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Space travel has transformed in the past several years. Given the burgeoning market for space tourism, in-flight medical emergencies are likely to be expected. Ultrasound is one of the few diagnostic and therapeutic modalities available for astronauts in space. However, while point-of-care ultrasound (POCUS) is available, there is no current standard of training for astronaut preparation. We suggest an organized and structured methodology by which astronauts should best prepare for space with the medical equipment available on board. As technology continues to evolve, the assistance of other artificial intelligence and augmented reality systems are likely to facilitate training and dynamic real-time needs during space emergencies. Summary: As space tourism continues to evolve, an organized methodology for POCUS use is advised to best prepare astronauts for space., Competing Interests: Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. Drs. Emily Frisch, Andrew Goldsmith, and Nicole Duggan all have received consulting or advising fees from Centaur Labs. Dr. Chanel Fischetti was formerly employed by Centaur Labs and owns equity in the company. She also is a consultant for Philips Ultrasound and LevelEx. Select authors (Drs. Dias, Savage, Loesche and Mormann) have received funding from, are currently employed by, or receive related funding/grant support from NASA or SpaceX.

Objective: The objective is to analytically determine the expected CG and build hardware to measure and verify the suited subject's CG for lunar extravehicular activity (EVA) training in an underwater environment., Background: For lunar EVAs, it is necessary for astronauts to train with a spacesuit in a simulated partial gravity environment. NASA's Neutral Buoyancy Laboratory (NBL) can provide these conditions by producing negative buoyancy for a submerged suited subject. However, it is critical that the center of gravity (CG) for the human-spacesuit system to be accurate for conditions expected during planetary EVAs., Methods: An underwater force-transducer system and individualized human-spacesuit model was created to provide real-time measurement of CG, including recommendations for weight placement locations and quantity of weight needed on the spacesuit to achieve a realistic lunar spacesuit CG. This method was tested with four suited subjects., Results: Across tested weighout configurations, it was observed that an aft and high CG location will have large postural differences when compared to low and fore CG locations, highlighting the importance of having a proper CG. The system had an accuracy of ±5lbs of the total lunar weight and within ± 15 cm for fore-aft and left-right CG directions of the model predictions., Conclusion: The developed method offers analytical verification of the suited subject's CG and improves simulation quality of lunar EVAs. Future suit design can also benefit by recommending hardware changes to create ideal CG locations that improve balance and mobility., Application: The developed methodology can be used to verify a proper CG location in future planetary EVA simulations such as different reduced gravity training analogs (e.g. active cable offloading systems).

Background: Long-duration exploration missions (LDEMs), such as voyages to Mars, will present unique medical challenges for astronaut crews, including communication delays and the inability to return to Earth early. Medical events threaten crewmember lives and increase the risk of mission failure. Managing a range of potential medical events will require excellent technical and nontechnical skills (NTSs). We sought to identify medical events with potential for rescue, range them according to the potential impact on crew health and mission success during LDEMs, and develop a list of NTSs to train for management of in-flight medical events., Materials and Methods: Twenty-eight subject matter experts with specializations in surgery, medicine, trauma, spaceflight operations, NTS training, simulation, human factors, and organizational psychology completed online surveys followed by a 2-d in-person workshop. They identified and rated medical events for survivability, mission impact, and impact of crewmember NTSs on outcomes in space., Results: Sudden cardiac arrest, smoke inhalation, toxic exposure, seizure, and penetrating eye injury emerged as events with the highest potential mission impact, greatest potential for survival, and that required excellent NTS for successful management. Key NTS identified to target in training included information exchange, supporting behavior, communication delivery, and team leadership/followership., Conclusions: With a planned Mars mission on the horizon, training countermeasures need to be developed in the next 3-5 y. These results may inform policy, selection, medical system design, and training scenarios for astronauts to manage in-flight medical events on LDEMs. Findings may extend to surgical and medical care in any rural and remote location., (Copyright © 2019. Published by Elsevier Inc.)

Neutral buoyancy's value was far from obvious when human spaceflight began in 1961. Starting in 1964, Environmental Research Associates, a tiny company in the suburbs of Baltimore, developed the key innovations in an obscure research project funded by NASA's Langley Research Center. The new Houston center dismissed it until a mid-1966 EVA crisis, after which it rapidly took over. In parallel, NASA Marshall Space Flight Center developed many of the same techniques, as did many large aerospace corporations, yet the long-run technological impact of corporate activity was near zero. Because ERA and Marshall's pioneering activities led to the two long-running NASA training centers at Houston and Huntsville, those two organizations deserve primary credit for the construction of the neutral buoyancy technological system., (Published by Elsevier Ltd.)

