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This article reports an experiment in which college students and professional combat air controllers performed a simulated team interaction task designed to explore the effects of the degree of politeness used by a directive giver and the degree of “social distance” (roughly, team affiliation and affinity between the directive giver and the recipient), on directive compliance behaviors and attitudes. The design and experimental approach was informed by the functional theory of politeness in social interactions developed by Brown and Levinson, although hypotheses are advanced that extend this essentially perceptual model to effects on behaviors and attitudes. Results showed that increased politeness in a directive significantly improved attitudes toward the directive giver. Social “nearness” operated similarly and influenced the degree of politeness perceived even when the request itself was unchanged. Both effects operate similarly for novices and experts. Compliance rates (and one portion of reaction time) were similarly affected by the politeness of the directive giver but, interestingly, were affected differently for novices and experts. The politeness of the directive giver increased compliance for novices but decreased it for experts. This result suggests that politeness perceptions are an important influence on work performance but that their interpretation can be influenced through training and/or work “culture.”

We previously developed a core representation for computationally comparing the information an operator needs to perform a task and the information provided by a user interface. This representation is based on information theoretic properties, thus it can be applied to a wide variety of work domains and information and display types. In prior work, we used this capability to dynamically and automatically reconfigure cockpit displays for military cockpits. More recently, we adapted this approach to the task of evaluating and critiquing display format designs for NASA's space operations. The representation and reasoning approach generalizes well to describing information types in procedural domains and the tool can analyze sets of display formats for sets of procedures, propose format improvements against a procedure set, project how changes to procedures will affect the suitability of existing formats, and project how changes to formats will improve or reduce their suitability for given procedures. Most recently, we have proposed extensions to evaluate and support “configuration consistency” of interfaces, within a system over time, across systems and even across vehicles and their associated work domains.

Computerized training systems may be the only viable solution to accommodate the quickly evolving learning needs, the short lead time, and the large number of students that must prepare for cross-cultural interactions. However, current systems place emphasis on language training, which is only part of the equation in effective communication. Knowledge about culturally dependent social norms directly impacts the interaction outcome. A dynamic, customizable, computationally tractable model for the code of conduct, or etiquette, can alert us of the specific communication protocols of groups of interest, and can prevent over-generalizations which can be detrimental to the end goal. We may not consciously care, or even be aware of etiquette, but it impacts our trust and affect for individuals, and ultimately shapes our subsequent actions. We have adapted a socio-linguistic model of human-human interaction for use in language and culture training. This computational model increases the social intelligence of virtual actors by allowing them to act and react to human students in ways that are more aligned with the humans they simulate. Capabilities for virtual agents to reason about and select actions not only enhances interaction fidelity, but can also result in time and cost savings in training scenario generation and maintenance.

We present a theory of perceived politeness and its sociological functions derived from the work of Brown and Levinson (1987) and then extend that theory toward a cognitive model of politeness and its effects on human decision making. We then report the results of an experiment in which participants' directive compliance behaviors and attitudes are examined under conditions varying the amount of politeness or rudeness used and the power or familiarity relationship between the participant and the directive giver. Results show significant impacts of politeness on a variety of directive compliance behaviors, and show accuracy for predicting the relationship of Social Distance on perceived politeness and directive compliance. Predictions about the role of Power relationships were generally not as effective.

We previously developed a core representation for describing the information a human needs to perform a task and the information provided by a user interface. This representation is highly abstract and is based on information theoretic properties, thus it can be applied to a wide variety of work domains and information and display types. Since information need and information conveyed are described in the same numerical scales, it is straightforward to compute a degree of match between them. In prior work, we used this capability to dynamically and automatically reconfigure cockpit displays for military cockpits. In recent work, however, we adapted this approach to the task of evaluating and critiquing display format designs to support procedure execution in the context of NASA's space operations. The representation and reasoning approach generalizes well to describing information types in procedural domains. The resulting tool can be used to (a) analyze a proposed display format for a given task, (b) propose a format for a given task, (c) project how changes to a procedure will affect the suitability of a previous format, and (d) project how changes to a format will improve or reduce its suitability for a given procedure.

A spatio-temporal model of housing price trends is developed that focuses on individual housing sales over time. The model allows for both the spatio-temporal lag effects of previous sales in the vicinity of each housing sale, and for general autocorrelation effects over time. A key feature of this model is the recognition of the unequal spacing between individual housing sales over time. Hence the residuals are modeled as a first-order autoregressive process with unequally spaced events. The maximum-likelihood estimation of this model is developed in detail, and tested in terms of simulations based on selected data. In addition, the model is applied to a small data set in the Philadelphia area.

