Space, the New Medical Frontier – Part 1

 

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NASA illustration of a medical emergency at a lunar colony

 

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Space nursing is the nursing specialty that studies how space travel impacts human response patterns. Similar to space medicine, the specialty also contributes to knowledge about nursing care of earthbound patients. Since the beginning of commercial aviation in the 1920s, nurses have been part of aviation and flight. In 1958, President Eisenhower signed the National Aeronautics and Space Act to form NASA. Part of this act was to recruit nurses to work closely with medical teams to determine the fitness of astronauts for space exploration. Nurses helped observe the effects of spaceflight on astronauts upon their return from missions.

 

In 1962. NASA announced the Space Nursing Program which required applicants to have a previous bachelor’s degree in nursing. In 1991, the Space Nursing Society was founded by Linda Plush with the help of Dr. Martha Rogers. It is based on Rogers’ Theory, the Science of unitary human beings. The Space Nursing Society is an international space advocacy organization devoted to space nursing and space exploration by registered nurses. The society is an affiliated, non-profit special interest group associated with the National Space Society. The society was founded in 1991 and has members from around the world including Australia, Canada, Czech Republic, England, Germany, Greece, Scotland and the United States. The society serves as a forum for the discussion and study of issues related to nursing in space and the impact of these studies on nursing on Earth.

 

 

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Astronaut John H. Glenn Jr., pilot of the Mercury-Atlas 6 earth-orbital space mission, confers with Astronaut Nurse Dolores B. O’Hara, R.N., during MA-6 prelaunch preparations.

 

 

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The International Space Station 2014

 

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One of the space laboratories

 

Space medicine is the practice of medicine on astronauts in outer space whereas astronautical hygiene is the application of science and technology to the prevention or control of exposure to the hazards that may cause astronaut ill health. Both these sciences work together to ensure that astronauts work in a safe environment. The main objective is to discover how well and for how long people can survive the extreme conditions in space, and how fast they can adapt to the Earth’s environment after returning from their voyage. Medical consequences such as possible blindness and bone loss have been associated with human spaceflight.

 

After World War 2, the US encouraged German physicians to join with American docs to form the School of Aviation Medicine (SAM) at Randolph Air Force Base, Texas, which is now called the US Air Force School of Aerospace Medicine, at Brooks Air Force Base, Texas. The pressure suit worn by early American astronauts, was developed at this time in the late 1940s.

 

Astronauts are not the only ones who benefit from space medicine research. Several medical products have been developed that are space spinoffs, that is practical applications for the field of medicine arising out of the space program. Because of joint research efforts between NASA, the National Institutes on Aging (a part of the National Institutes of Health), and other aging-related organizations, space exploration has benefited a particular segment of society, seniors. Evidence of aging related medical research conducted in space was most publicly noticeable during STS-95

 

Medical space spinoffs: pre-Mercury (1957-65), Gemini (1965-66) through Apollo (1968-72)

 

1. Radiation therapy for the treatment of cancer: In conjunction with the Cleveland Clinic, the cyclotron at Glenn Research Center in Cleveland, Ohio was used in the first clinical trials for the treatment and evaluation of neutron therapy for cancer patients.

 

2. Foldable walkers: Made from a lightweight metal material developed by NASA for aircraft and spacecraft, foldable walkers are portable and easy to manage.

 

3. Personal alert systems: These are emergency alert devices that can be worn by individuals who may require emergency medical or safety assistance. When a button is pushed, the device sends a signal to a remote location for help. To send the signal, the device relies on telemetry technology developed at NASA.

 

4. CAT and MRI scans: These devices are used by hospitals to see inside the human body. Their development would not have been possible without the technology provided by NASA after it found a way to take better pictures of the Earth’s moon.

 

5. Muscle stimulator device: This device is used for 1/2 hour per day to prevent muscle atrophy in paralyzed individuals. It provides electrical stimulation to muscles which is equal to jogging three miles per week. Christopher Reeve used these in his therapy.

 

6. Orthopedic evaluation tools: Equipment to evaluate posture, gait and balance disturbances was developed at NASA, along with a radiation-free way to measure bone flexibility using vibration.

 

7. Diabetic foot mapping: This technique was developed at NASA’s center in Cleveland, Ohio to help monitor the effects of diabetes in feet.

 

8. Foam cushioning: Special foam used for cushioning astronauts during liftoff is used in pillows and mattresses at many nursing homes and hospitals to help prevent ulcers, relieve pressure, and provide a better night’s sleep.

 

9. Kidney dialysis machines: These machines rely on technology developed by NASA in order to process and remove toxic waste from used dialysis fluid.

 

10. Talking wheelchairs: Paralyzed individuals who have difficulty speaking may use a talking feature on their wheelchairs which was developed by NASA to create synthesized speech for aircraft.

 

11. Collapsible, lightweight wheelchairs: These wheelchairs are designed for portability and can be folded and put into trunks of cars. They rely on synthetic materials that NASA developed for its air and space craft

 

12. Surgically implantable heart pacemaker: These devices depend on technologies developed by NASA for use with satellites. They communicate information about the activity of the pacemaker, such as how much time remains before the batteries need to be replaced.

