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A study protocol for assessing the effects of intangible cultural heritage experiences on human well-being

by Alicia Núñez García, Sofia de la Fuente García, Erfan Lowemi, Masood Masoodian, Renata Vieira, Aurea Rodrigues, Saturnino Luz

Background: While interventions have been designed which use extended reality (XR) technology in promoting physical, mental and social well-being through cultural heritage experiences, well-defined methodologies for the assessment of such interventions is lacking. Objectives: We present a protocol for evaluating the usability and effectiveness of an XR system that mediates and facilitates access to intangible cultural heritage experiences. We aim to assess the effects of these experiences on user well-being and attitudes across four case studies: ageing societies, sustainable tourism, disappearing communities, and immigration and multiculturalism. Methods and analysis: Participants will be randomly assigned to control or intervention groups. The effects of the XR intervention on well-being will be assessed through statistical analysis of the participants’ salivary cortisol and cortisone levels, physiological signals, and subjective ratings, both pre- and post-intervention and between control and intervention groups. Usability will be measured through a system usability scale. Speech will be recorded for qualitative and natural language processing analysis. Machine learning models will be developed for prediction of affect and well-being on multimodal data. Discussion: This is one of the first international and multidisciplinary studies to explore the effects of XR-mediated intangible cultural heritage experiences on well-being and attitudes towards issues of societal importance. One of the main strengths of this study is the range of data modalities it collects, and the range of methods it employs to analyse these data in a complementary manner, including qualitative, statistical and advanced machine learning methods. Conclusion: This protocol offers a method and four case studies to assess the potential of immersive XR experiences and interventions of intangible cultural heritage as contributors to increased well-being and as actors of societal change. It stands as a reference model for further similar interventions in the field.

Rapid sequential mixed-method study to identify barriers and explore solutions for improving equitable access to community-based eye care services in Uttar Pradesh, India

Por: Sabherwal · S. · Allen · L. · Javed · M. · Mazumdar · A. · Thaker · N. · Tlhajoane · M. · Rathore · D. · Singh · A. · Sood · I. · Bastawrous · A.
Objective

In low-income and middle-income countries, significant geographical and socioeconomic inequalities affect access to eye care. This study explores an equity-focused approach to improve access to eye care services provided by a community-based eye care organisation in northern India.

Design

A sequential exploratory mixed-method approach.

Setting

A high-volume eye screening programme in north Indian villages. Individuals identified with eye care needs during the screening were referred to the six nearby primary eye care centres.

Participants

7578 individuals identified with eye needs through a community-based eye screening programme. Of these, 4431 (58.6%) were women and 3137 (41.4%) were men.

Socioeconomic questions, developed by experts and lay representatives, were integrated into an ongoing digitally supported (Peek Vision) eye screening programme in north Indian villages. Data from referred individuals identified with eye needs were analysed using logistic regression with a mixed-effect model to identify socioeconomic characteristics most strongly associated with poor access to care after referral. A sequential exploratory mixed-method approach, including in-person interviews and follow-up telephonic surveys of individuals with these characteristics, was used.

Outcome

To identify barriers and gather suggestions for improving attendance from groups least likely to attend services.

Results

Of 7627 individuals referred for eye care, 7578 (99.3%) participated in the study. Of those, 2937 (38.5%) attended the Vision Centre, to which they were referred. The least likely to attend were individuals aged >16, those with dependents, and those referred for non-cataract conditions. Among the 3939 individuals with all three characteristics, the attendance rate was 35.3% compared with 42.5% (p

Conclusion

Suggested programme improvements, including better counselling, reminder calls and transportation, could increase access among those least likely to access services after referral. This study demonstrates a two-step approach for identifying solutions from individuals facing the most significant barriers to care. We will go on to conduct trials of these suggested interventions.

In Vitro, In Vivo, and Clinical Trial Approaches to Investigate the Effects of Medicinal Plants on Burn Wound Healing: A Systematic Review

ABSTRACT

Use of synthetic drugs for the treatment of burn wounds has decreased due to adverse effects, and they are gradually being replaced by compounds obtained from natural products, especially medicinal plants. This review focused on pre-clinical and clinical studies examining the efficacy of medicinal plants in promoting burn wound healing. This systematic review was performed congruent with the guidance delineated in the PRISMA statement. Databases such as PubMed, Scopus, Embase and Web of Science, along with the search engines Google Scholar and Google, were utilised to retrieve published literatures from 2000 to 2023. Articles were screened according to the determined criteria and appraised using primary evaluation checklists. A total of 108 published articles met the eligibility criteria and were selected for discussion. Of these, 72 were in vivo studies, 28 were in vitro studies and 8 were clinical trials. Various medicinal plants discussed in this review improve the burn wound healing process due to the presence of diverse biological compounds with antioxidant, anti-inflammatory and antibacterial properties. These plants affect the four phases of wound healing. These plant species and their compounds could be potentially used for the development of effective natural remedies against burn wounds.

