1. Introduction

Humans have been dreaming about Mars since the ancient Egyptian astronomers mapped its retrograde movement in1534 BCE (Novakovic, 2008). In 1877, Giovanni Schiaparelli used a 22 cm telescope and created the first map of Mars displaying the famous Martian canals. The canals later proved to be illusionary, but not before their purported existence ignited a period of intense speculation in both scientific (e.g., Percival Lowell) and literary circles (e.g., H.G. Wells) about the red planet and the possibility of life there. We have continued that speculation into modern times even though our technology has debunked the canals, eliminated the prospect of vibrant humanoid civilizations, and revealed our cousin planet to be a cold, harsh and desiccated environment. Our dreams have shrunk to microscopic life forms and plans for colonization tempered by the realities of the existing environment. Yet we would still go.

Across the years of contemplating exploration of Mars, one notable conclusion stands out: The human element is both the greatest strength and the greatest weakness for a Mars mission. From the earliest lunar design projects, there has been a tacit recognition that the success of the group would be the primary limiting factor in long duration missions (La Patra, 1968). There have been any number of scholarly reports from as far back as the beginning of the space era in the early 1960s (most notable the Case for Mars series and the Mars Exploration Studies by the British Interplanetary Society) that have explicitly recognized psychological and sociocultural factors as critical components to mission success. Interpersonal group processes have clearly been shown to impact significantly on behavior and performance in most challenging environments, especially those characterized by isolation and confinement (National Commission on Space, 1986; National Science Board, 1987; Space Science Board, 1987). While considerable improvements and advances have been made in technology, engineering and human factors, understanding the issues dealing with psychosocial human health and well-being are not significantly better in the new millennium than in the earliest days of space travel. While it is true that medical issues have become more specifically defined and identified, we are still grappling with questions that were raised from the beginning: What is the best fit individual for a mission to Mars? What is the best group for a mission to Mars?

2. The Mars Mission Challenge

The inescapable truth is that missions to Mars will not be psychologically comparable to any other undertaking humans have ever attempted. The enormous distance to travel and extraordinary novel environment will separate this chapter of human exploration from all other settings (e.g., historical expeditions to unknown parts of the Earth, wintering-over in Antarctica, long-term submergence in submarines, or even long-duration stays on orbital space stations). Mission scenarios call for crewmembers to endure extraordinary long periods of extreme confinement and isolation (18 months to 3 years) during their voyage to Mars and a stay on the Martian surface that may last from 500 to 1,000 days. Communication and data transmission will be significantly impacted as relative orbital positions between the Earth and Mars require one-way transmission times of 3 to 22 minutes and no real time two-way communication will be possible. Once underway, there will be no possibility for any re-supply or short-term rescue. Should something go wrong early in the mission, the crew would be faced with, at a minimum, continuing to Mars for a fly-by of the planet before heading back to Earth, and even then only if orbital alignment makes such a "quick return" possible.

Known psychological risks related to individual performance, behavioral health and crew interactions will be magnified by completely new unpredictable psychological challenges. For instance, given the historical importance of looking back at Earth reflected in numerous reports of astronauts from orbital or lunar flights, there is strong speculation that an "Earth-out-of-view phenomenon" will have a significant psychological impact, referring to the fact that astronauts traveling to Mars will be the first human beings put in a situation where the home planet will be reduced to another dot in space (Kanas & Manzey, 2008; Manzey, 2000). Our closest analogs would have been the early exploratory seafaring missions losing sight of land as they sailed into uncharted open ocean. However, these crews did not have to worry about such fundamental life support elements as breathable atmosphere or explosive decompression. The region may have been unfamiliar, but the physical environment was taken for granted; the only genuine worries being a fear of falling off the edge of the world.

3. The Stress of Boldly Going Where No One Has Gone Before

Despite the fact that most human space missions have successfully met mission goals to date, there is considerable anecdotal and behavioral evidence that a significant number of crewmembers have experienced psychological and interpersonal difficulties arising from the myriad stressors inherent in space missions, especially those involving longer durations (Shayler, 2000).

