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Chronic wounds commonly decrease patients' quality of life. Understanding how chronic wounds impact a patient's health‐related quality of life (HRQoL) is important for healthcare service delivery and treatment management. This study explored HRQoL among patients suffering from chronic wounds and investigated associations with patients' socio‐demographics and wound characteristics. Two hundred and thirty‐three patients across six primary care clinics were assessed and responded to a survey that collected information on socio‐demographic, wound characteristics, and HRQoL using the EQ‐5D‐5L instrument. Data were analysed by descriptive statistics and generalised linear models. The mean age of patients was 61.2 (SD: 14.6) years; 68.2% were males; and 61.8% were of Chinese origin. Arterial ulcers had the greatest negative impact on HRQoL related to mobility, self‐care, pain/discomfort and anxiety/depression, and the lowest VAS mean score 62.31 (SD: 28.3; range: 0‐100) indicating the worst health. HRQoL related to mobility was significantly associated with age (β = 0.008, P < .001), non‐Chinese ethnicity (β = 0.25, P = .001), mixed ulcers (β = −0.41, P = .022), atypical hard‐to‐heal wounds (β = −0.38, P = .021), wounds with low (β = 0.24, P = .044) to moderate (β = 0.29, P = .018) exudate level, and a wound duration ≥6 months (β = 0.19, P = .033). The findings can be used to improve healthcare delivery for patients with chronic wound to optimise their HRQoL.

The multiple benefits of ‘nature’ for human health and well‐being have been documented at an increasing rate over the past 30 years. A growing body of research also demonstrates the positive well‐being benefits of nature‐connectedness. There is, however, a lack of evidence about how people's subjective nature experience relates to deliberately designed and managed urban green infrastructure (GI) with definable ‘objective’ characteristics such as vegetation type, structure and density. Our study addresses this gap. Site users (n = 1411) were invited to walk through woodland, shrub and herbaceous planting at three distinctive levels of planting structure at 31 sites throughout England, whilst participating in a self‐guided questionnaire survey assessing reactions to aesthetics, perceived plant and invertebrate biodiversity, restorative effect, nature‐connectedness and socio‐demographic characteristics. There was a significant positive relationship between perceived naturalness and planting structure. Perceived naturalness was also positively related to the perceived plant and invertebrate biodiversity value, participants’ aesthetic appreciation and the self‐reported restorative effect of the planting. A negative relationship was recorded between perceived naturalness and perceived tidiness and care. Our findings showed that participants perceived ‘naturalness’ as biodiverse, attractive and restorative, but not necessarily tidy. Perceived naturalness was also related to participants’ educational qualifications, gender and nature‐connectedness, with women and more nature‐connected participants perceiving significantly greater levels of naturalness in the planting. These findings are highly significant for policymakers and built environment professionals throughout the world aiming to design, manage and fund urban GI to achieve positive human health and biodiversity outcomes. This applies particularly under austerity approaches to managing urban green spaces where local authorities have experienced cuts in funding and must prioritise and justify GI maintenance practices and regimes. A plain language summary is available for this article. Plain Language Summary

The aim of this study was to analyze and describe the sociodemographic and psychosocial profile, also to identify the risk of injury of a contemporary sample of Spanish amateur endurance runners regarding individual variables, training volume and personality. A total of 147 endurance runners (114 males and 33 females; age: 42.66 ± 11.54 years old; BMI: 22.83 ± 2.47 kg/m2) completed an ad hoc questionnaire designed for athletes older than 18 years old. Significant differences (p<0.001) were observed for the fact of having a personal trainer, with women reporting a higher percentage than men. Most of the athletes (68%) have been injured in the last 3 years, and no significant differences between sexes were found. The profile of the endurance runner is a normotypical 40-year-old male with some anxiety and low mood, who has studied at the university, he/she is married or has a couple. He has been training for 16 years, doing 51 kilometers per week, joining 12 annual competitions, and has been injured 2 times in the last 3 years. The most common injury is tendonitis, being the causes of injuries found in this study the footwear and the personal goal achievement. Keywords: Endurance athletes, runners, injuries, socio-demographics    

