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This paper aims to examine the prevalence and reasons for delayed discharge from two regional assessment and treatment units (ATUs) for people with learning disabilities, in line with the transforming care agenda.

This is a retrospective evaluation of 44 admissions and discharges from two ATUs from February 2019 to March 2022.

Of 44 admissions who were discharged during the included period, 20 experienced delays in their discharge. Delayed discharges occurred despite the two ATUs meeting standards for length of assessment and treatment as specified by the Learning Disability Professional Senate. The most prevalent reasons for discharge delays were identification of a new placement, recruitment of care staff and building work.

This paper offers an in-depth evaluation of recent delayed discharges from two regional ATUs, highlighting the most common reasons for delays and offering suggestion for reducing delays in future.

To facilitate the reception and care of discharged patients, streamlining processes at the University Hospital and promoting a seamless transition to continuity of care services post-discharge.

Hospitalised patients undergo the Blaylock risk assessment screening score (BRASS), a screening tool identifying those at risk of complex discharge.

Pre-pandemic, patients with a medium-to-high risk of complex discharge were predominantly discharged to their residence or long-term care facilities. During the pandemic, coinciding with an overall reduction in hospitalisation rates, there was a decrease in patients being discharged to their residence.

The analysis of discharges, with the classification of patients into risk groups, revealed a coherence between the BRASS score and the characteristics of the studied sample. This tool aids physicians in decision-making by identifying the need for a planned discharge in a systematic and organised manner, preventing the loss of crucial information.

This article reports on the experiences and evaluations of piloting health and social care discharge co‐ordinators in acute and community hospital settings. Benefits were felt with regard to length of stay, bed day use, and patient and staff experience, and were particularly notable where a discharge co‐ordinator employed by the community trust was put into the acute hospital setting. The pilots have supported a redesign of hospital discharge processes across Torbay Care Trust and South Devon Healthcare NHS Foundation Trust, and provided the foundation for improved partnership working and integrated service provision.

The paper aims to estimate the instantaneous breakdown voltage of the lightning discharge from simulated figures in an energized rod-plane configuration protected by a lightning rod. The same configuration of electrodes has been the subject of experimental investigations for the measurement of the instantaneous breakdown voltage using oscillographic monitoring. This study validates the simulation model by making a comparison with experimentation and involves the role of the inception field of the upward discharge in the propagation of this last one.

The research methodology is based on the development of a fractal lightning protection model based on real physical conditions of the discharge propagation, such as the downward discharge and the upward one emanating from protection. The voltage drop and the randomness character of the lightning discharge are also taken into account. The electrical field is an important parameter in discharge development; it is considered in this work at each step of the discharge propagation by the finite element method. The instantaneous breakdown voltage is measured and estimated by both empirical equations and simulated figures of lightning discharge

The established model that allows estimating the instantaneous breakdown voltage from simulated discharges and empirical equations gives results in a good agreement with experimentation. The involvement of the upward discharge inception field emanating from the lightning rod in the evolution of electrical discharge is illustrated.

The work presented in this paper aims to develop a new fractal lightning protection model taking into consideration physical phenomena intervening in the development of the lightning discharge.

The originality of this work consists of the combination between fractals modelling of the electrical discharge and the protection against lightning, in addition, to use one of the characteristics of the electrical discharge, which is the instantaneous breakdown voltage, to prove the importance of the inception field emanating from the upward discharge in the propagation criterion of this last one.

This paper aims at building a discharge model for the power cable bellows based on plasma energy deposition and analyzing the discharge ablation problem.

Aiming at the multiphysical mechanism of the discharge ablation process, a multiphysical field model based on plasma energy deposition is established to analyze the discharge characteristics of the power cable bellows. The electrostatic field, plasma characteristics, energy deposition and temperature field are analyzed. The discharge experiment is also carried out for result validation.

The physical mechanism of the bellows ablative effect caused by partial discharge is studied. The results show that the electric field intensity between the aluminum sheath and the buffer layer easily exceeds the pressure resistance value of air breakdown. On the plasma surface of the buffer layer, the electron density is about 4 × 1,019/m³, and the average temperature of electrons is about 3.5 eV. The energy deposition analysis using the Monte Carlo method shows that the electron range in the plasma is very short. The release will complete within 10 nm, and it only takes 0.1 s to increase the maximum temperature of the buffer layer to more than 1,000 K, thus causing various thermal effects.

Its physical process involves the distortion of electric field, formation of plasma, energy deposition of electrons, and abrupt change of temperature field.

The purpose of this study is to assess if the new community-enhanced rehabilitation team reduced anxiety and readmissions in service users discharged from an inpatient rehabilitation setting.

The study used both qualitative and quantitative methodology. Service user’s anxiety level was measured before being discharged and at the end of the Community Enhanced Rehabilitation Team (CERT) transition intervention. Six service users were interviewed to gain further understanding of their experiences of anxiety.

Findings showed the anxiety score was significantly lower (M = 1.5, 95% CI [0.051,2.99], t(20) = 2.159, p = 0.043) following the CERT intervention (M = 8.6, SD = 6.4) compared to before (M = 10.1, SD = 7.0). No service user receiving the CERT intervention was readmitted to hospital within 12 weeks of discharge from the inpatient setting, compared to three service users (15% of those discharged) who were discharged to other community services.