Confined and isolated environments are characterized by potentially serious stressors: physical demands (e.g., working in suits, reduced gravitational fields, extravehicular activities) as well as inescapable environmental characteristics (e.g., imminent danger, noise, isolation, confinement, loss of normal sensory stimuli, low habitable volume per person, limited opportunities for variety and change and complete dependence on a machine-dominated environment). Anecdotal reports from space and studies conducted in space analogue environments on Earth (e.g., the Antarctic, submarines, space simulation chambers) have isolated a number of psychosocial issues that may negatively affect crewmembers during multinational space missions (Bishop & Primeau, 2001; Bishop, Santy, & Faulk, 1998; Kanas, 1998; Kanas & Manzey, 2008; Morphew & Maclaren, 1997; Palinkas L., 2003; Sandal, Endresen, Vaernes, & Ursin, 1999). These issues include: 1) tension resulting from external stress and factors related to crew heterogeneity (e.g., differences in personality, gender, and career motivation); 2) variability in the cohesion of the crew; 3) improper use of leadership role (e.g., task/instrumental versus emotional/supportive); 4) cultural differences; and 5) language differences. Post-flight debriefings of space crews have routinely detected strong differences in values among crewmembers arising from their differences in professions, culture, age or nationality, all of which have been cited as reasons for crew tension. Although crews were able to effectively operate and accomplish mission goals on these short duration international space flights (Bluth, 1997; Kozerenko, Sled, & Salnitsky, 1986; Santy, Holland, Looper, & Marcondes-North, 1993), it was recognized that long duration missions would require true accommodation rather than mere tolerance.

It has been argued that the key factor to successful adaptation of the group is the individual’s capability to share the general values and aims of the group and to establish empathetic relations with partners. In studies simulating the influence of space flight, crewmembers more favorably perceived those they referred to as "supportive", "loving", "warm", and "socially competent", and who had an orientation toward empathetic interrelations and the social side of life (Gushin, Efimov, Smirnova, Vinokhodova, & Kanas, 1998). Several studies of small isolated groups have shown that in the process of cohesive group formation, crewmembers began to regard each other as very "similar" or "close", sharing common values and beliefs (Gushin, et al., 1997; Gushin, Efimov, Smirnova, Vinokhodova, & Kanas, 1998).

Other studies have demonstrated that those crewmembers who did not perceive others as close and similar to themselves, and who didn’t make attempts to understand and share the common group values ran the risk of becoming the "stranger" or the "alien" in the group (Gushin, Efimov, Smirnova, Vinokhodova, & Kanas, 1998; Leon & Koscheyev, 1997; Penwell, 1990). Among those factors mentioned by astronauts and cosmonauts as barriers to identification with others were the language barrier, cultural differences, gender differences, professional variation, and differences in perspective (Herring, 1997; Morphew & Maclaren, 1997). The importance of these factors is supported by studies that have found psychological reactions to space were distinctly different among various cultural backgrounds (Ritsher, 2005).

In contrast, several investigations have actually found evidence of positive, or salutogenic, psychological impacts of isolated, confined environments (Suedfeld & Steel, 2000; Ritscher, Kanas, Ihle, 2005). In early studies of sensory isolation personality characteristics in fact played a significant role in how subjects responded to prolonged and profound sensory and social deprivation. Almost all subjects reported experiencing a variety of illusions and simple to complex hallucinations, with some finding the experience horrifying and others as mystical and spiritually enlightening (Lilly 1956, 1973, 1977). Those who experience positive growth from their exposure in an extreme environment may be reflective of those who most successfully adapt to the demands of such environments. The identification of the defining characteristics of successful adapters is the holy grail of selecting the best fit individuals for long duration missions.

Yet another unknown is the effects of extraterrestrial environments upon the brain. Bone and muscle loss after even short duration flights are now well documented. However, neurobiological processes dramatically affect personality and intellectual functioning. Early and subsequent studies of prolonged social, sensory, and perceptual isolation in primates and other animals have consistently demonstrated significant effects on learning, memory, perception, and nerve growth versus neural degeneration (Casagrande & Joseph 1980; Joseph & Gallagher 1980; Joseph 1999). From these and other studies it can be concluded that it is of the utmost importance to keep astronauts socially and intellectually engaged and to provide optimal amounts of stimulation at all phases of the mission.

