Spacelab, as well as deployment of a satellite from the Shuttle, is considered. Selection of crews for a Space Shuttle mission, which may include as many as four payload specialists, is also discussed. Since medical requirements and flight training standards need not be as high for payload specialists as for the three members of the flight crew, the Shuttle may provide an opportunity for many scientists to perform experiments in space. Investigations of the critical opalescence of fluids and laser holography are proposed for Shuttle missions; X-ray astronomy is another likely candidate for inclusion in the program.

Mark, H.↗

NASA NTRS1992

Liquid-Spray Formulation Of Scopolamine

Scopolamine, fast-acting anticholinergic drug, formulated into drops administered intranasally. Formulation very useful for people who need immediate relief from motion sickness, and they can administer it to themselves. Also used in other clinical situations in which fast-acting anticholinergic medication required. Modified into such other forms as gel preparation, aqueous-base ointment, or aerosol spray or mist; also dispensed in metered-dose delivery system.

Putcha, Lakshmi↗

NASA NTRS1992

Spaceflight training issues - Shuttle versus Station

A comparative study is made of the training practices used for Space Shuttle crews and those projected for the NASA Space Station Freedom, with a view to the relative advantages anticipated for these methods in the fields of long-duration flights, on-orbit construction techniques, on-orbit maintenance requirements, medical expertise, and remote manipulator operations. A Training Operations Subpanel has been established by NASA for the coordination of training method developments across the various elements and phases of the program.

Hughes, Frank E.↗

NASA NTRS1999

Kennedy Space Center Coronary Heart Disease Risk Screening Program

Coronary heart disease (CHD) is the number one cause of death in the U.S. It is a likely cause of death and disability in the lives of employees at Kennedy Space Center (KSC) as well. The KSC Biomedical Office used a multifactorial formula developed by the Framingham Heart Study to calculate CHD risk probabilities for individuals in a segment of the KSC population who require medical evaluation for job certification. Those individuals assessed to have a high risk probability will be targeted for intervention.

Tipton, David A.↗

NASA NTRS2007

NASA/Haughton-Mars Project 2006 Lunar Medical Contingency Simulation

A viewgraph presentation describing NASA's Haughton-Mars Project (HMP) medical requirements and lunar surface operations is shown. The topics onclude: 1) Mission Purpose/ Overview; 2) HMP as a Moon/Mars Analog; 3) Simulation objectives; 4) Discussion; and 5) Forward work.

Scheuring, Richard A.↗

NASA NTRS2010

Visual Impairment and Intracranial Hypertension: An Emerging Spaceflight Risk

What is the risk? Given that astronauts exposed to microgravity experience a cephalad fluid shift, and that both symptomatic and asymptomatic astronauts have exhibited optic nerve sheath edema on MRI, there is a high probability that all astronauts have some degree of increased intracranial pressure (ICP; intracranial hypertension), and that those susceptible (via eye architecture, anatomy, narrow optic disc) have a high likelihood of developing papilledema (optic disc edema, globe flattening), choroidal folds, and/or hyperopic shifts and that the degree of edema may determine long-term or permanent vision impairment or loss. Back to back panels on this topic have been developed to address this emerging risk. The first panel will focus on the 6 clinical cases with emphasis on ophthalmic findings and imaging techniques used pre-, in-, and post-flight. The second panel will discuss the operational mitigation and medical requirements, the potential role of CO2 on ISS, and the research approach being developed. In total these back to back panels will explore what is known about this risk, what has been done immediately to address it, and how an integrated research model is being developed.

Fogarty, Jennifer A.↗

NASA NTRS2011

Cognitive Assessment in Long-Duration Space Flight

This slide presentation reviews the development and use of a tool for assessing spaceflight cognitive ability in astronauts. This tool. the Spaceflight Cognitive Assessment Tool for Windows (WinSCAT) has been used to provide ISS flight surgeons with an objective clinical tool to monitor the astronauts cognitive status during long-duration space flight and allow immediate feedback to the astronaut. Its use is medically required for all long-duration missions and it contains a battery of five cognitive assessment subtests that are scheduled monthly and compared against the individual preflight baseline.

