A novel multi-hazard risk assessment framework for coastal cities under climate change.

Coastal cities, as centres of human habitation, economic activity and biodiversity, are confronting the ever-escalating challenges posed by climate change. In this work, a novel Multi-Hazard Risk Assessment framework is presented with the focus on Coastal City Living Labs. The methodology provides a comprehensive assessment of climate-related hazards, including sea-level rise, coastal flooding, coastal erosion, land flooding, heavy precipitation, extreme temperatures, heatwaves, cold spells, landslides and strong winds. Its application is illustrated through a case study: the Coastal City Living Lab of Benidorm, Spain. The methodology incorporates remote sensing data from various satellite sources, such as ERA5, Urban Atlas and MERIT DEM, to evaluate multiple hazards through a systematic and standardized indicator-based approach, offering a holistic risk profile that allows for comparison with other European coastal cities. The integration of remote sensing data enhances the accuracy and resolution of hazard indicators, providing detailed insights into the spatiotemporal dynamics of climate risks. The incorporation of local expertise through the Coastal City Living Lab concept enriches data collection and ensures context-specific adequacy. The integration of local studies and historical extreme climate events enhances the validity and context of the risk indicators. The findings align with regional trends and reveal specific vulnerabilities, particularly related to heatwaves, heavy rainfall, and coastal flooding. Despite its strengths, the MHRA methodology faces limitations, including reliance on outdated datasets and the complexity of integrating multiple hazards. Continuous updates and adaptive management strategies are essential to maintain the accuracy and relevance of risk assessments. The broader implications of the methodology for global coastal cities highlight its potential as a model for developing targeted adaptation strategies.

Exploring inappropriate levels of care in intensive care.

BACKGROUND: Levels of care deemed as inappropriate generate moral distress among nurses and other intensive care professionals. Inappropriate levels of care and related moral distress are frequently broached as individual and psychological phenomena, reduced to how individuals feel and think about specific cases. However, this tends to obscure the complex context in which these situations occur, and on which healthcare professionals can act. There is thus a need for a more contextual and team-level lens on inappropriate levels of care. RESEARCH OBJECTIVE: This study aims to explore and understand the issue of inappropriate levels of care in an intensive care unit (ICU) through a contextual and team-level lens. RESEARCH DESIGN: Semi-structured interviews were conducted with nurses, respiratory therapists, and intensivists. Thematic analysis focused on understanding the causes and consequences of inappropriate levels of care, as well as potential avenues for improvement. This study is part of a 5-phase participatory living lab project on inappropriate levels of care conducted in the ICU of a Montreal (Quebec, Canada) hospital. This paper relates the initial phases of the project, focusing on understanding the issue, with reported events spanning from June 2022 to May 2023. ETHICAL CONSIDERATIONS: Ethics approval was sought and granted by the Research Ethics Board of the CIUSSS de l'Est-de-l'Île-de-Montréal. FINDINGS/DISCUSSION: Five broad themes intrinsically related to the phenomenon of inappropriate levels of care were explored with and by participants: (1) the process of determining levels of care, (2) the distinction between appropriate and inappropriate levels of care, (3) causes of inappropriate levels of care, (4) consequences of inappropriate levels of care and (5) potential avenues for improvement. CONCLUSION: This research provides a comprehensive understanding of inappropriate levels of care in the ICU and emphasizes the relevance of team-level explorations of complex ethical issues.

Promoting collective precycling behavior: results from a group intervention with Berlin households in Germany.

