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Keeping astronauts healthy in space isn’t easy − new training programs will prepare students to perform medicine while thousands of miles away from Earth

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theconversation.com – Arian Anderson, Emergency Medicine Physician, University of Colorado Anschutz Medical Campus – 2024-06-18 07:39:04

Space medicine professionals in training consult with each other during a simulation exercise.

Katya Arquilla

Arian Anderson, University of Colorado Anschutz Medical Campus

In the coming decade, more people will go to space than ever before as human spaceflight enters a new era. NASA, the European Space Agency and other governmental agencies are partnering to develop crewed missions beyond the Moon. At the same time, these agencies are collaborating with private companies using new technologies to drive down the price of space exploration.

Companies such as SpaceX, Blue Origin and Sierra Space have developed vehicles with reusable boosters, automated flight systems and lightweight materials to support these deep space missions. Some even have ambitions of their own to build private space stations, Moon bases or mining operations in the coming decades.

But as these technologies and partnerships rapidly make spaceflight more accessible, new challenges emerge. For one, maintaining the health and performance of an astronaut crew. My team of researchers and educators at the University of Colorado and others around the world are looking to address this issue.

A group of people in orange jumpsuits stand around a table, with a person laying on it.

With spaceflight set to expand, astronauts will need access to medical care over longer voyages and on commercial flights.

Katya Arquilla

Emerging medical challenges in space

NASA astronauts are some of the most accomplished people on the planet, and they’re some of the healthiest. Astronauts undergo extensive medical and psychological testing that in one study disqualified 26% of final-round applicants. This rigorous screening and testing process effectively limits the chance of a medical event occurring during a mission.

But as spaceflight becomes more accessible, astronaut crews on commercial missions will likely make up the majority of space travelers in the coming years. Private missions will be short and stay in a close orbit around Earth in the near term, but private crews will likely have less training and more chronic medical conditions than the professional astronauts currently living and working in space.

While experiments aboard the International Space Station have extensively studied the normal physiological changes occurring to the human system in weightlessness, there is limited to no data about how common chronic diseases such as diabetes or high blood pressure behave in the space environment.

Mars, shown from space.

During Mars missions, astronauts will be away from Earth for long periods of time, with limited access to medical resources.

CU/LASP EMM/EXI ITF/Kevin M. Gill, CC BY

This industry boom is also creating opportunities for long-duration missions to the Moon and Mars. Because of the length of missions and the distance from Earth, professional astronauts on these missions will experience prolonged weightlessness, leading to bone and muscle loss, communication delays of a few seconds up to 40 minutes, and extreme isolation for months to years at a time.

Crews must function autonomously, while being exposed to new hazards such as lunar or Martian dust. Because of the fuel required for these missions, resources will be limited to the lowest mass and volume possible.

As a result, mission planners will need to make difficult decisions to determine what supplies are truly necessary in advance, with limited or unavailable resupply opportunities for food, water and medicine. In space, for example, radiation and humidity inside a spacecraft can cause medications to deteriorate more quickly and become unavailable or even toxic to crew members.

Crews on the space station have access to a flight surgeon at Mission Control to help manage medical care in the same way telehealth is used on Earth. Crews on distant planets, however, will need to perform medical care or procedures autonomously.

In the event of a medical emergency, crews may not be able to evacuate to Earth. Unlike the space station, where medical evacuations to Earth can occur in less than 24 hours, lunar evacuations may take weeks. Evacuations from Mars may not be possible for months or even years.

Put simply, the current approaches to medical care in spaceflight will not meet the needs of future commercial and professional astronauts. Researchers will need to develop new technologies and novel training approaches to prepare future providers to treat medical conditions in space.

The current leaders in space medicine are either experts in aerospace engineering or in medicine, but rarely do experts have formal training or a complete understanding of both fields. And these disciplines often can’t speak each other’s language both literally and figuratively.

Training the next generation

To meet the evolving demands of human spaceflight, educators and universities are looking to develop a way to train specialists who understand both the limitations of the human body and the constraints of engineering design.

Some schools and hospitals, such as the University of Texas Medical Branch, have residency training programs for medical school graduates in aerospace medicine. Others, such as UCLA and Massachusetts General Hospital, have specialty training programs in space medicine, but these currently target fully trained emergency medicine physicians.

My team at the University of Colorado has created a program that integrates human physiology and engineering principles to train medical students to think like engineers.

Two domed tents connected by long tubes, in the desert.

The University of Colorado brings students to the desert to simulate a lunar base. Students work together to solve simulated medical issues that might occur during a space mission.

