Sheryl L. Bishop

Psychology and culture during long-duration space missions ☆

The International Academy of Astronautics Study Group on Psychology and Culture in LongDuration Space Missions first convened in May 2003, at the 14 Humans in Space Symposium in Banff, Canada. After this initial meeting to define the group’s task, members divided into subcommittees and worked on drafts of sections of the document over email. The group reconvened in person several times to coordinate the structure of the paper. These sessions occurred at scientific meetings where many of the members were present. The study group formally convened in 2003 at the International Astronautical Congress (IAC) in Bremen and at the Institute for Biomedical Problems 40 Anniversary Symposium in Moscow. In 2004 it convened at the IAC in Vancouver and at the Annual Meeting of the Aerospace Medical Association (AsMA) in Anchorage. In 2005 it convened at the Humans In Space Symposium in Graz, at the IAC in Fukuoka, and at the AsMA Meeting in Kansas City. In 2006 the group worked over e-mail and will convene at the IAC in Valencia after the paper is finished in order to debrief and set out plans for future work. The objective of this report is twofold: a) to describe the current knowledge of cultural, psychological, psychiatric, cognitive, and interpersonal issues that are relevant to the behavior and performance of astronaut crews and ground support personnel; and b) to make recommendations for future human space missions, including both transit and planetary surface operations on the Moon, Mars, and beyond. The focus will be on long-duration missions lasting at least six weeks, when important psychological and interpersonal factors begin to take their toll on crewmembers. This information is designed to provide guidelines for astronaut selection and training, in-flight monitoring and support, and post-flight recovery and re-adaptation. After a consideration of Cultural Issues, which impact on the entire report, four main sections follow: Personality, Coping, and Adaptation; Behavioral Health and Psychiatry; Cognition and Complex Performance Skills; and Interpersonal and Organizational Issues. For each of these sections, there is a review of general issues; implications for mission operations in terms of crew selection, training, monitoring and support, and re-adaptation to Earth; and operational and research recommendations involving future missions to Earth orbit, the lunar surface, or to Mars and beyond.

The effect of acculturation on progesterone/estriol ratios and preterm birth in hispanics

OBJECTIVE: To examine the Hispanic acculturation paradox by identifying the effect of acculturation on serum progesterone and estriol levels, the progesterone/estriol ratio, and preterm birth. METHODS: We used an observational, prospective design with 468 self-identified, low-income, pregnant Hispanic women. We used the Language Proficiency Subscale (from the Bidimensional Acculturation Scale for Hispanics) to measure acculturation. We measured progesterone and estriol in maternal serum at 22–24 weeks of pregnancy. We defined preterm birth as birth before 37 weeks of gestation. Statistical analysis was by Wilcox-Mann-Whitney and Kruskal-Wallis tests, analysis of variance, t tests, logistic regression, and structural equation modeling. RESULTS: English proficiency had an adjusted odds ratio of 4.03 (95% confidence interval 1.44–11.25), P<.001, and the lowest quartile of the progesterone/estriol ratio had an adjusted odds ratio of 2.93 (95% confidence interval 1.25–6.89), P<.001, to predict preterm birth. English proficiency was associated with a decrease in progesterone/estriol ratio and an increase in preterm birth. In structural equation modeling, the progesterone/estriol ratio mediated the relationship between acculturation and preterm birth. CONCLUSION: Hispanic woman have four times the risk of a preterm birth if they are more acculturated (ie, proficient in English). These findings demonstrate another possible aspect of obstetric risk, that of acculturation. Further refinement of the risk of acculturation is essential to clarify how we can adjust our clinical care to prevent increasing preterm birth with the increasing Hispanic population. LEVEL OF EVIDENCE: III

My Disaster Recovery: a pilot randomized controlled trial of an Internet intervention

Abstract This pilot study tested the efficacy of the My Disaster Recovery (MDR) website to decrease negative affect and increase coping self-efficacy. Fifty-six survivors of Hurricane Ike were recruited from a larger study being conducted at the University of Texas Medical Branch at the first anniversary of the storm. Restricted randomization was used to assign participants to the MDR website, an information-only website, or a usual care condition. Group×time interactions indicated that MDR reduced participant worry more than the other conditions. A similar trend was also identified for depression. Both websites were accessed a small to moderate amount and participants reported mixed satisfaction for both websites. Although the effect sizes for worry and depression were in the moderate to large range, small sample size and timing of the intervention qualify the findings. These preliminary findings encourage further evaluation of MDR with a larger, demographically diverse sample and indicate that the MDR website might be helpful in reducing worry and depression.

