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All sourcesNASA NTRSDOE OSTI
DOE OSTI2021

Performance Evaluation of Comparative Vacuum Monitoring and Piezoelectric Sensors for Structural Health Monitoring of Rotorcraft Components

The costs associated with the increasing maintenance and surveillance needs of aging structures are rising at an unexpected rate. Multi-site fatigue damage, hidden cracks in hard-to-reach locations, disbonded joints, erosion, impact, and corrosion are among the major flaws encountered in today’s extensive fleet of aging aircraft and space vehicles. Aircraft maintenance and repairs represent about a quarter of a commercial fleet’s operating costs. The application of Structural Health Monitoring (SHM) systems using distributed sensor networks can reduce these costs by facilitating rapid and global assessments of structural integrity. The use of in-situ sensors for real-time health monitoring can overcome inspection impediments stemming from accessibility limitations, complex geometries, and the location and depth of hidden damage. Reliable, structural health monitoring systems can automatically process data, assess structural condition, and signal the need for human intervention. The ease of monitoring an entire on-board network of distributed sensors means that structural health assessments can occur more often, allowing operators to be even more vigilant with respect to flaw onset. SHM systems also allow for condition-based maintenance practices to be substituted for the current time-based or cycle-based maintenance approach thus optimizing maintenance labor. The Federal Aviation Administration has conducted a series of SHM validation and certification programs intended to comprehensively support the evolution and adoption of SHM practices into routine aircraft maintenance practices. This report presents one of those programs involving a Sandia Labs-aviation industry effort to move SHM into routine use for aircraft maintenance. The Airworthiness Assurance NDI Validation Center (AANC) at Sandia Labs, in conjunction with Sikorsky, Structural Monitoring Systems Ltd., Anodyne Electronics Manufacturing Corp., Acellent Technologies Inc., and the Federal Aviation Administration (FAA) carried out a trial validation and certification program to evaluate Comparative Vacuum Monitoring (CVM) and Piezoelectric Transducers (PZT) as a structural health monitoring solution to specific rotorcraft applications. Validation tasks were designed to address the SHM equipment, the health monitoring task, the resolution required, the sensor interrogation procedures, the conditions under which the monitoring will occur, the potential inspector population, adoption of CVM and PZT systems into rotorcraft maintenance programs and the document revisions necessary to allow for their routine use as an alternate means of performing periodic structural inspections. This program addressed formal SHM technology validation and certification issues so that the full spectrum of concerns, including design, deployment, performance and certification were appropriately considered. Sandia Labs designed, implemented, and analyzed the results from a focused and statistically relevant experimental effort to quantify the reliability of a CVM system applied to Sikorsky S-92 fuselage frame application and a PZT system applied to an S-92 main gearbox mount beam application. The applications included both local and global damage detection assessments. All factors that affect SHM sensitivity were included in this program: flaw size, shape, orientation and location relative to the sensors, as well as operational and environmental variables. Statistical methods were applied to performance data to derive Probability of Detection (POD) values for SHM sensors in a manner that agrees with current nondestructive inspection (NDI) validation requirements and is acceptable to both the aviation industry and regulatory bodies. The validation work completed in this program demonstrated the ability of both CVM and PZT SHM systems to detect cracks in rotorcraft components. It proved the ability to use final system response parameters to provide a Green Light/Red Light (“GO” – “NO GO”) decision on the presence of damage. In additional to quantifying the performance of each SHM system for the trial applications on the S-92 platform, this study also identified specific methods that can be used to optimize damage detection, guidance on deployment scenarios that can affect performance and considerations that must be made to properly apply CVM and PZT sensors. These results support the main goal of safely integrating SHM sensors into rotorcraft maintenance programs. Additional benefits from deploying rotorcraft Health and Usage Monitoring Systems (HUMS) may be realized when structural assessment data, collected by an SHM system, is also used to detect structural damage to compliment the operational environment monitoring. The use of in-situ sensors for health monitoring of rotorcraft structures can be a viable option for both flaw detection and maintenance planning activities. This formal SHM validation will allow aircraft manufacturers and airlines to confidently make informed decisions about the proper utilization of CVM and PZT technology. It will also streamline future regulatory actions and formal certification measures needed to assure the safe application of SHM solutions.

