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Monitoring Human Performance on Future Deep Space Missions Abstract

NASA and the commercial spacecraft community are working diligently to put the first woman on the moon in the 2024 timeframe. At the same time, NASA researchers are thinking about how to solve the even larger challenges that future deep space missions will bring. Space travel itself is difficult, but astronauts on deep space missions will face obstacles and unknowns never before experienced. In addition to the altered gravity and hostile/closed environment of a spacecraft, deep space crews will face increased radiation, isolation, and distance from Earth. During Extravehicular Activity (EVA, or “spacewalk”) operations, crew will experience increased physical and cognitive workload due to extended types, frequencies and durations of tasks performed on exploration missions in partial gravity environments. All of these stressors will impact crew physical and mental health and performance in difficult-to-anticipate ways. Crew autonomy may be one of the biggest challenges faced. Communication delays and blackouts will occur, and in those situations, the crew may not have access to the Mission Control Center (MCC). They may be forced to be solely dependent on each other and the available information onboard to stay alive, healthy, and achieve the mission. The only conceivable way to meet the challenges of Earth independence is to enable the crew to monitor their own health and performance -- preferably unobtrusively as they perform their duties. Technologies and techniques must be developed to aid the crew in these assessments. A deep space mission is expected to have relatively short periods of high cognitive demand, stress, and fatigue, alongside potentially long periods of cognitive underload during the transit, where boredom, loneliness, and depression can set in. Both ends of this spectrum are dangerous. Crew must be made aware when their task performance drops significantly, when their cognitive workload is too high, when they have lost situation awareness, or when they are too stressed or too fatigued to perform well. They must be able to identify these risks, and then mitigate them with countermeasures available onboard. A number of self-monitoring technologies are presently being explored by NASA to advance crew state determination capabilities. These range from real-time, physiological workload and situation awareness assessments, to crew health measurements determining physical and mental fitness for duty, to task performance metrics such as suit resource expenditures. For EVA tasks during surface exploration missions, biomedical information such as metabolic rate may be provided to crewmembers for situational awareness related to task performance efficiency. In addition, translation distances, hydration, nutrition, inspired CO2 exposure and other consumables usage rates may be useful input metrics for modeling individualized performance during tasks to inform crew or provide estimates of work efficiency. Oculomotor metrics such as gaze dwell time, pupilometry, and eye tracking collected in advanced helmet mounted displays could potentially be used to characterize crew situation awareness. This paper highlights some of these projects, and provides broader discussion about the need for advanced monitoring and smart technologies, as NASA takes the leap into the next generation of space exploration.

Kritina Holden↗
DOE OSTI2020

Explainable Artificial Intelligence Recommendation System by Leveraging the Semantics of Adverse Childhood Experiences: Proof-of-Concept Prototype Development

The study of adverse childhood experiences and their consequences has emerged over the past 20 years. Although the conclusions from these studies are available, the same is not true of the data. Accordingly, it is a complex problem to build a training set and develop machine-learning models from these studies. Classic machine learning and artificial intelligence techniques cannot provide a full scientific understanding of the inner workings of the underlying models. This raises credibility issues due to the lack of transparency and generalizability. Explainable artificial intelligence is an emerging approach for promoting credibility, accountability, and trust in mission-critical areas such as medicine by combining machine-learning approaches with explanatory techniques that explicitly show what the decision criteria are and why (or how) they have been established. Hence, thinking about how machine learning could benefit from knowledge graphs that combine “common sense” knowledge as well as semantic reasoning and causality models is a potential solution to this problem. In this study, we aimed to leverage explainable artificial intelligence, and propose a proof-of-concept prototype for a knowledge-driven evidence-based recommendation system to improve mental health surveillance. We used concepts from an ontology that we have developed to build and train a question-answering agent using the Google DialogFlow engine. In addition to the question-answering agent, the initial prototype includes knowledge graph generation and recommendation components that leverage third-party graph technology. To showcase the framework functionalities, we here present a prototype design and demonstrate the main features through four use case scenarios motivated by an initiative currently implemented at a children’s hospital in Memphis, Tennessee. Ongoing development of the prototype requires implementing an optimization algorithm of the recommendations, incorporating a privacy layer through a personal health library, and conducting a clinical trial to assess both usability and usefulness of the implementation. This semantic-driven explainable artificial intelligence prototype can enhance health care practitioners’ ability to provide explanations for the decisions they make.