CHANGES IN FAMILY VARIABLES AMONG NORMAL AND OVERWEIGHT PRESCHOOLERS

Purpose: The purpose of this study was to examine differences in the weight and height of normal and overweight children in variables relating to the individual, home/family and community across a six month time period. Research Questions/Hypotheses: What are the ecological factors that influence the body mass index (BMI) of preschool children? Significance: The rate of overweight preschool children aged 2 to 5 years has more than doubled in the past 30 years. Low socioeconomic and ethnic minority groups have higher rates. Research shows a strong correlation between a childs size (height, weight, and BMI) and the ecological factors present in the familys environment. Methods: This study is a secondary data analysis from a cross sectional study of 200 Mexican American children ages 2–3 years old receiving WIC services. The sample consisted of 100 children with a BMI > 95% for age and 100 children with a BMI of <85% for age. Variables and measurements included: host/child (BMI percentile, diet, TV watching hours); agent/food (feeding assistance); microsystem/parent (parental BMI, acculturation level, employment, physical activities); microsystem/home (stimulation, TV hours); and microsystem/mother-child relationship (NCAST Teaching Scale).This study is limited to populations with similar characteristics. Results: Both overweight and normal weight children showed decreases in BMI, but maintained their between group differences even while slimming down (p = .000). Overweight children consumed significantly more fruit, bread and other carbohydrates, and total calories, than did normal weight children. Both groups of children increased significantly in their consumption of water, fruit juice and juice drinks, as well as meat and other protein. Maternal BMIs for overweight children were higher than those for the mothers of the normal weight children and increased across time. More overweight children ate in the presence of another person. The interaction patterns between mothers and overweight children were significantly more positive and responsive than were the interaction patterns of mothers and normal weight children. Discussion/Conclusion: multiple ecological factors influence the BMI of the preschooler leading to obesity. Nurses can use these findings to teach parents about the importance managing the environmental factors that contribute to childhood obesity and growth.

Relationship of psychological and physiological parameters during an arctic ski expedition

Considerable data (primarily physiological) have been collected during expeditions in extreme environments over the last century. Physiological measurements have only recently been examined in association with the emotional or behavioral state of the subject. Establishing this psychophysiological relationship is essential to understanding fully the adaptation of humans to the stresses of extreme environments. This pilot study investigated the simultaneous collection of physiological, psychological and behavioral data from a two-man Greenland expedition in order to model how specific relationships between physiological and psychological adaptation to a polar environment may be identified. The data collected describes changes in adrenal and other hormonal activity and psychological functioning. Levels of cortisol and testosterone were calculated. Factors influencing the plasma profiles of the aforementioned included 24-hour sunlight, high calorific intake of more than 28 000 kJ/day and extreme physical exercise. There was a difference between individual psychological profiles as well as self-report stress and physiological stress.

Evaluation of cardiac rhythm disturbances during extravehicular activity

This study represents the first systematic evaluation of dysrhythmias before, during, and after spaceflight including extravehicular activity (EVA). The data, based on 7 Shuttle crew members, revealed a nonsignificant decrease in ventricular and supraventricular ectopy during EVA, suggesting that the incidence of dysrhythmias is no greater during EVA than with any other phase of a mission or preflight.

Crew Size, Composition, and Time: Implications for Habitat and Workplace Design in Extreme Environments

The authors report the results of an ongoing study that investigates the effects of crew size, composition, mission duration, and mission interval on behavior and performance among polar and space expeditions. The standardized rates for a behavior/performance indicator constructed during the pilot study displayed distinctive patterns across different crew profiles and settings. Then, a further analysis over the missions in the pilot sample found compelling information suggesting that several factors created specific differentials between outside (baseline) groups (e.g., mission controllers, “folks back home”) and groups in extreme environments. These differentials reflected how the passage of time was subjectivized by crews and how the expeditionary situation was otherwise defined differently from baseline. These analyses suggest that the definition of the longduration mission, such as a mission to Mars, likely involves more than the issue of real-time duration. Also, crew size and composition of such ventures need to be examined in light of social and behavioral information that can be obtained from the expeditionary record. These analyses hold important implications for habitat and workplace design in extreme environments, such as those to be deployed for Mars surface operations.

