Transition Experiences Research Articles

Study on the Pathway of Energy Transition in Inner Mongolia under the "Dual Carbon" Goal

As an important strategic energy base in China, Inner Mongolia's energy exports are dominated by coal and electricity. Under the background of "double carbon" target, the energy transition of Inner Mongolia is of great significance to China’s energy security and carbon emission reduction. Based on the energy policy simulation model (EPS model), this paper explores the path of energy transition in Inner Mongolia by constructing the scenarios of developing renewable energy, developing CCS technology and carbon pricing, and simulating the policy situation based on the reality of Inner Mongolia and the energy transition experience of developed countries and regions. The results show that (1) The energy production and power generation under the development of renewable energy scenario (RE) and carbon pricing scenario (CP) are lower than the "Business as usual" scenario (BAU) for a certain period of time, which affects China's energy security. However, by 2060, power generation and energy production under both scenarios exceed the BAU scenario, and the energy production structure is dominated by renewable energy in both cases. (2) If the Inner Mongolia government focuses on short-term carbon emission reduction, the government should actively promote the establishment of a carbon emission trading market and increase the use of renewable energy through the improvement of the carbon pricing mechanism to promote carbon emission reduction in Inner Mongolia. If the Inner Mongolia government focuses on long-term energy supply stability, it should vigorously develop CCS technology.

“Into the Abyss” – Exploring Healthcare Professionals Experience of Transitions of Care from Stroke Early Supported Discharge Services in Ireland

Abstract Background Early Supported Discharge (ESD) is a key component of the stroke rehabilitation pathway. Evidence suggests that ongoing needs persist for people with stroke at the end of ESD, however little is known about the transition from ESD to other services. As such, the aim of this study was to explore healthcare professionals’ (HCPs) experiences of transitions of care from ESD services, in the Republic of Ireland. This was achieved through the following objectives: 1) Discussion of HCPs experience of transition from ESD, including ongoing needs of people with stroke and referral pathway utilisation; 2) Exploration of barriers and facilitators to ESD transition; 3) Discussion of potential solutions to barriers experienced. Methods A qualitative descriptive design was implemented using semi-structured interviews with HCPs working in ESD. Interviews took place online from November 2023 to January 2024 and were audio and video recorded and transcribed, via Microsoft Teams. Analysis of interview transcripts utilised an inductive coding approach through implementation of Braun and Clarke’s six step approach to thematic analysis. Results Nine HCPs took part in this study. A variety of ongoing needs and current referral pathways were described. Three key themes were identified: 1) “Into the Abyss”: Lack of a coordinated care pathway after ESD, 2) Role of communication and integrated information sharing in transition of care from ESD and 3) Facilitating care transition from ESD: current practices and future solutions. Conclusion This study highlights that at present, services in Ireland appear insufficient to cater to the ongoing needs of people with stroke after ESD. The roll out of community neurorehabilitation teams nationally and developing integrated communication systems are key areas for development, which warrant consideration by relevant stakeholders in order to optimise patient-centred care for this cohort.

Improving the evaluation of novice advanced practice nurse transition.

Novice advanced practice registered nurses (RNs) experience decreased self-confidence, anxiety, and identity confusion in their first year of practice, which leads to poor job satisfaction and turnover. Advanced practice RN fellowship programs, developed to bridge the gap from the RN to the advanced practice role, lack standardized measures for program evaluation. A large Midwestern pediatric hospital's advanced practice nurse fellowship program lacks a structured program evaluation. A quasi-experimental evidence-based improvement project was implemented to evaluate fellowship program outcomes for novice nurse practitioner transition and retention. All novice advanced practice RNs (APRNs) were enrolled in the site's 12-month APRN fellowship program. The transition experiences of enrollees who completed the fellowship program were assessed using the novice nurse practitioner role transition scale. In addition, role transition scores were compared for two subgroups: fellows in acute care and fellows in primary care roles. Fellowship participant retention 1 year after hire was measured. Postintervention data showed that most fellowship graduates had a positive transition experience as evidenced by at least a 4.33/6.0 mean total novice nurse practitioner role transition score. There was not a statistically significant difference between the transition scores of the acute care fellows and primary care fellows. The APRN fellowship program was effective in promoting a successful role transition from RN to novice APRN. Similar APRN fellowship programs may benefit from using this tool for program evaluation.

A journey through transitional care-family members' experiences post a life-threatening situation: A qualitative study.