42 ENGINEERING↗
DOE OSTI2022

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↗
NASA NTRS1994

Dual-Use Aspects of System Health Management

System Health Management functionality is an essential part of any space launch system. Health management functionality is an integral part of mission reliability, since it is needed to verify the reliability before the mission starts. Health Management is also a key factor in life cycle cost reduction and in increasing system availability. The degree of coverage needed by the system and the degree of coverage made available at a reasonable cost are critical parameters of a successful design. These problems are not unique to the launch vehicle world. In particular, the Intelligent Vehicle Highway System, commercial aircraft systems, train systems, and many types of industrial production facilities require various degrees of system health management. In all of these applications, too, the designers must balance the benefits and costs of health management in order to optimize costs. The importance of an integrated system is emphasized. That is, we present the case for considering health management as an integral part of system design, rather than functionality to be added on at the end of the design process. The importance of maintaining the system viewpoint is discussed in making hardware and software tradeoffs and in arriving at design decisions. We describe an approach to determine the parameters to be monitored in any system health management application. This approach is based on Design of Experiments (DOE), prototyping, failure modes and effects analyses, cost modeling and discrete event simulation. The various computer-based tools that facilitate the approach are discussed. The approach described originally was used to develop a fault tolerant avionics architecture for launch vehicles that incorporated health management as an integral part of the system. Finally, we discuss generalizing the technique to apply it to other domains. Several illustrations are presented.

Owens, P. R.↗
NASA NTRS2005

NCAR Johns Hopkins/CDC Climate and Health Summer Institute

The interactions between climate and health are rife with complexity and present many conceptual and methodological challenges. Possible effects of climate change on health are considered some of the most sensitive impacts of climate change and are a high priority for policy-makers and the public. As a first step toward improving tlit: quality of research, we developed a Climate and Health Workshop (Institute), geared toward teaching students various aspects of how to conduct integrated climate and health research. At the workshop scientists presented selected case studies of climate and health (e.g., heat mortality, vector-borne diseases), thus demonstrating a subset of key analytical tools and databases most useful to researchers in this field. Key research gaps in this research area were discussed. In this six-day Institute (21-28 July 2004, Boulder, Colorado), health scientists and students benefited from lectures and hands-on tools taught by top NCAR scientists. The attendees learned about health databases and epidemiologic methods from leading health scientists from CDC, Johns Hopkins, and other institutions from around the globe.

Mearns, Linda O.↗
NASA NTRS2006

Health and Fitness Evaluations for Long Duration Microgravity Exposure

The current health maintenance program for ISS is adequate; however the future of medical care and research in space requires a change where crew time efficiency and autonomy are emphasized. NASA s medical personnel are currently refining their ability to monitor and provide remote health care in such a manner. The proposed plan would evaluate health and fitness of the on orbit crew to; perform on orbit operations, and readiness to return to a terrestrial environment. A two tiered approach will utilize exercise and medical equipment, as well as periodic medical conferences with the flight surgeon, to provide a quantitative and clinical picture of the crew s health and fitness. Any off nominal health and fitness issues that could arise will be evaluated by providing an "armamentarium" of devices both medical and exercise specific to the on orbit crew to use. The ability for the crew to provide autonomous health care, with decreasing earth support, will become increasingly more important for exploration missions. This new plan of health care and maintenance will allow us to, development such efforts while continuing to monitor and provide the best possible health, care and medical research through the microgravity environment on board ISS.