To tackle the global waste crisis, there is an urgent need for decisive and joint action at multiple levels. The collective behavior of a community could make a significant contribution. This paper presents the results of a field experiment designed to promote packaging waste prevention - called precycling - in a newly formed community setting, in Berlin, Germany. The aim was to examine the effect of the intervention on precycling and to examine the underlying social identity processes. Over a four-week period, 132 participants from 96 different households digitally received a combination of different interventions, that were theoretically informed by the Social Identity Model of Pro-Environmental Action (SIMPEA). Households were assigned to two intervention groups and a waiting control group. Data was collected before, immediately after and four months after the intervention to assess the impact of the intervention using multilevel models. After the intervention, the overall precycling behavior increased significantly, but not as a result of the different group conditions. In the more comprehensive intervention group, which included social interaction and behavioral experimentation, the community identification was strengthened and the reuse behavior, as a subset of precycling, increased. While a number of social identity processes (collective efficacy beliefs, having a precycling action goal, crisis appraisal, and sufficiency attitudes) were found to positively predict the precycling behavior, surprisingly, the predictive power of social norms and ingroup identification could not be confirmed. Overall, the presented community intervention promoted precycling. However, in this dynamic real-world setting, not all intervention elements worked as expected. The pitfalls and opportunities of this intervention are discussed, and ideas for translating the results into everyday precycling activities are presented.

Digital Phenotyping of Geriatric Depression Using a Community-Based Digital Mental Health Monitoring Platform for Socially Vulnerable Older Adults and Their Community Caregivers: 6-Week Living Lab Single-Arm Pilot Study.

BACKGROUND: Despite the increasing need for digital services to support geriatric mental health, the development and implementation of digital mental health care systems for older adults have been hindered by a lack of studies involving socially vulnerable older adult users and their caregivers in natural living environments. OBJECTIVE: This study aims to determine whether digital sensing data on heart rate variability, sleep quality, and physical activity can predict same-day or next-day depressive symptoms among socially vulnerable older adults in their everyday living environments. In addition, this study tested the feasibility of a digital mental health monitoring platform designed to inform older adult users and their community caregivers about day-to-day changes in the health status of older adults. METHODS: A single-arm, nonrandomized living lab pilot study was conducted with socially vulnerable older adults (n=25), their community caregivers (n=16), and a managerial social worker over a 6-week period during and after the COVID-19 pandemic. Depressive symptoms were assessed daily using the 9-item Patient Health Questionnaire via scripted verbal conversations with a mobile chatbot. Digital biomarkers for depression, including heart rate variability, sleep, and physical activity, were measured using a wearable sensor (Fitbit Sense) that was worn continuously, except during charging times. Daily individualized feedback, using traffic signal signs, on the health status of older adult users regarding stress, sleep, physical activity, and health emergency status was displayed on a mobile app for the users and on a web application for their community caregivers. Multilevel modeling was used to examine whether the digital biomarkers predicted same-day or next-day depressive symptoms. Study staff conducted pre- and postsurveys in person at the homes of older adult users to monitor changes in depressive symptoms, sleep quality, and system usability. RESULTS: Among the 31 older adult participants, 25 provided data for the living lab and 24 provided data for the pre-post test analysis. The multilevel modeling results showed that increases in daily sleep fragmentation (P=.003) and sleep efficiency (P=.001) compared with one's average were associated with an increased risk of daily depressive symptoms in older adults. The pre-post test results indicated improvements in depressive symptoms (P=.048) and sleep quality (P=.02), but not in the system usability (P=.18). CONCLUSIONS: The findings suggest that wearable sensors assessing sleep quality may be utilized to predict daily fluctuations in depressive symptoms among socially vulnerable older adults. The results also imply that receiving individualized health feedback and sharing it with community caregivers may help improve the mental health of older adults. However, additional in-person training may be necessary to enhance usability. TRIAL REGISTRATION: ClinicalTrials.gov NCT06270121; https://clinicaltrials.gov/study/NCT06270121.

Understanding Health-Related Motivations for Urban Food Self-Production in the Light of Semantic Fields Analysis.