Being a family member to someone who suffers from a serious illness can change one's perspectives about life. A sudden and severe illness can result in a demanding journey that involves acute admission to hospital, intensive care, post-care, and finally, returning home. To describe the experience of staying beside a next of kin throughout the healthcare journey, from the onset of illness at home, to the intensive care unit, post-care, and returning home. The study employed a qualitative design, with data collected via semi-structured interviews and analysed using reflexive thematic analysis. A purposive sampling was used to recruit participants (n = 14), who had experiences of staying beside a next of kin throughout the healthcare journey from the onset of illness to discharge from the hospital. Family members' experiences were captured under the overarching theme Journey through an emotional turmoil and the themes Entering a new world, Continuing the journey towards something unknown, and Striving for the new normal at home. They described going through a non-linear process, characterised by transitions or changes in several aspects. The transitions included shifts in the roles that the family members played, in the various environments they found themselves in, and in the progression of the patient's illness or injury. The study suggested that family members with a next of kin who experienced life-threatening situations undergo challenging transitions. The informal caregiver role placed on family members of intensive care unit-survivors significantly impacts their lives and the healthcare systems should prioritise providing high-quality support to family members throughout the entire healthcare journey. Elevating the importance of nursing care within the healthcare system can contribute to delivering holistic care and facilitating transitions. Further research should focus on understanding the support that family members perceive as necessary to facilitate their transition and enhance their well-being.

The struggle of dealing with uncertainty: a qualitative, phenomenological study about how Dutch novice physical therapists experience their transition from student to professional

Objective To explain how Dutch novice physical therapists experience their transition from student to physical therapist in private practice. Methods A qualitative, phenomenological study was performed in The Netherlands to collect personal experiences from novice physical therapists who graduated <1 year ago. Data were collected with semi-structured interviews and analyzed using interpretative phenomenological analysis. Results The transition experience from student to novice physical therapist is a personal, complex, and context-dependent phenomenon. Sixteen novice physical therapists (of whom 10 were still working in private practice) said their transition was liberating, stressful, insecure, unexpected, chaotic, and challenging. The variety in experiences occurred from the fact that the impact of an experience varies from one individual to the other, depending on their previous (life) experiences, uncertainty tolerance, coping, and personal and professional environment. Four overarching themes emerged: (1) ‘Suddenly, I was on my own’, (2) ‘I was unprepared for the hassle and demands of clinical practice’, (3) ‘I couldn’t make the impact I expected’, and (4) ‘I had to find a new me’. Conclusions A novice physical therapist’s transition is a context-related phenomenon, unique for each individual and determined by individual experiences and coping strategies. Novice physical therapists described a feeling of ‘faking’: they had to pretend to know what they were doing [while treating a patient] while in reality, they felt like they did not. For some novice physical therapists, a primary reason to leave the profession.

Navigating transitions: Vietnamese students’ experiences and challenges in the first year of higher education

ABSTRACT This qualitative research delves into the intricate transitional experiences of Vietnamese students during their first year in higher education (HE). Grounded in the dynamically shifting socio-cultural landscape of Vietnam, the study captures the narratives of 15 students, emphasising the unique challenges faced by those from the Mekong Delta region. Utilising a robust analytical blend of sociocultural theory, transition theory, and constructivist grounded theory, the research surfaces seven poignant themes. These are: (1) ‘Cultural Dislocation’, capturing the tension between traditional values and modern, global influences; (2) the ‘Struggle with Academic Independence’ highlighting the challenges of autonomous learning; (3) the intricacies of navigating ‘Interpersonal Dynamics in Diversity’ in a multicultural academic environment; (4) the evident ‘Digital Divide’ accentuating the disparities in technological access and proficiency; (5) the delicate act of ‘Balancing Commitments’ between academic pursuits and deeply rooted familial responsibilities; and (6) the profound ‘Quest for Autonomy and Identity Formation’, signifying the transformative nature of HE as a space for profound self-discovery and personal growth. While offering specific insights into the Vietnamese context, the study resonates with global academic transitions, underscoring the urgent need for holistic educational approaches that address the diverse challenges and aspirations of contemporary students.