 

13. Implantable heart defibrillator: This tool continuously monitors heart activity and can deliver an electric shock to restore heartbeat regularity.

 

14. EMS communications: Technology used to communicate telemetry between Earth and space was developed by NASA to monitor the health of astronauts in space from the ground. Ambulances use this same technology to send information – like EKG readings – from patients in transport to hospitals. This allows faster and better treatment.

 

15. Weightlessness therapy: The weightlessness of space can allow some individuals with limited mobility on Earth – even those normally confined to wheelchairs – the freedom to move about with ease. Physicist Stephen Hawking took advantage of weightlessness in NASA’s Vomit Comet aircraft in 2007. This idea also led to the development of the Anti-Gravity Treadmill from NASA technology.

 

Medical investigations in space during the Space Shuttle era

 

John Glenn, the first American astronaut to orbit the Earth, returned with much fanfare to space once again on STS-95 at 77 years of age to confront the physiological challenges preventing long-term space travel for astronauts?loss of bone density, loss of muscle mass, balance disorders, sleep disturbances, cardiovascular changes, and immune system depression?all of which are problems confronting aging people as well as astronauts. Once again Glenn stepped forward to play a historic role in the future of space exploration, but this time he would provide new medical research in the field of gerontology as well.

 

FAST FORWARD: American scientists now have a national laboratory on the International Space Station (ISS), for health and medical research. Agreements between NIH, NASA and NSBRI (National Space Biomedical Research Institute create unique partnerships between these government agencies and academic and industrial communities. This cooperation is advancing biomedical research with the goal of ensuring a safe and productive long-term human presence in space. By developing new approaches and countermeasures to prevent, minimize and reverse critical risks to health, the Institute plays an essential, enabling role for NASA and bridges the research, technological and clinical expertise of the biomedical community with the scientific, engineering and operational expertise of NASA.

 

The ISS, which has been taking shape for much of the past decade, is an orbiting laboratory for many kinds of research. This relationship between the nation’s premier medical laboratories and the national space effort is a first, and already there is much excitement about the various advances to come from space-based research. “There are many new frontiers and considerable new knowledge that medical researchers can gain from using the space station,“ says Stephen I. Katz, M.D., Ph.D., director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and NIH’s liaison with NASA. Continuously inhabited by astronauts and scientists since 2000, the ISS is a perfect place to research all manner of scientific, technical, and medical questions. In fact, some medical research can only be performed in orbit. That means aboard the space station, where there is no gravity. The same weightlessness that lets space-suited astronauts move massive objects easily also offers a unique learning opportunity. Zero-gravity’s effects on astronauts’ skeletal systems and loss of bone and muscle mass have long attracted scientific interest, Dr. Katz says. “Research on the space station will help generate better understanding of how weightlessness affects the bone, muscle, and inner ear systems.“

 

The more we know about how the various systems of the human body react to weightlessness and the other conditions found only in space, the better able we will be to ensure the health of ISS crew members, as well as those future astronauts and researchers who will journey to the moon (again), Mars, and beyond.

 

The benefits also will pay off back on earth:

 

1. Increased understanding of bone-strength and loss of bone-mass may help patients suffering from delicate bones or muscle wasting diseases.

 

2. Without gravity to help orient them, astronauts experience changes in their sense of balance. Studying this phenomenon may yield insights into dizziness, vertigo, and balance problems and disorders related to the inner ear.

 

3. Observing the behavior of microbes and other organisms in space can generate insights into the behavior of organisms on earth, and perhaps lead to better understanding of infectious diseases and the immune system’s response to them.

 

Our health and medical knowledge and capabilities have grown greatly because of space exploration and the equipment and techniques developed for it. Remote health-monitoring sensors and temperature-lowering “cool suits“ are just two examples derived from the lessons learned from orbital space suits. And medical imaging technologies and ultrasound procedures are based, in part, on NASA innovations. Until the advent of the ISS, research missions in space were necessarily brief?usually only a few days or weeks, at best. With long-term human residence in space now made possible by the ISS, it is important that a certain percentage of each ISS crew be dedicated to vital medical research. As with everything connected with space travel, results will take time because of the planning, preparation, and training involved.

 

“An enormous amount of time will be required to develop the questions and experimental models for use on the space station,“ says Dr. Katz. “First, you have to make sure you’re asking important questions. Also, the scientists’ time is valuable, and it’s very expensive to put the experiments together and transport them to the space station.“ Added to this is additional training the astronauts  – many of whom are scientists – must complete to be able to perform the experiments correctly. Thanks to the formal agreement between NIH and NASA, the research will be carefully coordinated into high-priority areas, with promise of practical results. “Both NIH and NASA are committed to real cooperation,“ Dr. Katz says. This cooperation may serve as the foundation for a potential flowering of both space medicine and earth-based health care.000. “We are extremely pleased that this collaborative effort is moving forward,“ adds NIH Director Dr. Elias Zerhouni. “The International Space Station provides a unique environment where researchers can explore fundamental questions about human health issues, including how the body heals itself, fights infection, or develops diseases such as cancer or osteoporosis.“ Sources: NIAMS.gov; NASA.gov NIH.gov; NIAMS.gov; NSBRI.gov; Wikipedia.com

 

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