adverse childhood experiences↗
DOE OSTI2023

Cultivating a culture of inclusivity in heliophysics

A large number of heliophysicists from across career levels, institution types, and job titles came together to support a poster at Heliophysics 2050 and the position papers for the 2024 Heliophysics decadal survey titled “Cultivating a Culture of Inclusivity in Heliophysics,” “The Importance of Policies: It’s not just a pipeline problem,” and “Mentorship within Heliophysics.” While writing these position papers, the number of people who privately shared disturbing stories and experiences of bullying and harassment was shocking. The number of people who privately expressed how burned out they were was staggering. The number of people who privately spoke about how they considered leaving the field for their and their family’s health was astounding. And for as much good there is in our community, it is still a toxic environment for many. If we fail to do something now, our field will continue to suffer. While acknowledging the ongoing growth that we as individuals must work toward, we call on our colleagues to join us in working on organizational, group, and personal levels toward a truly inclusive culture, for the wellbeing of our colleagues and the success of our field. This work includes policies, processes, and commitments to promote: accountability for bad actors; financial security through removing the constant anxiety about funding; prioritization of mental health and community through removing constant deadlines and constant last-minute requests; a collaborative culture rather than a hyper-competitive one; and a community where people can thrive as whole persons and do not have to give up a healthy or well-rounded life to succeed.

mental health↗
DOE OSTI2021

10 New Insights in Climate Science 2020 - a Horizon Scan

We summarize some of the past year’s most important findings within climate change-related research. New research has improved our understanding of Earth’s sensitivity to carbon dioxide, finds that permafrost thaw could release more carbon emissions than expected and that the uptake of carbon in tropical ecosystems is weakening. Adverse impacts on human society include increasing water shortages and impacts on mental health. Options for solutions emerge from rethinking economic models, rights-based litigation, strengthened governance systems and a new social contract. The disruption caused by COVID-19 could be seized as an opportunity for positive change, directing economic stimulus towards sustainable investments.

29 ENERGY PLANNING, POLICY, AND ECONOMY↗
DOE OSTI2025

CareWELL: Multimodal Region Representation Learning with Spatial Contexts for Urban Health

Rapid urbanization affects living environments by intensifying exposure to air pollution, heat, noise, and urban dynamics, which together contribute to uneven health outcomes across neighborhoods. For instance, cardiovascular, respiratory, and mental health conditions are each influenced by distinct exposures such as air pollution, extreme temperatures, or limited access to green space. These heterogeneous patterns require understanding the characteristics of geographic regions in order to explain why urban health risks vary across urban areas. Recent work in self-supervised region representation learning provides a promising way to model such characteristics from multimodal geospatial data. However, existing methods face two major limitations: (i) they often depend on non-public datasets, limiting reproducibility and applicability, and (ii) their generic pretraining objectives overlook health-relevant determinants, including temporal variability in environmental exposures and inequalities in social conditions. To address these gaps, we propose Context-Aware Region rEpresentation with Weather, Environment, and Location Learning (CareWELL). CareWELL leverages large language models to encode seasonal variability in weather, employs contrastive learning to align geo-coordinate and weather representations, and introduces a context-aware objective that integrates socio-demographic factors while preserving spatial correlations. We evaluate CareWELL by predicting six urban health outcomes in Manhattan, New York City, and demonstrate that CareWELL consistently outperforms state-of-the-art baselines as well as a traditional spatial computing method. These results suggest the importance of context-aware pretraining objectives for learning health-relevant region representations.

Namgung, Min [ORNL]↗
DOE OSTI2023

Physical Education Teachers’ Representations of Their Training to Promote the Inclusion of Students with Disabilities