Introduction: With missions planned to travel greater distances from Earth at ranges that make real-time two-way communication impractical, astronauts will be required to perform autonomous medical diagnostic procedures during future exploration missions. Virtual guidance is a form of just-in-time training developed to allow novice ultrasound operators to acquire diagnostically-adequate images of clinically relevant anatomical structures using a prerecorded audio/visual tutorial viewed in real-time., Methods: Individuals without previous experience in ultrasound were recruited to perform carotid artery (N = 10) and ophthalmic (N = 9) ultrasound examinations using virtual guidance as their only training tool. In the carotid group, each untrained operator acquired two-dimensional, pulsed and color Doppler of the carotid artery. In the ophthalmic group, operators acquired representative images of the anterior chamber of the eye, retina, optic nerve, and nerve sheath. Ultrasound image quality was evaluated by independent imaging experts., Results: Of the studies, 8 of the 10 carotid and 17 of 18 of the ophthalmic images (2 images collected per study) were judged to be diagnostically adequate. The quality of all but one of the ophthalmic images ranged from adequate to excellent., Discussion: Diagnostically-adequate carotid and ophthalmic ultrasound examinations can be obtained by previously untrained operators with assistance from only an audio/video tutorial viewed in real time while scanning. This form of just-in-time training, which can be applied to other examinations, represents an opportunity to acquire important information for NASA flight surgeons and researchers when trained medical personnel are not available or when remote guidance is impractical.

The paper presents the view of space medicine and human factor experts on the problems of cosmonaut's research activities. Readiness of ISS crewmembers for conducting experiments and research equipment handling depends on the pre-flight training quality and course of adaptation to the flight conditions, the latter of particular criticality for participation in human use tests as an object.

We have shown before that subjects exposed to a changed gravitoinertial environment produce exaggerated manual forces. From the observed pattern of findings, we argued that initial forces were exaggerated because of abnormal vestibular activity and peak forces because of degraded proprioceptive feedback. If so, only peak but not initial forces should be affected by water immersion, an environment that influences proprioceptive feedback but not vestibular activity. The present study was undertaken to scrutinize this prediction. Twelve subjects sat in a chair once immersed in water and once on dry land, while producing pre-trained isometric forces with a joystick. In a control experiment, subjects performed a four-choice reaction-time task. During the joystick task, produced initial forces were comparable in water and on land, while peak (+24%) and end forces (+22%) were significantly higher in water, as was their reaction time (+6%). During the control task, reaction time was comparable in water and on land. Our findings corroborate the above notion that initial forces increase when the vestibular system is stimulated (gravitoinertial change, visual field motion, but not water immersion), while peak forces increase when proprioceptive feedback is degraded (probably all three scenarios) and are not corrected until response end. Our findings further confirm the absence of cognitive slowing in simple-choice reaction tasks under shallow-water immersion conditions.

The Japan Aerospace Exploration Agency (JAXA) provides extravehicular activity (EVA) training to astronauts in a weightless environment test building (WETS) located in Tsukuba City. For EVA training, Tsukuba Medial Center Hospital (TMCH) has established an emergency medical support system, serving as operations coordinator. Taking the perspective of emergency physicians, this paper provides an overview of the medical support system and examines its activities over the past decade as well as future issues. Fortunately, no major accident has occurred during the past 10 years of NBS. Minor complaints (external otitis, acute otitis media, transient dizziness, conjunctival inflammation, upper respiratory inflammation, dermatitis, abraded wounds, etc.) among the support divers have been addressed onsite by attending emergency physicians. Operations related to the medical support system at the WETS have proceeded smoothly for the former NASDA and continue to proceed without event for JAXA, providing safe, high-quality emergency medical services. If an accident occurs at the WETS, transporting the patient by helicopter following initial treatment by emergency physicians can actually exacerbate symptoms, since the procedure exposes a patient who was recently within a hyperbaric environment to the low-pressure environment involved in air transportation. If a helicopter is used, the flight altitude should be kept as low as possible by taking routes over the river.