Roden, Sean Kevin↗
NASA NTRS2000

Bone Quest - A Space-Based Science and Health Education Unit

This proposal addresses the need for effective and innovative science and health education materials that focus on space bone biology and its implications for bone health on Earth. The focus of these materials, bone biology and health, will increase science knowledge as well as health awareness. Current investigations of the bone loss observed after long-duration space missions provide a link between studies of bone health in space, and studies of osteoporosis, a disease characterized by bone loss and progressive skeletal weakness. The overall goal of this project is to design and develop web-based and print-based materials for high school science students, that will address the following: a) knowledge of normal bone biology and bone biology in a microgravity environment; b) knowledge of osteoporosis; c) knowledge of treatment modalities for space- and Earth-based bone loss; and d} bone-related nutrition knowledge and behavior. To this end, we propose to design and develop a Bone Biology Tutorial which will instruct students about normal bone biology, bone biology in a microgravity environment, osteoporosis - its definition, detection, risk factors, and prevention, treatment modalities for space- and Earth-based bone loss, and the importance of nutrition in bone health. Particular emphasis will be placed on current trends in . adolescent nutrition, and their relationships to bone health. Additionally, we propose to design and develop two interactive nutrition/health ' education activities that will allow students to apply the information provided in the Bone Biology Tutorial. In the first, students will apply constructs provided in the Bone Biology Tutorial to design "Bone Health Plans" for space travelers.

Smith, Scott M.↗
NASA NTRS2011

Using NASA Remotely Sensed Data to Help Characterize Environmental Risk Factors for National Public Health Applications

NASA Marshall Space Flight Center is collaborating with the University of Alabama at Birmingham (UAB) School of Public Health and the Centers for Disease Control and Prevention (CDC) National Center for Public Health Informatics to address issues of environmental health and enhance public health decision making by utilizing NASA remotely sensed data and products. The objectives of this study are to develop high-quality spatial data sets of environmental variables, link these with public health data from a national cohort study, and deliver the linked data sets and associated analyses to local, state and federal end-user groups. Three daily environmental data sets will be developed for the conterminous U.S. on different spatial resolutions for the period 2003-2008: (1) spatial surfaces of estimated fine particulate matter (PM2.5) exposures on a 10-km grid utilizing the US Environmental Protection Agency (EPA) ground observations and NASA's MODerate-resolution Imaging Spectroradiometer (MODIS) data; (2) a 1-km grid of Land Surface Temperature (LST) using MODIS data; and (3) a 12-km grid of daily Solar Insolation (SI) using the North American Land Data Assimilation System (NLDAS) forcing data. These environmental data sets will be linked with public health data from the UAB REasons for Geographic And Racial Differences in Stroke (REGARDS) national cohort study to determine whether exposures to these environmental risk factors are related to cognitive decline and other health outcomes. These environmental datasets and public health linkage analyses will be disseminated to end-users for decision making through the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) system.

Al-Hamdan, Mohammad↗
NASA NTRS2013

It's the Heat AND the Humidity -- Assessment of Extreme Heat Scenarios to Enable the Assessment of Climate Impacts on Public Health