•COVID-19 vaccine willingness in Flanders (Belgium) was high: 84.2%.•Though we observed significant variations over time (July-December 2020).•We found multiple vaccine-hesitant spatial clusters, mostly at the Flemish borders.•Many socio-demographic and behavioural factors associated with vaccine willingness. A year after the start of the COVID-19 outbreak, the global rollout of vaccines gives us hope of ending the pandemic. Lack of vaccine confidence, however, poses a threat to vaccination campaigns. This study aims at identifying individuals’ characteristics that explain vaccine willingness in Flanders (Belgium), while also describing trends over time (July–December 2020). The analysis included data of 10 survey waves of the Great Corona Survey, a large-scale online survey that was open to the general public and had 17,722–32,219 respondents per wave. Uni- and multivariable general additive models were fitted to associate vaccine willingness with socio-demographic and behavioral variables, while correcting for temporal and geographical variability. We found 84.2% of the respondents willing to be vaccinated, i.e., respondents answering that they were definitely (61.2%) or probably (23.0%) willing to get a COVID-19 vaccine, while 9.8% indicated maybe, 3.9% probably not and 2.2% definitely not. In Flanders, vaccine willingness was highest in July 2020 (90.0%), decreased over the summer period to 80.2% and started to increase again from late September, reaching 85.9% at the end of December 2020. Vaccine willingness was significantly associated with respondents’ characteristics: previous survey participation, age, gender, province, educational attainment, household size, financial situation, employment sector, underlying medical conditions, mental well-being, government trust, knowing someone with severe COVID-19 symptoms and compliance with restrictive measures. These variables could explain much, but not all, variation in vaccine willingness. Both the timing and location of data collection influence vaccine willingness results, emphasizing that comparing data from different regions, countries and/or timepoints should be done with caution. To maximize COVID-19 vaccination coverage, vaccination campaigns should focus on (a combination of) subpopulations: aged 31–50, females, low educational attainment, large households, difficult financial situation, low mental well-being and labourers, unemployed and self-employed citizens.

Introduction Somatic mutation testing in solid tumours represents a rapidly advancing field which increases opportunities for access to molecularly targeted therapeutics and clinical trials. This systematic review determined whether socio‐demographic inequalities affect utilisation of novel somatic mutation testing. Methods Following PRISMA 2020 guidance, MEDLINE, EMBASE, Scopus, CINAHL, Web of Science, PubMed and PsycINFO were searched for peer‐reviewed studies (January 2018–March 2025). Data was extracted reporting utilisation of novel somatic mutation testing panels, including Oncotype DX, for solid tumours by socio‐demographic measures. A modified International Society for Pharmacoeconomics and Outcomes Research (ISPOR) checklist assessed study quality. Unadjusted odds ratios (ORs) and 95% confidence intervals (CIs) were calculated where needed and narrative synthesis undertaken. Data was stratified by receipt of Oncotype DX testing and next‐generation sequencing (NGS) panels. Results The 27,749 citations screened identified 24 studies meeting the inclusion criteria. These reported on two modalities of testing (Oncotype DX and other NGS sequencing panels) across five cancers. Twenty‐three studies were from US populations. These highlighted disparities in utility of testing across socio‐demographic measures and particularly decreased utilisation with increased age, non‐white ethnicity, lower socio‐economic status, and non‐private insurance. The mean study quality score by a modified ISPOR checklist was 8.3/10. Conclusion These results provide a contemporary update on evidence of disparities in access to novel genomic testing. As an expanding field, this requires further investigation to prevent accentuations in inequitable implementation of precision oncology and differences in outcomes between different socio‐demographic groups. This systematic review investigates whether inequalities exist in the utilisation of tumour and ctDNA somatic mutation testing in solid tumours. The review concludes that, across tumour types, testing modalities and socio‐demographic factors, inequalities exist and require further exploration.

Objective This study aimed to provide population-level data regarding trends in multimorbidity over 13 years. Methods We linked provincial health administrative data in Ontario, Canada, to create 3 cross-sectional panels of residents of any age in 2003, 2009, and 2016 to describe: (i) 13-year trends in multimorbidity prevalence and constellations among residents and across age, sex, and income; and (ii) chronic condition clusters. Multimorbidity was defined as having at least any 2 of 18 selected conditions, and further grouped into levels of 2, 3, 4, or 5 or more conditions. Age-sex standardized multimorbidity prevalence was estimated using the 2009 population as the standard. Clustering was defined using the observed combinations of conditions within levels of multimorbidity. Results Standardized prevalence of multimorbidity increased over time (26.5%, 28.8%, and 30.0% across sequential panels), across sex, age, and area-based income. Females, older adults and those living in lower income areas exhibited higher rates in all years. However, multimorbidity increased relatively more among males, younger adults, and those with 4 or 5 or more conditions. We observed numerous and increasing diversity in disease clusters, namely at higher levels of multimorbidity. Conclusion Our study provides relevant and needed population-based information on the growing burden of multimorbidity, and related socio-demographic risk factors. Multimorbidity is markedly increasing among younger age cohorts. Also, there is an increasing complexity and lack of common clustering patterns at higher multimorbidity levels.