Purpose: To develop a model that will accurately predict the distance spherical lens correction needed to be worn by National Aeronautics and Space Administration astronauts while training underwater. The replica space suit's helmet contains curved visors that induce refractive power when submersed in water., Methods: Anterior surface powers and thicknesses were measured for the helmet's protective and inside visors. The impact of each visor on the helmet's refractive power in water was analyzed using thick lens calculations and Zemax optical design software. Using geometrical optics approximations, a model was developed to determine the optimal distance spherical power needed to be worn underwater based on the helmet's total induced spherical power underwater and the astronaut's manifest spectacle plane correction in air. The validity of the model was tested using data from both eyes of 10 astronauts who trained underwater., Results: The helmet's visors induced a total power of -2.737 D when placed underwater. The required underwater spherical correction (FW) was linearly related to the spectacle plane spherical correction in air (FAir): FW = FAir + 2.356 D. The mean magnitude of the difference between the actual correction worn underwater and the calculated underwater correction was 0.20 ± 0.11 D. The actual and calculated values were highly correlated (r = 0.971) with 70% of eyes having a difference in magnitude of <0.25 D between values., Conclusions: We devised a model to calculate the spherical spectacle lens correction needed to be worn underwater by National Aeronautics and Space Administration astronauts. The model accurately predicts the actual values worn underwater and can be applied (more generally) to determine a suitable spectacle lens correction to be worn behind other types of masks when submerged underwater.

Background: We have developed an analogue of postflight sensorimotor dysfunction in astronauts using pseudorandom galvanic vestibular stimulation (GVS). To date there has been no study of the effects of extended GVS on human subjects and our aim was to determine optimal exposure for astronaut training based on tolerance to intermittent and continuous galvanic stimulation., Methods: There were 60 subjects who were exposed to a total of 10.5 min of intermittent GVS at a peak current of 3.5 mA or 5 mA. A subset of 24 subjects who tolerated the intermittent stimulus were subsequently exposed to 20-min continuous stimulation at 3.5 mA or 5 mA., Results: During intermittent GVS the large majority of subjects (78.3%) reported no or at most mild motion sickness symptoms, 13.3% reported moderate symptoms, and 8.3% experienced severe nausea and requested termination of the stimulus. During 20-min continuous exposure, 83.3% of subjects reported no or at most mild motion sickness symptoms and 16.7% (all in the 5-mA group) experienced severe nausea., Conclusion: Based on these results, we propose two basic modes of GVS application to minimize the incidence of motion sickness: intermittent high (5 mA) amplitude, suited to simulation of intensive operator tasks requiring a high-fidelity analogue of postflight sensorimotor dysfunction such as landing or docking maneuvers; and continuous low (3.5 mA) amplitude stimulation, for longer simulation scenarios such as extra vehicular activity. Our results suggest that neither mode of stimulation would induce motion sickness in the large majority of subjects for up to 20 min exposure.

Purpose: To test the ability of non-expert ultrasound operators of divergent backgrounds to detect the presence, size, location, and composition of foreign bodies in an ocular model., Methods: High school students (N = 10) and NASA astronauts (N = 4) completed a brief ultrasound training session which focused on basic ultrasound principles and the detection of foreign bodies. The operators used portable ultrasound devices to detect foreign objects of varying location, size (0.5-2 mm), and material (glass, plastic, metal) in a gelatinous ocular model. Operator findings were compared to known foreign object parameters and ultrasound experts (N = 2) to determine accuracy across and between groups., Results: Ultrasound had high sensitivity (astronauts 85%, students 87%, and experts 100%) and specificity (astronauts 81%, students 83%, and experts 95%) for the detection of foreign bodies. All user groups were able to accurately detect the presence of foreign bodies in this model (astronauts 84%, students 81%, and experts 97%). Astronaut and student sensitivity results for material (64% vs. 48%), size (60% vs. 46%), and position (77% vs. 64%) were not statistically different. Experts' results for material (85%), size (90%), and position (98%) were higher; however, the small sample size precluded statistical conclusions., Conclusions: Ultrasound can be used by operators with varying training to detect the presence, location, and composition of intraocular foreign bodies with high sensitivity, specificity, and accuracy.