School inclusion is based on the need to adopt and implement a holistic view of education, training, and human development embodied in the idea of everyone, for everyone. In the context of Physical Education (PE), there are still several constraints to the realization of this universal desideratum. Among these, teacher training and qualification for the inclusion of students with Specific Health Needs (SHNs) stands out. That is, students with physical and mental health problems whose impact is significantly manifested in the learning process. Thus, the objective of this study was to identify the representations of PE teachers about their training to develop inclusive processes with students with SES. Participants in this study were 151 PE teachers from different regions and districts of Portugal (Algarve, Aveiro, Castelo Branco, Lisbon, Porto, and Viseu) who had 23.6 ± 8.1 years of teaching service. Teachers answered an online questionnaire, on the Google Forms platform, with open and closed questions about their education and training to develop inclusive processes in PE. The results indicate two significant dimensions: (1) initial training for teaching inclusive PE and (2) continuous training for inclusion. Regarding initial training, a large majority of the teachers under study, at the end of their initial training, did not have the essential skills to teach PE to students with SES. It was also identified that a large majority reported not having had any contact with students with SES throughout their training process for teaching. It was also recognized that this training was not adjusted to the development of intervention skills with students with SHN. Regarding continuous training, it was identified that attendance at this training increased their skills to teach PE to students with SHN. Workshops/actions/training courses are the main training models adopted. However, it is recognized that the training provided does not respond concretely to their training needs to intervene with students with SHN, since teachers essentially seek to improve intervention in the context of inclusive physical education. We conclude that teacher training for inclusion is not yet fully adjusted to the reality of the inclusive school paradigm. In this sense, in practical terms, the following are suggested: (1) the need for reinforcement in study plans with specific and long-term curricular units; (2) the introduction of real practice components in context; and (3) supervised pedagogical practice in diverse contexts.

Celestino, Tadeu (ORCID:0000000163087981)↗
NASA NTRS2015

NASA Child Fitness Promotion Program in Young Children in South Korea

Childhood obesity is a serious global public health concern (WHO, 2015; Wang Y & Lobstein T, 2006). Low self-esteem and related mental health problems are common in obese children (Strauss RS, 2000) as well as poor academic performance and career development (Gurley-Calvez T, 2010).Westernized dietary habits and sedentary lifestyles are identified as the major risk factors of current alarming rate of obesity along with genetic susceptibility (Popkin BM, 1999). Children in many countries, including South Korea, have become increasingly sedentary due to urbanization changes in their respective societies (Ng SW, et al. 2009, Salmon J et al. 2011). In particular, South Korea had abundant dissemination of mobile technology, such as tablet and smart phone devices. Children have become reliant on mobile devices and are less likely to perform physical activities (Do, et al, 2013). Effective and sustainable intervention programs are needed to fight the global obesity epidemic (IOM, 2012; Wang Y et al, 2013; Wang Y et al, 2015). Previous studies suggested focus on prevention strategies that begin in early childhood, a period when children establish their life habits. (Salmon J et al. 2011). Recent systematic reviews and meta-analysis including ours found that obesity prevention programs for young children have a greater intervention effect (Waters E, et al, 2011; Wang Y et al, 2013; Wang Y et al, 2015). The NASA Mission X: Train Like an Astronaut (MX) program was developed to promote children's exercise and healthy eating with excitement for training like an astronaut (Lloyd C, 2012).At present, the NASA MX Program covered 28 countries, enrolled children through their teachers in school setting (MX report 2014, 2015). This pilot study adapted the NASA MX intervention program for young children in South Korea. We assessed its feasibility and effectiveness in promoting physical activity (PA) in children and in improving parents' perspectives. We also examined the status of PA in young children. More than 80% of five-year-old children go to a Kindergarten or day care center in South Korea (MH Suh et al, 2013).Thus, reaching young children through child care and education settings could be a good approach for early childhood obesity prevention.

Min, Jungwon↗
NASA NTRS1998

Psychological and Behavioral Health Issues of Long-Duration Space Missions

It will be the responsibility of the long-duration space flight crew to take the actions necessary to maintain their health and well-being and to cope with medical emergencies without direct assistance from support personnel, including maintaining mental health and managing physiological and psychological changes that may impair decision making and performance. The Behavior and Performance Integrated Product Team at Johnson Space Center, working, within the Space Medicine, Monitoring, and Countermeasures Program, has identified critical questions pertaining to long-duration space crew behavioral health, psychological adaptation, human factors and habitability, and sleep and circadian rhythms. Among the projects addressing these questions are: the development of tools to assess cognitive functions during space missions; the development of a model of psychological adaptation in isolated and confined environments; tools and methods for selecting individuals and teams well-suited for long-duration missions; identification of mission-critical tasks and performance evaluation; and measures of sleep quality and correlation to mission performance.