In the United States, extreme heat is the most deadly weather-related hazard. In the face of a warming climate and urbanization, which contributes to local-scale urban heat islands, it is very likely that extreme heat events (EHEs) will become more common and more severe in the U.S. In a NASA-funded project supporting the National Climate Assessment, we are providing historical and future measures of extreme heat to enable assessments of the impacts of heat on public health over the coterminous U.S. We use atmospheric temperature and humidity information from meteorological reanalysis and from Global Climate Models (GCMs) to provide data on past and future heat events. The project s emphasis is on providing assessments of the magnitude, frequency and geographic distribution of extreme heat in the U.S. to facilitate public health studies. In our approach, long-term climate change is captured with GCM output, and the temporal and spatial characteristics of short-term extremes are represented by the reanalysis data. Two future time horizons, 2040 and 2090, are the focus of future assessments; these are compared to the recent past period of 1981-2000. We are characterizing regional-scale temperature and humidity conditions using GCM output for two climate change scenarios (A2 and A1B) defined in the Special Report on Emissions Scenarios (SRES). For each future period, 20 years of multi-model GCM output have been analyzed to develop a heat stress climatology based on statistics of extreme heat indicators. Differences between the two future and past periods have been used to define temperature and humidity changes on a monthly time scale and regional spatial scale. These changes, combined with hourly historical meteorological data at a spatial scale (12 km) much finer than that of GCMs, enable us to create future climate realizations, from which we compute the daily heat stress measures and related spatially-specific climatological fields. These include the mean annual number of days above certain thresholds of maximum and minimum air temperatures, heat indices and a new heat stress variable that gives an integrated measure of heat stress (and relief) over the course of a day. Comparisons are made between projected (2040 and 2090) and past (1990) heat stress statistics. All output is being provided at the 12 km spatial scale and will also be aggregated to the county level, which is a popular scale of analysis for public health researchers. County-level statistics will be made available by our collaborators at the Centers for Disease Control and Prevention (CDC) via the Wide-ranging Online Data for Epidemiologic Research (WONDER) system. CDC WONDER makes the information resources of the CDC available to public health professionals and the general public. This addition of heat stress measures to CDC WONDER will allow decision and policy makers to assess the impact of alternative approaches to optimize the public health response to EHEs. It will also allow public health researchers and policy makers to better include such heat stress measures in the context of national health data available in the CDC WONDER system. The users will be able to spatially and temporally query public health and heat-related data sets and create county-level maps and statistical charts of such data across the coterminous U.S.

Crosson, William L↗
NASA NTRS2013

Public Health Applications of Remotely-sensed Environmental Datasets for the Conterminous United States

NASA Marshall Space Flight Center is collaborating with the University of Alabama at Birmingham (UAB) School of Public Health and the Centers for Disease Control and Prevention (CDC) National Center for Public Health Informatics to address issues of environmental health and enhance public health decision-making using NASA remotely-sensed data and products. The objectives of this study are to develop high-quality spatial data sets of environmental variables, link these with public health data from a national cohort study, and deliver the linked data sets and associated analyses to local, state and federal end-user groups. Three daily environmental data sets were developed for the conterminous U.S. on different spatial resolutions for the period 2003-2008: (1) spatial surfaces of estimated fine particulate matter (PM2.5) exposures on a 10-km grid using the US Environmental Protection Agency (EPA) ground observations and NASA's MODerate-resolution Imaging Spectroradiometer (MODIS) data; (2) a 1-km grid of Land Surface Temperature (LST) using MODIS data; and (3) a 12-km grid of daily Incoming Solar Radiation (Insolation) and heat-related products using the North American Land Data Assimilation System (NLDAS) forcing data. These environmental data sets were linked with public health data from the UAB REasons for Geographic And Racial Differences in Stroke (REGARDS) national cohort study to determine whether exposures to these environmental risk factors are related to cognitive decline, stroke and other health outcomes. These environmental datasets and the results of the public health linkage analyses will be disseminated to end-users for decision-making through the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) system and through peer-reviewed publications respectively. The linkage of these data with the CDC WONDER system substantially expands public access to NASA data, making their use by a wide range of decision makers feasible. By successful completion of this research, decision-making activities, including policy-making and clinical decision-making, can be positively affected through utilization of the data products and analyses provided on the CDC WONDER system.

Al-Hamdan, Mohammad↗
NASA NTRS2021

Asthma and Particulate Matter Pollution: Insights from Health Survey and Air Quality Monitoring in the Buzzard Point, Washington, DC Neighborhood

Air pollution, climate change, and other environmental factors contribute to increasing asthma in manycities, including Washington, DC. This work provides a case study of how community input, neighborhood-level health surveys, and air quality monitoring can inform the understanding of asthma and air pollution.A partnership between residents, concerned citizens, scientists, and educators has been working for envi-ronmental health in a DC neighborhood located on a major roadway, next to concrete batch plants andclose to several construction projects. A 2016 Community Health and Safety Study by the DC Departmentof Health, Office of Health Equity, recognized this particular neighborhood as more vulnerable to healthimpacts from recent construction in the area, compared with the surrounding areas, due to lower averageincome and higher percentage of seniors and children. This work presents neighborhood health surveysand air quality monitoring data at a more granular, local level than available from DC governmentagencies. The health surveys documented residents’ experiences around air pollution, asthma,and other health concerns. A key finding was evidence that asthma might be undercounted in thisneighborhood; among residents who did not indicate a diagnosis of asthma, many discussed havingsymptoms that could reflect asthma. Air quality monitoring (particulate matter [PM]) did not indicate thatfederal air quality standards have been violated. Real-time PM data, however,illustrated how current PMstandards, such as 1- and 24-hour averages, may fail to capture shorter duration high PM events that areconsistent with resident concerns.