Background: The objective of the study was to assess if performance of basic laparoscopic skills on a virtual reality (VR) simulator is impaired in microgravity relative to normal gravitational influences., Materials and Methods: Fourteen subjects with various educational backgrounds underwent basic laparoscopy skill training for five consecutive days on the ground before flying aboard NASA's KC-135 zero-gravity laboratory. The participants performed basic laparoscopic exercises (clip applying, grasping, cutting, and suturing) on a VR laparoscopy simulator, both on the ground and during 25-s microgravity windows in parabolic flight. Skill levels after ground training were compared with skill levels in performing the same tasks in microgravity. Blinded reviewers measured the number of tasks successfully completed, tissue damage number, left and right hand path lengths during task execution, and percentage of task attempts that resulted in successful completion., Results: A significant increase in tissue injury (t test, P < 0.05) and task erosion were seen in clip applying, cutting, and grasping in microgravity (45%, 20% and 57% decrease in task attempts that resulted in a successful completion, respectively). However, there was no significant difference in the left and right hand path lengths, and the total number of tasks successfully completed on the ground versus in microgravity, for any of the four laparoscopic exercises (t test, P > 0.05)., Conclusion: This study demonstrates decreased efficiency and increased injury to the simulated tissues in performing laparoscopic skills during microgravity as compared to performing these skills in standard gravitational influence. Additional experiments are indicated to further develop and validate VR microgravity surgical simulation.

Among the principal objectives of the Phase 1 NASA/Mir program were for the United States to gain experience working with an international partner, to gain working experience in long-duration space flight, and to gain working experience in planning for and executing research on a long-duration space platform. The Phase 1 program was to provide the US early experience prior to the construction and operation of the International Space Station (Phase 2 and 3). While it can be argued that Mir and ISS are different platforms and that programmatically Phase 1 and ISS are organized differently, it is also clear that many aspects of operating a long-duration research program are platform independent. This can be demonstrated by a review of lessons learned from Skylab, a US space station program of the mid-1970s, many of which were again "learned" on Mir and are being "learned" on ISS. Among these are optimum crew training strategies, on-orbit crew operations, ground support, medical operations and crew psychological support, and safety certification processes., (c2005 Published by Elsevier Ltd.)

Background: Astronaut spacewalk training can result in a variety of symptom complaints and possible injuries. This study quantified and characterized signs, symptoms, and injuries resulting from extravehicular activity spacesuit training at NASA's Neutral Buoyancy Laboratory, Johnson Space Center, Houston, TX, immersion facility., Methods: We identified the frequency and incidence of symptoms by location, mechanisms of injury, and effective countermeasures. Recommendations were made to improve injury prevention, astronaut training, test preparation, and training hardware. At the end of each test, a questionnaire was completed documenting signs and symptoms, mechanisms of injury, and countermeasures., Results: Of the 770 tests, there were 190 in which suit symptoms were reported (24.6%). There were a total of 352 reported suit symptom comments. Of those symptoms, 166 were in the hands (47.16%), 73 were in the shoulders (20.7%), and 40 were in the feet (11.4%). Others ranged from 6.0% to 0.28%, respectively, from the legs, arms, neck, trunk, groin, and head. Causal mechanisms for the hands included moisture and hard glove contacts resulting in fingernail injuries; in the shoulders, hard contact with suit components and strain mechanisms; and in the feet, hard boot contact. The severity of symptoms was highest in the shoulders, hands, and feet., Conclusions: Most signs and symptoms were mild, self-limited, of brief duration, and were well controlled by available countermeasures. Some represented the potential for significant injury with consequences affecting astronaut health and performance. Correction of extravehicular activity training-related injuries requires a multidisciplinary approach to improve prevention, medical intervention, astronaut training, test planning, and suit engineering.

Objective: To implement malfunction simulation in spaceflight training simulator., Method: The principle of malfunction simulation was defined according to spacecraft malfunction predict and its countermeasures. The malfunction patterns were classified, and malfunction type was confirmed. A malfunction simulation model was established, and the malfunction simulation was realized by math simulation., Result: According to the requirement of astronaut training, a spacecraft subsystem malfunction simulation model was established and realized, such as environment control and life support, GNC, push, power supply, heat control, data management, measure control and communication, structure and so on., Conclusion: The malfunction simulation function implemented in the spaceflight training simulator satisfied the requirements for astronaut training.

One of the key contributions to the development and operation of the International Space Station (ISS) is ESA's Columbus Laboratory Module. It will be transported to the ISS, together with its payload complement, on Space Shuttle Assembly Flight 1E in 2006. Columbus's readiness for launch requires the availability not only of the Module itself, but also three other major elements being provided by ESA, namely: the Ground Segment, consisting of the Columbus Control Centre and the User Support and Operations Centres (USOCs), the Operations products, and the Crew Training.

