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on august 31st a nasa team of experts

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arrived in santiago for about a week as

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part of nasa's commitment to provide u.s

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assistance nasa's assistance was only a

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small contribution to the chilean

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government's overall rescue effort

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the nasa team included two medical

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doctors a psychologist and an engineer

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dr michael duncan deputy chief medical

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officer and nasa space life sciences

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directorate at nasa's johnson space

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center in houston led the team the other

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team members are physician j.d polk

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psychologist al holland and engineer

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the chileans

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had a plan for refeeding

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we reviewed that plan with them and

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basically you know agreed with the kinds

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of things that they were doing

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as we got to talking about things like

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vitamin d supplements

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for example we talked to them about how

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we do that

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in our astronauts in space

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and

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you know those were the kinds of of

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of recommendations that we or

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for the ascent portion of this ride in

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the rescue cage to the surface

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we

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received varying

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reports on how long that ride was going

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to take

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it is so cramped in there that you can't

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move around much you can't flex your

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muscles so you're in in essence

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standing at attention

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and any any military recruit that has

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stand that had stood at attention for

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any length of time knows uh the the risk

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of fainting is is real

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um so

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you know the the idea of doing a fluid

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load

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much like we do with our astronauts

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of giving them

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giving the miners a

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liquids that had carbohydrates in it had

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electrolytes

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and salt in it

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all designed to increase their central

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blood volume

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we also suggested

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things like compression stockings to the

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lower extremities and lower abdomen

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again to drive the blood centrally keep

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the blood pressure up and prevent the

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as you get past the rescue phase

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of of extracting them directly out of

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the mind

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one of our physicians is a

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specialist in emergency

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medical evacuation

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and he talked to them a lot about you

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know some things to consider

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having a triage site

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which the chileans had already you know

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planned for

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but you know talking more about how we

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would evacuate them from the site and

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get them to the hospital

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and kind of you know help talk through

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some plans there and i think that

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our chilean colleagues listened to that

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and implemented a lot of things that

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that you know he

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the other thing that was very important

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you know from

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the standpoint of the care of the miners

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was from the psychological support

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standpoint and of course with our

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long-duration crews we have

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a team of experts

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that provide behavioral health and

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support not only of the astronaut but of

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their families

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and this

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i think was an important contribution

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that that we talked through with their

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psychologists that were topside at the

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mine

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site in addition

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the

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is completed

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the

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thinking

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uh you know completely outlined on how

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they were going to handle the miners

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once they they they got them out and i

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think we were able to you know provide

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some insights and and hopefully there

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are some things that they drew from that

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that that were

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important and that they've implemented

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such things as the celebrity status of

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the of the minor

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these guys were not prepared for that

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and there's going to be a lot of

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pressures on them from

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society not only

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locally but in their country and really

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nasa's part in this

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was

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you know just one small part and a very

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uh overwhelming effort by the the

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chilean government

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it's all about the miners it's all about

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the chilean's response and their

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spirit and tenacity to go after that you

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know we were just pleased to be a part

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we had a preconceived notion of what

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things might apply from space flight to

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the chilean mine and what was surprising

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to us and probably to our chilean

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counterparts once we got down there and

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actually understood what it was the

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miners were going through and looked at

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the difficulties

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that the chilean health authorities and

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the engineers were going to attempt to

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tackle was how many things we could

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actually translate from space flight

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that were

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over and above

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anticipated

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whether it was the refeeding plan

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whether it was the fluid loading

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protocol that we use from the shuttle

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and soyuz return

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down to the requirements for how to

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write

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specific requirements for the escape

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module and what things to use in the

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escape module and

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how to guard against certain dangers or

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hazards in the escape module so it

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really ranged from engineering to

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medical to psychological

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even

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our processes at nasa

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how we build

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leadership structures or how we develop

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documents

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to instruct folks how to build certain

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elements things that we're used to on a