Eksuzian, Daniel J.↗
NASA NTRS2009

ISS Hygiene Activities - Issues and Resolutions

Hygiene is something that is usually taken for granted by those of us on the Earth. The ability to perform hygiene satisfactorily during long duration space flight is crucial for the crew's ability to function. Besides preserving the basic health of the crew, crew members have expressed that the ability to clean up on-orbit is vital for mental health. Providing this functionality involves more than supplying hygiene items such as soap and toothpaste. On the International Space Station (ISS), the details on where and how to perform hygiene were left to the crew discretion for the first seventeen increments. Without clear guidance, the methods implemented on-orbit have resulted in some unintended consequences to the ISS environment. This paper will outline the issues encountered regarding hygiene activities on-board the ISS, and the lessons that have been learned in addressing those issues. Additionally, the paper will address the resolutions that have been put into place to protect the ISS environment while providing the crew sufficient means to perform hygiene.

Prokhorov, Kimberlee S.↗
DOE OSTI2024

Seeking help for perinatal depression and anxiety: a systematic review of systematic reviews from an interdependent perspective

Abstract Background Seeking help for perinatal mood and anxiety disorders is crucial for women’s mental health and babies’ development, yet many women do not seek help for their condition and remain undiagnosed and untreated. This systematic review of systematic reviews aimed at summarizing and synthesizing findings from all systematic reviews on seeking help for PMAD in the context of interdependence theory, highlighting the interdependent relationship between women and healthcare providers and how it may impact women’s seeking-help process. Methods Four electronic databases were searched, and 18 studies published up to 2023 met inclusion criteria for review. Results The capability, opportunity and motivation model of behavior was used as a framework for organizing and presenting the results. Results demonstrate that seeking help for PMAD is a function of the interdependent relationship between perinatal women’s and healthcare providers’ psychological and physical capabilities, social and physical opportunities, and their reflective and automatic motivation. Conclusions Unmet needs in perinatal mental healthcare is an important public health problem. This systematic review of systematic reviews highlights key factors for policymakers, researchers, and practitioners to consider to optimize healthcare systems and interventions in a way that enhances perinatal women’s treatment whenever necessary.

Bina, Rena (ORCID:0000000340729229)↗
NASA NTRS1990

Psychological Health Maintenance on Space Station Freedom

The scheduling of crew rotations for up to 180 days on Space Station Freedom presents a special challenge for behavioral scientists who are tasked with providing psychological support for the crews, their families, and mission flight controllers. Preflight psychological support planning may minimize the negative impact of psychological and social issues on mission success, as well as assist NASA management in making real-time mission planning decisions in the event of a significant social event (for example, the death of a family member). During flight, the combined psychological, emotional, and social stressors on the astronauts must be monitored, along with other aspects of their health. The Health Maintenance Facility (HMF) will have the capability of providing preventive, diagnostic, and therapeutic assistance for significant psychiatric and interpersonal problems which may develop. Psychological support will not end with the termination of the mission. Mental health professionals must be part of the team of medical personnel whose job will be to facilitate the transition—physical and mental—from the space environment back to planet Earth. This paper reviews each phase of mission planning for Space Station Freedom and specifies those factors that may be critical for psychological health maintenance on extended-duration space missions.

Patricia A Santy↗
NASA NTRS2024

Expanding Ketamine Application for Treatment of Acute Suicidality in Long-Duration Spaceflight

Introduction. The transition to exploration missions places a heightened risk on behavioral health in spaceflight. Although serious psychiatric emergencies during spaceflight have been rare, longer duration missions increase the possibility of emergence in latent mental health disorders due to genetic predisposition, increased autonomy, isolation, helplessness, loss of family member, or catastrophic events. Complicated grief and bereavement have the highest rate of suicidal ideation. Recently, ketamine has been used as an emergent intervention for acute suicidality, promoting its stability, ease of administration, favorable safety profile, and outcomes for reduction of suicidal intent. The goal of this study was to review current literature and collate the understanding of ketamine as a safe, effective pharmacological adjunct for acute suicidality in spaceflight. Methods. This literature review was conducted to collate data on ketamine use for acute suicidality and inform on stability, limitations and utilization of ketamine within extreme environments. Results. 122 publications were reviewed for relevance including 23 randomized-control trials for ketamine use in behavioral emergencies. Discussion. Ketamine is a diverse pharmaceutical with multiple advantageous indications, including acute suicidality, pain, and sedation. Terrestrial use of ketamine suggests a rapidly efficacious medication for reduction in acute suicidality. As behavioral stressors expand related to extended missions, contingencies for behavioral emergencies become increasingly important. Although this review is not intended to re-develop current International Space Station (ISS) protocols, it is the first to discuss the benefits of ketamine in spaceflight as a potential safe, effective multifaceted tool for future exploration missions and treatment for acute suicidal ideation.