A central source of cultural differences is the communication of politeness, which can powerfully affect perception and behavior. Our computational adaptation of a universal theory of human politeness (from Brown and Levinson, 1987) combines culture-specific aspects of social context to generate expectations, score, interpret and recommend polite and impolite behaviors. Tests show this approach could reduce software development costs and increase an intelligent agent's behavior repertoire through the incorporation of modular, cross-cultural etiquette libraries.

In future long duration Mars exploration missions, network limitations and the lack of real-time communication capabilities will impact various aspects of space crew performance as well as behavioral health. Studies in ground-based analogs of Isolated and Confined Environments (ICE) such as Antarctica have identified sensory and social monotony as threats to crew psychological well-being. Given the importance of behavioral health to mission success and the extreme conditions of space travel, new methods of maintaining psycho-social health and social connections to support systems are critical. We describe ANSIBLE -- A Network of Social Interactions for Bilateral Life Enhancement. ANSIBLE leverages Virtual Environments (VEs) to deliver evidence based wellness promoting strategies and socially intelligent Virtual Agents (VAs) as tools to facilitate asynchronous human-human communication, and counteract behavioral health challenges associated with prolonged isolation and deep space exploration.

SIFT has pioneered a human-automation integration architecture, called Playbook™, based on a shared model of the tasks in the domain. This shared task model provides a means of human-automation communication about plans, goals, methods and resource usage—a process akin to referencing plays in a sports team's playbook. The Playbook enables human operators to interact with subordinate systems with the same flexibility as with well-trained human subordinates, thus allowing for adaptive automation. We describe this approach and its application in an ongoing project called Playbook-enhanced Variable Autonomy Control System™ (P-VACS).

Trends have been extensively used in operations to monitor and manage evolving process situations. They provide detail about process variables but can take up significant screen space, potentially occluding other important monitoring parameters. As more data becomes available to the operations team, trends could proliferate and overload the operator. This paper presents the time-based information needs generated from plant personnel interviews, and discusses four existing and six alternative formats for displaying time-based information to tackle this problem. A framework was also developed to link the requirements to design options. The framework can be used to assess the benefits and limitations of the display options and help inform design based on the conditions of use in operations.

In the space exploration domain, limitations in the Deep Space Network and the lack of real-time communication capabilities will impact various aspects of future long duration exploration such as a multi-year mission to Mars. One dimension of interest is the connection between flight crews and their Earth-based social support system, their family, friends, and colleagues. Studies in ground-based analogs of Isolated and Confined Environments (ICE) such as Antarctica have identified sensory deprivation and social monotony as threats to crew psychological well-being. Given the importance of behavioral health to mission success and the extreme conditions of space travel, new methods of maintaining psycho-social health and social connections to support systems are critical. In this paper we explore the use of Virtual Environments (VEs) and Virtual Agents (VAs) as tools to facilitate asynchronous human-human communication, and counteract behavioral health challenges associated with prolonged isolation and deep space exploration.

We describe the theory, implementation and initial validation of a tool to assess interpersonal relationships and team states through non-intrusive discourse analysis. ADMIRE was developed to assess power/leadership relationships through scoring politeness behaviors in textual dialog to compute a graph of power asserted vs. afforded between individuals—an org chart—trackable over time. ADMIRE was formally tested in a military exercise where it proved 100% successful at deriving power relationships in 3 military chat rooms. Subsequent work extended ADMIRE’s core approach with novel linguistic behaviors to identify “Team Comfort/Routine” (C/R) indicating when a team is performing in a well-understood, relaxed task context. Initial validation is provided by discriminating the disastrous Apollo 13 mission from others.