The presence of even low levels of chronic stressors, if not met with functional adaptation and/or countermeasures, produce subjective symptoms of stress, persistent performance incompetence, accelerated fatigability, altered mood states, increased rate of infections, and decrements in attention and cognitive functioning (Bishop, Kobrick, Battler, & Binsted, in press; Kanas & Manzey, 2008; Palinkas L., 1991; Sloan & Cooper, 1986; Smith, 1990). Most of the performance effects found so far seem to be associated with more general stress effects related to problems of adaptation to the extreme living and working conditions in a confined and isolated environment that are mediated by individual factors such as personality and culture. In the context of a Mars mission, it has been proposed that the most severe stressors might involve the monotony and boredom resulting from the long periods of low workload, hypo-stimulation, and restricted social contacts due to isolation from family and friends. Yet any mission of significant length will be characterized by periods of hyperarousal stemming from intense work schedules, high activity, excitement, media and public attention, and heightened performance demands which all interact to impact sleep, motivation, attention, physical and mental functioning, e.g., the Earth proximate departure and return phases of the journey, or arrival at Mars and deployment to and return from the surface. The juxtaposition of prolonged periods of low work schedules, minimal activity, repetitive and monotonous station-keeping duties, isolation, confinement, loss of privacy, restricted social contacts, over-familiarity with team-members and environment which undermine motivation, performance and psychosocial functioning, providing countermeasures for this dynamic environment-situation becomes a challenge indeed!

One could argue that the stress of exploration is inherent in any endeavor that is characterized by unknown dangers, isolation and confinement. What makes the stress associated with long duration space missions of special concern? The obvious answer is that there is no exit for participants. Once launched on a trajectory to Moon or Mars, the crew is committed. There is no turning back, no quick rescue, no way out except forward. The implications of the incapability to terminate an expedition are profound. The role of stress and its impact on coping, performance, motivation, behavior, cognitive functioning and psychological well-being must be taken into account in mission planning. All required resources for assessing, monitoring and countering stressors must be resident with the crew given the delays in communication and isolation. Without the ability to return at will, the success of the mission rests with how well planners have selected the best individuals and provided the right resources.

4. What Is "Close Enough": The Role of Analogs

Clearly, the need to know what is needed and what works before the launch to Mars demands that substantive research into selection, training, and support be conducted. But how to conduct relevant research when teams in space have been small (1-3 persons) and largely unavailable to the greater scientific community. The National Academy of Sciences in their white paper, "A Risk Reduction Strategy for Human Exploration of Space: A Review of NASA's Bioastronautics Roadmap" (Longnecker and Molins 2006), clearly articulated the critical role of analog environments and digital simulation to evaluating and developing mitigation strategies and countermeasures to the risks to the human in space. The value of both natural (e.g., polar expeditions, deep caving teams, saturation diving), man-made (e.g., operational Antarctica bases, submarines) and simulated environments (e.g., bed rest studies, mock EVA simulations, Mars Society habitats, Concordia Antarctic Research facility) to test hardware and instrumentation is incontestable. In addition, the use of these analog environments to test various medical, physiological, behavioral and psychological protocols and the effectiveness of countermeasures has been repeated demonstrated, e.g., the problems associated with adverse effects on thyroid functioning with iodination of drinking water or the superior performance of mixed gendered teams.

The use of space analog environments in which to systematically study individual and group adaptation has had to content with some significant compromises (Bishop, 2010). For instance, there is no good substitute for a microgravity since buoyant environments (i.e., underwater) which can be configured to compensate somewhat for gravity also entail resistance forces to the water itself that are not present in a vacuum. Thus, all analog environments are simulations of greater or lesser fidelity along varying dimensions of interest. An analog for testing equipment or hardware may any relevance to assessing how human operators will fare psychologically or as a team. Others may address important components of human adaptation, e.g., confinement, but fail utterly to incorporate true environmental threats. The use of extreme unusual environments (e.g., Antarctica, deep caving, saturation diving) allow an assessment of the impact of true dangerous, unpredictable environments but provide challenges to comparing across specific environments. The spectrum of fidelity to space among terrestrial analogs ranges from laboratory studies where the impact of environmental threat and physical hardship, as well as true isolation and confinement, are limited and, even, sometimes absent, to real teams in real, extreme environments characterized by very little control over extraneous variables. Yet, there is no other alternative. The best approach is to utilize analogs that incorporate capabilities for testing hardware, software and the human operators whose lives depend on successful and effective human-machine and human-human competencies.