Shizuka Hsieh↗
NASA NTRSDate not supplied

Results of the 2022 Mental Health Survey of the Planetary Science Community

The mental health struggles within academia and research are well recognized in the science community and have been further illustrated by the numerous cultural memes and comics (e.g., PhD Comics). With the recent COVID-19 pandemic, mental health has become a topic of concern more so than ever before, as depression and anxiety have become an invisible consequence of social isolation and distancing. In addition, recent social events in the United States have reignited attention towards important social injustices surrounding people of color, women, and LGBTQ+ in academia. If diversity, equity, inclusion, and accessibility are to become major components of improving planetary science, it is also important to understand the mental health status of the community, as it could expose deeply embedded policies, rules, and culture that may hinder any work in sustaining and advancing people belonging to marginalized groups. Studies have been conducted to further understand the mental health of those in academia. These studies have shown that before the pandemic, there was a mental health crisis among graduate students, which became a larger problem with increasing anxiety and depression due to the pandemic. Soon after, the planetary science community recognized this concern in the recent 2023 Planetary Science Decadal White Paper, which proposed that NASA should invest in understanding the scope and impact of mental health problems within the planetary science community and how to address the issue. In this study, we conducted a mental health survey to examine the mental health of the planetary science community. We examined the overall anxiety, depression, and stress severity of the community, rather than diagnosing the community’s condition or determining the proportion of the population having a clinical anxiety, depressive, stress, or trauma-related diagnosis. To emphasize, the results are not intended to make clinical diagnoses, nor are they being used to do so for the purpose of this study.

D Trang↗
DOE OSTI2020

Quantifying cover crop effects on soil health and productivity

The dataset presented here supports the research paper entitled “A calculator to quantify cover crop effects on soil health and productivity”. Soil health (sometimes used synonymously with soil quality) is a concept that describes soil as a living system to sustain plants, animals, and human. Soil physical, chemical, and biological properties, along with their interactions, are required to quantify soil health. The use of cover crops in agricultural rotations may enhance soil health, yet there has been little progress in understanding how external factors such as climate, soil type, and agronomic practices affect soil and cash crop responses. In response, this dataset compiles measurements from 281 studies and provides an analysis of field-measured changes in 38 soil health indicators due to cover crop usage. Environmental and background indicators were also compiled to assess how climatic and management practices affect soil and cash crop responses to cover crops, with specific categories including climate type (tropical, arid, temperate, and continental), soil texture (coarse, medium, and fine), cover crop type (legume, grass, multi-species mixture, and other), and cash crop type (corn, soybean, wheat, vegetable, corn-soybean rotation, corn-soybean-wheat rotation, and other). An unbalanced analysis of variation was used to determine the hierarchy of most to least important factors that affected responsiveness of each soil health indicator. Based on the hierarchy structure, a soil health calculator was then developed to quantify the response of 13 parameters – erosion, runoff, weed suppression, soil aggregate stability, leaching, infiltration, microbial biomass carbon, soil bulk density, soil organic carbon, soil nitrogen, microbial biomass nitrogen, cash crop yield, and saturated hydraulic conductivity – to cover crops. The presented data in the calculator report the mean change in parameter values based on all combinations of climate, soil texture, cover crop type, and cash crop type.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2021

Predicting measures of soil health using the microbiome and supervised machine learning

