Risk factors for gastrointestinal bleeding in patients with gastrointestinal cancer using edoxaban

Background In the Hokusai VTE Cancer study, the risk of major bleeding was 2.9% higher in the edoxaban group compared with the dalteparin group, mainly due to more gastrointestinal bleedings in patients with gastrointestinal cancer. The identification of risk factors for gastrointestinal bleeding may help to guide the use of DOACs in these patients. Objectives To evaluate risk factors for gastrointestinal bleeding in patients with gastrointestinal cancer receiving edoxaban. Patients/Methods In this nested case-control study in patients with gastrointestinal cancer randomized to edoxaban in the Hokusai VTE Cancer study, cases (patients with clinically relevant gastrointestinal bleeding during treatment) were randomly matched to three controls (patients who had no gastrointestinal bleeding). Data for the 4-week period prior to bleeding were retrospectively collected. Odds ratios (ORs) were calculated in a crude conditional logistic regression model and a multivariable model adjusted for age, sex, and cancer type. Results Twenty-four cases and 64 matched controls were included. In the multivariable analysis, advanced cancer, defined as regionally advanced or metastatic cancer (OR 3.6, 95% CI 1.01-12.6) and low hemoglobin levels (OR 4.8, 95% CI 1.5-16.0) were significantly associated with bleeding. There was no significant difference in patients with resected tumors (OR 0.4, 95% CI 0.1-1.4), or in patients on chemotherapy (OR 1.3, 95% CI 0.5-3.5). Conclusion Advanced cancer and low hemoglobin levels were associated with an increased risk of gastrointestinal bleeding in patients with gastrointestinal cancer receiving edoxaban. We were unable to identify other risk factors, mainly due to limited statistical power.Thrombosis and Hemostasi

The complexity of consumer attitudes towards sustainable alternatives

We need a systemic transformation of our way of life to limit climate change and stay within the planetary boundaries. Individuals play an important role in this transition, for example through their consumption choices. Consumers accepting and adopting sustainable alternatives over conventional products is crucial in creating market pull and driving widespread availability. However, green purchasing behaviour is very complex and influenced by a range of psychological and situational factors. In this dissertation, I took a multi-method and often descriptive approach to better understand the perceptions of and attitude towards two types of sustainable alternatives: bio-based plastic (Chapters 2-4) and a modular smartphone (Chapter 5). One of the ways I did this was by using a network approach that visualises people’s attitudes towards the attitude object or behaviour of intertest. Overall, this thesis demonstrates an apparent consumer demand for bio-based bottles and sustainable smartphones. Participants consistently had positive attitudes towards these products and indicated purchase intentions and a willingness to pay a price premium. However, they also displayed a general lack of knowledge about these sustainable alternatives. This research exemplifies the complexity of attitudes and perceptions towards sustainable alternatives, as a great variety of factors were related to purchase intentions. While this complexity is daunting, the fact that so many factors are relevant illustrates that there are many ways to reach the goal of more sustainable consumption

The complexity of consumer attitudes towards sustainable alternatives

We need a systemic transformation of our way of life to limit climate change and stay within the planetary boundaries. Individuals play an important role in this transition, for example through their consumption choices. Consumers accepting and adopting sustainable alternatives over conventional products is crucial in creating market pull and driving widespread availability. However, green purchasing behaviour is very complex and influenced by a range of psychological and situational factors. In this dissertation, I took a multi-method and often descriptive approach to better understand the perceptions of and attitude towards two types of sustainable alternatives: bio-based plastic (Chapters 2-4) and a modular smartphone (Chapter 5). One of the ways I did this was by using a network approach that visualises people’s attitudes towards the attitude object or behaviour of intertest. Overall, this thesis demonstrates an apparent consumer demand for bio-based bottles and sustainable smartphones. Participants consistently had positive attitudes towards these products and indicated purchase intentions and a willingness to pay a price premium. However, they also displayed a general lack of knowledge about these sustainable alternatives. This research exemplifies the complexity of attitudes and perceptions towards sustainable alternatives, as a great variety of factors were related to purchase intentions. While this complexity is daunting, the fact that so many factors are relevant illustrates that there are many ways to reach the goal of more sustainable consumption

Organizations can make a real impact on sustainable development

Organizations are instrumental in addressing socio-environmental crises and achieving the UN Sustainable Development Goals. In this issue of One Earth, Sharpe et al. show that organizational commitments to sustainability can reinforce pro-environmental motivation and behavior at work. Here, we expand on key behaviors, motives, and barriers for how organizations can reduce their environmental impact

(Not) Doing the Right Things for the Wrong Reasons: An Investigation of Consumer Attitudes, Perceptions, and Willingness to Pay for Bio-Based Plastics

Fossil-based plastics are significant contributors to global warming through CO2 emissions. For more sustainable alternatives to be successful, it is important to ensure that consumers become aware of the benefits of innovations such as bio-based plastics, in order to create demand and a willingness to initially pay more. Given that consumer attitudes and (inaccurate) beliefs can influence the uptake of such new technologies, we investigated participants’ attitudes towards fossil-based and bio-based plastic, their perceived importance of recycling both types of plastic, their willingness to pay, and their perceptions of bio-based plastic in four studies (total N = 961). The pre-registered fourth study experimentally manipulated information about bio-based plastic and measured willingness to pay for different types of plastic. The results suggest participants hold very favourable attitudes and are willing to pay more for bio-based products. However, they also harbour misconceptions, especially overestimating bio-based plastic’s biodegradability, and they find it less important to recycle bio-based than fossil-based plastic. Study 4 provided evidence that educating consumers about the properties of bio-based plastic can dispel misconceptions and retain a favourable attitude and a high willingness to pay. We found mixed evidence for the effect of attitudes on willingness to pay, suggesting other psychological factors may also play a role. We discuss how attitudes and misconceptions affect the uptake of new sustainable technologies such as bio-based plastics and consumers’ willingness to purchase them