5. Selecting the "Best"

So, what kind of person will qualify as the ‘best fit’? When selecting best fit individuals, it currently appears that we will have to seek those that do not require high levels of sustained stimulation or high levels of interpersonal interaction and support. The burden of support will have to shift away from the "absent" network of family and friends to members of the present crew. The reduced circle of social contacts will challenge crewmembers to be able to balance needs for affiliation with autonomy and privacy needs. Selected individuals will be characterized by effective coping strategies based on self-reliance and autonomy as well as a cooperative group focus. Individuals with high needs for social support will likely be more susceptible to the negative effects of social isolation from friends and family (Sandal, Endresen, Vaernes, & Ursin, 1999) as well as more likely to engage in interpersonal disclosure with team mates that may later lead to discomfort and regret (Suedfeld, 2003). This is an area that needs substantial further attention and research.

The problem of selection is multifold. Individual factors deriving from both nature and nurture clearly contribute to group dynamics. For example, whether lack of privacy is perceived as a stressor, and thus produces detrimental effects on mood and performance, largely depends on both the personality of the individual as well as the cultural background (Raybeck, 1990). Similar effects may be assumed for other stressors as well, like monotony and boredom, time-pressure, or workload. In addition, culture also might be a factor influencing higher-order cognitive processes such as decision-making or the use of schemes in information processing. Studies in analog environments have confirmed that the kind of mission has a significant influence upon the type of "best fit" crew needed (Bishop, 2002; Endler, 2004; Palinkas, Gunderson, & Holland, 2000; Sandal, 2000).

Expeditionary missions (e.g., flags and footsteps like the lunar missions) typically engage very task focused individuals with lesser demands for skills in sustained interpersonal interaction whereas missions dedicated to science or establishment of sustainable bases enroll the expertise of individuals with notably different personality profiles and skill sets as well as mission demands for sustained group engagement. The fact that psychological stress has been found in all isolated and confined environments supports a view that these same factors are a risk for long duration lunar and Martian crews as well (Kanas, 2004). Psychological difficulties not only affect individual crewmembers, but they could have potentially disastrous effects on mission performance, e.g., a clinically depressed astronaut might be unable to perform required tasks in an emergency situation. If such problems are not understood and addressed, they will most certainly result in 1) decreased crew morale and compatibility; 2) withdrawal or territorial behavior as crewmembers cease to interact with each other; 3) scapegoating or singling out individuals for blame for various outcomes as solutions to group conflicts; and 4) the formation of subgroups that compete with each other and destroy crew unity.

6. "When" Makes a Difference in What is Needed

The task of identifying the best fit and how to train and support them is further complicated by the fact that individual and group functioning will vary dramatically depending on the phase of the mission. The differences in mission duration for those environments we have studied to date (11 months for Antarctica; four to six months for MIR or the International Space Station, weeks for expeditionary missions) appear to play a significant role. Although mission task profiles on the surface can be treated as distinct from flight segments, the functioning of the crew cannot be so neatly separated. Both in-flight and planet-side individual and group functioning will be impacted by what comes before. Research findings on space and analog missions lasting six weeks or more have demonstrated that psychological and interpersonal issues grow in importance across time and may become some of the most significant factors for a space flight to and from Mars (Kanas & Manzey, 2008). Some studies have found significant psychological and interpersonal difficulties after the halfway point of a mission (Bechtel & Berning, 1991; Gushin, et al., 1997; Kanas & Manzey, 2008; Sandal, Vaernes, & Ursin, 1995). In this perspective, a sense of relief that half of the mission is over is outweighed by the realization that another half is yet to come. Another time model incorporates Rohrer’s three sequential phases, which include: 1) initial anxiety; 2) mid-mission depression; and 3) terminal euphoria (Kanas, 1990, 1998; Kanas & Manzey, 2008). Currently, efforts to validate the existence of specific critical phases of adaptation noted in earlier studies of Russian long-duration space missions (Myasnikov & Zamaletdinov, 1998) and in personnel over-wintering on Antarctic research stations has been equivocal (Kanas & Ritsher, 2005; Stuster, Bachelard, & Suedfeld, 2000; Palinkas, 2003; Bergan et al., 1996; Palinkas, Gunderson, & Holland, 2000). When applied to a Mars mission profile, there may be further macro phase cycles bracketing the anticipatory preparation of the trip to Mars, the stimulation of exploration while on the surface, and a return phase dominated by the long trip home without the excitement of either prior phases.