STEM PhD holders working outside academia: the role of social support in career transition

ABSTRACT This paper explores the role of social support in career transition experiences among science, technology, engineering, and mathematics (STEM) PhD holders working outside academia. Inter-country interview data were collected from PhD graduates from the UK (n = 10), Spain (n = 10) and Finland (n = 10) in 2022. Though the results varied somewhat by individual, they show that both engaging and disengaging experiences were socially embedded. Receiving instrumental support, e.g. time or funding, was a key factor in engaging transition experiences and the lack of it in the disengaging ones. Job stability, work-life relationships, personal values, the work environment, work-task fit, and finances contributed to the engaging and disengaging transition experiences across the countries. This paper is one of the first qualitative studies focusing on STEM PhD holders’ social support and (dis)engaging transition experiences to a career beyond academia in a cross-national setting. The findings help to understand better STEM PhD holders’ experiences beyond academia. The results can be used in doctoral education and PhD careers’ development.

‘Slow Time Like the Present’

Abstract Romanian New Wave cinema (rnw) has been recognised as a medium that addressed the way people felt about their historical trauma, a vernacular insertion nuancing declarations that Nicolae Ceausescu was a ‘megalomaniacal dictator’, and a means to attract and negotiate international interest in the country’s culture. rnw was a subversive and self-conscious commentary on the experience of transition from communism to capitalism as much as aesthetic entertainment. This article argues that rnw was critical of the idea of a transformative watershed – predominant in conceptions of 1989 across the Euro-Atlantic space – and qualifications of the teleological imaginary that encompassed it. Drawing on film theory, as well as the tension between collective and individual memory, the author argues that rnw was a self-conscious and creative effort at commemorating a past, contributing to a more democratic debate about the ways in which recent history bears upon the present.

Work readiness of student nurses voluntarily supporting NHS during COVID-19 pandemic: a mixed methods investigation into students’ experiences

Background: Transition from education to the workforce has been recognised as difficult and linked to ‘reality shock.’ Due to the unprecedented circumstances of the COVID-19 pandemic, many student nurses opted in for NHS emergency placements and prematurely transitioned to the workplace, which calls for an in-depth investigation of the work readiness and transition experiences of this cohort. Aim: The aim of this study was to investigate self-perceived work readiness, the effectiveness of support provided by the universities and the NHS as well as explore the experiences of student nurses who responded to the COVID-19 crisis to understand the impact of this early transition to the clinical workforce. Design: A mixed methods study was conducted. It included two stages: (1) an online survey consisting of a work readiness questionnaire and close- and open-ended questions about received support; and (2) online semi-structured interviews that were thematically analysed. Methods: Participants were nursing students from Scottish universities who took on emergency NHS placements. Thirty-three (30 females and 3 males) participants completed the survey and 8 of them (all female) participated in semi-structured interviews. The Work Readiness Scale for graduate nurses along with questions about the support received were completed in the first stage of the study. Results: Organisational acumen was perceived by participants as higher than social intelligence, work competence and personal work characteristics. Three superordinate themes emerged: (1) participants expressed appreciation of and need for coordination of support from the university and the NHS as a key factor in easing into their role; (2) they indicated the sense of obligation as the key driver for taking up this placement; (3) placement was seen as an opportunity to understand their role and develop their professional identity. Conclusions: The findings found the importance of support from the clinical placement and academic teams to help with the integration and application of theory into practice.

Do integrated stroke units affect patient and family experience of care transitions?

Purpose Patients and families identify discharge from hospital as highly challenging. Less is known about experiences of transition between acute services and inpatient rehabilitation. We aimed to understand the experiences of patients and families as they transition to inpatient rehabilitation services, before and after the opening of a new integrated stroke and rehabilitation unit (ISU). Materials and methods Adults were recruited 7 days after transfer to inpatient rehabilitation, in two 6-month periods before and after the opening of the ISU. Their experiences of care continuity were evaluated with a survey. Univariate analyses compared survey data pre- and post-ISU. A subset of participants completed semi-structured interviews that underwent thematic analysis. Results 150 patients were recruited (median age 60 years, range 20-92 years, 72 female). There were no differences between pre- and post-ISU survey scores for patient or family experiences (all p > 0.3). Interview analysis identified 3 major themes: “Whānaungatanga - the foundation of patient experience”, “In the dark and out of control”, and “A nice view…but I want to be able to do more.” Conclusions Implementation of an integrated stroke and rehabilitation unit maintained levels of patient and family satisfaction. Interviews identified important themes for services planning to improve patient experience.