Exploring levels and factors associated with transition challenges for Syrian refugee parents resettled in Canada

by Hala Tamim, Elena Levitskaya, MacGregor Goodman, Gwen Ehi, Aliza Maqsood, Safoura Zangiabadi, Yunis Khaled

Although the literature has documented numerous challenges Syrian refugees face during their resettlement in Canada, the unique transition experiences of Syrian refugee parents remain underexplored. This study examines demographic, community and social, migration, and health-related factors that influence the level of difficulty experienced by Syrian refugee parents in Canada during their transition. This cross-sectional, interview-based study was conducted from March 2021 to March 2022, involving 540 Syrian refugee parents in Ontario with at least one child under the age of 18. Transition difficulty was measured based on the question “How difficult has the transition into Canada been for you?” Responses ranged from 1 representing “Not difficult at all” and 5 representing “Very difficult”. 6.5% of participants rated their transition as “Not difficult at all”, 15.9% as “Not difficult, “20.6% as “Neutral”, 43% as “Difficult”, and 13.7% as “Very difficult”. Results of the multiple linear regression analyses indicated that greater transition difficulty was significantly associated with experiences of discrimination at children’s school events (Adjβ = 0.138, p = 0.038), dissatisfaction with friendships (Adjβ = 0.134, p = 0.006), being over age 45 (Adjβ = 0.301, p = 0.047), lower proficiency in English or French (Adjβ = − 0.145, p = 0.008), longer duration spent in Canada (Adjβ = 0.123, p 

Time trend and geographical distribution of major depressive disorder in Iran, 1990 to 2021: results from the Global Burden of Disease Study

Objective

Major depressive disorder (MDD) is a disabling disease and is recognised as a serious, public health concern. In this study, we aimed to determine the burden and trends of MDD in Iran.

Design and participants

Secondary data from the Global Burden of Disease study were used to analyse the time trend and geographical distribution of age-standardised rate incidence and disability-adjusted life years (DALYs) of MDD from 1990 to 2021 by sex and province, in Iran. Join point regression and ArcGIS software were used for these estimations.

Main outcomes and measures

Incidence and DALYs.

Results

The trend analysis from 1990 to 2021 generally showed an increasing trend of incidence and DALYs. The highest annual percent change (APC) for incidence (6.594 95% UI: 3.727, 9.473) and DALYs (6.396 95% UI: 3.552, 9.286) of MDD in Iran was observed from 2019 to 2021 segment. Also, the geographical distribution analysis showed that the highest average annual percent change (AAPC) for incidence and DALYs of MDD in both sexes was, respectively, in Kurdistan province (0.774; [95% UI: 0.619, 0.976] and Yazd province (0.760; [95% UI: 0.601, 0.918]). Finally, the highest incidence and DALYs for MDD in 2021 were in Kerman and Fars provinces and the lowest in East Azarbayejan, Lorestan, Hamedan, Chahar Mahal and Bakhtiari, Golestan and Khorasan-e-Razavi provinces.

Conclusion

The findings of this study indicate an increasing trend in the burden of MDD in Iran and show the necessity of creating national policies and preventive and therapeutic measures for mental health disorders in the population.

Effectiveness of vaccination in patients undergoing dialysis or patients with chronic kidney disease: a systematic review protocol

Por: Karim · M. · Milone · B. · Buh · A. · Wisener · N. · Benomar · C. · Mei Nsen · P. · Akbari · A. · Brown · P. A. · Hundemer · G. L. · Sood · M.
Introduction

Vaccination has been an effective public health intervention for immunising individuals against many common communicable and non-communicable diseases. However, there is limited information on the efficacy of vaccination among patients undergoing dialysis or patients with chronic kidney disease (CKD). The objective of this review is to assess the effectiveness of vaccination within dialysis and CKD patient populations.

Methods and analysis

This will be a systematic review of studies assessing the effectiveness of vaccination among CKD and dialysis patients. Relevant studies will be identified using MEDLINE, Embase, Scopus and Cochrane Library. All searches will be conducted from database inception to October 2025. Only observational studies such as cohort, prospective, retrospective and cross-sectional studies will be included. Data pertaining to patient outcomes and study design will be extracted. A narrative synthesis will be conducted as well as a meta-analysis if data permitting this analysis is extracted from included studies.

Ethics and dissemination

Since data collection will be conducted by examining existing studies, no ethical approval or consent will be required. The results of this review will be published in a peer-reviewed journal as well as presented at seminars, conferences and symposiums.

Trial registration number

This review protocol has been registered in International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42025648534.

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