Long duration space flights such as a two and a half year mission to Mars present many unique challenges to the behavioral health of astronauts. Factors such as social monotony, workload, a confined environment, sensory deprivation, and limited access to family and psychosocial support can affect crew welfare and task performance. NASA recognizes a "risk of performance decrements due to inadequate cooperation, coordination, communication, and psychosocial adaptation within a team;" reports from Mir revealed that conflicts between crew members have resulted in early termination of missions. Currently, flight crews and support staff have real time voice and video communications capabilities on the International Space Station to keep astronauts connected, and allow operations staff to monitor the crew's well-being. However, communications for long duration missions will likely be limited and disrupted by time latencies. Crew workload may also prohibit crew members from providing the extensive self-reports that the Earth-bound support team needs to accurately access the crew's psychological health. Further, the metrics of interest are difficult to obtain because some are inherently qualitative, while others may not be amendable to self-reports. We first describe an extensive review of psycho-social dimensions relevant to long duration space flight, their manifestations, and possible detection methods. We then describe a novel method of non-intrusive detection developed initially for application in the Empire Challenge military exercise in 2010. This system, called ADMIRE for Assessment of Discourse Media Indicators of Relative Esteem, leverages prior work in cultural and socio-linguistic theory to develop standardized, non-intrusive methods for data collection and knowledge extraction about factors salient to group psychosocial dynamics. Finally, we describe our approach to follow-up work applying ADMIRE to historical space flight data, as well as in ongoing studies in space analog environments to identify potential changes in individual and team psycho-social factors before they lead to deficits in health and task performance.

This demonstration illustrates a computational analysis method using information theoretic attributes to quantitatively characterize information need for task performance, as well as information conveyed by a candidate display. Once represented in this way, various computational algorithms can provide a "mismatch" analysis of the "fit" between the two. This approach has been implemented in a prototype user interface analysis tool: MAID (Multi-modal Aid for Interface Design). MAID supports user interface design and redesign in response to procedure revisions for NASA applications. MAID has been demonstrated on examples of designs for the International Space Station, Space Shuttle (both current interfaces and proposed upgrades) and for hypothetical designs for the Crew Exploration Vehicle Orion. At least one of these examples will be presented.

Recent studies have suggested that a series of low-energy, single-pass ablative laser resurfacing micropeels can reduce photoaging with decreased downtime. This randomized, prospective single-blinded trial sought to determine the ideal settings of sequential erbium:yttrium-aluminum-garnet (Er:YAG) laser treatments that maximize efficacy and patient satisfaction.Forty-six subjects with mild-to-moderate facial dyschromia and rhytides were evenly randomized to two Er:YAG treatment arms. Patients in the lower fluence (LF) (2.5 J/cm2) and higher fluence (HF) (3.8 J/cm2) groups each received three one-pass, full-face treatments one month apart. Patient and investigator assessments of rhytides, dyschromia and global appearance were performed at baseline and at four, eight and 20 weeks using a nominal scale from 1–4. Adverse events and patient satisfaction were also evaluated.Patient scores showed rhytid improvement only with HF treatments. Investigator scores at three months post-treatment showed dyschromia was significantly improved in both study arms, with a 24 and 36 percent reduction for the LF and HF groups, respectively. Global appearance scores improved by 25 and 32 percent, respectively. A trend towards greater post-procedure erythema and time-to-erythema resolution was observed in the HF group. Mild peeling was the most common adverse event. Individuals who underwent LF treatments were more likely to pursue future treatments.Both settings resulted in moderate but significant improvement in dyschromia, although only HF treatment improved rhytides. The decreased downtime of LF treatments made this the preferred choice of patients.

If culture is expressed in the patterns of behavior, values and expectations of a group, then a central element in the practical modeling and understanding of culture is the expression of politeness and its roles in governing and influencing behavior. The authors have been developing computational models of “politeness” and its role in power and familiarity relationships, urgency, indebtedness, etc. Such a model, insofar as it extends to human-machine interactions, will enable better and more effective decision aids. This model, based on a universal theory of human politeness, links aspects of social context (power and familiarity relationships, imposition, character), which have culture-specific values, to produce expectations about the use of polite, redressive behaviors (also culturally defined). The authors have linked this “politeness perception” model to a coarse model of decision making and behavior in order to predict influences of politeness on behavior and attitudes. This chapter describes the algorithm along with results from multiple validation experiments: two addressing the model’s ability to predict perceived politeness and two predicting the impact of perceived politeness on compliance behaviors in response to directives. The authors conclude that their model tracks well with subjective perceptions of American cultural politeness and that its predictions broadly anticipate and explain situations in which perceived politeness in a directive yields improved affect, trust, perceived competence, subjective workload, and compliance, though somewhat decreased reaction time. The model proves better at accounting for the effects of social distance than for power differences.