One of the contemporary challenges facing urban areas is the necessity to identify novel approaches to resident involvement in solution creation, with a particular focus on ensuring the best possible nutrition. By investigating the process of co-participation of city dwellers in a unique education project, this paper aims to gain a deeper understanding of the health-related motivations that underpin the decision of early adopters of the implemented technological innovations to join the social experiment. The qualitative study employed purposive sampling and in-depth interviews conducted in two waves, the first between October and November 2022 and the second between September 2023 and January 2024. The study comprised 42 participants drawn from two communities of residents in Lódz and Warsaw, Poland. Transcriptions of the interviews were carried out using semantic field analysis, employing a quantitative approach that counts the frequency of keyword occurrences. Three categories of semantic fields were identified: associations, oppositions, and actions toward the subject, including positive, neutral, and negative temperatures. The findings demonstrate that the health concerns of residents are a pivotal factor in their decision to participate in urban food self-production initiatives, given their limited access to nutritious and healthy vegetables. This is related to several factors, including restrictions related to urbanization and the displacement of local suppliers, lifestyle, and the fast pace of urban life. The dissemination of innovative solutions for growing food in urban environments could, therefore, facilitate awareness-raising and motivation to alter the dietary habits of inhabitants.

Interest of a Hospital-Based Geriatric Living Lab among Inpatients with Neurocognitive Disorders: The ALLEGRIA Cross-Sectional Study.

INTRODUCTION: The objectives of this study were to determine the participation rates, levels of engagement, and abilities to answer User eXperience (UX) questionnaires according to the presence and severity of major neurocognitive disorders (MNCD) among participants involved in gerontechnological experimentations within a hospital-based geriatric clinical living lab. METHODS: Cross-sectional analysis examining all consecutive geriatric patients involved in the Allegro living lab experimentations, separated according to the presence and severity of MNCD. Participation rates were assessed using the "Task-Based Experiment"-type User eXperience (TBE-UX). Participation was considered successful if patients fully completed the TBE-UX experimental procedure. Engagement level was characterized using a five-point scale: interactive, constructive, active, passive, and disengaged. The abilities to answer UX questionnaires were characterized using a five-point scale from "no completion" to "completion in autonomy." RESULTS: 313 patients were included. All patients without MNCD and with mild MNCD fully completed the TBE-UX procedures. Their engagement behaviors were rather active and constructive. All patients without MNCD and 88% of those with mild MNCD were able to fully complete the UX questionnaires. 96.2% of the patients with moderate MNCD fully followed the TBE-UX procedures. Their engagement behaviors were mainly active or passive. 64.2% were able to fully complete the UX questionnaires. 76.5% of the patients with severe MNCD fully followed the TBE-UX procedures. Their engagement behaviors were mainly passive or disengaged. 35.3% were able to fully complete the UX questionnaires. CONCLUSION: Living lab experimentations appear feasible with older adults, even with those with MNCD. Task support can be offered to those with severe MNCD.

Living Lab Data of Patient Needs and Expectations for eHealth-Based Cardiac Rehabilitation in Germany and Spain From the TIMELY Study: Cross-Sectional Analysis.

BACKGROUND: The use of eHealth technology in cardiac rehabilitation (CR) is a promising approach to enhance patient outcomes since adherence to healthy lifestyles and risk factor management during phase III CR maintenance is often poorly supported. However, patients' needs and expectations have not been extensively analyzed to inform the design of such eHealth solutions. OBJECTIVE: The goal of this study was to provide a detailed patient perspective on the most important functionalities to include in an eHealth solution to assist them in phase III CR maintenance. METHODS: A guided survey as part of a Living Lab approach was conducted in Germany (n=49) and Spain (n=30) involving women (16/79, 20%) and men (63/79, 80%) with coronary artery disease (mean age 57 years, SD 9 years) participating in a structured center-based CR program. The survey covered patients' perceived importance of different CR components in general, current usage of technology/technical devices, and helpfulness of the potential features of eHealth in CR. Questionnaires were used to identify personality traits (psychological flexibility, optimism/pessimism, positive/negative affect), potentially predisposing patients to acceptance of an app/monitoring devices. RESULTS: All the patients in this study owned a smartphone, while 30%-40% used smartwatches and fitness trackers. Patients expressed the need for an eHealth platform that is user-friendly, personalized, and easily accessible, and 71% (56/79) of the patients believed that technology could help them to maintain health goals after CR. Among the offered components, support for regular physical exercise, including updated schedules and progress documentation, was rated the highest. In addition, patients rated the availability of information on diagnosis, current medication, test results, and risk scores as (very) useful. Of note, for each item, except smoking cessation, 35%-50% of the patients indicated a high need for support to achieve their long-term health goals, suggesting the need for individualized care. No major differences were detected between Spanish and German patients (all P>.05) and only younger age (P=.03) but not sex, education level, or personality traits (all P>.05) were associated with the acceptance of eHealth components. CONCLUSIONS: The patient perspectives collected in this study indicate high acceptance of personalized user-friendly eHealth platforms with remote monitoring to improve adherence to healthy lifestyles among patients with coronary artery disease during phase III CR maintenance. The identified patient needs comprise support in physical exercise, including regular updates on personalized training recommendations. Availability of diagnoses, laboratory results, and medications, as part of a mobile electronic health record were also rated as very useful. TRIAL REGISTRATION: ClinicalTrials.gov NCT05461729; https://clinicaltrials.gov/study/NCT05461729.

