European Society of Intensive Care Medicine guidelines on end of life and palliative care in the intensive care unit.

The European Society of Intensive Care Medicine (ESICM) has developed evidence-based recommendations and expert opinions about end-of-life (EoL) and palliative care for critically ill adults to optimize patient-centered care, improving outcomes of relatives, and supporting intensive care unit (ICU) staff in delivering compassionate and effective EoL and palliative care. An international multi-disciplinary panel of clinical experts, a methodologist, and representatives of patients and families examined key domains, including variability across countries, decision-making, palliative-care integration, communication, family-centered care, and conflict management. Eight evidence-based recommendations (6 of low level of evidence and 2 of high level of evidence) and 19 expert opinions were presented.

Patient safety incidents in paediatric radiology: how to care for the professional?

Patient safety incidents in paediatric radiology have profound impacts not only on the patient and their family, but also on the well-being and professional practice of healthcare professionals. These incidents, which range from procedural and diagnostic incidents to serious adverse events leading to harm or even death of the patient, may evoke feelings of distress, guilt, and anxiety among paediatric radiologists (in-training), ultimately affecting their confidence and ability to deliver high-quality care. Recognizing the importance of addressing these challenges, healthcare organizations should implement strategies to support professionals in coping with and learning from these incidents.

An Interprofessional Faculty Development Program for Workplace-Based Learning.

Background: Most faculty development programs in health professions education, pivotal in cultivating competent and effective teachers, focus on systematic, planned and formal learning opportunities. A large part of clinical teaching however, encompasses ad-hoc, informal and interprofessional workplace-based learning whereby individuals learn as part of everyday work activities. To fully harness the educational potential embedded in daily healthcare practices, prioritizing interprofessional faculty development for workplace-based learning is crucial.

Clinical supervision under pressure: a qualitative study amongst health care professionals working on the ICU during COVID-19.

Purpose: The unprecedented influx of patients in 2020 with COVID-19 to intensive care units (ICU) required redeployment of healthcare professionals without adequate previous ICU-training. In these extraordinary circumstances, pivotal elements of effective clinical supervision emerged. This study sets out to explore the nature, aspects and key features of supervision under highly demanding circumstances among certified and redeployed health-care professionals on COVID-19 ICUs.

The logic behind entrustable professional activity frameworks: A scoping review of the literature.

Introduction: Entrustable professional activities (EPAs), discrete profession-specific tasks requiring integration of multiple competencies, are increasingly used to help define and inform curricula of specialty training programmes. Although guidelines exist to help guide the developmental process, deciding what logic to use to draft a preliminary EPA framework poses a crucial but often difficult first step. The logic of an EPA framework can be defined as the perspective used by its developers to break down the practice of a profession into units of professional work.

Supervision, Interprofessional Collaboration, and Patient Safety in Intensive Care Units during the COVID-19 Pandemic.

To meet coronavirus disease (COVID-19) demands in the spring of 2020, many intensive care (IC) units (ICUs) required help of redeployed personnel working outside their regular scope of practice, causing an expansion and change of staffing ratios. How did this composite alternative ICU workforce experience supervision, interprofessional collaboration, and quality and safety of care under the unprecedented clinical circumstances at the height of the first pandemic wave as lived experiences uniquely captured during the first peak of the pandemic? An international, cross-sectional survey was conducted among physicians, nurses, and allied personnel deployed or redeployed to ICUs in Utrecht, New York, and Dublin from April to May of 2020. Data were analyzed separately for the three sites.

An EPA for better Bedside Teaching.

Background: Bedside teaching (BST), a time-honoured tradition of clinical teaching which integrates theoretical knowledge and clinical practice, has declined steeply over the last decade. Moreover, many clinician teachers today are not specifically trained in and/or comfortable in delivering effective BST. Resucitating this valuable educational format may require a new approach to preparing teachers and setting the stage for effective BST.

Breathing life into bedside teaching in the era of COVID-19.

Bedside skills have been declining over the last two decades, with multiple studies reporting increasing reliance on investigations and technology in making diagnostic decisions. During the Covid-19 crisis, even less time is spent at the bedside, and physical examinations seem markedly truncated or non-existent. It is possible that cost of health care, doctor-patient relationships, and the clinical reasoning skills could be seriously impacted by ongoing decrease in bedside skills and the teaching of these skills.

Blended learning for postgraduates; an interactive experience.

Background: Blended learning has the potential to stimulate effective learning and to facilitate high quality education. For postgraduate health professionals, blended learning is relatively new. For this group we developed, implemented and evaluated two blended learning modules in a master program on quality and safety in patient care.

Defensive medicine among neurosurgeons in the Netherlands: a national survey.

Objective: In defensive medicine, practice is motivated by legal rather than medical reasons. Previous studies have analyzed the correlation between perceived medico-legal risk and defensive behavior among neurosurgeons in the United States, Canada, and South Africa, but not yet in Europe. The aim of this study is to explore perceived liability burdens and self-reported defensive behaviors among neurosurgeons in the Netherlands and compare their practices with their non-European counterparts.

Bridging generation gaps in medical education: a "light bulb moment" at the Association for Medical Education in Europe annual conference in Barcelona.

Generation gaps have been described before and so have ways to deal with them. But they were mainly focused on the teachers. We would like to bridge these generation gaps, not only by creating awareness but also by learning from each other.

Long-term compliance with lipid-lowering medication after genetic screening for familial hypercholesterolemia.

Background: Familial hypercholesterolemia is a common lipid disorder that predisposes to premature cardiovascular disease. Lipid-lowering treatment of affected individuals is widely advocated, and maximum benefit can be obtained if medication is started early. A screening program for familial hypercholesterolemia is ongoing in the Netherlands since 1994.

Consumption of tall oil-derived phytosterols in a chocolate matrix significantly decreases plasma total and low-density lipoprotein-cholesterol levels.

In a randomized, double-blind, placebo-controlled trial we evaluated the effect of dietary chocolates enriched with a wood-based phytosterol-phytostanol mixture, containing 18 % (w/w) sitostanol, compared with placebo dietary chocolates in seventy subjects with primary hypercholesterolaemia (total cholesterol levels below 8 mmol/l). For 4 weeks, participants consumed three servings of the phytosterol-enriched chocolate/d that provided 1.8 g unesterified phytosterols/d or a placebo chocolate in conjunction with a low-fat, low-cholesterol diet.

Declaring war on undertreatment: rationale for an aggressive approach to lowering cholesterol.

Few things are better understood within the medical community than the relationship between elevated total and low-density lipoprotein cholesterol (LDL-C) levels, cardiovascular disease and death. There is consensus in the treatment guidelines of numerous national and international bodies that cholesterol levels in at-risk patients should be reduced to target levels that have been shown in population studies to be associated with low rates of coronary heart disease (CHD). However, dyslipidaemia continues to be underdiagnosed and undertreated.

Association between increased arterial-wall thickness and impairment in ABCA1-driven cholesterol efflux: an observational study.

Background: Decreased concentrations of HDL cholesterol are associated with increased cardiovascular risk. These concentrations are directly related to cholesterol efflux from cells-the first step and a key process in reverse cholesterol transport. Cholesterol efflux is mediated by the ATP-binding cassette A1 transporter (ABCA1), the rate-limiting step in the production of HDL.