Katya Arquilla

This program aims to help students understand human health and performance in the spaceflight environment. It approaches these topics from an engineering design and constraints perspective to find solutions to the challenges astronauts will face.

One of our most popular classes is called Mars in Simulated Surface Environments. This class puts students through engineering and medical scenarios in a simulated Mars environment in the Utah desert. Students deal with the challenges of working and providing care while wearing a spacesuit and on a desolate Mars-like landscape.

The stress of the simulations can feel real to the students, and they learn to apply their combined skill sets to care for their fellow crew members.

Educational programs like these and others aim to create cross-trained specialists who understand both patient care and the procedural nature of engineering design and can merge the two, whether for space tourists in orbit or as a pioneer to the surface of another planet.

A new period of spaceflight is here, and these programs are already training experts to make space accessible and safe.The Conversation

Arian Anderson, Emergency Medicine Physician, University of Colorado Anschutz Medical Campus

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Being alone has its benefits − a psychologist flips the script on the ‘loneliness epidemic’

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theconversation.com – Virginia Thomas, Assistant Professor of Psychology, Middlebury – 2025-04-04 07:18:00

Studies show that choosing ‘me time’ is not a recipe for loneliness but can boost your creativity and emotional well-being.
FotoDuets/iStock via Getty Images Plus

Virginia Thomas, Middlebury

Over the past few years, experts have been sounding the alarm over how much time Americans spend alone.

Statistics show that we’re choosing to be solitary for more of our waking hours than ever before, tucked away at home rather than mingling in public. Increasing numbers of us are dining alone and traveling solo, and rates of living alone have nearly doubled in the past 50 years.

These trends coincided with the surgeon general’s 2023 declaration of a loneliness epidemic, leading to recent claims that the U.S. is living in an “anti-social century.”

Loneliness and isolation are indeed social problems that warrant serious attention, especially since chronic states of loneliness are linked with poor outcomes such as depression and a shortened lifespan.

But there is another side to this story, one that deserves a closer look. For some people, the shift toward aloneness represents a desire for what researchers call “positive solitude,” a state that is associated with well-being, not loneliness.

As a psychologist, I’ve spent the past decade researching why people like to be alone – and spending a fair amount of time there myself – so I’m deeply familiar with the joys of solitude. My findings join a host of others that have documented a long list of benefits gained when we choose to spend time by ourselves, ranging from opportunities to recharge our batteries and experience personal growth to making time to connect with our emotions and our creativity.

YouTube video
Being alone can help remind people who they are.

So it makes sense to me why people live alone as soon as their financial circumstances allow, and when asked why they prefer to dine solo, people say simply, “I want more me time.”

It’s also why I’m not surprised that a 2024 national survey found that 56% of Americans considered alone time essential for their mental health. Or that Costco is now selling “solitude sheds” where for around US$2,000 you can buy yourself some peace and quiet.

It’s clear there is a desire, and a market, for solitude right now in American culture. But why does this side of the story often get lost amid the warnings about social isolation?

I suspect it has to do with a collective anxiety about being alone.

The stigma of solitude

This anxiety stems in large part from our culture’s deficit view of solitude. In this type of thinking, the desire to be alone is seen as unnatural and unhealthy, something to be pitied or feared rather than valued or encouraged.

This isn’t just my own observation. A study published in February 2025 found that U.S. news headlines are 10 times more likely to frame being alone negatively than positively. This type of bias shapes people’s beliefs, with studies showing that adults and children alike have clear judgments about when it is – and importantly when it is not – acceptable for their peers to be alone.

This makes sense given that American culture holds up extraversion as the ideal – indeed as the basis for what’s normal. The hallmarks of extraversion include being sociable and assertive, as well as expressing more positive emotions and seeking more stimulation than the opposite personality – the more reserved and risk-averse introverts. Even though not all Americans are extraverts, most of us have been conditioned to cultivate that trait, and those who do reap social and professional rewards. In this cultural milieu, preferring to be alone carries stigma.

But the desire for solitude is not pathological, and it’s not just for introverts. Nor does it automatically spell social isolation and a lonely life. In fact, the data doesn’t fully support current fears of a loneliness epidemic, something scholars and journalists have recently acknowledged.

In other words, although Americans are indeed spending more time alone than previous generations did, it’s not clear that we are actually getting lonelier. And despite our fears for the eldest members of our society, research shows that older adults are happier in solitude than the loneliness narrative would lead us to believe.

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It’s all a balancing act – along with solitude, you need to socialize.