Increasing evidence supports an inverse association between vitamin D deficiency and cardiovascular disease (CVD) in the general population (1, 2). Low or deficient levels of 25-hydroxyvitamin D (25[OH]D) have been linked to stroke (3), ischemic heart disease (4, 5), and heart failure (5), as well as hypertension (6), diabetes(1, 6), hypertriglyceridemia (1, 6), obesity (7), and the metabolic syndrome (8). The Third National Health and Nutrition Examination Survey (NHANES-III) (6), found that the frequency of selected cardiovascular risk factors including obesity, hypertension, diabetes, and hypertriglyceridemia was significantly higher in the lowest (

SummaryTumor necrosis factor (TNF)-targeted therapies are increasingly being prescribed in the management of a variety of inflammatory and autoimmune diseases. The use of this class of medications also pose risks of developing an assortment of pulmonary side effects including infections (TB, bacterial, and fungal infections), pulmonary nodules, chronic pneumonitis/fibrosis, SLE-like reactions, vasculitis, and exacerbations of underlying lung disease. In addition to surveillance for tuberculosis prior to initiation of TNF-targeted therapy, a high level of vigilance should be maintained during administration for infectious and non-infectious complications, even years into a patient's course. The available evidence argues for caution in using these agents in patients with pre-existing lung disease and heightened suspicion of accelerated nodule formation in those with pre-existing rheumatoid nodules. Management centers on excluding infection, identifying confounders (especially methotrexate or pre-existing lung disease), and promptly discontinuing TNF-targeted therapy. In some instances, invasive procedures (e.g. bronchoscopy or VATS lung biopsy) will be necessary to establish the proper diagnosis, and the administration of steroids may be beneficial.

We argue that traditional cultural factors models (from Hofstede, Nisbett, etc.) are too abstract to provide good predictions of important human performance behaviors such as directive compliance. Instead, we focus on culture-specific social interaction behaviors (i.e., "etiquette") as a bridge between abstract cultural factors and human performance. We describe a computational model of etiquette and politeness perception, called CECAEDA (Computational Effects of Cultural Attributes and Etiquette on Directive Adherence). CECAEDA consists of four parts: (1) a culturally universal model of politeness perceptions, their causes and effects, (2) a culturally universal cognitive model compliance decision making and behaviors, (3) a set of hypotheses about how politeness perceptions alter directive compliance, and (4) a set of hypotheses about how cultural factors (specifically, those proposed by Hofstede [1]) affect etiquette perceptions and, thus, directive compliance in culture-specific ways. Each component is discussed in detail, followed by a brief presentation of our research test bed and paradigm for evaluating CECAEDA.

Rationale and Objectives To expose students in the premedical years to imaging and its indications, to enhance their understanding of pathologic processes by allowing direct visualization, and to teach physical diagnosis through an integrated, multispecialty approach. Materials and Methods A total of 166 second-year medical students participated in a novel imaging session that accompanied the physical diagnosis course they were concurrently enrolled in. Students were provided a didactic orientation to imaging and taught how to use Picture Archiving and Communications System software. The students then participated in interactive imaging sessions in which they were able to scroll through entire imaging cases of real, anonymized patients with accompanying clinical scenarios and physical examination findings. Results Of 89 students responding to an online curricular feedback questionnaire, 41% believed that the imaging correlated with the other information taught in the course and 46% found it was helpful to their learning. The majority of students (64%) believed that the sessions helped challenge them to think about physical diagnosis in a different way. Conclusion Physical diagnosis on the wards requires a multispecialty approach and the early introduction of this technique through the integrated mode of teaching we present will benefit students in their clinical years and future careers.

SIFT has been developing an approach to adaptable automation control of multiple Unmanned Air Vehicles (UAVs) we call a Playbook because it is based on the metaphor of a sports team's book of acceptable plays. Playbook represents a delegation approach to human-automation interactions because it allows a human operator to task or delegate authority to automation with much of the same flexibility with which a human supervisor or team captain can delegate objectives, methods, constraints and even detailed instructions to subordinates. In previous work, we have described the Playbook architecture and approach, illustrated interfaces, presented initial data clarifying its benefits and describing collaborative interactions with it. Here, we review the Playbook concept and previous work and then report on newly implemented play capabilities including the ability for the Playbook to coordinate the activities of multiple UAVs to track a ground-based moving target -- a play that requires Playbook to dynamically replan within authority delegated to it by the human operator.

SIFT has pioneered a human-automation integration architecture, called Playbook(TM), based on a shared model of the tasks in the domain. This shared task model provides a means of human-automation communication about plans, goals, methods and resource usage a process akin to referencing plays in a sports team's playbook. The Playbook enables human operators to interact with subordinate systems with the same flexibility as with well-trained human subordinates, thus allowing for adaptive automation. We describe this approach and its application in an ongoing project called Playbook-enhanced Variable Autonomy Control System(TM) (P-VACS).