Soil health encompasses a range of biological, chemical, and physical soil properties that sustain the commercial and ecological value of agroecosystems. Monitoring soil health requires a comprehensive set of diagnostics that can be cost-prohibitive for routine analyses. The soil microbiome provides a rich source of information about soil properties, which can be assayed in a high-throughput, cost-effective way. We evaluated the accuracy of random forest (RF) and support vector machine (SVM) regression and classification models in predicting 12 measures of soil health, tillage status, and soil texture from 16S rRNA gene amplicon data with an operationally relevant sample set. We validated the efficacy of the best performing models against independent datasets and also tested best practices for processing microbiome data for use in machine learning. Soil health metrics could be predicted from microbiome data with the best models achieving a Kappa value of ~0.65, for categorical assessments, and a R2 value of ~0.8, for numerical scores. Biological health ratings were better predicted than chemical or physical ratings. Validation with independent datasets revealed that models had general predictive value for soil properties, including yield. The ecological profiles of several taxa important for model accuracy matched the observed relationships with soil health, including Pyrinomonadaceae, Nitrososphaeraceae, and Candidatus Udeaobacter. Models trained at the highest taxonomic resolution proved most accurate, with losses in accuracy resulting from rarefying, sparsity filtering, and aggregating at higher taxonomic ranks. Furthermore, our study provides the groundwork for developing scalable technology to use microbiome-based diagnostics for the assessment of soil health.

16S rRNA gene↗
DOE OSTI2025

VA Community Determinants of Health Data Curation Documentation FY26-Q1

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources. With funding from the VA Office of Mental Health and Suicide Prevention (OMHSP), the Community Determinants of Health (EDH) Data project has developed innovative datasets associated with specific health outcomes, a methodology for transforming spatiotemporal data from one spatial reference (e.g., a 1km grid) to another (e.g., US Census Tracts), and capabilities for modeling health outcomes. These datasets represent an enhancement of the Agency for Healthcare Research and Quality (AHRQ), addressing key gaps by introducing finer spatial resolution (Census Tract) and additional geographical covariates into existing data. The curation and standardization of these datasets is a complex task since they often originate from various sources and are measured at different spatial and temporal resolutions. For example, US Census data products typically use census blocks, block groups, or counties, while data like weather data are available on 1km grids. Some economic data may only be available at the zip code level. In this context, ‘standardized’ means that all datasets share the same spatial extent (e.g., US Census Tract and/or County), and ‘curated’ implies a repeatable process with data provenance and the use of appropriate methodologies for covariate conversion. The Community Determinants of Health datasets draw from multiple sources, resulting in variables with varying degrees of availability, patterns of missing data, and methodological considerations across different sources, geographies, and years.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2024

Health Care Usage During the COVID-19 Pandemic and the Adoption of Telemedicine: Retrospective Study of Chronic Disease Cohorts

Background: The COVID-19 pandemic accelerated telehealth adoption across disease cohorts of patients. For many patients, routine medical care was no longer an option, and others chose not to visit medical offices in order to minimize COVID-19 exposure. In this study, we take a comprehensive multidisease approach in studying the impact of the COVID-19 pandemic on health care usage and the adoption of telemedicine through the first 12 months of the COVID-19 pandemic. Objective: We studied the impact of the COVID-19 pandemic on in-person health care usage and telehealth adoption across chronic diseases to understand differences in telehealth adoption across disease cohorts and patient demographics (such as the Social Vulnerability Index [SVI]). Methods: We conducted a retrospective cohort study of 6 different disease cohorts (anxiety: n=67,578; depression: n=45,570; diabetes: n=81,885; kidney failure: n=29,284; heart failure: n=21,152; and cancer: n=35,460). We used summary statistics to characterize changes in usage and regression analysis to study how patient characteristics relate to in-person health care and telehealth adoption and usage during the first 12 months of the pandemic. Results: We observed a reduction in in-person health care usage across disease cohorts (ranging from 10% to 24%). For most diseases we study, telehealth appointments offset the reduction in in-person visits. Furthermore, for anxiety and depression, the increase in telehealth usage exceeds the reduction in in-person visits (by up to 5%). We observed that younger patients and men have higher telehealth usage after accounting for other covariates. Patients from higher SVI areas are less likely to use telehealth; however, if they do, they have a higher number of telehealth visits, after accounting for other covariates. Conclusions: The COVID-19 pandemic affected health care usage across diseases, and the role of telehealth in replacing in-person visits varies by disease cohort. Understanding these differences can inform current practices and provides opportunities to further guide modalities of in-person and telehealth visits. Critically, further study is needed to understand barriers to telehealth service usage for patients in higher SVI areas. A better understanding of the role of social determinants of health may lead to more support for patients and help individual health care providers improve access to care for patients with chronic conditions.

