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Globally “non-urgent” health care services were ceased in response to the 2020 outbreak of COVID-19, until 2021, when restrictions were lifted. In the UK, this included speech and language therapy services. The implications of COVID-19 restrictions have not been explored. This study aimed to examine the impact of the UK’s COVID-19 response on speech and language therapy services.

An online survey of the practice of speech and language therapists (SLTs) in the UK was undertaken. This explored SLTs’ perceptions of the demand for their services at a time when COVID-19 restrictions had been lifted, compared with before the onset of the pandemic. The analysis was completed using descriptive statistics and content analysis.

Respondents were mostly employed by the UK’s National Health Service (NHS) or the private sector. Many participants reported that demands on their service had increased compared with before the onset of the pandemic. The need to address the backlog of cases arising from shutdowns was the main reason for this. Contributing factors included staffing issues and redeployment. Service users were consequently waiting longer for NHS therapy. Private therapy providers reported increased demand, which they directly attributed to these NHS challenges.

This presents the only focused account of the impact of the national response to COVID-19 on speech and language therapy services in the UK. It has been identified that services continue to face significant challenges, which indicate a two-tier system is emerging. Healthcare system leaders must work with service managers and clinicians to create solutions and prevent the system from being overwhelmed.

The dermatology service on the islands of Orkney, with a population of approximately 22,500, was taken over by National Health Service (NHS) Tayside in August 2018. This paper aims to provide an overview of the planning and review of a highly efficient and effective dermatology service for a rural island population.

The service includes visiting dermatology consultants, enhanced electronic referral vetting, skin surgery services, a General Practice (GP) with extended role (GPwER) in dermatology, specialist virtual clinics, urgent advice for inpatients at the local district general hospital and remote systemic therapy monitoring. A new phototherapy service has been set up in an island GP practice.

Local GPs and consultant dermatologists find the enhanced vetting service useable, efficient and educational. Between August 2018 and November 2022, there have been 1,749 referrals. Of these referrals, 60% were seen in clinic or a GPwER surgery, with 40% managed remotely by providing advice back to the referring GP. The number of consultations performed by the GPwER has grown over the past 3 years, and in the last year, it accounted for more than 50% of patient appointments. The waiting time has been significantly reduced using this model.

This remote service uses an integrated approach of teledermatology (TD) whilst offering continual in-person services using local capabilities including a GPwER and island general surgeons. New treatment facilities are provided to the island population. Continual educational feedback to the primary care referrer is provided, and it enhances relationships that greatly aid the high-quality dermatology service provided.

The COVID-19 pandemic has created a significant disruption in the educational systems worldwide. Some institutions opted for emergency remote education due to the need to cancel in-person activities. The aims of this paper were to evaluate the use of asynchronous methodology in health sciences education, determine whether asynchronous methodology was sacrificing overall student satisfaction, and investigate whether satisfaction improved as the program develops.

Initially, there was phase 1 that corresponded to four weeks of activities. Each professor produced a video lesson, and after each video lesson, a weekly educational activity was made available. Next, phase 2 was implemented using the same methodology, however lasting six weeks. Three questionnaires were developed, and a Likert scale was administered to verify the students’ level of satisfaction. Data were analyzed using frequency distributions, mean values, standard deviation and confidence interval. The normality of the sum data (total of the questionnaires) was tested using the Kolmogorov–Smirnov test.

Although the students pointed out that the asynchronous methodology facilitated access to the content and considered this methodology satisfactory, they expressed a reduced level of satisfaction regarding emergency remote education in general when data from the first weeks were compared to those of the previous weeks. It is clear that students became increasingly discouraged and tired over time, which motivated the institution to shift into a combination of synchronous and asynchronous methodology to improve student learning.

Teaching in the field of health care encompasses difficult competencies that sometimes are impossible to be learned remotely, so there is a need to examine and evaluate properly the remote education in this area. With careful planning, educational institutions can evaluate their experiences during the pandemic, allowing those involved to highlight strengths and identify weaknesses to better prepare for future needs to improve remote education.