Developing a living lab in ethics: Initial issues and observations.

Living labs are interdisciplinary and participatory initiatives aimed at bringing research closer to practice by involving stakeholders in all stages of research. Living labs align with the principles of participatory research methods as well as recent insights about how participatory ways of generating knowledge help to change practices in concrete settings with respect to specific problems. The participatory, open, and discussion-oriented nature of living labs could be ideally suited to accompany ethical reflection and changes ensuing from reflection. To our knowledge, living labs have not been explicitly trialed and reported in ethics literature. In this discussion paper, we report and discuss four initial issues that marked the process of setting up a living lab in ethics: (1) determining the goals and expected outcomes of an ethics living lab; (2) establishing operational procedures; (3) selecting communities and defining pilot projects; and (4) adopting a lens to tackle emerging questions and challenges. We explain these four issues and present the paths taken based on the novel and specific orientation, that is, living ethics, at the basis of this project. In alignment with living ethics and É-LABO, we approach challenges as learning opportunities to ask not only "how" questions but also "why" questions. We hope that this discussion paper informed by our experience helps to clarify the theoretical, methodological, and practical approaches necessary to successfully adopt and employ living labs in ethics.

Monitoring data from an office room in a real operating building, suitable for state-space energy modelling.

The dataset provides all necessary variables for data-driven energy modelling of an office room. The measurement data have been obtained from an office building operating as living lab in a temperate climate of Central Europe. The temperatures and the ventilation air flowrate are raw measurements, while the heat flows are calculated from measurements. The incoming solar irradiance is calculated with two façade models -simple and enhanced-, using measurements (solar irradiance, movable shading settings) and building characteristics (geometry, glazing and shading properties). One year and four months of data is provided with a fine one-minute time step and a coarser fifteen-minute time step. The dataset can be used to test and validate data-driven models, for example for predictive control applications.

Living Lab-Based Service Interaction Design for a Companion Robot for Seniors in South Korea.

A living lab is a valuable method for designing tangible and intangible service elements, ensuring a comprehensive user experience. Developing a digital companion service, which users may be unfamiliar with, requires observing user behavior in real-world environments and analyzing living and behavioral patterns. A living lab starts with understanding user characteristics and behaviors. Living lab methods have an impact on the accuracy and precision of service design. The number of seniors in South Korea is rapidly increasing, leading to a rise in social issues like solitary deaths and suicide. Addressing these problems has led to a growing demand for companion robots. To design effective companion services, understanding seniors' living environments and their cognitive and behavioral traits is essential. This opinion piece, based on a national R&D project, presents the development of a digital companion for seniors. It offers insights, providing a comprehensive overview of living lab-based service interaction design and proposing methodologies about living lab environment construction and experimentation and considerations when designing robot interaction functions and appearance. The living lab environment includes real living spaces, laboratories, virtual reality settings, and senior welfare centers. Using the research findings, we created service scenarios, analyzed senior language characteristics, and developed the concept and facial expressions of the digital companion. To successfully introduce a novel service, it is crucial to analyze users' real-life behavior and adjust the service accordingly.

Research protocol of the Laval-ROSA Transilab: a living lab on transitions for people living with dementia.