Aircraft parabolic flights provide repetitively up to 20 s of reduced gravity during ballistic flight manoeuvres. Parabolic flights are used to conduct short microgravity investigations in Physical and Life Sciences, to test instrumentation and to train astronauts before a space flight. The European Space Agency (ESA) has organized since 1984 thirty parabolic flight campaigns for microgravity research experiments utilizing six different airplanes. More than 360 experiments were successfully conducted during more than 2800 parabolas, representing a cumulated weightlessness time of 15 h 30 m. This paper presents the short duration microgravity research programme of ESA. The experiments conducted during these campaigns are summarized, and the different airplanes used by ESA are shortly presented. The technical capabilities of the Airbus A300 'Zero-G' are addressed. Some Physical Science, Technology and Life Science experiments performed during the last ESA campaigns with the Airbus A300 are presented to show the interest of this unique microgravity research tool to complement, support and prepare orbital microgravity investigations., (c2004 Elsevier Ltd. All rights reserved.)

It is likely that the first responder to a medical emergency in space will be a nonphysician. Terrestrial experience has shown that even under optimal conditions experienced clinicians can have difficulty establishing an airway. Establishing and maintaining a patent airway is essential to ensuring a successful outcome from cardiopulmonary resuscitation or respiratory failure secondary to trauma or acute illness. A patent airway is required to provide a pathway for ventilation and oxygenation. For minimally trained care providers the airway will also be the first route of administration of resuscitative pharmacologic agents. It is therefore of paramount importance that the method for securing and airway permit a successful outcome when used by nonphysician crewmembers during medical emergencies in space. This article evaluates airway management in the microgravity environment and applies to both the International Space Station and the Space Shuttle, whether operating independently or docked.

To ensure safety of cosmonauts impacted by +Gx loads during insertion into orbit of a Soyuz-type space vehicle, it is critical to conduct appropriate medical selection of candidates to space flights, to give them proper complete physical and specialized centrifuge training, and to make it sure that at the moment of actual injection the cosmonaut's posture is optimal relative to the g-vector and that the body is tight fitting the custom-molded couch. No AGS is needed. For the purposes of protection of cosmonauts descending in the Soyuz vehicles, vital are countermeasures applied in the course of flight, water-salt supplements on the descent day, and the optimal posture, an anti-g suit, and a custom-molded couch with an additional body-restraint system and dampers used on the phase of reentry.

The efficacy of countermeasure exercise for diminishing disturbances induced by microgravity in motor system and its visceral supply during different stages of long-duration flight was evaluated. The results of both bicycle and locomotor testing indicate that physical fitness of cosmonaut does not become worse in the course of the long-duration flight. On the contrary, the lowest fitness was recorded at the first stage of mission, just after one month of flight. The "dead period" at the beginning of space flight seems to be a manifestation of the acute decrease in physical condition on transition from 1 G to microgravity, when none of the regular countermeasure regimes is sufficiently effective and acute increase of volume and intensity of training is impossible under the conditions of space flight.

The European Space Agency (ESA) contribution to the International Space Station (ISS) goes much beyond the delivery of hardware like the Columbus Laboratory, its payloads and the Automated Transfer Vehicles. ESA Astronauts will be members of the ISS crew. ESA, according to its commitments as ISS international partner, will be responsible to provide training on its elements and payloads to all ISS crewmembers and medical support for ESA astronauts. The European Astronaut Centre (EAC) in Cologne has developed over more than a decade into the centre of expertise for manned space activities within ESA by contributing to a number of important co-operative spaceflight missions. This role will be significantly extended for ISS manned operations. Apart from its support to ESA astronauts and their onboard operations, EAC will have a key role in training all ISS astronauts on ESA elements and payloads. The medical support of ISS crew, in particular of ESA astronauts has already started. This paper provides an overview on status and further plans in building up this homebase function for ESA astronauts and on the preparation towards Training Readiness for ISS crew training at EAC, Cologne. Copyright 2001 by the European Space Agency. Published by the American Institute of Aeronautics and Astronautics, Inc., with permission. Released to IAF/IAA/AIAA to publish in all forms., (c2003 Elsevier Ltd. All rights reserved.)

ESA astronauts' ISS flight opportunities are considered as a vital source to meet the utilisation, operation and political objectives that Europe has established for participating in the International Space Station programme. Recent internal ESA assessments have demonstrated that a rate of three flights per year for European Astronauts should be maintained as a minimum objective. The current flight rate is lower than this. In order to improve this situation, in the context of the activation of the ESA ISS Commercialisation programme, ESA is developing the conditions for the establishment of commercially based human spaceflights with the financial support of both ESA and the private sector or, in the future, only the latter. ESA is working in a Partnership with the space industry to facilitate the implementation of such projects and support customers with a range of end-to-end commercial services. The opportunities and challenges of a "commercial human spaceflight", involving a member of the European Astronaut Corps, or a privately employed flight participant, are discussed here., (c2003 Elsevier Science Ltd. All rights reserved.)

