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Objective: To evaluate self‐reported substance user profiles for individuals with migraine and compare these to the general population. Background: There is increasing attention to lifestyle influences such as substance use as presumed migraine triggers. Methods: Data on substance use were collected by survey in a large migraine cohort and from the biannual survey in the general Dutch population for substances. A representative cohort of Dutch patients with migraine (n = 5176) and the Dutch general population (n = 8370) was included. Patients with migraine were subdivided into episodic (EM) and chronic migraine (CM). Substance consumption was compared between the general population and patients with migraine, and between migraine subgroups after standardization for sex and level of education. Results: Included patients with migraine were 83.4% female (4319/5176) and had a mean (standard deviation) age of 44.8 (11.3) years. Patients with migraine reported less illicit drug use (odds ratio [OR] 0.48, 95% confidence interval [CI] 0.42–0.55; p < 0.001), less current and lifetime smoking (OR 0.60, 95% CI 0.55–0.65; p < 0.001 and OR 0.75, 95% CI 0.71–0.79; p < 0.001), and less current alcohol consumption (OR 0.66, 95% CI 0.62–0.70; p < 0.001) compared with the general population. Prevalence of substance use was compared between CM and EM participants and showed higher illicit drug use (OR 1.73, 95% CI 1.11–2.69; p = 0.011), higher current smoking (OR 1.61, 95% CI 1.22–2.11; p < 0.001) but less alcohol use (OR 0.54, 95% CI 0.43–0.68; p < 0.001) for participants with CM compared with EM. No differences were found for a history of smoking (OR 1.18, 95% CI 0.92–1.50, p = 0.19). Conclusions: Individuals with migraine are less likely to use illicit drugs, smoke, or drink alcohol compared with the general population. Patients with CM less often consume alcohol, while they more often use illicit drugs and smoke compared to those with EM. [ABSTRACT FROM AUTHOR]

Aims: Knowledge about adverse drug events caused by drug–drug interactions (DDI‐ADEs) is limited. We aimed to provide detailed insights about DDI‐ADEs related to three frequent, high‐risk potential DDIs (pDDIs) in the critical care setting: pDDIs with international normalized ratio increase (INR+) potential, pDDIs with acute kidney injury (AKI) potential, and pDDIs with QTc prolongation potential. Methods: We extracted routinely collected retrospective data from electronic health records of intensive care units (ICUs) patients (≥18 years), admitted to ten hospitals in the Netherlands between January 2010 and September 2019. We used computerized triggers (e‐triggers) to preselect patients with potential DDI‐ADEs. Between September 2020 and October 2021, clinical experts conducted a retrospective manual patient chart review on a subset of preselected patients, and assessed causality, severity, preventability, and contribution to ICU length of stay of DDI‐ADEs using internationally prevailing standards. Results: In total 85 422 patients with ≥1 pDDI were included. Of these patients, 32 820 (38.4%) have been exposed to one of the three pDDIs. In the exposed group, 1141 (3.5%) patients were preselected using e‐triggers. Of 237 patients (21%) assessed, 155 (65.4%) experienced an actual DDI‐ADE; 52.9% had severity level of serious or higher, 75.5% were preventable, and 19.3% contributed to a longer ICU length of stay. The positive predictive value was the highest for DDI‐INR+ e‐trigger (0.76), followed by DDI‐AKI e‐trigger (0.57). Conclusion: The highly preventable nature and severity of DDI‐ADEs, calls for action to optimize ICU patient safety. Use of e‐triggers proved to be a promising preselection strategy. [ABSTRACT FROM AUTHOR]

The combined use of the bicycle and the train in the Netherlands has risen steadily over the past decade. However, little is yet known about the underlying processes driving the growth of bike–train use in the Netherlands. Are new bike–train trips replacing car trips, or are they primarily an extension of existing train travel and cycling practices? The present study investigates this question by exploring the main trajectories of bike–train uptake in the Randstad area. Following a mobility biographies approach, our study seeks to identify the triggers or "key events" which lead to the uptake of bike–train use, and explores their relationship with existing travel behaviour. To this end, we carried out an online survey aimed at people who started commuting regularly by bike–train. Our results show that trajectories of uptake are varied, with a similar proportion of respondents starting to commute by bike–train in order to replace cycling, driving and public transport. While in some cases people shifted to bike–train on their existing commuting trip, most respondents started travelling by bike–train following a change in work or residential location. Overall, our findings suggest that most people do not start commuting by bike–train out of particular preference, but merely because they consider it provides the best available option. Nevertheless, the large proportion of respondents with access to a car suggests that the bike–train system is able to provide an attractive alternative to car-based interurban mobility. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to assess whether migraine-related outcomes changed during intelligent lockdown when compared with the prior period. Methods: This was a cohort study evaluating the first month of intelligent lockdown in the Netherlands (12 March to 8 April 2020) compared with one baseline month (13 February to 11 March 2020). We identified 870 migraine patients treated at the Leiden Headache Center with headache e-diaries during the period of interest. Adherence to the e-diary had to be ≥80%, yielding 592 enrolled patients. Results: Intelligent lockdown led to a decrease in monthly migraine days (−0.48; 95% CI: −0.78 to −0.18, p = 0.002) and acute medication days (−0.48; 95% CI: −0.76 to −0.20, p < 0.001), and an increase in general well-being (0.11; 95% CI: 0.06 to 0.17, p < 0.001). No differences in non-migrainous headache days and pain coping were observed. Consistent results were found in a subset that was followed for 4 months. Conclusions: Our findings imply that intelligent lockdown measures can improve migraine disability despite of the potential negative effects of COVID-19 and lockdown. We hypothesise that this effect is a combined result of working from home, scaling down demanding social lives, and freedom to choose how to organise one's time. [ABSTRACT FROM AUTHOR]

Although companies have shown a growing awareness of the importance of Corporate Sustainability (CS), integration of CS into their business activities is still problematic. Most of the CS research focuses on large corporations, with limited discussions of Small and Medium Sized Enterprises (SMEs). Research on SMEs has shown that most CS activities have been developed in isolation, and have not yet been totally integrated into the business activities. This research aims to understand how SMEs integrate CS into their business activities. Eighteen SMEs were analysed. These SMEs were, on their explicit request, supported in enhancing the integration of CS into their business activities. The external change agents connected to this consultancy firm applied four CS integration tools, which was based on their own experience in supporting the integration of CS in companies. The data generated through the application of these tools gives this research a specific, external change agent perspective that contributes to the understanding of CS integration. Tables including the tool data of all companies were used to analyse all eighteen cases as well as to enable a cross case comparison. The data showed that a balance proved to be necessary between a physical and social focus in the SMEs' vision on CS, the CS integration activities, the conditions for the CS change agent and the CS assessment. The research also found that although companies in a more advanced CS growth stage have more management system certifications, the management system itself is not used to ensure CS integration. [ABSTRACT FROM AUTHOR]