ALBERT

Description: The Behavioral Health and Performance Section (BHP) at NASA Johnson Space Center provides direct and indirect psychological services to the International Space Station (ISS) astronauts and their families. Beginning with the NASA-Mir Program, services available to the crews and families have gradually expanded as experience is gained in long-duration flight. Enhancements to the overall BHP program have been shaped by crewmembers' personal preferences, family requests, specific events during the missions, programmatic requirements, and other lessons learned. The BHP program focuses its work on four areas: operational psychology, behavioral medicine, human-to-system interface, and sleep and circadian. Within these areas of focus are psychological and psychiatric screening for astronaut selection as well as many resources that are available to the crewmembers, families, and other groups such as crew surgeon and various levels of management within NASA. Services include: preflight, in flight, and postflight preparation; training and support; resources from a Family Support Office; in-flight monitoring; clinical care for astronauts and their families; and expertise in the workload and work/rest scheduling of crews on the ISS. Each of the four operational areas is summarized, as are future directions for the BHP program.

Description: The Behavioral Health and Performance group at NASA Johnson Space Center provides psychological support services and behavioral health monitoring for ISS astronauts and their families. The ISS began as an austere outpost with minimal comforts of home and minimal communication capabilities with family, friends, and colleagues outside of the Mission Control Center. Since 1998, the work of international partners involved in the Space Flight Human Behavior and Performance Working Group has prepared high-level requirements for behavioral monitoring and support. The "buffet" of services from which crewmembers can choose has increased substantially. Through the process of development, implementation, reviewing effectiveness and modifying as needed, the NASA and Wyle team have proven successful in managing the psychological health and well being of the crews and families with which they work. Increasing the crew size from three to six brought additional challenges. For the first time, all partners had to collaborate at the planning and implementation level, and the U.S. served as mentor to extrapolate their experiences to the others. Parity in available resources, upmass, and stowage had to be worked out. Steady progress was made in improving off-hours living and making provisions for new technologies within a system that has difficulty moving quickly on certifications. In some respect, the BHP support team fell victim to its previous successes. With increasing numbers of crewmembers in training, requests to engage our services spiraled upward. With finite people and funds, a cap had to placed on many services to ensure that parity could be maintained. The evolution of NASA BHP services as the ISS progressed from three- to six-crew composition will be reviewed, and future challenges that may be encountered as the ISS matures in its assembly-complete state will be discussed.

Description: The Space Flight Cognitive Assessment Tool for Windows (WinSCAT) is a computer-based, self-administered battery of five cognitive assessment tests developed for medical operations at NASA's Johnson Space Center in Houston, Texas. WinSCAT is a medical requirement for U.S. long-duration astronauts and has been implemented with U.S. astronauts from one NASA/Mir mission (NASA-7 mission) and all expeditions to date on the International Space Station (ISS). Its purpose is to provide ISS crew surgeons with an objective clinical tool after an unexpected traumatic event, a medical condition, or the cumulative effects of space flight that could negatively affect an astronaut's cognitive status and threaten mission success. WinSCAT was recently updated to add network capability to support a 6-person crew on the station support computers. Additionally, WinSCAT Version 2.0.28 has increased difficulty of items in Mathematics, increased number of items in Match-to-Sample, incorporates a moving rather than a fixed baseline, and implements stricter interpretation rules. ISS performance data were assessed to compare initial to modified interpretation rules for detecting potential changes in cognitive functioning during space flight. WinSCAT tests are routinely taken monthly during an ISS mission. Performance data from these ISS missions do not indicate significant cognitive decrements due to microgravity/space flight alone but have shown decrements. Applying the newly derived rules to ISS data results in a number of off-nominal performances at various times during and after flight.. Correlation to actual events is needed, but possible explanations for off-nominal performances could include actual physical factors such as toxic exposure, medication effects, or fatigue; emotional factors including stress from the mission or life events; or failure to exert adequate effort on the tests.

Description: Although the astronaut training flow for the International Space Station (ISS) spans 2 years, each astronaut or cosmonaut often spends most of their training alone. Rarely is it operationally feasible for all six ISS crewmembers to train together, even more unlikely that crewmembers can practice living together before launch. Likewise, ISS Flight Controller training spans 18 months of learning to manage incredibly complex systems remotely in plug-and-play ground teams that have little to no exposure to crewmembers before a mission. How then do all of these people quickly become a team - a team that must respond flexibly yet decisively to a variety of situations? The answer implemented at NASA is Space Flight Resource Management (SFRM), the so-called "soft skills" or team performance skills. Based on Crew Resource Management, SFRM was developed first for shuttle astronauts and focused on managing human errors during time-critical events (Rogers, et al. 2002). Given the nature of life on ISS, the scope of SFRM for ISS broadened to include teamwork during prolonged and routine operations (O'Keefe, 2008). The ISS SFRM model resembles a star with one competency for each point: Communication, Cross-Culture, Teamwork, Decision Making, Team Care, Leadership/Followership, Conflict Management, and Situation Awareness. These eight competencies were developed with international participation by the Human Behavior and Performance Training Working Group. Over the last two years, these competencies have been used to build a multi-modal SFRM training flow for astronaut candidates and flight controllers that integrates team performance skills into the practice of technical skills. Preliminary results show trainee skill increases as the flow progresses; and participants find the training invaluable to performing well and staying healthy during ISS operations. Future development of SFRM training will aim to help support indirect handovers as ISS operations evolve further with the retirement of the Space Shuttle Program.