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day-to-day basis

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that we take for granted we're actually

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the urine test strip

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which can test for something we call

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specific gravity which can tell you how

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well hydrated you are

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ketones which can tell you whether or

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not you've got adequate nutrition or in

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our starvation state

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and even check for blood or myoglobin

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which is a protein

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from muscle breakdown that can bombard

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the kidney

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that was very

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fruitful

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chileans

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because they took that advice they used

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that with the miners and they found out

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that about 50 percent of those miners

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had positive myoglobin for that protein

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breaking down

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which could cause kidney failure if left

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being confined in a high stress

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environment in an enclosed space

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like the mine

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can cause reactivation of viruses

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epstein-barr virus herpes virus we see

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that in space flight with the

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reactivation of those viruses and that

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can last for months even after you're

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out on the surface or after the ordeal

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we see that months after astronauts

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return from space flight the same thing

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it was astounding to see it in this and

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that type of in your face direct

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applicability of space flight technology

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and development and protocols that we've

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had an engineering

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expertise

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used directly on the ground

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and there's no better payoff than to

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when we arrived down there at the end of

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august first of september

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there was a mindset which was rather

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short-term

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they were a mining community thinking

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about rescue and all the

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mine disasters that had occurred in the

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past rescues occurred very quickly

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one of the things we try to do is to

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shift that mindset in the minors in the

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families in the top side personnel and

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in the message that went out from these

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people

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toward the long-term run so that their

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expectations

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about when they might be coming out were

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more realistic and therefore their

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coping would be more realistic therefore

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we provided information

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and guidance

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regarding

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individual self-control and how what

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individual coping mechanisms could be

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encouraged

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by topside on the part of the miners

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advice to give the miners some training

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to give the miners about how to manage

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themselves and their emotions and their

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expectations over a long period of time

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in a small space

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about how to manage their relationships

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with other minors

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and for the

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leaders

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and some of the key personnel is how to

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manage team dynamics in confinement over

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a long period of time

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we were concerned about desynchrony

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among the miners of their sleep wake

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cycles that they would start to perhaps

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free run

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which is a situation in which your sleep

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wake cycles begin to drift off the usual

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24 hour

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pattern so we wanted to entrain the

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individuals sleep wake cycles and their

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internal clock so to speak

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with a regular light dark pattern

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which was similar to the one top side so

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that they would be able to communicate

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more effectively with topside people as

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also made regular

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the social life down under so that

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everyone was on the same wake up go to

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sleep time

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people were able to eat together

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there was communication with the doctor

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at a certain time of day and so you had

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this regularity which not only

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stabilizes an individual but stabilizes

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their small community that they had down

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one of my recommendations was that nasa

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could help

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perhaps flushing out some of these

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requirements for the rescue capsule

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upon returning to the united states i

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got an email from the minister of health

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asking for that

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asking for us to

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to provide them some requirements for

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the capsule and so i put together a team

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of

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around

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center

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and over the course of three days we we

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hammered out

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about a 12 or 13 page

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requirements list for the capsule and

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after we had sent these requirements

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down

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i got a

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some communication with

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another

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navy chilean navy commander that i had

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met down there and he was intimately

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involved in the design process of this

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capsule

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with the chilean navy engineers and he

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told me that that they had incorporated

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most of the suggestions that we had

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when i saw the first

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minor being extracted last night i was

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uh

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you know both happy and very relieved

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and

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final design of the capsule is working

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just you know just great so i'm very

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happy about that

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a couple things that i'll remember most

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about this whole experience is one one

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is the uh

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the open openness and graciousness of

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the chilean people i thought they were

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very very nice

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very

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of the things that we

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recommended they ought to do

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the other thing i'm taking away from

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this is that

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our agency is really really has a lot of

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exceptional people

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and

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that that

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20 or so engineers that uh offered to

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drop everything and work with me for

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three days to put this requirements list

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together i think

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really exemplifies that the things that