Ethical issues raised by the new orientations in ergonomics and living labs.

User Experience Theory (UXT) provides us with criteria for designing products and technical systems for everyday activities (playing, learning, working,…) so as to satisfy users. Living Labs (LL), are plateforms used for the design and evaluation of technical systems. As such, they constitute tools that bring to this process some constraints., However these constraints have to be articulated to the UXT. In other words, UXT should specify the place, the role and function LL should play in the design of new products, how it should contribute to satisfying UX, and how the methods and techniques should be conceived or borrowed from other disciplines. UXT also raises ethical issues: impartiality (independent, public, replicable) of research models in the context of economical constraints (dependant, private, secret prototypes) and of industrial pressure, the use of intrusive and persuasive techniques, even with the prior informed consent of participants, ergo-marketing, deontology codes, the use of specific participants, belonging of an UX innovative solution, confidentiality with ICT, and so on. Because the UX, as well as LL literature, have shown little concerns for ethical considerations, till now, we define LL-UX ethical issues as a new research topic, and we list a number of problems to be solved in order to have an ethical LL-UX methodology for open innovation.

Ultraflex precision colonic stent placement as a bridge to surgery in patients with malignant colon obstruction.

BACKGROUND: Emergency surgery for malignant colon obstruction entails relatively high morbidity and mortality rates and typically necessitates a 2-step resection. These problems might be potentially mitigated by placement of a self-expanding metal stent (SEMS) as a bridge to surgery. A nitinol colorectal SEMS may offer several advantages, but available evidence on the utility of this SEMS type remains highly limited. OBJECTIVE: Our purpose was to evaluate the effectiveness and safety as a bridge to surgery of a nitinol SEMS designed for colorectal use. DESIGN: Prospective and retrospective multicenter clinical study. SETTING: Sixteen European study centers. PATIENTS: Thirty-six patients with malignant colonic obstruction. INTERVENTIONS: Nitinol colorectal SEMS placement. MAIN OUTCOME MEASURES: Technical success in accurate SEMS placement with coverage of the entire stricture length, clinical success in alleviating colonic obstructive symptoms, and bridging to elective surgery. RESULTS: Technical success was achieved in 97% of patients with a 95% CI of 85% to 100% and clinical success in 81% (95% CI, 64%-92%). Elective surgery was performed in 94% (95% CI, 81%-99%) of patients at a median of 11 days (95% CI, 7-15 days) after SEMS placement. SEMS-related perforation occurred in 3 patients. LIMITATIONS: No control group was included in this nonrandomized cohort study. CONCLUSIONS: In this first comparatively large clinical study of a nitinol colorectal SEMS as a bridge to surgery, a high proportion of patients successfully proceeded to elective surgery after prior decompression by SEMS placement.