Leaders beyond sport: an exploratory comparative analysis of international and domestic college athletes’ leadership competencies

PurposeThe purpose of this study was to explore the leadership competencies of the National Collegiate Athletic Association (NCAA) college athletes and assess the potential differences between domestic and international college athletes.Design/methodology/approachA quantitative, non-experimental research design was employed, including the use of an electronic survey to collect data. Survey research allows for extensive data management and a quick data collection method (Creswell &amp; Creswell, 2018). The survey was conducted using online Qualtrics software, which allowed convenience in administration, maintenance, nationwide distribution and data export and analysis.FindingsThe findings of this study suggest that domestic college athletes develop greater leadership competencies than their international peers.Practical implicationsThe study implications include both practical and academic contributions. The research in the area of leadership development in college athletes has been growing. Previous research has focused on the benefits of the leadership development (Lewis, 2023); however, minimal research has been dedicated to exploring actual leadership constructs within the college athlete population. Moreover, this study focused on the differences between domestic and international college athletes’ leadership constructs. International college athletes go through additional challenges while balancing the academic part of being college athletes (Ridpath, Rudd, &amp; Stokowski, 2020).Originality/valueMinimal research has been dedicated to exploring actual leadership constructs within the student-athlete population. This study is the first study that explored leadership constructs from the quantitative lens and focusing on both domestic and international student-athletes. The literature on international student-athletes mainly focuses on the motivation arriving to the United States of America (Love &amp; Kim, 2011) and their transitional experiences (Popp, Pierce, &amp; Hums, 2011; Jolly, Stokowski, Paule-Koba, Arthur-Banning, &amp; Fridley, 2022). However, limited literature focuses on the preparation of international student-athlete for life beyond their sport.

Exploring Vietnamese student experiences of transitioning from high school into a transnational university

ABSTRACT Transnational education (TNE) – a form of education where learners study in a different country to the awarding institution has been increasingly prevalent globally. Vietnam is not an exception. This article explores university transition experiences of TNE students in Vietnam. Thematic analysis of 20 in-depth interviews with TNE students identified eight inter-related transition challenges associated with new learning environments and academic requirements, including English oral communication, freedom, career uncertainty, peer relationships, technology, self-directed learning, time as well as study workload management, and writing skills. Findings also revealed that students used different strategies to cope with transition challenges. Specifically, they applied a self-directed approach to adapt to the new environment and sought support from peers, lecturers, advisors, and the library to overcome transition difficulties. Employing a TNE student transition theoretical framework, this article discusses the role of students’ relationship capital, resilience, and confidence in coping with the transition to university, and proposes transition support across three stages of the student journey: commencement, middle years, and senior years. The paper carries theoretical, policy, and practical implications for enhancing student transition experiences critical to TNE higher education.

Multiexperience-Assisted Efficient Multiagent Reinforcement Learning.

Recently, multiagent reinforcement learning (MARL) has shown great potential for learning cooperative policies in multiagent systems (MASs). However, a noticeable drawback of current MARL is the low sample efficiency, which causes a huge amount of interactions with environment. Such amount of interactions greatly hinders the real-world application of MARL. Fortunately, effectively incorporating experience knowledge can assist MARL to quickly find effective solutions, which can significantly alleviate the drawback. In this article, a novel multiexperience-assisted reinforcement learning (MEARL) method is proposed to improve the learning efficiency of MASs. Specifically, monotonicity-constrained reward shaping is innovatively designed using expert experience to provide additional individual rewards to guide multiagent learning efficiently, with the invariance guarantee of the team optimization objective. Furthermore, a reward distribution estimator is specially developed to model an implicated reward distribution of environment by using transition experience from environment, containing collected samples (state-action pair, reward, and next state). This estimator can predict the expectation reward of each agent for the taken action to accurately estimate the state value function and accelerate its convergence. Besides, the performance of MEARL is evaluated on two multiagent environment platforms: our designed unmanned aerial vehicle combat (UAV-C) and StarCraft II Micromanagement (SCII-M). Simulation results demonstrate that the proposed MEARL can greatly improve the learning efficiency and performance of MASs and is superior to the state-of-the-art methods in multiagent tasks.