Social media disrupts our solitude

However, solitude’s benefits don’t automatically appear whenever we take a break from the social world. They arrive when we are truly alone – when we intentionally carve out the time and space to connect with ourselves – not when we are alone on our devices.

My research has found that solitude’s positive effects on well-being are far less likely to materialize if the majority of our alone time is spent staring at our screens, especially when we’re passively scrolling social media.

This is where I believe the collective anxiety is well placed, especially the focus on young adults who are increasingly forgoing face-to-face social interaction in favor of a virtual life – and who may face significant distress as a result.

Social media is by definition social. It’s in the name. We cannot be truly alone when we’re on it. What’s more, it’s not the type of nourishing “me time” I suspect many people are longing for.

True solitude turns attention inward. It’s a time to slow down and reflect. A time to do as we please, not to please anyone else. A time to be emotionally available to ourselves, rather than to others. When we spend our solitude in these ways, the benefits accrue: We feel rested and rejuvenated, we gain clarity and emotional balance, we feel freer and more connected to ourselves.

But if we’re addicted to being busy, it can be hard to slow down. If we’re used to looking at a screen, it can be scary to look inside. And if we don’t have the skills to validate being alone as a normal and healthy human need, then we waste our alone time feeling guilty, weird or selfish.

The importance of reframing solitude

Americans choosing to spend more time alone is indeed a challenge to the cultural script, and the stigmatization of solitude can be difficult to change. Nevertheless, a small but growing body of research indicates that it is possible, and effective, to reframe the way we think about solitude.

For example, viewing solitude as a beneficial experience rather than a lonely one has been shown to help alleviate negative feelings about being alone, even for the participants who were severely lonely. People who perceive their time alone as “full” rather than “empty” are more likely to experience their alone time as meaningful, using it for growth-oriented purposes such as self-reflection or spiritual connection.

Even something as simple as a linguistic shift – replacing “isolation” with “me time” – causes people to view their alone time more positively and likely affects how their friends and family view it as well.

It is true that if we don’t have a community of close relationships to return to after being alone, solitude can lead to social isolation. But it’s also true that too much social interaction is taxing, and such overload negatively affects the quality of our relationships. The country’s recent gravitational pull toward more alone time may partially reflect a desire for more balance in a life that is too busy, too scheduled and, yes, too social.

Just as connection with others is essential for our well-being, so is connection with ourselves.The Conversation

Virginia Thomas, Assistant Professor of Psychology, Middlebury

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Measles can ravage the immune system and brain, causing long-term damage – a virologist explains

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theconversation.com – Peter Kasson, Professor of Chemistry and Biomedical Engineering, Georgia Institute of Technology – 2025-03-31 07:16:00

Measles infections send 1 in 5 people to the hospital.
wildpixel/ iStock via Getty Images Plus

Peter Kasson, Georgia Institute of Technology

The measles outbreak that began in west Texas in late January 2025 continues to grow, with 400 confirmed cases in Texas and more than 50 in New Mexico and Oklahoma as of March 28.

Public health experts believe the numbers are much higher, however, and some worry about a bigger resurgence of the disease in the U.S. In the past two weeks, health officials have identified potential measles exposures in association with planes, trains and automobiles, including at Washington Dulles International Airport and on an Amtrak train from New York City to Washington, D.C. – as well as at health care facilities where the infected people sought medical attention.

Measles infections can be extremely serious. So far in 2025, 14% of the people who got measles had to be hospitalized. Last year, that number was 40%. Measles can damage the lungs and immune system, and also inflict permanent brain damage. Three in 1,000 people who get the disease die. But because measles vaccination programs in the U.S. over the past 60 years have been highly successful, few Americans under 50 have experienced measles directly, making it easy to think of the infection as a mere childhood rash with fever.

As a biologist who studies how viruses infect and kill cells and tissues, I believe it is important for people to understand how dangerous a measles infection can be.

Underappreciated acute effects

Measles is one of the most contagious diseases on the planet. One person who has it will infect nine out of 10 people nearby if those people are unvaccinated. A two-dose regimen of the vaccine, however, is 97% effective at preventing measles.

When the measles virus infects a person, it binds to specific proteins on the surface of cells. It then inserts its genome and replicates, destroying the cells in the process. This first happens in the upper respiratory tract and the lungs, where the virus can damage the person’s ability to breathe well. In both places, the virus also infects immune cells that carry it to the lymph nodes, and from there, throughout the body.

YouTube video
Measles can wipe out immune cells’ ability to recognize pathogens.