The concept of in-flight expert system for controlling (ESC) the physical training program during extended, including Martian, space missions has been developed based on the literature dedicated to the microgravity countermeasures and a retrospective analysis of effectiveness of the known ESC methods. This concept and the principle of crew autonomy were used as prime assumptions for defining the structure of ESC-based training in long-duration and planetary missions.

Objective: To verify validity of the increase in adaptability of blood redistribution in human body with repeated body position change training and to find preferable training method for increasing astronaut's adaptability of blood redistribution., Method: Twelve subjects were randomly divided into group A and B. Six subjects in each group were trained with mode A and B repeated position change (9 times in 11 d) respectively. Their head-down tilt (HDT -30 degrees/30 min) tolerance and orthostatic tolerance were determined before and after training to verify training effects., Result: 1) Two kinds of repeated body position change training modes increased all subjects' HDT tolerance. Compared with pre-training, during HDT test subjects' symptom scores in group B were significantly lower than those in group A (P<0.05) and after training decreasing magnitude of heart rate in group B increased significantly (P<0.01). Then mode B to be preferable training method in increasing HDT tolerance was suggested. 2) Two kinds of training modes improved all subjects' orthostatic tolerance. Compared with pre-training, during orthostatic tolerance test increasing magnitude of mean arterial blood pressure in group B increased significantly (P<0.05) and a trend of increasing magnitude of heart rate in group B was appeared smaller than in group A (P<0.10). Mode B to be preferable training method in increasing orthostatic tolerance was suggested too., Conclusion: Repeated body position change training could increase adaptability to blood redistribution in human body. Mode B was preferable training method and would be hopeful to be used in astronaut training.

Fixed-base full task flight training simulator is a very critical and important integrated training facility. It is mostly used in training of integrated skills and tasks, such as running the flight program of manned space flight, dealing with faults, operating and controlling spacecraft flight, communicating information between spacecraft and ground. This simulator was made up of several subentries including spacecraft simulation, simulating cabin, sight image, acoustics, main controlling computer, instructor and assistant support. It has implemented many simulation functions, such as spacecraft environment, spacecraft movement, communicating information between spacecraft and ground, typical faults, manual control and operating training, training control, training monitor, training database management, training data recording, system detecting and so on.

The subject of space medico-engineering which takes manned space flight as its own task, played an important role in China's manned space project, and developed rapidly. According to China's next three manned space objectives: 1) to develop the technology of extra-vehicle activity (EVA) and test the astronauts' performance ability of EVA; 2) to develop the technology of docking with other object spacecraft in space; 3) to found a relatively large space lab, the research directions and key technology of space medico-engineering have been given, including astronaut's selection and training; requirements and evaluation of medicine and ergonomics of the space lab design; the researches of fields in astronauts' medical monitoring and space medicine; technology of environmental control and life support system in space module; technology of EVA or docking; and technology of simulation of astronaut's training.

After several years of planning and preparation, ESA's ISS training programme has become operational. Between 26 August and 6 September, the European Astronaut Centre (EAC) near Cologne gave the first ESA advanced training course for an international ISS astronaut class. The ten astronauts who took part--two from NASA, four from Japan and four from ESA--had begun their advanced training programme back in 2001 with sessions at the Johnson Space Center (JSC) in Houston and at the Japanese Training Centre in Tsukuba. During their stay in Cologne, the ten astronauts participated in a total of 33 classroom lessons and hands-on training sessions, which gave them a detailed overview of the systems and subsystems of the Columbus module, the Automated Transfer Vehicle (ATV), and the related crew operations tasks. They were also introduced to the four ESA experiment facilities to be operated inside the Columbus module. After their first week of training at EAC, the astronauts were given the opportunity to see the flight model of the Columbus module being integrated at the site of ESA's ISS prime contractor, Astrium in Bremen. The second week of training at EAC included hands-on instruction on the Columbus Data Management System (DMS) using the recently installed Columbus Crew Training Facility. In preparation for the first advanced crew training session at EAC, two Training Readiness Reviews (TRR) were conducted there in June and August. These reviews were supported by training experts and astronauts from NASA, NASDA and CSA (Canada), who were introduced to ESA's advanced training concept and the development process, and then analysed and evaluated the training flow, content and instructional soundness of lessons and courses, as well as the fidelity of the training facilities and the skills of the ESA training instructors. The International Training Control Board (ITCB), made up of representatives from all of the ISS International Partners and mandated to control and coordinate all multilateral training for ISS crew and ground-support personnel, testified to ESA's readiness to provide Advanced Training by declaring the EAC TRR successful. The completion of this first training course was therefore a good opportunity for the Astronaut Training Division to assess the status of its training programme. The comments and recommendations of the training experts and the astronauts who took part have been carefully evaluated and the results are being fed back into the ongoing training development process.