Kane, Robert↗

NASA NTRS2011

Space: The Final Frontier of Bone Density

It is a medical requirement at NASA to evaluate the skeletal integrity of "long-duration" astronauts by measuring bone mineral density [BMD] with DXA technology. A long-duration mission is a spaceflight that is greater than 30 days but is typically the continuous 120-180 day missions aboard the International Space Station [ISS]. Not only does NASA use the BMD index to monitor fracture risk in this astronaut population, but these measures are also used to describe the effects of spaceflight, to certify skeletal health readiness for flight, to monitor the recovery of lost bone mass after return to earth, and to evaluate the efficacy of countermeasures to bone loss. However, despite the fact that DXA-based BMD is a widely-applied surrogate for bone strength that is grounded in an abundance of population-based fracture data, its applicability to the long-duration astronaut is limited. The cohort of long-duration astronauts is not the typical group for evaluating osteoporosis or determining age-related fracture risk. The cohort is young (< 55 years), predominantly male and exposed to novel risk factors for bone loss besides the weightlessness of space. NASA is concerned about early onset osteoporosis in the astronaut exposed to long-duration spaceflight, especially since any detectable symptoms are likely to manifest after return to earth and perhaps years after space travel. This risk raises the question: is NASA doing enough now to mitigate a fracture event that may manifest later? This presentation will discuss the limitations and constraints to understanding skeletal changes due to prolonged spaceflight and the recommendations, by clinical experts in osteoporosis and BMD, to transition research technologies for clinical decision-making by NASA.

Sibonga, Jean D.↗

NASA NTRS2012

Plasma Cytokine Levels During Long-Duration Spaceflight

Determine the in-flight status of immunity, physiological stress, viral immunity/reactivation. Specific measurements include leukocyte distribution, T cell function, cytokine production profiles (mRNA, intracellular, secreted, plasma), virus-specific T cell number/function, latent herpesvirus reactivation, stress hormone levels. Determine the clinical risk related to immune dysregulation for exploration class spaceflight, as well as an appropriate monitoring strategy for spaceflight-associated immune dysfunction, that could be used for the evaluation of countermeasures. Specific Study Objectives: Determine the nutritional status of astronauts before, during, and after spaceflight ensure adequate intake of energy, protein, and vitamins during missions. The Clinical Nutritional Status Assessment measures dietary intake, body composition, protein, bone, iron, mineral, vitamin, and antioxidant status (60 total analytes). Currently, it is a medical requirement for U.S. crewmembers on-board the ISS. The results of data analysis are used both to understand the connections between nutrition and human health during space flight, and to develop effective dietary strategies to reduce adverse health impacts (including bone loss, loss of important vitamins and minerals, and increased genetic damage from radiation).

Crucian, Brian E.↗

NASA NTRS2014

Portable Load Measurement Device for Use During ARED Exercise on ISS

The Advanced Resistive Exercise Device (ARED) (Fig.1) is unique countermeasure hardware available to crewmembers aboard the International Space Station (ISS) used for resistance exercise training to protect against bone and muscle loss during long duration space missions. ARED instrumentation system was designed to measure and record exercise load data, but: - Reliably accurate data has not been available due to a defective force platform. - No ARED data has been recorded since mid-2011 due to failures in the instrumentation power system. ARED load data supports on-going HRP funded research, and is available to extramural researchers through LSDA-Repository. Astronaut Strength, Conditioning, and Rehabilitation specialists (ASCRs) use ARED data to track training progress and advance exercise prescriptions. ARED load data is necessary to fulfill medical requirements. HRP directed task intends to reduce to program risk (HRP IRMA Risk 1735), and evaluate the XSENS ForceShoeTM as a means of obtaining ARED load data during exercise sessions. The XSENS ForceShoes"TM" will fly as a hardware demonstration to ISS in May 2014 (39S). Additional portable load monitoring devices (PLMDs) are under evaluation in the ExPC Lab. PLMDs are favored over platform redesign as they support future exploration needs.

Hanson, A.↗

NASA NTRS2014

The Importance of Data Visualization: Incorporating Storytelling into the Scientific Presentation

From its inception in 2000, one of the primary tasks of the Biomedical Data Reduction Analysis (BDRA) group has been translation of large amounts of data into information that is relevant to the audience receiving it. BDRA helps translate data into an integrated model that supports both operational and research activities. This data integrated model and subsequent visual data presentations have contributed to BDRA's success in delivering the message (i.e., the story) that its customers have needed to communicate. This success has led to additional collaborations among groups that had previously not felt they had much in common until they worked together to develop solutions in an integrated fashion. As more emphasis is placed on working with "big data" and on showing how NASA's efforts contribute to the greater good of the American people and of the world, it becomes imperative to visualize the story of our data to communicate the greater message we need to share. METHODS To create and expand its data integrated model, BDRA has incorporated data from many different collaborating partner labs and other sources. Data are compiled from the repositories of the Lifetime Surveillance of Astronaut Health and the Life Sciences Data Archive, and from the individual laboratories at Johnson Space Center that support collection of data from medical testing, environmental monitoring, and countermeasures, as designated in the Medical Requirements Integration Documents. Ongoing communication with the participating collaborators is maintained to ensure that the message and story of the data are retained as data are translated into information and visual data presentations are delivered in different venues and to different audiences. RESULTS We will describe the importance of storytelling through an integrated model and of subsequent data visualizations in today's scientific presentations and discuss the collaborative methods used. We will illustrate the discussion with examples of graphs from BDRA's past work supporting operations and/or research efforts.

Babiak-Vazquez, A.↗