Trans (on) YouTube: Localizing transnational narratives on two Polish trans YouTube channels

Abstract This article explores genres and narratives of gender transition on two Polish YouTube channels (forming one collective) to illustrate negotiations between transnational and local understandings, performances, and interpretations of (trans)gender identity. “Trans YouTube” is a valuable performative and discursive space, allowing (especially young) trans creators to maintain, present, and communicate the desired sense of self. The article explores multilingual and multimodal practices on Polish trans YouTube and discusses their role in localizing the transnational LGBTQ+ discourse within the local socio-cultural context. Applying the perspective of translation studies and exploring the role of translation (and non-translation) in localizing the transnational concepts of gender and sexuality makes it possible to trace the process of trans-creating the new language of the Polish trans community, a language that emphasizes trans social media users’ agency and is capable of expressing their individualized and localized gender transition experiences.

Mixed Methods Evaluation of a Youth-Friendly Clinic for Young People Living with HIV Transitioning from Pediatric Care.

(1) Background: Adolescents and young adults face challenges when transitioning to adult care due to emerging adulthood and changing providers and insurance. Young people living with HIV (YPLHIV) have additional obstacles with mental health and stigma. During transition, only 55% of YPLHIV are retained in care, and 65% are virally suppressed. To address these challenges, the Adolescent and Young Adult Health Care Transition Clinic (AYAHCTC) was created at Vanderbilt University Medical Center in 2017. This mixed methods study evaluates the initial cohort and solicits YPLHIVs' perspectives on transition barriers and facilitators. (2) Methods: Quantitative analyses (n = 21) characterized patients' demographics, clinical engagement, and retention. Qualitative interviews (n = 5) captured patients' transition experiences. (3) Results: This study, conducted in the Southeastern USA, included a cohort where 47.6% were born abroad, with all participants being US citizens by birth or naturalization. Patients' mean age at first visit was 19.6 years. The average AYAHCTC duration was 2.21 years. First-year engagement and retention were 100% and 95.5%, respectively. Viral suppression rates improved from 66.7% at the first visit to 81.0% at the last visit. Eleven patients transitioned out of AYAHCTC. Qualitative analyses indicate that barriers to transition include leaving trusted providers, reduced parental guidance, developing autonomy, and perceived loss of confidentiality in adult clinic environment. Transition was facilitated by youth-friendly services, clear communication, and strong relationships with AYAHCTC providers. (4) Conclusions: YPLHIV positively viewed AYAHCTC experiences. Future directions include optimizing services to build YPLHIVs' independence, supporting YPLHIV experiencing stigma, assuaging concerns about switching providers, collaborating with adult clinics to maintain confidentiality, and designing interventions focused on adherence during transition.

Understanding the experiences of transition for newly qualified mental health nurses and their potential to stay in the role: A qualitative exploration

AimTo understand the experiences of transition from the perspective of newly qualified mental health nurses and the impact this may have on their potential to remain in the role. BackgroundDuring the transitional period following registration newly qualified nurses experience feelings of being overwhelmed and shock. Internationally there is limited research on factors influencing transitional experiences in the field of mental health. DesignA qualitative exploration was conducted using thematic content analysis to analyse the data gathered from semi-structured interviews Method18 Newly qualified mental health nurses from two NHS Mental Health trusts were interviewed, all within 18 months of registration. Data were analysed and themes generated addressing the research aim. Results/Findings:Five themes were co-created using this inductive technique: ‘Transition to new role’, ‘Support for new role’, ‘Professional identity’, ‘Role development’ and ‘Working environment’. These themes are representative headings with the sub-themes making up the contributory content. Themes highlighted issues concerning newly qualified nurses and the transition which included aspects of anxiety and feeling overwhelmed initially. This highlighted the feelings associated with transition and progression through the process of liminality. Supervision was identified in the context of formal support, the presence of which is conducive to a positive transition. Imposter syndrome and experiencing reality shock were common aspects of role development and acknowledging the sense of responsibility gained once registered. Safety was highlighted as many experienced their first role on in-patient environments which was busy and potentially hostile. ConclusionThe transition of newly qualified nurses in mental health services can prove to be a difficult experience, therefore it requires acknowledgment and careful consideration. Understanding the liminal process may allow staff to appreciate the effect of the transition and to understand that the NQN will face overwhelming and unfamiliar responsibilities. Despite the demands to boost the workforce in mental health services there is a need to understand how best to integrate NQN’s into their role during this transition. Caution must be used if we are not to lose more NQN’s, as despite concerns there are still NQN’s looking to mental health nursing as their future and chosen career.

Women's experiences with continuity for effective coordination during maternal and neonatal continuum in Kenya: An interpretive phenomenology.