60 APPLIED LIFE SCIENCES↗
NASA NTRS1991

A health maintenance facility for space station freedom

We describe a health care facility to be built and used on an orbiting space station in low Earth orbit. This facility, called the health maintenance facility, is based on and modeled after isolated terrestrial medical facilities. It will provide a phased approach to health care for the crews of Space Station Freedom. This paper presents the capabilities of the health maintenance facility. As Freedom is constructed over the next decade there will be an increase in activities, both construction and scientific. The health maintenance facility will evolve with this process until it is a mature, complete, stand-alone health care facility that establishes a foundation to support interplanetary travel. As our experience in space continues to grow so will the commitment to providing health care.

Health Promotion/organization & administration/sta↗
DOE OSTI2021

The soil health assessment protocol and evaluation applied to soil organic carbon

The concept of soil health has evolved over the past several decades, recognizing that dynamic soil property response to management and land use is highly dependent on site-specific factors that must be considered when interpreting soil health measurements. Initially, the Soil Management Assessment Framework (SMAF) and Comprehensive Assessment of Soil Health (CASH) were developed and used globally for scoring soil health indicators. However, both SMAF and CASH frameworks were developed using a relatively small dataset and their interpretation curves were not validated at the nationwide scale. Expanding upon these concepts, we propose the Soil Health Assessment Protocol and Evaluation (SHAPE) tool. The SHAPE was developed using 14,680 soil organic C (SOC) observations from across the United States, and accounts for edaphic and climate factors at the continental scale. Data were compiled from the literature, the Cornell Soil Health Laboratory, and the Kellogg Soil Survey Laboratory. In this approach, scoring curves are Bayesian model-based estimates of the conditional cumulative distribution function (CDF) for defined soil peer groups reflecting five soil texture and five soil suborder classes adjusted for mean annual temperature and precipitation. Specifically, SHAPE produces scores between 0 and 1 (0–100%) for measured SOC values that reflect the quantile or position within the conditional CDF along with measures of uncertainty. Herein, we focus on development of the SHAPE scoring curve for SOC with our case studies. SHAPE is a flexible, quantitative tool that provides a regionally relevant interpretation of this key soil health indicator.

54 ENVIRONMENTAL SCIENCES↗
DOE OSTI2020

Development of Employee Health Services Scorecards and Dashboards for Sandia National Laboratories (SAND2020-2243 J)

The mission of Employee Health Services (EHS) at Sandia National Laboratories is to positively and efficiently impact the health of Sandia through patient-centered, cost-effective, community-connected care in support of its mission and people. We strive to continuously improve the delivery of health and wellness services. For the past few years, we have modeled our health programs around findings from the 2010 World Economics Forum (WEF): there are 8 top health risks and behaviors that drive 15 chronic conditions which account for 80% of the total health-care costs for all chronic illness worldwide. The WEF goes on to state that information and innovation are the keys to prevention, and EHS has decided to take a strong stand in both categories by utilizing health scorecards and department dashboards to visualize and share metrics with Sandia Leadership to foster improvements in employee wellness and optimize wellness offerings. Finally, these 2 types of information-sharing tools allow us to track the dollars spent and saved on our wellness programs, and show leadership where there is risk, where there is progress, and where there is need by providing current data that gives monthly, quarterly, and yearly feedback.

60 APPLIED LIFE SCIENCES↗