1. What are revenge effects, and how can they be prevented?
2. What is human factors psychology/ergonomics/cognitive engineering?
3. How does the systems approach deal with error?
4. What are the different levels of analysis?
5. How can antibiotic resistance be explained?
6. What are some of the difficulties in applying theories of cognitive psychology?
Some things are ____ to use
e.g., using a pen, reading a book
Some things are ___
e.g., flying an Airbus A380, using doors
Why are some things easier to use than others?
• __________
• better ______!
Worst case of bad design: _______ effects (Tenner, 1996): unforeseen, ironic, and unintended consequences of complex systems
e.g., arthritic hands cannot open _____-proof bottles of pain reliever
(solution: “____-open” bottles)
- not the same thing as trade-offs or side effects, which are known in advance and don’t prevent use
How can we avoid revenge effects--think of everything?
Who can help in the design of things that are understandable and usable?
Human factors psychology:
• the design of equipment and systems that people use--intentionally taking into account human perception, cognition, and behaviour
• also called __________ (Greek): ergo (“work”) and nomos (“laws”), coined by Jastrzębowski (1857)
• or cognitive ___________: applies knowledge of cognitive psychology to the design and operation of human-machine systems
1. Physical __________: the immediate environment
- research field: _____________ (measurement of human physical variation)
- design of displays, controls, etc.
2. __________ Behaviour: the actor
- research field: psychology
- ultimate “cause” of errors (i.e., _____)
- affected by memory, biases, heuristics
3. Interpersonal, Team, & Group Behaviour: _____ dynamics
- research fields: social psychology, sociology
- teams work cooperatively toward a common goal (groups merely have something in common with other members)
- diffusion of responsibility decreases reliability of group
- affected by decision-making factors like __________
4. Organizational & Management Behaviour: the structure of ___________
- research field: industrial/organizational (“I/O”) psychology, management theory
- create ______, which affects entire organization
- responsible for development of ______ culture
5. _____ & Regulatory Rules: what is allowed/acceptable
- research field: legal scholars, governments?
- restrict what can/cannot be done, via laws
6. Societal & Cultural Pressures: the socio-cultural context
- research fields: cultural anthropology, sociology, economics, political science
- affected by economic and political pressures, cultural beliefs
Also consider ____________ among components.
1. Physical Level
Bacteria
- Louis Pasteur (1862): French chemist
• illness not caused by bad air (“miasma”)
• bacteria cause infections
• demonstrated that germs did not spontaneously generate
- single-cell organisms found naturally on skin, in mucous membranes, and lining of intestinal tract (________ flora)
- unknown how many kinds there are
- may be aerobic, or anaerobic (do not require oxygen)
- there are over 300 kinds in your _____ alone
- in/on your body, there are about as many bacteria as there are _____ cells
Antibiotics
- Alexander Fleming (1928): discovered that bacteria did not survive on plate ____________ by bread mould
- penicillin widely available by early 1940s
- modern ___________:
• bacteriostatic: inhibit growth, allowing host to generate an immune response
• bacteriocidal: kill bacteria
- mechanisms: attack outer wall or inner membrane, or attack chemical pathways necessary for bacteria to survive and multiply
- 15 groups of antibiotics
e.g., group IV (macrolides and lincosamines) includes azithromycin (Zithromax®) and clarithromycin (Biaxin®); group IX (glycopeptides) includes vancomycin (Vancocin®)
Antibiotic Resistance
- bacteria constantly mutate
- an antibiotic may kill most--but not all--pathogenic bacteria
- survivors have resistance genes: “_________”; will propagate and be transmitted
- microbiome (beneficial resident bacteria which compete with pathogens) also affected
- resistance can be transferred via DNA, plasmids, or viruses
- common resistant strains:
• methicillin-resistant Staphylococcus aureus (MRSA)
• vancomycin-resistant Enterococci (VRE)
• penicillin-resistant Streptococcus pneumoniae (PRSP)
- use of antibiotics is a major cause of resistance (“the antibiotic _______”)
- is a serious problem (CCA, 2019)
• 26% of bacterial infections in Canada are resistant to first-line antibiotics
• in 2018, there were 250,000 resistant bacterial infections in Canada, and more than 5,400 deaths
• antibiotic resistance costs the Canadian health care system $1.4B/year
Environment
- 50-70% of antibiotic use in U.S. is in ___________
- >75% in Canada (since 2018, antibiotics for livestock require a prescription)
- excreted residues can spread into soil and water supplies, fostering resistant bacterial strains
- trace quantities found in _____ supplies in North America and Europe
2. Individual Level
- most respiratory tract infections caused by viruses (however, viral infection can lead to a secondary bacterial infection)
- 54% of adults believe antibiotics are effective against viral infections (they are not; NIPA, 2000)
3. Interpersonal, Team, & Group Behaviour
- physicians blamed for over-prescription of antibiotics
- about 33% of 150 million outpatient antibiotic prescriptions are ___________ (Levy, 1998)
- culture to test for bacterial infection takes 2 days
- if refused prescription for antibiotics, 11% of patients would see another physician
4. Organizational Level
- lack of public awareness of best practices/consequences
- physicians’ non-compliance with clinical guidelines
5. Legal & Regulatory Level
- most antibiotics used in livestock production are similar to those used in humans
- easy to get: many are over-the-counter, do not require vet’s prescription
6. Societal & Cultural Level
- people expect instant remedies for medical problems
1. Physical Level
- ________ and development into new antibiotics must continue
2. Individual Level
- do not seek antibiotics unless actually required
- finish taking all prescribed antibiotics
- change your behaviours to avoid infections
• do not touch the _-____ (eyes, nose, mouth)
• wear a mask
• cover your cough: cough and sneeze into your ______, not your hands
• wash your hands (80% of common infections spread by hands)
1. use warm water and soap (not _____________ soap)
2. rub hands for 20 seconds (“Twinkle twinkle” song)
3. rinse for 10 seconds
4. dry with a towel
5. use towel to turn off taps, open door
3. Interpersonal, Team, & Group Behaviour
- do not demand antibiotics from physician (reduction in antibiotic prescriptions reduced/almost eliminated resistant Strep in Japan, Finland, & Iceland)
4. Organizational Level
- public education campaigns like Do bugs need drugs? (Alberta Health Services, 2000), Be Antibiotics Aware (Centers for Disease Control and Prevention, 2019), and Antibiotic Awareness Week
- clinical practice guidelines established by Alberta Medical Association, Canadian Medical Association, etc.
- National Information Program on Antibiotics (1996)
- Alliance for the Prudent Use of Antibiotics (1981)
5. Legal and Regulatory Level
- pass ____ to restrict use of antibiotics in agriculture
6. Societal & Cultural Level
- change _________ and social norms about antibiotics drug use
- increase cost of antibiotics
Challenges to human factors psychology (Landauer, 2003; Kadir et al., 2019):
- ________ theories studied, instead of concrete applications
- subtle psychological effects have been most studied; more information on robust effects needed
- principles of cognition rarely influence machine ______
- _________ are largely unaware of cognitive principles
- more empirical evidence needed from ____-_____ settings (e.g., workplaces, industry, etc.)
- research should be more ________, including all levels of the systems approach
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