This chapter demonstrates the ways in which digital inclusion functions as a super social determinant of health, particularly within the arena of family carework and healthcare for vulnerable disabled US communities. The focus on vulnerable populations, including the elderly, chronically ill, young disabled, neurodivergent, and/or medically complex children and the families that care for them, is a useful case to present a compelling argument for the need to take seriously digital inclusion to maximize health, safety, and well-being for growing populations of Americans today. The authors argue that digital inclusion is an increasingly influential social determinant of health and a key dimension of health equity that offers important benefits and potentials, especially for vulnerable patient populations, for whom in-home and family-centered care are necessary parts of health maintenance, prevention, and well-being. The chapter ends with a discussion of ways that the US government can mitigate digital barriers and facilitate equitable access to broadband internet and e-health resources that address the intersections of digital, health, and care inequalities, with significant impacts in all three dimensions.

The purpose of this paper was to gain a qualitative view of the participant experience of using home-based transcranial direct current stimulation (tDCS). Acceptability impacts patient preference, treatment adherence and outcomes. However, acceptability is usually assessed by rates of attrition, while multifaceted constructs are not reflected or given meaningful interpretations. tDCS is a novel non-invasive brain stimulation that is a potential treatment for major depressive disorder (MDD). Most studies have provided tDCS in a research centre. As tDCS is portable, the authors developed a home-based treatment protocol that was associated with clinical improvements that were maintained in the long term.

The authors examined the acceptability of home-based tDCS treatment in MDD through questionnaires and individual interviews at three timepoints: baseline, at a six-week course of treatment, and at six-month follow-up. Twenty-six participants (19 women) with MDD in a current depressive episode of at least moderate severity were enrolled. tDCS was provided in a bifrontal montage with real-time remote supervision by video conference at each session. A thematic analysis was conducted of the individual interviews.

Thematic analysis revealed four main themes: effectiveness, side effects, time commitment and support, feeling held and contained. The themes reflected the high acceptability of tDCS treatment, whereas the theme of feeling contained might be specific to this protocol.

Qualitative analysis methods and individual interviews generated novel insights into the acceptability of tDCS as a potential treatment for MDD. Feelings of containment might be specific to the present protocol, which consisted of real-time supervision at each session. Meaningful interpretation can provide context to a complex construct, which will aid in understanding and clinical applications.

Eating disorders (EDs) remain a major health concern, and their incidence has further increased since the COVID-19 pandemic. Given the equally increasing demands on treatments and service provision and the high levels of relapse post-treatment, it is important that research explore novel and innovative interventions that can further support recovery for individuals with EDs. There is growing evidence that arts interventions are beneficial for recovery from EDs. This study aims to evaluate the feasibility of conducting a stand-up comedy course to support ED recovery.

The study used a qualitative interview study design to evaluate the recovery benefits of participating in stand-up comedy workshops for a pilot group of people in recovery from EDs (n = 10).

The comedy intervention was well-attended and had high acceptability and feasibility. For most individuals, participating in the course had a positive impact, including promoting personal recovery (PR) outcomes across all five elements of the CHIME framework. Unique assets of the course included providing participants with an opportunity to distance themselves from everyday worries of living with an ED; the opportunity to cognitively reframe situations by making them the object of humour; and providing a safe space to (re-)build a positive sense of self.

This is the first study, to the best of the authors’ knowledge, that evaluates stand-up comedy workshops for ED recovery and further demonstrates the potential of arts interventions and the relevance of PR frameworks in this field.

This study aims to facilitate access to vascular disease screening for low-income individuals living in remote and conflict areas based on the results of a pilot trial in Colombia. Also, to increase the amount of diagnosis training of vascular surgery (VS) in civilians.

The operation method includes five stages: strategy development and adjustment; translation of the strategy into a real-world setting; operation logistics planning; strategy analysis and adoption. The operation plan worked efficiently in this study’s sample. It demonstrated high sensibility, efficiency and safety in a real-world setting.

The authors developed and implemented a flow model operating plan for screening vascular pathologies in low-income patients pro bono without proper access to vascular health care. A total of 140 patients from rural areas in Colombia were recruited to a controlled screening session where they underwent serial noninvasive ultrasound assessments conducted by health professionals of different training stages in VS.