BACKGROUND: The Laval-ROSA Transilab is a living lab that aims to support the Laval Integrated Health and Social Services Centres (Quebec, Canada) in consolidating the Quebec Alzheimer Plan. It aims to improve care transitions between different settings (Family Medicine Groups, home care, and community services) and as such improve the care of people living with dementia and their care partners. Four transition-oriented innovations are targeted. Two are already underway and will be co-evaluated: A) training of primary care professionals on dementia and interprofessional collaboration; B) early referral process to community services. Two will be co-developed and co-evaluated: C) developing a structured communication strategy around the dementia diagnosis disclosure; D) designation of a care navigator from the time of dementia diagnosis. The objectives are to: 1) co-develop a dashboard for monitoring transitions; 2) co-develop and 3) co-evaluate the four targeted innovations on transitions. In addition, we will 4) co-evaluate the impact and implementation process of the entire Laval-ROSA Transilab transformation, 5) support its sustainability, and 6) transfer it to other health organizations. METHODS: Multi-methods living lab approach based on the principles of a learning health system. Living labs are open innovation systems that integrate research co-creation and knowledge exchange in real-life settings. Learning health systems centers care improvement on developing the organization's capacity to learn from their practices. We will conduct two learning cycles (data to knowledge, knowledge to practice, and practice to data) and involve various partners. We will use multiple data sources, including health administrative databases, electronic health records data, surveys, semi-structured interviews, focus groups, and observations. DISCUSSION: Through its structuring actions, the Laval-ROSA Transilab will benefit people living with dementia, their care partners, and healthcare professionals. Its strategies will support sustainability and will thus allow for improvements throughout the care continuum so that people can receive the right services, at the right time, in the right place, and from the right staff.

Exploring stakeholders' perspectives on the adaptation of the Living Lab approach to dementia care: A qualitative study.

Collaborative research can promote knowledge translation and help to link care practice and research. Academic-practice partnerships enable joint research projects in collaboration between care professionals, researchers, patients, and other stakeholders. This qualitative study was conducted during the adaptation phase of the Living Lab Dementia, an academic-practice partnership for collaborative research on long-term dementia care. The aim was to explore stakeholders' perspectives on linking care practice and research in a sustainable, research-focused partnership. Data were collected in fifteen qualitative interviews with representatives from three stakeholder groups: nursing care professionals, people with dementia, and nursing researchers. Thematic Framework Analysis resulted in five themes: (1) Access, (2) Expectations, (3) Shaping the collaboration, (4) Linking Pins, and (5) Participation. The findings suggest that care professionals expect support in implementing research results into practice. Researchers should take the lead in shaping the collaboration and create opportunities for stakeholders to get involved.

Development of agroecology in Austria and Germany.

Background: Transforming food systems is necessary to address the global issues of severe biodiversity loss, hunger, and malnutrition as well as the consequences of the rapidly advancing climate change. Agroecology as a systemic approach has been recognised as a promising path of change exemplified in various case studies strengthening this transformation. The aim of this study is to get insight specifically for Austria and Germany in providing an overview of the advancement in agroecology in both countries and identify agroecology-related initiatives. Methods: 21 interviews with experts were conducted to determine the recognition, understanding, and development of agroecology in Austria and Germany in terms of movement, practice, policies, education, and research. In addition, information about agroecology-related initiatives was collected from interviews with 24 representatives of initiatives and literature analysis. Data was analysed according to five activity categories under which agroecology manifest: movement, practice, living lab, science and research infrastructure, and training and education. Results: Results show that the term agroecology is not commonly used in Austria and Germany, where the concept is mainly associated to a scientific discipline. Practices considered agroecological are implemented primarily through organic agriculture, which is very developed in Austria and to a lesser extent in Germany. Many networks, food policy councils, associations, and scientific projects related to agroecology exist, each with specific purposes and ambitions to change farming and food systems. While most selected initiatives do not explicitly refer to agroecology, all follow certain agroecological principles and aim at contributing to accelerate the agroecological transition. Conclusions: Clarifying the concept of agroecology, overcoming economic and political barriers as well as fostering participation of a multitude of stakeholders in the transition is essential for the future development of agroecology in Austria and Germany.