7. Monitoring and Support

By definition, adaptation presumes an accommodation over time. The issue of critical periods in adaptation for Mars is even more important given that such knowledge may enable both crewmembers and Mission Control personnel to prepare for problems and intervene before maladjustments result in operational impact. Given that there will be multiple duration milestones that affect psychological well-being (e.g., half-way points in the trip out and back, halfway points for surface mission, third quarter mission total, planned EVA missions, significant holidays, family events), any viable strategy for a successful mission to Mars will have to encompass countermeasures, monitoring and support that are adaptive to the changing salience of factors particular to mission phases.

The challenges of monitoring and providing psychological support to a Mars mission are inherently different than those for Shuttle, Mir or ISS. In the past, supportive activities have focused on providing increased novelty and stimulation for space crews during times of monotony or asthenia--a depressive state characterized by apathy and listlessness-- (Kanas, et al., 2001) through surprise food deliveries and presents via resupply vehicles, increased contact with Earthside communities and therapists and adjusting schedules to accommodate performance deficits due to maladaptation or stress (Kanas, 1991). For an expeditionary mission, first line capability must reside with the crew since two-way communications with Earth will be delayed by distance for up to 45 minutes. It will be essential for crewmembers to monitor themselves first. All crewmembers will need to be aware of psychosocial issues and trained to recognize a basic level of 1) individual psychopathology and dysfunctional small group behavior; 2) the individual and interpersonal effects of stressors to be expected during the mission; 3) crisis intervention techniques and the facilitation of group awareness, cohesion, and team-building; and 4) the appropriate use of tranquilizers and other psychoactive medications, including their usefulness and side effects under conditions of microgravity (Kanas, et al., 2009). Crewmembers should be monitored for symptoms and signs of developing psychiatric disturbances through a variety of psychological and physiological approaches. Provisions and facilities for restraining and secluding a potentially suicidal, violent, or impulsive crewmember should be made in mission planning. Internationally approved test batteries for mission monitoring of interrelationships among crewmembers and group performance effectiveness do not yet exist and need to be created.

Countermeasures will need to be both passive (e.g., monitoring through routine cognitive assessment, stress hormonal levels) and active (e.g., scheduled group briefings and personal communication access to support resources). All external contact will, by necessity, be recorded and entail lagged response times. As a consequence, psychological support will primarily depend on the skills of on-board crewmembers and the quality of intelligent tools which are able to detect subtle performance decrements before they lead to overt performance decrements in mission tasks or personal functioning.

In addition to the monitoring of the individual state, the interactions of crewmembers in space will also need to be monitored and conflicts resulting from psychosocial issues will need to be dealt with as they arise. Monitoring of intra- and intergroup relations will involve psychological and physiological assessment at both the individual and group level. Assessment data about the psychosocial climate within the crew will need to be provided to individuals, the team physician and Mission Control evaluators. Analysis of crew behavior and performance should provide immediate feedback to the crew and time-lagged monitoring information to Mission Control support teams. In order to detect such possible adverse effects and to provide appropriate support and countermeasures (e.g. re-scheduling of mission tasks, accommodation of work-rest schedules), tools are needed which are able to discern subtle performance decrements before they lead to overt performance decrements in mission tasks. For monitoring purposes, subjective reports used in combination with more objective and non-invasive methods would be most useful. Specialized computer tests will be needed to investigate cognitive functioning, personality and relationships within the group and to assess individual and group performance (Gushin, Efimov, Smirnova, Vinokhodova, & Kanas, 1998; Kanas, 1991; Kane, Short, Sipes, & Flynn, 2005; Savilov, et al., 1997). The use of computerized tests that may help crewmembers assess their cognitive state and their ability to perform certain behaviors at various times during the mission are currently being assessed. So far, such methods have mostly been utilized in research, and more experience from operational applications are needed. Approaches also need to take the operational constraints of the different mission phases into account. Even with the constraints inherent in interplanetary missions, provision of in-flight support to crewmembers is likely to be a highly important countermeasure to stabilize the emotional state, to ensure optimal well-being of astronauts, and to maintain a close contact between space crew and ground. The methods utilized for this purpose will rely on the availability of effective space-ground communication systems (audio/video transmissions) and high-fidelity and easily available tele-medicine/ tele-psychological store and forward consultation. Attention should be given to enhancing individually tailored leisure time activities that take into account changing interests and needs over the course of the mission (Kanas & Manzey, 2008).