Ketamine, Suicidality, Spaceflight↗
NASA NTRS2016

Impacts of Extreme Events on Human Health

Increased Exposure to Extreme Events Key Finding 1: Health impacts associated with climate-related changes in exposure to extreme events include death, injury, or illness; exacerbation of underlying medical conditions; and adverse effects on mental health[High Confidence]. Climate change will increase exposure risk in some regions of the United States due to projected increases in the frequency and/or intensity of drought, wildfires, and flooding related to extreme precipitation and hurricanes [Medium Confidence].Disruption of Essential Infrastructure Key Finding 2: Many types of extreme events related to climate change cause disruption of infrastructure, including power, water, transportation, and communication systems, that are essential to maintaining access to health care and emergency response services and safeguarding human health [High Confidence].Vulnerability to Coastal Flooding Key Finding 3: Coastal populations with greater vulnerability to health impacts from coastal flooding include persons with disabilities or other access and functional needs, certain populations of color, older adults, pregnant women and children, low-income populations, and some occupational groups [High Confidence].Climate change will increase exposure risk to coastal flooding due to increases in extreme precipitation and in hurricane intensity and rainfall rates, as well as sea level rise and the resulting increases in storm surge.

floods↗
DOE OSTI2026

VA Community Determinants of Health Data Curation Documentation FY26-Q3

The U.S. Department of Veterans Affairs (VA) places the health and well-being of our nation’s veterans as its top priority. VA is dedicated to offering timely access to high-quality, evidence-based mental health care that meets the needs of veterans and supports their reintegration into society. One of our core missions is to prevent suicide among veterans through innovative approaches and resources.

99 GENERAL AND MISCELLANEOUS↗
DOE OSTI2022

Impact of WELL certification on occupant satisfaction and perceived health, well-being, and productivity: A multi-office pre- versus post-occupancy evaluation

The WELL Building Standard (WELL) is currently one of the most comprehensive building certification programs that aim to enhance the health and well-being of building occupants. However, there is a lack of systematic evaluation of the effectiveness of WELL in achieving its goal. This study investigates the impact of WELL certification on occupant satisfaction with the workplace and occupant perceived health, well-being, and productivity. More than 1300 pre- and post-occupancy survey responses provided by the nearly same cohort of occupants from six companies in North America were quantitatively analyzed. The results showed that transitioning to WELL certified offices from non-WELL certified offices had a positive impact on occupant satisfaction with the workplace and occupant perceived health, well-being, and productivity, with increases in means from pre-to post-occupancy being highly statistically significant. The majority of the studied occupant satisfaction parameters as well as occupant perceived mental health had large effect sizes. While they improved from pre-to post-occupancy, the analysis revealed small effect sizes for occupant perceived physical health and self-assessed productivity. The majority of the effect sizes for the perceived well-being parameters were large and medium. In addition to analyzing the survey responses in aggregate, the responses were examined at the individual company level to confirm the by-company and aggregate findings aligned.

32 ENERGY CONSERVATION, CONSUMPTION, AND UTILIZATI↗
DOE OSTI2021

Mining and Validating Social Media Data for COVID-19–Related Human Behaviors Between January and July 2020: Infodemiology Study