Embracing women's experiences in decision-making is imperative for continuity in effective coordination of maternal and neonatal health (MNH); women are the end users within the care ecosystem. Through women's continuous feedback, skilled birth attendants (SBAs) and the healthcare system get to understand emerging issues based on their needs and preferences. The purpose of this article is to describe women's experiences of continuity for effective coordination of care through the transitions in the MNH continuum in Kenya. The study was conducted in selected counties of Kenya based on birth rates per woman as follows: Wajir (7.8) Narok (6.0) Kirinyaga (2.3) and Nairobi (2.7) (1). The clients were interviewed concerning their experiences of the MNH continuum of care in English and Kiswahili. An interpretive hermeneutic phenomenological approach was used to construct the experiences of women of continuity during transitions in the MNH continuum for effective care coordination. Twelve participants were interviewed between January and April 2023. Atlas ti 22 software was used for data analysis. Four women experiences were highlighted: Women unawareness of preconception care, use of prenatal care, labour, birthing and postpartum flow and the women's view on the MNH continuum. The women reported their segmental and transitional experience of the MNH continuum as one that did not consistently meet their needs and preferences in order for them to fully agree that the continuum enhanced continuity for effective coordination. They felt that they experienced continuity in some segments while in some they did not.Contribution:The embrace of women's experience of their needs and preferences through the MNH continuum (segments and transitional segments) through the lens of continuity for effective coordination is timely towards the improvement of maternal and neonatal care by 2030.

Survivorship preparedness and activation among survivors of lymphoma.

Taking an active role in managing post-treatment care has emerged as a key aspect of promoting a successful transition into survivorship and is associated with better patient outcomes. In this study, we focus on two key aspects of active self-management, activation and preparedness. Activation was defined as understanding one's role in the care process and having the knowledge, skill, and confidence to take on a role in managing self-care. Preparedness was defined as the extent to which individuals perceived they had sufficient information about what to expect after cancer treatments are completed. The study goal was to characterize survivorship preparedness and activation among lymphoma survivors within 5years of treatment completion in New Jersey and examine the association of sociodemographic, medical, care transition experiences, practical concerns, and psychosocial factors with activation and preparedness. One hundred and one Hodgkin lymphoma or non-Hodgkin lymphoma survivors who had completed treatment within 5years completed a survey of survivorship care experiences (response rate = 34.12%). Approximately 60% of survivors reported high activation, with similar percentages for higher preparedness. Less activated survivors were significantly (p < .05) younger, married, resided in a more deprived geographic area, and reported more fatigue and information needs. Less activated survivors reported recalling that their providers were significantly (p < .05) less likely to discuss long-term side effects, psychosocial needs, risk-reducing lifestyle recommendations, and how to manage other medical concerns. Fewer care transition practices were most strongly associated with lower preparedness. A significant proportion were not activated for survivorship, and both activation and preparedness were strongly associated with providers' survivorship transition practices. Implementing programs to foster more activation and preparedness for lymphoma survivorship care would benefit from education about recommended follow-up care and healthy lifestyle practices. Providers should routinely ask about their patients' confidence and preparedness for survivorship and provide referrals for appropriate care as needed.

The uniquely relational role of nurses during the closure of large residential institutions for people with intellectual disability in Australia: A qualitative study

ABSTRACT Background After decades of planning, nurses played a pivotal role in achieving the closure of large residential institutions for people with intellectual disability by 2018. This paper describes the experiences of nurses facilitating the closure of these institutions in New South Wales and Victoria, Australia. Method An interview-based, qualitative study was conducted with twenty-four registered nurses from Australia who had more than twelve months’ experience of caring for people with intellectual disability any time between 1960 and 2016. Results Nurses facilitated transition for residents and their families during devolution. However, nurses’ personal experiences of transition to work in community settings was complicated by inconsistent preparation, uncertainty of employment, and changes in professional status. Conclusions Extensive experience and detailed knowledge of their clients enabled nurses to maximise opportunities for smooth transition out of institutions into community care for people with intellectual disability. Devolution was personally and professionally costly for some nurses.

Patient and carer transition outcomes and experiences at the Westmead Centre for Adolescent and Young Adult Health, Westmead, Australia: protocol for a longitudinal cohort study

IntroductionThe Westmead Centre for Adolescent and Young Adult Health is a purpose-built facility supporting integrated care for young patients with a variety of long-term health conditions transitioning from paediatric services...