Systems Barriers to Medication Management During Hospital to Home Transitions of Older Adults With Dementia

The hospital-to-home transition is a high-risk period for medication errors and adverse events for older adults living with dementia. Researchers conducted a qualitative study using semi-structured interviews and participant solicited diaries. Caregivers of adults ages 55 and older were recruited to understand barriers to medication management during hospital to skilled home health care transitions. We used a human factors engineering approach to guide our understanding of systems level barriers. At least two researchers independently coded each transcript using content analysis and the ATLAS.ti software. We interviewed 23 caregivers and identified five barrier types stemming from systems breakdowns related to: (1) knowledge and information, (2) access to and use of resources and tools, (3) caregiver burden, (4) pandemic concerns, and (5) health limitations. Caregivers grappled with receiving overwhelming, insufficient, incorrect, or conflicting information, and had difficulty managing information from different sources. Latinx caregivers encountered language barriers that impeded role and task clarity. Caregivers expressed mistrust in health systems elements and inability to access resources. Caregivers were in need of additional caregiving assistance, financial aid, and tools to manage medications. Balancing multiple medications and responsibilities left caregivers burdened. The health limitations of the older adult and COVID-19 concerns related to reduced access to resources and ability to deliver and receive in person care complicated task management. Altogether these barriers reflect systems level breakdowns impeding task understanding, execution, and overall management. These findings will inform the development of interdisciplinary strategies to ensure safer care transitions.

Design methodology of analytical games for knowledge acquisition

Analytical games explore a problem or a domain with a research purpose. Considerable research is ongoing to investigate improvements to analytical game design, execution and exploitation. Moreover, the fast-paced technological developments in many fields, such as artificial intelligence and virtual reality, make it even more compellingto account for the advantages and limitations of these new capabilities. In game design, the use of digital means is often regarded as a mere technical factor that relates to the platform selection, facilitator support and data recording processes. In this work a shift in perspective is proposed, to move from technology-oriented design selection criteria towards a broader assessment of the design choices. In fact, the introductionof technology (i.e., automation and autonomy) will not lead to a substitution of tasks, but will intrinsically change the game environment. This work introduces a framework to provide a structured guidance on the aspects to be factored in the different design phases of an analytical game, including the potential impact of the adoption of automation and autonomy. The proposed approach is based on previous research in the fieldof simulation-based serious gaming, model-driven engineering and human factors engineering. The framework is applied to Knowledge Acquisition Analytical Games as a case study.

ПРИНЦИПИ ПРОЕКТУВАННЯ ЛЮДИНО-МАШИННОЇ ВЗАЄМОДІЇ У ЦИФРОВОМУ СЕРЕДОВИЩІ

Modern society life is inextricably linked with the digital environment. A consequence is the transformation of ergatic systems into digital ones. The result is the emergence of new types of man-machine interaction. The essential feature of such interaction is to minimise human involvement in the ergatic system functioning. According to this, the issues of organising the safe and effective functioning of digital ergatic systems have priority importance. In this regard, the aim was to study the features of man-machine interaction in an actual digital ergatic system. We chose an ergatic system for research. The main elements of the system were students (70 people of the first-year study) and teachers (5 people) of the Simon Kuznets Kharkiv National University of Economics, as well as the digital system “Personal training systems the Simon Kuznets Kharkiv National University of Economics” (PTS). This digital system is an adapted model of the Moodle digital system. The study found out that the key components that determine the safety and efficiency of the digital ergatic system are the operator's digital mindset, digital tools and digital devices. The study of these components in the system made it possible to establish that it had a balanced state. It is substantiated the optimal form of man-machine interaction in the system. It is mixed learning. It is shown that the tendency to minimise the human role in a digital ergatic system does not always have the expected positive result, which determines the need for further research on this issue. In addition, we analysed the difficulties arising in the design of digital systems. The main reason for this is a lack of developers awareness of the ergonomic and cognitive aspects of man-machine interaction. It is shown that the development of critical thinking and intuition in students is closely related to the individual trajectory of learning. For this, it is essential to update interdisciplinary knowledge. In this case, it is necessary to familiarise students with current concepts and system-forming principles, which are the basis of human factors engineering. It was substantiated that the application of current concepts and system-forming principles in training will allow optimising man-machine interaction. The positive results will be evidence even at the stage of designing digital systems