Community rehabilitation pathways would benefit from having interventions to aid patient transitions from inpatient to the community. The National Health Service (NHS) trusts develop community rehabilitation teams as recommended by the National Institute for Health and Care Excellence (NICE), and they should consider including transitional support as part of their model.

It is recommended that as NHS trusts design and implement community mental health teams, they should consider including transition support as part of their model.

People with severe and enduring mental health difficulties who have been in an inpatient rehabilitation setting would benefit from community transitional support. This study suggests that such support helps reduce anxiety and readmission.

Community rehabilitation teams are currently being developed across the NHS as part of the NHS long-term plan. These teams are new, and as such, there is a dearth of information regarding their effectiveness. To the best of the authors’ knowledge, this is one of the first studies to evaluate outcomes in these new teams.

Transition from inpatient mental health care to community living can be very difficult, as people are at an increased risk of suicide, self-harm and ultimately readmission into hospital. There is little research conducted exploring peer support workers’ (PSWs) lived experiences that could provide insight into the key transitions of care, particularly the support required after discharge from inpatient mental health care. The purpose of this paper is thus to provide a particular insight into what it feels like being discharged from psychiatric care from a PSW’s perspective, how may support be improved post-discharge and what factors might impact the potential for readmission into inpatient care.

A qualitative, phenomenological approach was adopted to explore and describe PSWs’ lived experiences of transitioning from psychiatric care. Four PSWs who were employed by a UK secure mental health facility were recruited. PSW is a non-clinical role with their main duty to support patients, and they were considered for this type of the study for their experience in negotiating the discharge process to better carry out their job as a PSW.

After being discharged from psychiatric care, PSWs experienced issues that had either a negative impact on their mental wellbeing or even resulted in their readmission back into inpatient psychiatric care. This study identified three inter-related recurrent themes – continuity of support, having options and realisation, all concerning difficulties in adjusting to independent community life following discharge. The findings of the study highlighted the importance of ensuring that service users should be actively involved in their discharge planning, and the use of effective post-discharge planning processes should be used as a crucial step to avoid readmission.

A deeper insight into the factors that impact on readmission to secure care is needed. The active involvement of service users in effective pre- and post-discharge planning is crucial to avoid readmission.

Mental health professionals should consider developing more effective discharge interventions in collaboration with service users; inpatient services should consider creating more effective post-discharge information care and support packages. Their lived experience empowers PSWs to play a key role in guiding patients in the discharge process.

This is the first study, to the best of the authors’ knowledge, to explore what it feels like being discharged from inpatient mental health care by interviewing PSWs employed at a forensic mental health hospital by adopting a phenomenological approach. This paper offers a deeper insight into the transition process and explores in detail what support is needed post discharge to avoid potential readmission from PSWs’ perspectives.

People experiencing homelessness are high-users of hospital care in Canada. To better understand the scope of the issue, and how these patients are discharged from hospital, a national survey of key stakeholders was conducted in 2017. The paper aims to discuss this issue.

The Canadian Observatory on Homelessness distributed an online survey to their network of members through e-mail and social media. A sample of 660 stakeholders completed the mixed-methods survey, including those in health care, non-profit, government, law enforcement and academia.

Results indicate that hospitals and homelessness sector agencies often struggle to coordinate care. The result is that these patients are usually discharged to the streets or shelters and not into housing or housing with supports. The health care and homelessness sectors in Canada are currently structured in a way that hinders collaborative transfers of patient care. The three primary and inter-related gaps raised by survey participants were: communication, privacy and systems pressures.

The findings are limited to those who voluntarily completed the survey and may indicate self-selection bias. Results are limited to professional stakeholders and do not reflect patient views.

Identifying systems gaps from the perspective of those who work within health care and homelessness sectors is important for supporting system reforms.

This survey was the first to collect nationwide stakeholder data on homelessness and hospital discharge in Canada. The findings help inform policy recommendations for more effective systems alignment within Canada and internationally.

The purpose of this paper is to investigate the effect of power on pulsed plasma thruster (PPT) discharge current with respect to its peak, duration, and behavior while the power elevates in a low power range.

A rectangular parallel‐plate breech‐fed PPT has been developed with a self‐inductor coupling element connecting the PPT cathode to the ignitor plug cathode. The PPT has been operated in vacuum chamber at 10⁻⁶ mbar and its discharge current has been recorded using a Rogowski coil while input power has been changed by means of varying the capacitor voltage at given capacitance and frequency.

The analysis leads to elucidate the effects of input power on discharge current of a PPT employing a self‐inductor coupling element. The power varies within a range of less than 10 to more than 50 W. The results show that current peak rises from 5 to 10 kA while discharge duration and behavior seems to be independent of power within the operating range. Additionally, utilization of the coupling element seems to change the typical oscillating behavior of PPT discharge to a more efficient behavior.

The analysis is mainly focused on breech‐fed PPTs while employing a coupling element.

The paper analyzes the influence of power on discharge current of a PPT employing a self‐inductor coupling element. It clarifies the behavior of current peak, duration and behavior while power varies in a low power range. The effect of coupling element is shown to be promising. The results can be a help in design of μPPTs.