Conectar
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.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.
A sequential exploratory mixed-method approach.
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.
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.
To identify barriers and gather suggestions for improving attendance from groups least likely to attend services.
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
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.
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.
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.
Incidence and DALYs.
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.
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.
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.
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.
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.
This review protocol has been registered in International Prospective Register of Systematic Reviews (PROSPERO), registration number CRD42025648534.
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