Engineering, Life Sciences, and Health/Medicine Synergy in Aerospace Human Systems Integration: The Rosetta Stone Project

In the realm of aerospace engineering and the physical sciences, we have developed laws of physics based on empirical and research evidence that reliably guide design, research, and development efforts. For instance, an engineer designs a system based on data and experience that can be consistently and repeatedly verified. This reproducibility depends on the consistency and dependability of the materials on which the engineer works and is subject to physics, geometry and convention. In life sciences and medicine, these apply as well, but individuality introduces a host of variables into the mix, resulting in characteristics and outcomes that can be quite broad within a population of individuals. This individuality ranges from differences at the genetic and cellular level to differences in an individuals personality and abilities due to sex and gender, environment, education, etc

Advanced Environmental Monitoring and Control Program: Technology Development Requirements

Human missions in space, from the International Space Station on towards potential human exploration of the moon, Mars and beyond into the solar system, will require advanced systems to maintain an environment that supports human life. These systems will have to recycle air and water for many months or years at a time, and avoid harmful chemical or microbial contamination. NASA's Advanced Environmental Monitoring and Control program has the mission of providing future spacecraft with advanced, integrated networks of microminiaturized sensors to accurately determine and control the physical, chemical and biological environment of the crew living areas. This document sets out the current state of knowledge for requirements for monitoring the crew environment, based on (1) crew health, and (2) life support monitoring systems. Both areas are updated continuously through research and space mission experience. The technologies developed must meet the needs of future life support systems and of crew health monitoring. These technologies must be inexpensive and lightweight, and use few resources. Using these requirements to continue to push the state of the art in miniaturized sensor and control systems will produce revolutionary technologies to enable detailed knowledge of the crew environment

International Space Station Multilateral Medical Policy Board Transitions in Space Medicine 25 Years in Photos

This collection of photographic highlights covers the past 25 years of international collaboration in human spaceflight. Beginning in 1993, the international community came together to develop the medical systems for an international space station. Initially, this collaboration was bilateral in support of the Shuttle / Mir Space Station (Phase 1). However, the framework that was established to serve as the medical authority structure provided a foundation for the multilateral boards and panel, which were codified in the memoranda of understanding

Surgical Capabilities for Exploration and Colonization Space Flight - An Exploratory Symposium

Identify realistic and achievable pathways for surgical capabilities during exploration and colonization space operations and develop a list of recommendations to the NASA Human Research Program to address challenges to developing surgical capabilities

Evaluating a Web-Based Interface for Internet Telemedicine

The objective is to introduce the usability engineering methodology, heuristic evaluation, to the design and development of a web-based telemedicine system. Using a set of usability criteria, or heuristics, one evaluator examined the Spacebridge to Russia web-site for usability problems. Thirty-four usability problems were found in this preliminary study and all were assigned a severity rating. The value of heuristic analysis in the iterative design of a system is shown because the problems can be fixed before deployment of a system and the problems are of a different nature than those found by actual users of the system. It was therefore determined that there is potential value of heuristic evaluation paired with user testing as a strategy for optimal system performance design

The Empirical Foundations of Telemedicine Interventions in Primary Care

Introduction: This article presents the scientific evidence for the merits of telemedicine interventions in primary care. Although there is no uniform and consistent definition of primary care, most agree that it occupies a central role in the healthcare system as first contact for patients seeking care, as well as gatekeeper and coordinator of care. It enables and supports patient-centered care, the medical home, managed care, accountable care, and population health. Increasing concerns about sustainability and the anticipated shortages of primary care physicians have sparked interest in exploring the potential of telemedicine in addressing many of the challenges facing primary care in the United States and the world. Materials and Methods: The findings are based on a systematic review of scientific studies published from 2005 through 2015. The initial search yielded 2,308 articles, with 86 meeting the inclusion criteria. Evidence is organized and evaluated according to feasibility/acceptance, intermediate outcomes, health outcomes, and cost. Results: The majority of studies support the feasibility/acceptance of telemedicine for use in primary care, although it varies significantly by demographic variables, such as gender, age, and socioeconomic status, and telemedicine has often been found more acceptable by patients than healthcare providers. Outcomes data are limited but overall suggest that telemedicine interventions are generally at least as effective as traditional care. Cost analyses vary, but telemedicine in primary care is increasingly demonstrated to be cost-effective. Conclusions: Telemedicine has significant potential to address many of the challenges facing primary care in today's healthcare environment. Challenges still remain in validating its impact on clinical outcomes with scientific rigor, as well as in standardizing methods to assess cost, but patient and provider acceptance is increasingly making telemedicine a viable and integral component of primary care around the world.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140293/1/tmj.2016.0045.pd

A Strategic Vision for Telemedicine and Medical Informatics in Space Flight

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63255/1/15305620050503924.pd

Minimally Invasive Expeditionary Surgical Care Using Human-Inspired Robots

This technical report serves as an updated collection of subject matter experts on surgical care using human-inspired robotics for human exploration. It is a summary of the Blue Sky Meeting, organized by the Florida Institute for Human and Machine Cognition (IHMC), Pensacola, Florida, and held on October 2-3, 2018. It contains an executive summary, the final report, all of the presentation materials, and an updated reference list

The Telehealth Enhancement of Adherence to Medication (TEAM) in pediatric IBD trial: Design and methodology

Medication nonadherence is a significant health care issue requiring regular behavioral treatment. Lack of sufficient health care resources and patient/family time commitment for weekly treatment are primary barriers to receiving appropriate self-management support. We describe the methodology of the Telehealth Enhancement of Adherence to Medication (TEAM) trial for medication nonadherence in pediatric inflammatory bowel disease (IBD). For this trial, participants 11–18 years of age will be recruited from seven pediatric hospitals and will complete an initial 4-week run in to assess adherence to a daily medication. Those who take less than 90% of their prescribed medication will be randomized. A total of 194 patients with IBD will be randomized to either a telehealth behavioral treatment (TBT) arm or education only (EO) arm. All treatment will be delivered via telehealth video conferencing. Patients will be assessed at baseline, post-treatment, 3-, 6-, and 12-months. We anticipate that participants in the TBT arm will demonstrate a statistically significant improvement at post-treatment and 3-, 6-, and 12-month follow-up compared to participants in the EO arm for both medication adherence and secondary outcomes (i.e., disease severity, patient quality of life, and health care utilization). If efficacious, the TEAM intervention could be disseminated broadly and reduce health care access barriers so that patients could receive much needed self-management intervention