Other important support activities include private psychological consults (even if conducted in store-and-forward formats), providing informal space-ground contact and news from Earth (preferably in the crew member’s native language and from homeland news sources), and opportunities to maintain close contact with family and friends on Earth on a regular basis. An important issue that needs careful consideration concerns the variables that affect whether very bad news from home (e.g., death of a close relative) should be transmitted to astronauts in flight when they can’t do anything about it. In general, providing support concerning medical and psychological problems for crewmembers' families during the mission can contribute to maintaining the crew member’s concentration on the objectives of the mission by relieving them of considerations about possible problems at home and feelings of responsibility. In addition, families should be coached in interacting with their remote family member and be prepared for possible psychological changes in the course of the mission.

Remote monitoring of crewmembers' performance and behavior represents an important basis for early detection of any signs of impaired performance and behavior, and for providing ground-based counseling and advice to the crew (including planning of interventions). It has been shown that performance impairments might be expected primarily during adaptation to the space environment and during specific stress states induced by sleep problems, high workload and/or emotional burden. During the mission, crewmembers may be reluctant to give information regarding emotional stress and adaptation. Willingness to discuss personal matters may be reflective of personality differences as well as expectations of the privacy of information. Experience from multinational airlines suggests that there are cultural differences in attitudes regarding discussion of personal problems and fallibility (Merritt & Helmreich, 1998).

Computer-interactive intervention programs show promise for addressing the autonomous and remote psychological, medical and performance monitoring demands for a Mars mission. Recent suggestions have proposed that a computerized format for identifying problems as well as supplying prevention and intervention information may be more comfortable to crewmembers than disclosing highly personal information to other crewmembers with whom they have to work with in close quarters for an extended period of time. Furthermore, research suggests that computer-based intervention programs delivering cognitive-behavioral, behavior therapy, and self-help instruction are just as or more effective than face-to-face types of intervention for dealing with mild to moderate depression, anxiety disorders, and other types of psychopathology (Bachofen, et al., 1999; Cavanagh & Shapiro, 2004; Proudfoot, Goldberg, Mann, Everitt, Marks, & Gray, 2003).

A number of habitability factors may also enhance coping abilities of crewmembers in dealing with these living conditions. One potential enabling technology involves the use of immersive virtual reality systems and haptic technologies to enhance leisure activities and environmental stimuli. Telepresence and full fidelity audio/video/3-D communication replay capability will provide for more effective psychological support and interaction for crewmembers and to families and friends back on Earth. Both habitability and mission structure factors will play a significant role in generating group fusion (e.g., cohesion, teamwork, interpersonal trust) or group fission (e.g., discord, conflict, miscommunication, reduction in performance and well-being).

8. Conclusion

The selection, monitoring and support of the best fit team for a Mars mission begins with the individual but ends with the group. Psychological countermeasures must be implemented before, during and after the mission, and involve crewmembers and their families, as well as relevant ground support personnel. Current knowledge on long-term effects of coping and adaptation is still limited, and assumptions are based on anecdotal data or research in Earth-bound analogs. To determine the generalization of these findings to crews in space, it will be necessary to compare findings from analogs with psychosocial results from actual space missions which has historically been very difficult to obtain. The demarcation of short-term from long-term effects is one important issue for future research, i.e. where adaptation and possibly wellness problems become frequent and/or serious (Dion, 2004). Such knowledge would enable selection, training, and support tailored to meet the specific demands of each mission.

It is important to identify organizational and environmental characteristics that contribute to impaired psychological coping and well-being in multinational crews living and working in space. This should include considering the impact of culture at different levels, e.g. at professional, organizational and national levels. Much more empirical work is needed on defining individual characteristics (e.g., personality, attitude, motivation, needs, skills, coping strategies) and group characteristics that promote optimum coping and adaptation under different kinds of multinational missions. Also the most efficient methods for assessment of such characteristics need to be determined. Such knowledge would be helpful in the development of psychological countermeasures, including selection and crew assignment, psychological training programs and in-flight support systems.

A major challenge in evaluating the efficiency of psychological countermeasures is the identification of valid and reliable performance criteria against which they can be tested. Given the likelihood that Mars crews will include members of both genders, various national and cultural backgrounds and substantially larger crews than ISS, it would be highly desirable that all partners identify and agree to establish a set of common standards and procedures for the selection, training, support, and evaluation of Mars mission crews.

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