Background: Team-based palliative care interventions have shown positive results for patients at the end of life in both hospital and community settings. However, evidence on the effectiveness of transmural, that is, spanning hospital and home, team-based palliative care collaborations is limited. Aim: To systematically review whether transmural team-based palliative care interventions can prevent hospital admissions and increase death at home. Design: Systematic review and meta-analysis. Data sources: MEDLINE (Ovid), Embase (Ovid), CINAHL (Ebsco), PsychINFO (Ovid), and Cochrane Library (Wiley) were systematically searched until January 2021. Studies incorporating teams in which hospital and community professionals co-managed patients, hospital-based teams with community follow-up, and case-management interventions led by palliative care teams were included. Data was extracted by two researchers independently. Results: About 19 studies were included involving 6614 patients, of whom 2202 received an intervention. The overall pooled odds ratio of at least one hospital (re)admissions was 0.46 (95% confidence interval (CI) 0.34–0.68) in favor of the intervention group. The highest reduction in admission was in the hospital-based teams with community follow-up: OR 0.21 (95% CI 0.07–0.66). The pooled effect on home deaths was 2.19 (95% CI 1.26–3.79), favoring the intervention, with also the highest in the hospital-based teams: OR 4.77 (95% CI 1.23–18.47). However, studies had high heterogeneity regarding intervention, study population, and follow-up time. Conclusion: Transmural team-based palliative care interventions, especially hospital-based teams that follow-up patients at home, show an overall effect on lowering hospital admissions and increasing the number of patients dying at home. However, broad clinical and statistical heterogeneity of included studies results in uncertainty about the effect size.
The COVID-19 pandemic has accelerated remote working and working at the office. This hybrid working is an indispensable part of today's life even within Agile Software Development (ASD) teams. Before COVID-19 ASD teams were working closely together in an Agile way at the office. The Agile Manifesto describes 12 principles to make agile working successful. These principles are about working closely together, face-to-face contact and continuously responding to changes. To what extent does hybrid working influence these agile principles that have been indispensable in today's software development since its creation in 2001? Based on a quantitative study within 22 Dutch financial institutions and 106 respondents, the relationship between hybrid working and ASD is investigated. The results of this research show that human factors, such as team spirit, feeling responsible and the ability to learn from each other, are the most decisive for the success of ASD. In addition, the research shows that hybrid working creates a distance between the business organization and the IT department. The findings are valuable for Managers, HR professionals and employees working in the field of ASD as emphasizing and fostering Team Spirit, Learning Ability, and a Sense of Responsibility among team members can bolster the Speed of ASD.
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This article discusses some characteristics of the educational framework of the programme and tries to compare the results of the programme as reported by graduates with the 'professional competencies for Sustainable Development’, as formulated by DHO (the organisation for Sustainable Higher Education in the Netherlands). Because of the strong international character of the programme (students from more than 50 different countries in all continents of the world graduated since 1996), a specific issue of concern is the applicability of the Dutch Sustainable Competences in an international setting, and the implications for the teaching and learning approach. The experiental learning theory and the learning styles as defined by Kolb (1984) and the cultural dimensions as described by Hofstede (2009) are used to check this. Results from short online interviews with graduates all over the world illustrate the results of this comparison.
MULTIFILE