Description: Two areas of focus for optimizing behavioral health and human performance during International Space Station missions are 1) sleep and circadian assessment and 2) behavioral medicine. The Mir experience provided the opportunity to examine the use and potential effectiveness of tools and procedures to support the behavioral health of the crew. The experience of NASA has shown that on-orbit performance can be better maintained if behavioral health, sleep, and circadian issues are effectively monitored and properly addressed. For example, schedules can be tailored based upon fatigue level of crews and other behavioral and cognitive indicators to maximize performance. Previous research and experience with long duration missions has resulted in the development and upgrade of tools used to monitor fatigue, stress, cognitive function, and behavioral health. Self-assessment and objective tools such as the Spaceflight Cognitive Assessment Tool have been developed and refined to effectively address behavioral medicine countermeasures in space.

Description: No abstract available

Description: This slide presentation reviews the International Space Station (ISS) Operations space flight resource management, which was adapted to the ISS from the shuttle processes. It covers crew training and behavior elements.

Description: This slide presentation reviews the development and use of a tool for assessing spaceflight cognitive ability in astronauts. This tool. the Spaceflight Cognitive Assessment Tool for Windows (WinSCAT) has been used to provide ISS flight surgeons with an objective clinical tool to monitor the astronauts cognitive status during long-duration space flight and allow immediate feedback to the astronaut. Its use is medically required for all long-duration missions and it contains a battery of five cognitive assessment subtests that are scheduled monthly and compared against the individual preflight baseline.

Description: The Spaceflight Cognitive Assessment Tool for Windows (WinSCAT) is a computer program that administers a battery of five timed neuro-cognitive tests. WinSCAT was developed to give astronauts an objective and automated means of assessing their cognitive functioning during space flight, as compared with their own baseline performances measured during similar prior testing on the ground. WinSCAT is also intended for use by flight surgeons to assess cognitive impairment after exposure of astronauts to such cognitive assaults as head trauma, decompression sickness, and exposure to toxic gas. The tests were selected from among a group of tests, denoted the Automated Neuropsychological Assessment Metrics, that were created by the United States Navy and Army for use in evaluating the cognitive impairment of military personnel who have been subjected to medication or are suspected to have sustained brain injuries. These tests have been validated in a variety of clinical settings and are now in the public domain. The tests are presented in a Microsoft Windows shell that facilitates administration and enables immediate reporting of test scores in numerical and graphical forms.

Description: During the NASAMir program of the 1990s and due to the challenges inherent in the International Space Station training schedule and operations tempo, it was clear that a special focus on supporting families was a key to overall mission success for the ISS crewmembers pre, in and postflight. To that end, in January 2001 the first Family Services Coordinator was hired by the Behavioral Health and Performance group at NASA JSC and matrixed from Medical Operations into the Astronaut Office's organization. The initial roles and responsibilities were driven by critical needs, including facilitating family communication during training deployments, providing missionspecific and other relevant trainings for spouses, serving as liaison for families with NASA organizations such as Medical Operations, NASA management and the Astronaut Office, and providing assistance to ensure success of an Astronaut Spouses Group. The role of the Family Support Office (FSO) has modified as the ISS Program matured and the needs of families changed. The FSO is currently an integral part of the Astronaut Office's ISS Operations Branch. It still serves the critical function of providing information to families, as well as being the primary contact for US and international partner families with resources at JSC. Since crews launch and return on Russian vehicles, the FSO has the added responsibility for coordinating with Flight Crew Operations, the families, and their guests for Soyuz launches, landings, and Direct Return to Houston postflight. This presentation will provide a summary of the family support services provided for astronauts, and how they have changed with the Program and families the FSO serves. Considerations for future FSO services will be discussed briefly as NASA proposes one year missions and beyond ISS missions. Learning Objective: 1) Obtain an understanding of the reasons a Family Support Office was important for NASA. 2) Become familiar with the services provided for astronauts and their families and how they changed with the Program and family needs.