Introduction: Our objectives were to examine mononuclear cell gene expression profiles in patients with systemic lupus erythematosus (SLE) and healthy controls and to compare subsets with and without atherosclerosis to determine which genes’ expression is related to atherosclerosis in SLE. Methods: Monocytes were obtained from 20 patients with SLE and 16 healthy controls and were in vitro-differentiated into macrophages. Subjects also underwent laboratory and imaging studies to evaluate for subclinical atherosclerosis. Whole-genome RNA expression microarray was performed, and gene expression was examined. Results: Gene expression profiling was used to identify gene signatures that differentiated patients from controls and individuals with and without atherosclerosis. In monocytes, 9 out of 20 patients with SLE had an interferon-inducible signature compared with 2 out of 16 controls. By looking at gene expression during monocyte-to-macrophage differentiation, we identified pathways which were differentially regulated between SLE and controls and identified signatures based on relevant intracellular signaling molecules which could differentiate SLE patients with atherosclerosis from controls. Among patients with SLE, we used a previously defined 344-gene atherosclerosis signature in monocyte-to-macrophage differentiation to identify patient subgroups with and without atherosclerosis. Interestingly, this signature further classified patients on the basis of the presence of SLE disease activity and cardiovascular risk factors. Conclusions: Many genes were differentially regulated during monocyte-to-macrophage differentiation in SLE patients compared with controls. The expression of these genes in mononuclear cells is important in the pathogenesis of SLE, and molecular profiling using gene expression can help stratify SLE patients who may be at risk for development of atherosclerosis.

Objective:To investigate an outbreak of scabies in an inner-city teaching hospital, identify pathways of transmission, institute effective control measures to end the outbreak, and prevent future occurrences.Design:Outbreak investigation, case-control study, and chart review.Setting:Large tertiary acute-care hospital.Results:A patient with unrecognized Norwegian (crusted) scabies was admitted to the acquired immunodeficiency syndrome (AIDS) service of a 940-bed acute-care hospital. Over 4 months, 773 healthcare workers (HCWs) and 204 patients were exposed to scabies. Of the exposed HCWs, 147 (19%) worked on the AIDS service. Risk factors for being infested with scabies among HCWs included working on the AIDS service (odds ratio [OR], 5.3; 95% confidence interval [CI95], 2.17-13.15) and being a nurse, physical therapist, or HCW with extensive physical contact with infected patients (OR, 4.5; CI95, 1.26-17.45). Aggressive infection control precautions beyond Centers for Disease Control and Prevention barrier and isolation recommendations were instituted, including the following: (1) early identification of infected patients; (2) prophylactic treatment with topical applications for all exposed HCWs; (3) use of two treatments 1 week apart for all cases of Norwegian scabies; (4) maintaining isolation for 8 days and barrier precautions for 24 hours after completing second treatment for a diagnosis of Norwegian scabies; and (5) oral ivermectin for treatment of patients who failed conventional therapy.Conclusions:HCWs with the most patient contact are at highest risk of acquiring scabies. Because HCWs who used traditionally accepted barriers while caring for patients with Norwegian scabies continued to develop scabies, we found additional measures were required in the acute-care hospital. HCWs with skin exposure to patients with scabies should receive prophylactic treatment. We recommend (1) using heightened barrier precautions for care of patients with scabies and (2) extending the isolation period for 8 days or 24 hours after the second treatment with a scabicide for those patients with Norwegian scabies. Oral ivermectin was well tolerated for treating patients and HCWs who failed conventional treatment. Finally, we developed a surveillance system that provides a “barometric measure” of the infection rate in the community. If scabies increases in the community, a tiered triage system is activated to protect against transmission among HCWs or hospital patients.

Fetal brain iron deficiency occurs in human pregnancies complicated by diabetes mellitus or intrauterine growth retardation. Because neurocognitive deficits are more common in the offspring of these pregnancies, we tested the hypothesis that perinatal brain iron deficiency predisposes the neonatal hippocampus, a structure important for memory processing, to injury. Brain iron concentration was reduced by 45% in 45 neonatal rats by maternal dietary iron restriction during gestation. Right-sided neuronal injury in four hippocampal subareas was induced by hypoxic-ischemic insult (ipsilateral carotid artery ligation and subsequent hypoxia on postnatal d 7) and was quantified histochemically on d 8 by cytochrome c oxidase activity (n = 30), and on d 14 by Nissl staining (n = 15). Acute right-sided cytochrome c oxidase activity loss occurred in CA1 (P = 0.02), CA3c (P < 0.001) and dentate gyrus (P < 0.001) in the iron-deficient group, whereas only CA1 (P = 0. 003) was affected in the iron-sufficient group. Long-term right-sided Nissl substance loss occurred in CA1 (P = 0.001), CA3a,b (P < 0.001) and dentate gyrus (P = 0.008) in the iron-deficient group, but only in CA1 (P = 0.004) in the iron-sufficient group. No increase in right-sided free-iron staining was present in either group. Perinatal iron deficiency predisposes the neonatal hippocampus to a greater acute loss of neuronal metabolic activity after an hypoxic-ischemic event, suggesting compromised cellular energetics. The subsequently greater loss of hippocampal neuronal integrity suggests poorer recoverability after injury in the perinatal iron-deficient brain.