Verification of a Comfort-Enhanced Liquid Cooling Vest

Firefighter uniforms provide thermal protection and block radiant as well as high-temperature heat. However, they limit cooling and the dissipation of internal heat from the body. This study attempted to improve firefighter uniforms by developing and evaluating a comfortable and thermally balanced design. This study recruited six male college students for a within-subject comparison of vests with and without active liquid cooling. The participants used a questionnaire to report their comfort level in each body part while performing various motions. A biomechanical analysis was performed to objectively evaluate the comfort level of the cooling vest before and after the test. Subsequently, the participants’ blood pressure and ear as well as skin temperature were measured as they ran on a treadmill. The participants also responded to a questionnaire regarding their thermal perception. The results revealed that the cooling vest was comfortable and flexible. The data from the psychological questionnaire indicated that the participants were satisfied with the warmth, coolness, and other various aspects of the cooling vest. Moreover, the cooling vest positively affected the wearer’s microclimate and provided a comfortable thermal balance. The current findings demonstrate the feasibility of using human-factors-engineering-based objective verification methods for designing products.

Object-Process Methodology as an Alternative to Human Factors Task Analysis

Objective We define and demonstrate the use of OPM-TA—a model-based task analysis (TA) framework that uses object-process methodology (OPM) ISO 19450 as a viable alternative to traditional TA techniques. Background A variety of different TA methods exist in human factors engineering, and several of them are often applied successively for a broad task representation, making it difficult to follow. Method Using OPM-TA, we modeled how an International Space Station (ISS) astronaut would support extravehicular activities using the existing robotic arm workstation with a new control panel and an electronic procedure system. The modeling employed traditional TA methods and the new OPM-TA approach, enabling a comparison between them. Results While the initial stages of modeling with OPM-TA follow those of traditional TA, OPM-TA modeling yields an executable and logically verifiable model of the entire human–robot system. Both OPM’s hierarchical set of diagrams and the equivalent, automatically generated statements in a subset of natural language text specify how objects and processes relate to each other at increasingly detailed levels. The graphic and textual OPM modalities specify the system’s architecture, which enables its function and benefits its users. To verify the model logical correctness model, we executed it using OPM’s simulation capability. Conclusion OPM-TA was able to unify traditional TA methods and expand their capabilities. The formal yet intuitive OPM-TA approach fuses and extends traditional TA methods, which are not amenable to simulation. It therefore can potentially become a widely used means for TA and human–machine procedure development and testing.

Risk Factors Analysis of Car Door Crashes Based on Logistic Regression

Unlike door crash accidents predominantly involving bicycles in Australia, the UK, and other Western countries, cases in Taiwan are far more fatal as they usually involve motorcycles. This is due to the unique anthropogeography and transportation patterns of Taiwan, particularly the numbers of motorcycles being twice that of cars. Both path analysis and multivariate logistic regression methods were adopted in this study. The multivariate logistic regression analysis results have shown that the main risk factors causing serious injuries in door crashes include winter, morning, male motorcyclists, heavy motorcycles, and the left sides of cars. Regarding the gender differences in motorcyclists, it appears that female motorcyclists have higher door crash accident rates, while the odds of severe injury and fatality in male motorcyclists are 1.658 times greater than that of female motorcyclists. The risk factors derived from the multivariate logistic regression analysis were further discussed and analysed. It was found that the causes of serious injuries and deaths stemming from door crashes were related to the risk perception ability, reaction ability, visibility, and riding speed of the motorcyclists. Therefore, suggestions on risk management and accident prevention were proposed using advocacy through the 3E strategies of human factors engineering design.

Parallel Assessment Tracks for Human-Centered Design (PATH): A Framework for Transitioning to a New Health Information Technology System

This practice-oriented paper presents a human-centered design (HCD) framework that we developed to perform a comprehensive evaluation of a new health information technology (HIT) system under development, intended to replace a legacy system. The Department of Veterans Affairs (VA) Veteran Crisis Line (VCL) program provides a vital service in crisis intervention and suicide prevention. VCL staff rely on a Customer Relationship Management (CRM) legacy system, Medora. VCL intended to replace Medora with Microsoft Dynamics 365 (D365) CRM system. Due to wide-spread criticism of D365, the VA Human Factors Engineering (HFE) team engaged in a multi-study, mixed-method HCD evaluation to investigate the legacy system and intended replacement in terms of ability to support VCL staff needs. The HCD framework we developed to perform this evaluation may be adapted for other large-scale HIT transitions and may provide human factors practitioners with guidance to make evidence-based decisions to support (or abandon) such transitions.