Unlabelled: The role of cross-cultural factors in long-duration international space missions was examined during an isolation study that simulated many of the conditions aboard the International Space Station., Methods: Interactions involving two heterogeneous crews and one homogeneous crew staying in isolation from 110 to 240 days were studied. Data consisted of post-isolation interviews with crewmembers, ground support personnel and management, observational data, and public statements by crewmembers. Data was analyzed using the techniques of linguistic anthropology and ethnography., Results: Sub-cultural (organizational and professional) differences played a larger role than national differences in causing misunderstandings in this study. Conversely, some misunderstandings and conflicts were escalated by participants falsely assuming cultural differences or similarities. Comparison between the two heterogeneous crews showed the importance of training, personality factors, and commander and language skills in preventing and alleviating cultural misunderstandings., Conclusion: The study revealed a number of ways that cultural differences, real as well as assumed, can play a role and interact with other, non-cultural, factors in causing and/or precipitating conflict situations. It is postulated that such difficulties can be avoided by selecting culturally adaptive crewmembers and by cross-cultural and language training. Also the crew composition and role of commander were found to be important in mitigating conflict situations., (c2002 Lister Science.)

In November 2000, the National Aeronautics and Space Administration (NASA) and its partners in the International Space Station (ISS) ushered in a new era of space flight: permanent human presence in low-Earth orbit. As the culmination of the last four decades of human space flight activities. the ISS focuses our attention on what we have learned to date. and what still must be learned before we can embark on future exploration endeavors. Space medicine has been a primary part of our past success in human space flight, and will continue to play a critical role in future ventures. To prepare for the day when crews may leave low-Earth orbit for long-duration exploratory missions, space medicine practitioners must develop a thorough understanding of the effects of microgravity on the human body, as well as ways to limit or prevent them. In order to gain a complete understanding and create the tools and technologies needed to enable successful exploration. space medicine will become even more of a highly collaborative discipline. Future missions will require the partnership of physicians, biomedical scientists, engineers, and mission planners. This paper will examine the future of space medicine as it relates to human space exploration: what is necessary to keep a crew alive in space, how we do it today, how we will accomplish this in the future, and how the National Aeronautics and Space Administration (NASA) plans to achieve future goals.

As the duration of space flights increases and crews become more heterogeneous, psychosocial factors are likely to play an increasingly important role in determining mission success. The operations of the International Space Station and planning of interplanetary missions represent important future challenges for how to select, train and monitor crews. So far, empirical evidence about psychological factors in space is based on simulations and personnel in analog environments (i.e. polar expeditions, submarines). It is apparent that attempts to transfer from these environments to space requires a thorough analysis of the human behavior specific to the fields. Recommendations for research include the effects of multi-nationality on crew interaction, development of tension within crews and between Mission Control, and prediction of critical phases in adaptation over time. Selection of interpersonally compatible crews, pre-mission team training and implementation of tools for self-monitoring of psychological parameters ensure that changes in mission requirements maximize crew performance.

Spaceflight operations, including the International Space Station (ISS) and a mission to Mars, depend on international cooperation. Accordingly, safety, performance, and mission success rely on how well crews and operational personnel with different cultural backgrounds operate together. This paper outlines 10 areas related to spaceflight that are influenced by the national culture and backgrounds of personnel: (a) Communication, (b) Cognition and Decision Making, (c) Technology Interfacing, (d) Interpersonal Interactions, (e) Work, Management, and Leadership Style, (f) Personal Hygiene and Clothing, (g) Food Preparation and Meals, (h) Religion and Holidays, (i) Recreation, and (j) Habitat Aesthetics. Research findings and recommendations are presented, as well as a multicultural training approach to reduce potential challenges for long-duration spaceflight.