"A living lab within a lab": approaches and challenges for scaling digital public health in resource-constrained settings.

A living lab is an emerging concept, particularly in Europe, as a vehicle to develop digital innovations through a process of co-produced design and development, which takes place, physically and socially, in real-life use contexts. However, there is limited research relating to guiding our understanding of the process by which such labs are established, and digital innovations are co-created and scaled to other settings requiring similar solutions. Furthermore, beyond Europe, the concept of a living lab has not found widespread application in low- and middle-income countries (LMICs), particularly in their public health contexts. Public health systems offer the unique scaling challenge of "all or nothing", implying that data are required from the whole population rather than isolated pilot settings. The living lab approach promises the rich potential to strengthen public systems but comes with twin interconnected challenges. First, for building appropriate digital solutions to address local public health challenges, and second, in scaling them to other public health facilities. This article investigates these twin challenges through ongoing empirical work in India and identifies three key domains of analysis, which are as follows: the first concerns the process of establishing an enabling structure of a "living lab within a lab"; the second concerns leveraging the capabilities offered by free and open-source digital technologies; and the third concerns the driving impetus to scaling through agile and co-constructed technical support.

Innovation through the Quintuple Helix in living labs: lessons learned for a transformation from lab to ecosystem.

Introduction: In the process of growing societies, and especially in the digital era we live in, there is a need for a strong push for innovation that puts citizens at the center of the process from the beginning to build more resilient, cooperative and flexible communities. Different collaborative design approaches have emerged in recent decades, one of the most interesting being Living Labs, which involves user-centered design and co-creative innovation that bring together different actors and roles. However, although these new methodologies are harnessing creativity, some aspects of this new, more ecosystemic and complex vision are not clearly understood: possible barriers, how to facilitate local and operational solutions, overcoming institutional blockage, integrating new roles, etc. Methods: The incorporation of the Quintuple Helix as a driver to ensure greater coordinated participation of local actors has proven its usefulness and impact during the re-adaptation of LifeSpace (previously named Smart House Living Lab), managed by the Polytechnic University of Madrid (Spain), a transformation based on the experiences and lessons learned during the large-scale ACTIVAGE pilot funded by the European Commission, more specifically at the Madrid Deployment Site. It involved more than 350 older adult people and other stakeholders from different areas, including family members, formal and informal caregivers, hospital service managers, third-age associations, and public service providers, forming a sense of community, which was called MAHA. Results: The living lab infrastructure evolved from a single multi-purpose environment to incorporate three harmoniously competing environments: (1) THE LAB: Headquarters for planning, demonstration, initial design phases and entry point for newcomers to the process, (2) THE CLUB: Controlled interaction environment where returning users validate solutions, focusing mainly on AHA services (MAHA CLUB), such as exergames, social interaction applications, brain training activities, etc. (3) THE NEIGHBOURHOOD: Real-life environments for free and open interaction between actors and implementation of previously validated and tested solutions. Conclusion: The Quintuple Helix model applied in LifeSpace's new vision allows a coordinated involvement of a more diverse set of actors, beyond the end-users and especially those who are not traditionally part of research and innovation processes.

Demand response in the workplace: A field experiment.

To increase the share of intermittent renewable energy in our production mix, occupants of buildings can be called upon to lower, anticipate or postpone their consumption according to the network balance. This article presents a small-scale field experiment aimed at introducing demand response in the workplace. We test the impact of load-shedding signals assorted with incentives on the energy consumption of workers in the tertiary sector. Two incentive schemes are tested, namely, an honorary contest and a monetary tournament. The results show a reduction in workers power demand during the load-shedding periods when the incentives are based on the honorary contest. In contrast, the monetary tournament where workers can win money according to their behavior seems to have no impact. The results also suggest that few workers can be responsible for a large part of energy consumption while the building is partially automatically controlled.

Use of a Living Lab Approach to Implement a Smoke-Free Campus Policy.

