Background Early palliative care team consultation has been shown to reduce costs of hospital care. The objective of this study was to investigate the association between palliative care team (PCT) consultation and the content and costs of hospital care in patients with advanced cancer. Material and Methods A prospective, observational study was conducted in 12 Dutch hospitals. Patients with advanced cancer and an estimated life expectancy of less than 1 year were included. We compared hospital care during 3 months of follow‐up for patients with and without PCT involvement. Propensity score matching was used to estimate the effect of PCTs on costs of hospital care. Additionally, gamma regression models were estimated to assess predictors of hospital costs. Results We included 535 patients of whom 126 received PCT consultation. Patients with PCT had a worse life expectancy (life expectancy <3 months: 62% vs. 31%, p < .01) and performance status (p < .01, e.g., WHO status higher than 2:54% vs. 28%) and more often had no more options for anti‐tumour therapy (57% vs. 30%, p < .01). Hospital length of stay, use of most diagnostic procedures, medication and other therapeutic interventions were similar. The total mean hospital costs were €8,393 for patients with and €8,631 for patients without PCT consultation. Analyses using propensity scores to control for observed confounding showed no significant difference in hospital costs. Conclusions PCT consultation for patients with cancer in Dutch hospitals often occurs late in the patients’ disease trajectories, which might explain why we found no effect of PCT consultation on costs of hospital care. Earlier consultation could be beneficial to patients and reduce costs of care.

This article presents a collaborative inquiry analysis of the school improvement experiences of four persistently low-performing schools. It draws on the experiences of three members of the Laboratory for the Design and Redesign of Schools (LDRS) consortium who helped during their planning for restructuring or restructuring phases and one regional official who oversaw their grant support and school improvement interventions. The authors explore the role of organizational change to improved teaching and learning in the schools. The schools' mixed leadership and organizational capacity and belief in their teaching efficacy limited the benefits of state, district, and regional supports and resources, which school leaders were ill-equipped to coordinate. Combining leadership and organizational development with curricular and instructional reform models would be more promising.

The publication in September of a report from the US National Research Council, Trends in the Early Careers of Life Scientists, posed a question in my mind, as I'm sure it did in the minds of the many graduate students and postdocs already contemplating their futures as scientists with fearful anxiety. What is the value of a PhD in biological science if you can't be a biologist?The report (available at