What generally lands people with measles in the hospital is the disease’s effects on the lungs. As the virus destroys lung cells, patients can develop viral pneumonia, which is characterized by severe coughing and difficulty breathing. Measles pneumonia afflicts about 1 in 20 children who get measles and is the most common cause of death from measles in young children.

The virus can directly invade the nervous system and also damage it by causing inflammation. Measles can cause acute brain damage in two different ways: a direct infection of the brain that occurs in roughly 1 in 1,000 people, or inflammation of the brain two to 30 days after infection that occurs with the same frequency. Children who survive these events can have permanent brain damage and impairments such as blindness and hearing loss.

Yearslong consequences of infection

An especially alarming but still poorly understood effect of measles infection is that it can reduce the immune system’s ability to recognize pathogens it has previously encountered. Researchers had long suspected that children who get the measles vaccine also tend to have better immunity to other diseases, but they were not sure why. A study published in 2019 found that having a measles infection destroyed between 11% and 75% of their antibodies, leaving them vulnerable to many of the infections to which they previously had immunity. This effect, called immune amnesia, lasts until people are reinfected or revaccinated against each disease their immune system forgot.

Occasionally, the virus can lie undetected in the brain of a person who recovered from measles and reactivate typically seven to 10 years later. This condition, called subacute sclerosing panencephalitis, is a progressive dementia that is almost always fatal. It occurs in about 1 in 25,000 people who get measles but is about five times more common in babies infected with measles before age 1.

Researchers long thought that such infections were caused by a special strain of measles, but more recent research suggests that the measles virus can acquire mutations that enable it to infect the brain during the course of the original infection.

There is still much to learn about the measles virus. For example, researchers are exploring antibody therapies to treat severe measles. However, even if such treatments work, the best way to prevent the serious effects of measles is to avoid infection by getting vaccinated.The Conversation

Peter Kasson, Professor of Chemistry and Biomedical Engineering, Georgia Institute of Technology

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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Supreme Court considers whether states may prevent people covered by Medicaid from choosing Planned Parenthood as their health care provider

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theconversation.com – Naomi Cahn, Professor of Law, University of Virginia – 2025-04-02 17:04:00

Planned Parenthood clinics, like this one in Los Angeles, are located across the United States.
Patrick T. Fallon/AFP via Getty Images

Naomi Cahn, University of Virginia and Sonia Suter, George Washington University

Having the freedom to choose your own health care provider is something many Americans take for granted. But the Supreme Court is weighing whether people who rely on Medicaid for their health insurance have that right, and if they do – is it enforceable by law?

That’s the key question at the heart of a case, Medina v. Planned Parenthood South Atlantic, that began during President Donald Trump’s first term in office.

“There’s a right, and the right is the right to choose your doctor,” said Justice Elena Kagan on April 2, 2025, during oral arguments on the case. John J. Bursch, the Alliance Defending Freedom lawyer who is representing South Carolina Director of Health and Human Services Eunice Medina, countered that none of the words in the underlying statute had what he called a “rights-creating pedigree.”

As law professors who teach courses about health and poverty law as well as reproductive justice, we think this case could affect access to health care for 72 million Americans, including low-income people and their children and people with disabilities.

Excluding Planned Parenthood

The case started with Julie Edwards, who is enrolled in Medicaid and lives in South Carolina. After she struggled to get contraceptive services, she was able to receive care from a Planned Parenthood South Atlantic clinic in Columbia, South Carolina.

Planned Parenthood, an array of nonprofits with roots that date back more than a century, is among the nation’s top providers of reproductive services. It operates two clinics in South Carolina, where Medicaid patients can get physical exams, cancer screenings, contraception and other services. It also provides same-day appointments and keeps long hours.

In July 2018, however, South Carolina Gov. Henry McMaster issued an executive order that barred health care providers in South Carolina that offer abortions from reimbursement through Medicaid.

That meant Planned Parenthood, a longtime target of conservatives’ ire, would no longer be reimbursed for any type of care for Medicaid patients, preventing Edwards from transferring all her gynecological care to that office as she had hoped to do.

Planned Parenthood and Edwards sued South Carolina, claiming that the state was violating the federal Medicare and Medicaid Act, which Congress passed in 1965, by not letting Edwards obtain care from the provider of her choice.

A ‘free-choice-of-provider’ requirement

Medicaid operates as a partnership between the federal government and the states. Congress passed the law that led to its creation based on its power under the Constitution’s spending clause, which allows Congress to subject federal funds to certain requirements.