The offspring of pregnancies complicated by diabetes mellitus or intrauterine growth retardation are at increased risk for perinatal asphyxia and for long-term neurocognitive sequelae. Both gestational conditions are characterized by an increased prevalence of brain iron deficiency. The hippocampus is important for a variety of cognitive functions (e.g., recognition memory) and is susceptible to hypoxicischemic (HI) injury. To evaluate the hypothesis that brain iron deficiency increases the vulnerability of the hippocampus to HI injury and to assess whether iron induced reperfusion injury has any role in such injuries, we ligated the right common carotid artery in 15 perinatally iron-deficient and 15 iron-sufficient 7-day-old rat pups,and exposed them to 2.5 hours of 8% FIO2(Levine model). The non-ligated left side served as the undamaged internal control. On day 14, neuronal injury was quantified histochemically by assessing intensity of staining for Nissl substance in 4 hippocampal subareas in both hemispheres using optical densitometry in gray scale units (range: 1/white-254/black). To assess iron induced reperfusion injury, sections were stained for iron by modified Perl's reaction. The brain iron concentration of the iron-deficient group was 55% of control (p

Postnatally acquired dietary iron deficiency has adverse long-term effects on neurodevelopment. Recently, our laboratory has identified gestational conditions (diabetes mellitus, intrauterine growth retardation) which result in a significant prevalence of perinatal brain iron deficiency. These groups of infants have poorer long-term developmental outcome, but the role of iron deficiency is unknown. Loss of cytochrome oxidase (CytOx) activity in the region of the hippocampus, an area central to cognitive function (recognition memory), has been shown to be an early and sensitive indicator of neuronal damage following perinatal hypoxic-ischemic encephalopathy (HIE) in the rat. We hypothesized that perinatal iron deficiency enhances the vulnerability of the hippocampus to HIE injury. Twenty 7-day-old, iron-deficient rat pups and 20 iron-sufficient controls underwent right carotid artery ligation and were exposed to 2.5 hours of hypoxia (8% FIO2). In this model (the Levine model), both hypoxia and ischemia (right side), but not hypoxia alone (left side), are needed to induce changes in neuronal CytOx activity. The left side is thus the internal control. The mean ± SD brain iron concentration of the iron-deficient group was 40% lower than the iron-sufficient group (28.0± 6.8 v 51.0 ± 7.8; p

We describe a virtual reality telecommunications ecosystem developed under funding from NASA entitled ANSIBLE: A Network of Social Interactions for Bilateral Life Enhancement. ANSIBLE is a communication support toolset which enables multi-faceted human-human and human-virtual agent interactions designed to accommodate technical and environmental limitations of long duration space flight. The primary objectives are to address communication limitations and provide telehealth options to combat behavioral health threats in future long duration exploration class missions. The system is current being evaluated in a human subject study that takes place at the Hawaii Space Exploration Analog and Simulation (HI-SEAS) facilities in Waimea, HI. There, an international mixed gender group of scientists are undergoing adjustments in physiology and lifestyle that are analogous to some of the challenges in a confined environment over twelve month isolation mission under Mars-exploration conditions (e.g. with communication latencies and blackouts, in close quarters, under restricted water and energy use). Preliminary analysis show that the ANSIBLE treatment group scored better perceived social closeness and perceived relationship satisfaction in self-report surveys compared to a control group who participated in a prior eight month isolation mission in the same facility and used only conventional asynchronous communication methods (i.e. email, voice and video recordings). In the real world, verbal interactions go hand-in-hand with interactions with tangible things. Virtual items can be called upon to serve as powerful and meaningful aides for communications. We posit that the observed increase in social connectedness is due to the affordances of VR, where situational contexts that are often not communicated in traditional telecommunications are made explicit in the virtual world.