Publications by authors named "E M Michiels"

Background: The yeast Saccharomyces cerevisiae, commonly used in industry, exhibits complex metabolism due to the Crabtree effect, fermenting alcohol even under aerobic conditions when glucose exceeds 0.10-0.15 g/L.

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Background: In paediatric palliative care, children with life-threatening and life-limiting conditions, their families, and their health care professionals often face difficult decisions about treatment, goals of care, and delivery of care. Advance care planning and shared decision-making are strategies that can improve quality of care by discussing goals and preferences on future care. In this paper, we provide recommendations that aim to optimise advance care planning and shared decision-making in paediatric palliative care in the Netherlands.

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Background: Children with life-threatening and life-limiting conditions can experience high levels of suffering due to multiple distressing symptoms that result in poor quality of life and increase risk of long-term distress in their family members. High quality symptom treatment is needed for all these children and their families, even more so at the end-of-life. In this paper, we provide evidence-based recommendations for symptom treatment in paediatric palliative patients to optimize care.

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Article Synopsis
  • Shared decision-making (SDM) is a collaborative process where healthcare professionals partner with families to make treatment decisions based on the family's values and care goals.
  • Recent advancements in Dutch pediatric palliative care, like the Individual Care Plan (ICP) and the Evidence-Based Guideline on Pediatric Palliative Care (DGPPC), have spurred increased interest in SDM and Advance Care Planning (ACP).
  • Despite these positive developments, a significant cultural shift is still needed among healthcare providers, moving away from a paternalistic mindset to one that values the input and priorities of families in care decisions.
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Background: Provision of paediatric palliative care for children with life-threatening or life-limiting conditions and their families is often complex. Guidelines can support professionals to deliver high quality care. Stakeholders expressed the need to update the first Dutch paediatric palliative care guideline with new scientific literature and new topics.

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