The plan was designed to be implemented in remote, conflict areas with limited access to VS care. Vascular injuries are critically important and common among civilians and military forces in regions with active armed conflicts. As this strategy can be modified and adapted to different medical specialties and geographic areas, the authors recommend checking the related legislation and legal aspects of the intended areas where we will implement this tool.

Different sub-specialties can implement the described method to be translated into significant areas of medicine, as the authors can adjust the deployment and execution for the assessment in peripheral areas, conflict zones and other public health crises that require a faster response. This is necessary, as the amount of training to which VS trainees are exposed is low. A simulated exercise offers a novel opportunity to enhance their current diagnostic skills using ultrasound in a controlled environment.

Evaluating and assessing patients with limited access to vascular medicine and other specialties can decrease the burden of vascular disease and related complications and increase the number of treatments available for remote communities.

It is essential to assess the most significant number of patients and treat them according to their triage designation. This management is similar to assessment in remote areas without access to a proper VS consult. The authors were able to determine, classify and redirect to therapeutic interventions the patients with positive findings in remote areas with a fast deployment methodology in VS.

Access to health care is limited due to multiple barriers and the assessment and response, especially in peripheral areas that require a highly skilled team of medical professionals and related equipment. The authors tested a novel mobile assessment tool for remote and conflict areas in a rural zone of Colombia.

The goal of this research is to analyse the obstacles to the implementation of mobile health (mHealth) in India and to gain an understanding of the contextual inter-relationships that exist amongst those obstacles.

Potential barriers and their interrelationships in their respective contexts have been uncovered. Using MICMAC analysis, the categorization of these barriers was done based on their degree of reliance and driving power (DP). Furthermore, an interpretive structural modeling (ISM) framework for the barriers to mHealth activities in India has been proposed.

The study explores a total of 15 factors that reduce the efficiency of mHealth adoption in India. The findings of the Matrix Cross-Reference Multiplication Applied to a Classification (MICMAC) investigation show that the economic situation of the government, concerns regarding the safety of intellectual technologies and privacy issues are the primary obstacles because of the significant driving power they have in mHealth applications.

Promoters of mHealth practices may be able to make better plans if they understand the social barriers and how they affect each other; this leads to easier adoption of these practices. The findings of this study might be helpful for governments of developing nations to produce standards relating to the deployment of mHealth; this will increase the efficiency with which it is adopted.

At this time, there is no comprehensive analysis of the factors that influence the adoption of mobile health care with social cognitive theory in developing nations like India. In addition, there is a lack of research in investigating how each of these elements affects the success of mHealth activities and how the others interact with them. Because developed nations learnt the value of mHealth practices during the recent pandemic, this study, by investigating the obstacles to the adoption of mHealth and their inter-relationships, makes an important addition to both theory and practice.

The coronavirus disease 2019 (COVID-19) pandemic has had a big impact on organisations globally, leaving organisations with no choice but to adapt to the new reality of remote work to ensure business continuity. Such an unexpected reality created the conditions for testing new applications of smart home technology whilst working from home. Given the potential implications of such applications to improve the working environment, and a lack of research on that front, this paper pursued two objectives. First, the paper explored the impact of smart home applications by examining the factors that could contribute to perceived productivity and well-being whilst working from home. Second, the study investigated the role of productivity and well-being in motivating the intention of remote workers to use smart home technologies in a home-work environment in the future.

The study adopted a cross-sectional research design. For data collection, 528 smart home users working from home during the pandemic were recruited. Collected data were analysed using a structural equation modelling approach.

The results of the research confirmed that perceived productivity is dependent on service relevance, perceived usefulness, innovativeness, hedonic beliefs and control over environmental conditions. Perceived well-being correlates with task-technology fit, service relevance, perceived usefulness, perceived ease of use, attitude to smart homes, innovativeness, hedonic beliefs and control over environmental conditions. Intention to work from a smart home-office in the future is dependent on perceived well-being.

The findings of the research contribute to the organisational and smart home literature, by providing missing evidence about the implications of the application of smart home technologies for employees' perceived productivity and well-being. The paper considers the conditions that facilitate better outcomes during remote work and could potentially be used to improve the work environment in offices after the pandemic. Also, the findings inform smart home developers about the features of technology which could improve the developers' application in contexts beyond home settings.