Aerospace medicine and human performance
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Aerosp Med Hum Perform · Nov 2019
ReviewChallenges in Clinical Management of Radiation-Induced Illnesses During Exploration Spaceflight.
A literature review was conducted to identify terrestrial management standards for radiation-induced illnesses, focusing on prodromal symptom treatment. Terrestrial management was compared to current spaceflight medical capabilities to identify gaps and highlight challenges involved in expanding capabilities for future exploration spaceflight. ⋯ Current spaceflight medical resources, such as those found on the International Space Station, may be sufficient to manage some aspects of radiation-induced illness, although effective treatment of all potential manifestations would require substantial expansion of capabilities. Terrestrial adjunctive therapies or more experimental treatments are unavailable in current spaceflight medical capabilities but may have a role in future management of acute radiation exposure.DISCUSSION: Expanded medical capabilities for managing radiation-induced illnesses could be included onboard future exploration vehicles. However, this would require substantial research, time, and funding to reach flight readiness, and vehicle limitations may restrict such capabilities for exploration missions. The benefits of including expanded capabilities should be weighed against the likelihood of significant radiation exposure and extensive mission design constraints.Blue RS, Chancellor JC, Suresh R, Carnell LS, Reyes DP, Nowadly CD, Antonsen EL. Challenges in clinical management of radiation-induced illnesses during exploration spaceflight. Aerosp Med Hum Perform. 2019; 90(11):966-977.
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Aerosp Med Hum Perform · Dec 2018
ReviewFracture Risk in Spaceflight and Potential Treatment Options.
A literature search was conducted on current fracture risk predictive models and suggestions for treatment. ⋯ In conclusion, the best strategy for mitigating musculoskeletal injuries for deep-space missions will be a combination of BMD loss reduction coupled with improvements in management protocols for potential fractures.Swaffield TP, Neviaser AS, Lehnhardt K. Fracture risk in spaceflight and potential treatment options. Aerosp Med Hum Perform. 2018; 89(12):1060-1067.
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INTRODUCTION: Government space agencies and commercial spaceflight companies are seeking to expand human space exploration. Spaceflight can place considerable psychological stressors on humans, yet policies to support behavioral health in human spaceflight are still in their nascent stages. This article reviews international and domestic space policy relevant to behavioral health, as well as existing gaps in policy frameworks regarding the behavioral health of spaceflight crew and passengers. ⋯ Morris NP. Behavioral health policy for human spaceflight. Aerosp Med Hum Perform. 2018; 89(12):1068-1075.
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Evidence supports the efficacy of incorporating select recognized aviation practices and procedures into healthcare. Incident analysis, debrief, safety brief, and crew resource management (CRM) have all been assessed for implementation within the UK healthcare system, a world leader in aviation-based patient safety initiatives. Mindful application, in which aviation practices are specifically tailored to the unique healthcare setting, show promise in terms of acceptance and long-term sustainment. ⋯ Aviation modeled incident analysis, debrief, safety brief, and CRM training are increasingly undertaken within the UK healthcare system. Nuanced application, in which the unique aspects of the healthcare setting are addressed as part of a comprehensive safety approach, shows promise for long-term success. The patient safety brief and aviation modeled incident analysis are in earlier phases of implementation, and warrant further analysis.Powell-Dunford N, Brennan PA, Peerally MF, Kapur N, Hynes JM, Hodkinson PD. Mindful application of aviation practices in healthcare. Aerosp Med Hum Perform. 2017; 88(12):1107-1116.
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Aerosp Med Hum Perform · May 2017
ReviewTransferring Aviation Practices into Clinical Medicine for the Promotion of High Reliability.
Aviation is a classic example of a high reliability organization (HRO)-an organization in which catastrophic events are expected to occur without control measures. As health care systems transition toward high reliability, aviation practices are increasingly transferred for clinical implementation. ⋯ The adoption of aviation practices into clinical medicine facilitates an evolution toward high reliability. Evidence for the efficacy of the checklist and crew resource-management training is robust. Transference of aviation accident investigation practices is preliminary. A standardized, independent investigation process could facilitate the development of a safety culture commensurate with that achieved in the aviation industry.Powell-Dunford N, McPherson MK, Pina JS, Gaydos SJ. Transferring aviation practices into clinical medicine for the promotion of high reliability. Aerosp Med Hum Perform. 2017; 88(5):487-491.