Background: Health authorities can minimize the impact of an emergent infectious disease outbreak through effective and timely risk communication, which can build trust and adherence to subsequent behavioral messaging. Monitoring the psychological impacts of an outbreak, as well as public adherence to such messaging, is also important for minimizing long-term effects of an outbreak. Objective: We used social media data from Twitter to identify human behaviors relevant to COVID-19 transmission, as well as the perceived impacts of COVID-19 on individuals, as a first step toward real-time monitoring of public perceptions to inform public health communications. Methods: We developed a coding schema for 6 categories and 11 subcategories, which included both a wide number of behaviors as well codes focused on the impacts of the pandemic (eg, economic and mental health impacts). We used this to develop training data and develop supervised learning classifiers for classes with sufficient labels. Classifiers that performed adequately were applied to our remaining corpus, and temporal and geospatial trends were assessed. We compared the classified patterns to ground truth mobility data and actual COVID-19 confirmed cases to assess the signal achieved here. Results: We applied our labeling schema to approximately 7200 tweets. The worst-performing classifiers had F1 scores of only 0.18 to 0.28 when trying to identify tweets about monitoring symptoms and testing. Classifiers about social distancing, however, were much stronger, with F1 scores of 0.64 to 0.66. We applied the social distancing classifiers to over 228 million tweets. We showed temporal patterns consistent with real-world events, and we showed correlations of up to –0.5 between social distancing signals on Twitter and ground truth mobility throughout the United States. Conclusions: Behaviors discussed on Twitter are exceptionally varied. Twitter can provide useful information for parameterizing models that incorporate human behavior, as well as for informing public health communication strategies by describing awareness of and compliance with suggested behaviors.

60 APPLIED LIFE SCIENCES↗
NASA NTRS2003

Monitoring Outpatient Care

Each year, health care costs for managing chronically ill patients increase as the life expectancy of Americans continues to grow. To handle this situation, many hospitals, doctors practices, and home care providers are turning to disease management, a system of coordinated health care interventions and communications, to improve outpatient care. By participating in daily monitoring programs, patients with congestive heart failure, chronic obstructive pulmonary disease, diabetes, and other chronic conditions requiring significant self-care are facing fewer emergency situations and hospitalizations. Cybernet Medical, a division of Ann Arbor, Michigan-based Cybernet Systems Corporation, is using the latest communications technology to augment the ways health care professionals monitor and assess patients with chronic diseases, while at the same time simplifying the patients interaction with technology. Cybernet s newest commercial product for this purpose evolved from research funded by NASA, the National Institute of Mental Health, and the Advanced Research Projects Agency. The research focused on the physiological assessment of astronauts and soldiers, human performance evaluation, and human-computer interaction. Cybernet Medical's MedStar Disease Management Data Collection System is an affordable, widely deployable solution for improving in-home-patient chronic disease management. The system's battery-powered and portable interface device collects physiological data from off-the-shelf instruments.

Source record↗
DOE OSTI2025

Cross‐Cultural Validation of the Binge Eating Disorder Screener‐7 ( BEDS ‐7) Across 42 Countries

ABSTRACT Objective This study aimed to evaluate the reliability and validity of the Binge Eating Disorder Screener‐7 (BEDS‐7) across 42 countries and 26 languages, assessing its reliability and validity as a screening tool for binge‐eating disorder (BED) in diverse cultural contexts. Specifically, it sought to enhance early recognition of BED symptoms in primary care settings globally, contributing to a standardized framework for assessing BED. Method The International Sex Survey, a cross‐sectional online study, was conducted in 42 countries and 26 languages. A diverse community sample of 82,243 participants, aged 18 years or older, completed the BEDS‐7 and measures of sexuality, mental health, substance use, and sociodemographic characteristics. Confirmatory factor analyses and tests of measurement invariance were employed to evaluate the reliability and validity of the BEDS‐7 across languages, countries, genders, and sexual orientations. Results The BEDS‐7 demonstrated scalar factorial invariance across languages and countries, indicating consistent factor loadings and item intercepts. In contrast, the screener showed residual invariance across gender and sexual orientation groups, supporting its robustness across these demographics. Kruskal–Wallis tests revealed significant differences in BED symptoms across languages, countries, genders, and sexual orientations, with the highest BED scores observed among queer, pansexual, and gender‐diverse individuals. The BEDS‐7 also demonstrated adequate reliability (Cronbach's alpha > 0.80) and moderate criterion validity. Discussion The findings provide further evidence of the reliability and validity of the BEDS‐7 as a potential screening tool for identifying probable cases of BED globally, facilitating early intervention in primary care settings.

Gewirtz‐Meydan, Ateret [School of Social Work, Fac↗