ObjectivesComorbidity in traumatic brain injury (TBI) has been recognised to alter the clinical course of patients and influence short-term and long-term outcomes. We synthesised the evidence on the effects of different comorbid conditions on early and late mortality post-TBI in order to (1) examine the relationship between comorbid condition(s) and all-cause mortality in TBI and (2) determine the influence of sociodemographic and clinical characteristics of patients with a TBI at baseline on all-cause mortality.DesignSystematic review.Data sourcesMedline, Central, Embase, PsycINFO and bibliographies of identified articles were searched from May 1997 to January 2019.Eligibility criteria for selecting studiesIncluded studies met the following criteria: (1) focused on comorbidity as it related to our outcome of interest in adults (ie, ≥18 years of age) diagnosed with a TBI; (2) comorbidity was detected by any means excluding self-report; (3) reported the proportion of participants without comorbidity and (4) followed participants for any period of time.Data extraction and synthesisTwo independent reviewers extracted the data and assessed risk of bias using the Quality in Prognosis Studies tool. Data were synthesised through tabulation and qualitative description.ResultsA total of 27 cohort studies were included. Among the wide range of individual comorbid conditions studied, only low blood pressure was a consistent predictors of post-TBI mortality. Other consistent predictors were traditional sociodemographic risk factors. Higher comorbidity scale, scores and the number of comorbid conditions were not consistently associated with post-TBI mortality.ConclusionsGiven the high number of comorbid conditions that were examined by the single studies, research is required to further substantiate the evidence and address conflicting findings. Finally, an enhanced set of comorbidity measures that are suited for the TBI population will allow for better risk stratification to guide TBI management and treatment.PROSPERO registration numberCRD42017070033

PurposeThe widespread dietary adoption of cultured meat could provide important benefits to animal welfare, the environment, food safety and security. This study examines consumer segmentation and consumer motives for choice of cultured meat in China.Design/methodology/approachThe data were collected by means of a web-based questionnaire (n = 608) distributed in the two cites of Shanghai and Chengdu. Factor analysis, cluster analysis and path analysis were employed for data analysis.FindingsThree consumer segments were identified with regard to the acceptance of cultured meat in China: Conservatives (25.7%), Acceptors (41.9%) and Pioneers (32.4%). Significant differences were recognised in age, household income, education and household size between the three consumer segments. The following meat choice motives (MCMs) have significant influences on Chinese participants’ attitudes and/or purchase intentions towards cultured meat: usually eat, environmental concern, societal concern, mood, purchase convenience and price.Originality/valueThis is the first study to develop a factorial construct of MCMs based on a previous theoretical model of food choice motives (FCMs) in China. The study contributes understanding of choice motives for cultured meat in a non-Western setting, particularly in China - the country consuming the largest quantity of pork. Further, this is the first study to recognise segments that are directly based on consumer attitudes and purchase intentions towards cultured meat. The findings of this study will help global producers and policymakers to create effective promotion strategies and policies for this innovative product in developing countries, particularly in China.

Purpose – The purpose of this paper is to analyze the barriers perceived by consumers to lowering their meat consumption levels and adopting a plant-based diet, which means a diet that includes mainly non-meat foods, yet it can contain both vegetarian and meat meals. Design/methodology/approach – The prevalence of different barriers for following a plant-based diet is addressed, as well as consumer profiles considering socio-demographics, values and meat consumption frequencies. The data were collected in 2010 by a survey questionnaire, sent to 4,000 randomly selected Finns (response rate=47.3, n=1,890). Findings – Different types of barriers are perceived to hinder the adoption of a plant-based diet, including meat enjoyment, eating routines, health conceptions and difficulties in preparing vegetarian foods. These barriers are strongly correlated, indicating that consumers may not make qualitative difference between different barriers. Furthermore, there are distinct socio-demographic, value and especially meat consumption frequency elements that strengthen the barrier perception, these being male gender, young age, rural residence, household type of families with children, low education, absence of a vegetarian family member or friend, valuation of traditions and wealth and high meat consumption frequency. Social implications – High meat consumption is related to many environmental and public health problems. The results call for multifaceted policy implications that should concentrate on different barriers and certain socio-demographic, value and meat eating groups. Importantly, focus should be not only on the group with the strongest barrier perception but also on those particularly willing to make changes in their meat consumption patterns. One practical implication could be to increase the availability of vegetarian foods in public cafeterias or school canteens, as a decrease in meat consumption frequency is strongly correlated with the alleviation of the barrier perception. Originality/value – Information about differences in socio-demographics, values and meat consumption frequencies between consumers provide opportunities for focussing policy actions to aid the adoption of a plant-based diet.

Purpose Although shopping well-being has become a focal construct in retail shopping studies, little is known about the key drivers of this construct. This study aims to further discern some of the key antecedents of shopping well-being by particularly focusing on the role of congruity. Furthermore, the study explores whether shoppers’ demographic characteristics moderate the effects of congruity on shopping well-being. Design/methodology/approach Data were collected from a survey of actual shoppers in two urban Canadian shopping malls via a mall intercept. Structural equation modeling using SmartPLS was conducted to validate the study’s model. Findings Functional congruity has a stronger effect than self-congruity on shopping well-being. Shoppers’ demographic variables do not generally act as moderators in the investigated linkages. Practical implications This study can help mall managers formulate better marketing programs that would ultimately enhance shopping well-being. Originality/value The study advances the retailing literature by putting forward a conceptual model that remedies identified shortcomings related to functional and self-congruity and establishes new linkages between functional congruity, self-congruity and shopping well-being. Furthermore, the study explores whether shoppers’ demographic variables moderate the effects of functional and self-congruity on shopping well-being.