Two years later, due to concerns that states were restricting which providers Medicaid recipients could choose, Congress added a “free-choice-of-provider” requirement to the program. It states that people enrolled in Medicaid “may obtain such assistance from any institution, agency, community pharmacy, or person, qualified to perform the service or services required.”

This provision is at the core of this case. At issue is whether a civil rights statute provides a right for Medicaid beneficiaries to sue a state when their federal rights have been violated. Known as Section 1983, it was enacted in 1871.

Bursch, backed by the Trump administration, argued before the court that the absence of words like “right” in the Medicaid provision that requires states to provide a free choice of provider means that neither Edwards nor Planned Parenthood has the authority to file a lawsuit to enforce this aspect of the Medicaid statute.

Nicole A. Saharsky, Planned Parenthood’s lawyer, argued that the creation of a right shouldn’t depend on “some kind of magic words test.” Instead, she said it was clear that the Medicaid statute created “a right to choose their own doctor” because “it’s mandatory” that the state provide this option to everyone with health insurance through Medicaid.

She also emphasized that Congress wanted to protect “an intensely personal right” to be able “to choose your doctor, the person that you see when you’re at your most vulnerable, facing … some of the most significant … challenges to your life and your health.”

Restricting Medicaid funds

Through a federal law known as the Hyde Amendment, Medicaid cannot reimburse health care providers for the cost of abortions, with a few exceptions: when a patient’s life is at risk or her pregnancy is due to rape or incest. Some states do cover abortion when their laws allow it, without using any federal funds.

Therefore, Planned Parenthood only gets federal Medicaid funds for abortions in those limited circumstances.

McMaster explained that he removed “abortion clinics,” including Planned Parenthood, from the South Carolina Medicaid Program because he didn’t want state funds to indirectly subsidize abortions.

South Carolina “decided that Planned Parenthood was unqualified for many reasons, chiefly because they’re the nation’s largest abortion provider,” Bursch told the Supreme Court.

But only 3% of Planned Parenthood’s services nationwide last year were related to abortion. Its most common service is testing for sexually transmitted diseases. Across the nation, Planned Parenthood provides health care to more than 2 million patients per year, most of whom have low incomes.

Man with gray hair in a suit and red tie speaks at a podium.
South Carolina Gov. Henry McMaster speaks to a crowd during an election night party on Nov. 3, 2020, in Columbia.
Photo by Sean Rayford/Getty Images

Section 1983

Because the Medicaid statute itself does not allow an individual to sue, Edwards and Planned Parenthood are relying on Section 1983.

Lower courts have repeatedly upheld that the Medicaid statute provides Edwards with the right to obtain Medicaid-funded health care at her local Planned Parenthood clinic.

And the Supreme Court has long recognized that Section 1983 protects an individual’s ability to sue when their rights under a federal statute have been violated.

In 2023, for example, the court found such a right under the Medicaid Nursing Home Reform Act. The court held that Section 1983 confers the right to sue when a statute’s provisions “unambiguously confer individual federal rights.”

Consequences beyond South Carolina

The court’s decision in the Medina case on whether Medicaid patients can choose their own health care provider could have consequences far beyond South Carolina. Arkansas, Missouri and Texas have already barred Planned Parenthood from getting reimbursed by Medicaid for any kind of health care. More states could follow suit.

In addition, given Planned Parenthood’s role in providing expansive contraceptive care, disqualifying it from Medicaid could harm access to health care and increase the already-high unintended pregnancy rate in America.

The ramifications, likewise, could extend beyond the finances of Planned Parenthood.

If the court rules in South Carolina’s favor, states could also try to exclude providers based on other characteristics, such as whether their employees belong to unions or if they provide their patients with gender-affirming care, further restricting patients’ choices.

Or, as Kagan observed, states could go the opposite direction and exclude providers that don’t provide abortions and so forth. What’s really at stake, she said, is whether a patient is “entitled to see” the provider they choose regardless of what their state happens to “think about contraception or abortion or gender transition treatment.”

If the Supreme Court rules that Edwards does have a right to get health care at a Planned Parenthood clinic, the controversy would not be over. The lower courts would then have to decide whether South Carolina appropriately removed Planned Parenthood from Medicaid as an “unqualified provider.”

And if the Supreme Court rules in favor of South Carolina, then Planned Parenthood could still sue South Carolina over its decision to find them to be unqualified.The Conversation

Naomi Cahn, Professor of Law, University of Virginia and Sonia Suter, Professor of Law, George Washington University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

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