A comparison of the evaluation and treatment of cervical dysplasia by gynecologists and nurse practitioners.

Cervical dysplasia, a precursor to cervical cancer, affects approximately 6% to 10% of women in the United States. Although cervical dysplasia traditionally is diagnosed and treated by gynecologists, nurse practitioners with special education and expertise in the evaluation and treatment of the condition have begun providing care to many women in rural and other medically underserved areas where there is limited access to specialized physicians. This study compared cervical dysplasia evaluation and treatment techniques of 11 gynecologists and 6 nurse practitioners using abstracted patient records. The MDs showed a greater variation in performance than nurse practitioner colposcopists (NPCs) when evaluated on 10 criteria. NPC practices fell within the range of MDs, and when they were statistically different, NPCs practices were more consistent with generally accepted medical practice. These data suggest that NPCs were more likely to adhere to a consistent set of practices. It can be concluded that NPCs are viable alternative providers in the evaluation and treatment of cervical dysplasia.

Ventilatory Responses to Hypoxia and High Altitude During Sleep in Aconcagua Climbers

Abstract Background/Objective.—We examined the changes in ventilation during sleep at high altitude using the LifeShirt monitoring system on 2 climbers who were attempting to summit Mount Aconcagua (6956 m). Methods.—Prior to the summit attempt, we measured cardiovascular and pulmonary function at 401 m (Rochester, MN) and gathered respiratory and cardiovascular data during sleep using the LifeShirt monitoring system with exposure to normobaric normoxia and normobaric hypoxia (simulated 4300 m). We then monitored the ventilatory response during sleep at 3 altitudes (4100 m, 4900 m, and 5900 m). Results.—During normoxic sleep, subjects had normal oxygen saturation (O2sat), heart rate (HR), respiratory rate (RR), tidal volume (VT) and minute ventilation (VE), and exhibited no periodic breathing (O2sat = 100 ± 2%, HR = 67 ± 1 beats/min, RR = 16 ± 3 breaths/min, VT = 516 ± 49 mL, and VE = 9 ± 1 L/min, mean ± SD). Sleep during simulated 4300 m caused a reduction in O2sat, an increase in HR, RR, VT, and VE, and induced periodic breathing in both climbers (O2sat = 79 ± 4%, HR = 72 ± 14 beats/min, RR = 20 ± 3 breaths/min, VT = 701 ± 180 mL, and VE = 14 ± 3 L/min). All 3 levels of altitude had profound effects on O2sat, HR, and the ventilatory strategy during sleep (O2sat = 79 ± 2, 70 ± 8, 60 ± 2%; HR = 70 ± 12, 76 ± 6, 80 ± 3 beats/min; RR = 17 ± 6, 18 ± 4, 20 ± 6 breaths/min; VT = 763 ± 300, 771 ± 152, 1145 ± 123 mL; and VE = 13 ± 1, 14 ± 0, 22 ± 4 L/min; for 4100 m, 4900 m, and 5900 m, respectively). There were strong negative correlations between O2sat and VE and ventilatory drive (VT/Ti, where Ti is the inspiratory time) throughout the study. Conclusions.—Interestingly, the changes in ventilatory response during simulated altitude and at comparable altitude on Aconcagua during the summit attempt were similar, suggesting reductions in FiO2, rather than in pressure, alter this response.

EXTENDED MISSION SYSTEMS INTEGRATION STANDARDS FOR THE HUMAN- ENVIRONMENT AND HUMAN-HUMAN INTERFACES

Needed is an analytical human factors evaluation framework or tool that would provide empirical metrics for the design of habitable environments and for the optimal functioning of the human crews who must live and work in such environments. Standards that result from this effort could be merged with the database products related to the Man-Systems Integration Standards (MSIS) ∗ managed at NASA-JSC.