The value of human work, even when it is primarily physical, arises from unique cognitive capabilities. This paper samples a broadly distributed research base regarding influences of the physical environment on human cognition. The presentation draws primarily on studies conducted within the context of dynamic physical domains of work, to address controls and information sources for enabling human intervention, and related reasoning and planning. Several examples illustrate the role of the environment as a source of information and as an influence on the sequencing of work activity. Life support is discussed both as an instance of a dynamic physical system, and for its potential to preclude direct engagement with the environment, with predictable cognitive consequences.

The European Astronaut Centre, the home base of ESA's Astronaut Corps, celebrated its 10th anniversary on 17 May 2000 with a media event highlighting the past, present and future of the Agency's manned space programme.

The operation of the International Space Station (ISS) will be a global multilateral endeavour. Each International Partner will be responsible for the operation of its elements and for providing a crew complement proportional to its share of the overall resources. The preparations of the European Astronaut Centre to furnish training and medical support for the ISS astronauts are described.

As aerospace missions get increasingly frequent and complex, training becomes ever more critical. Training devices in all levels are demanded. Computer-Aided Training (CAT) system, because its economic, efficient and flexible, is attracting more and more attention. In this paper, the basic factors of CAT system were discussed; the applications of CAT system in training for manned space flight were illustrated. Then we prospected further developments of CAT system.

This article provides an analysis of the utility of micro-worlds for human factors research in extended spaceflight. It outlines potential areas of application of the micro-world research paradigm in the context of spaceflight. While the research literature provides several examples of micro-worlds that simulate different work environments of high complexity, little work has been done with this tool in the operational environment of spaceflight. The author presents a micro-world, called CAMS, that has been especially developed for use in space-related research. The results from a research programme (comprising seven studies using CAMS) are presented. Based on a comparative analysis of the benefits and limitations of micro-worlds compared to other simulation types, the author argues that micro-worlds can be a very effective tool, provided their inherent limitations are taken into consideration.

Formation and development of human motor function in phylogenesis and ontogenesis is known to be under the influence of Earth's gravitational field. So the relatively constant neuromotor and mass-inertial proportions between motor system's elements have been formed with human being during evolution process. This facilitated the development of enough stabile and reliable coordination structures of genotypical and phenotypical acquirements with human being. Essential changes in the coordination structure of many capital motor acquirements have been observed due to micro-gravitation during orbital flight conditions.

This work intends to design, analyze and solve, from the systems control perspective, a complex, dynamic, and multiconstrained planning system for generating training plans for crew members of the NASA-led International Space Station. Various intelligent planning systems have been developed within the framework of artificial intelligence. These planning systems generally lack a rigorous mathematical formalism to allow a reliable and flexible methodology for their design, modeling, and performance analysis in a dynamical, time-critical, and multiconstrained environment. Formulating the planning problem in the domain of discrete-event systems under a unified framework such that it can be modeled, designed, and analyzed as a control system will provide a self-contained theory for such planning systems. This will also provide a means to certify various planning systems for operations in the dynamical and complex environments in space. The work presented here completes the design, development, and analysis of an intricate, large-scale, and representative mathematical formulation for intelligent control of a real planning system for Space Station crew training. This planning system has been tested and used at NASA-Johnson Space Center.

In preparation for the international manned space station various international and national space agencies are already participating with the Russian MIR programme with short, medium, and long term presence on the MIR station. Although selection criteria for all crew include careful psychological screening, with some effort also regarding team build-up, this has proved insufficient; moreover. little or no effort is expended in the area of psycho-social- or team training. This paper propounds the authors' thesis that, in addition to the steps already being taken, psycho-social training is essential for long-duration flight. A concrete proposal is made for such a training program, with an overview of how such a program will look like; examples of past applications are given.

To sustain the rate of extravehicular activity (EVA) required to assemble and maintain the International Space Station, we must enhance our ability to plan, train for, and execute EVAs. An underlying analysis capability has been developed to ensure EVA access to all external worksites as a starting point for ground training, to generate information needed for on-orbit training, and to react quickly to develop contingency EVA plans, techniques, and procedures. This paper describes the use of computer-based EVA worksite analysis techniques for EVA worksite design. EVA worksite analysis has been used to design 80% of EVA worksites on the U.S. portion of the International Space Station. With the launch of the first U.S. element of the station, EVA worksite analysis is being developed further to support real-time analysis of unplanned EVA operations. This paper describes this development and deployment of EVA worksite analysis for International Space Station (ISS) mission support.