While universities have increasingly become tobacco-/smoke-free, to our knowledge, no campus has reported 100% policy compliance. Innovative approaches to encourage compliance and ongoing data collection are needed. This paper describes actions undertaken, framed within a Living Lab (LL) approach, to implement smoke-free campus policies in an Irish university. The action research comprised student-collected data on observed smoking on campus to evaluate adherence and compliance, first to a smoke-free zones policy (June 2016-March 2018), and then to a smoke-free campus policy (March 2019-February 2020). From June 2016-February 2020, 2909 smokers were observed. Adherence, defined as the average reduction in number of observed smokers from baseline in May 2016, reduced by 79% from 5.7 to 4.9 . Compliance, defined as the proportion of smokers who complied when reminded of the policy, was 90% (2610/2909). Additional activities included development of a broader health promotion programme; identification of a pattern of 'social smoking'; and promoting increased awareness of the environmental harms of tobacco. Ongoing policy implementation is essential for smoke-free policies and should include data collection and evaluation. Actions framed within the characteristics of a LL achieved fewer observed smokers. A LL approach is recommended to encourage policy adherence and compliance.

Data-Driven Smart Living Lab to Promote Participation in Rehabilitation Exercises and Sports Programs for People with Disabilities in Local Communities.

Patients discharged from hospitals after an inpatient course of medical treatment for any ailment or traumatic injury that results in disabling conditions and are rendered mobility impaired require ongoing systematic sports and exercise programs to maintain healthy lifestyles. Under such circumstances, a rehabilitation exercise and sports center, accessible throughout local communities, is critical for promoting beneficial living and community participation for these individuals with disabilities. An innovative data-driven system equipped with state-of-the-art smart and digital equipment, set up in architecturally barrier-free infrastructures, is essential for these individuals to promote health maintenance and overcome secondary medical complications following an acute inpatient hospitalization or suboptimal rehabilitation. A federally funded collaborative research and development (R&D) program proposes to build a multi-ministerial data-driven system of exercise programs using a smart digital living lab as a platform to provide pilot services in physical education and counseling with exercise and sports programs for this patient population. We describe the social and critical aspects of rehabilitating such a population of patients by presenting a full study protocol. A modified sub-dataset of the previously generated 280-item full dataset is applied using a data-collecting system-"The Elephant"-as an example of how data acquisition will be achieved to assess the effects of lifestyle rehabilitative exercise programs for people with disabilities.

The Integration of Live Video Tools to Help Bystanders During an Emergency Call: Protocol for a Mixed Methods Simulation Study.

BACKGROUND: Early action by bystanders is particularly important for the survival of individuals in need of emergency care, especially those experiencing a cardiac arrest or an airway obstruction. However, only a few bystanders are willing to perform cardiopulmonary resuscitation. The use of a live video during emergency calls appears to have a positive effect on the number of cardiopulmonary resuscitations performed by bystanders. OBJECTIVE: The objective of this study is to propose and evaluate the relevance of a living lab methodology involving video calls in simulated life-threatening emergency situations. METHODS: The first study aimed at analyzing the process of dealing with out-of-hospital cardiac arrest at a dispatch center and identifying the needs of the dispatchers. The second study is a pretest of a living lab. The third study focuses on a living lab in which 16 situations of cardiac arrest and airway obstruction are simulated. The simulation includes both a live video and transmission of a video demonstration of emergency procedures. The measures focus on 3 areas: the impact of video tools, development of collaboration within the community, and evaluation of the method. RESULTS: The results of the first study show that dispatchers have an interest in visualizing the scene with live video and in broadcasting a live demonstration video when possible. The initial results also show that collaboration within the community is enhanced by the shared simulation and debriefing experiences, clarifying regulation procedures, and improving communication. Finally, an iterative development based on the lessons learned, expectations, and constraints of each previous study promotes the existence of a living lab that aims to determine the place of live video tools in the sequence of care performed by dispatchers. CONCLUSIONS: Living labs offer the opportunity to grasp previously undetected insights and refine the use of the applications while potentially developing a sense of community among the stakeholders. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/40699.