The COVID-19 pandemic initiated a mass switch to psychological therapy being delivered remotely, including at Anxiety UK, a national mental health charity. Understanding the impact of this forced switch could raise implications for the provision of psychological therapies going forwards.

To understand whether the forced switch to remote therapy had any impact on outcomes, and if certain groups should continue to be routinely offered certain delivery modalities in future.

Data were available for 2323 individuals who accessed Anxiety UK services between January 2019 and October 2021. Demographic data, baseline and discharge anxiety and depression symptoms, and mode of therapy delivery were available.

Regression models were built to model (a) the mode of therapy delivery received pre-pandemic using logistic regression, and (b) outcomes pre- and post-pandemic onset within demographic groups.

No statistically significant changes in baseline anxiety symptoms, demographics or outcomes were observed before and after the onset of the COVID-19 pandemic.

Pre-pandemic, males were more likely to receive online video therapy than telephone therapy (Relative Risk Ratio (RRR) 1.42, [1.01, 1.99]), while older clients were less likely to receive online video therapy (RRR 0.98, [0.97, 0.99]). However, no differences in outcomes were observed post-pandemic onset within these groups, with only the number of sessions of therapy being a significant predictor of outcomes.

Anxiety UK services remained effective throughout the pandemic. We observed no evidence that any demographic group had worse outcomes following the forced switch to remote therapy.

Effective doctor–patient communication is a core competency for healthcare professionals. With the pivot to online clinical education and assessment due to the COVID-19 pandemic, there was a need to explore the views of psychiatric trainees and examiners on assessment of communication skills during online high stakes postgraduate examinations.

The study was designed as descriptive qualitative research. All candidates and examiners of the September and November 2020 sitting of online Basic Specialist Training exam (a clinical Objective Structured Clinical Examination exam completed in the first 4 years of psychiatry training) were invited to participate. The respondents were interviewed by Zoom which was transcribed verbatim. Data were analyzed by NVivo20 pro and various themes and subthemes were drawn using Braun and Clarke thematic analysis.

A total of seven candidates and seven examiners were interviewed with an average duration of 30 minutes and 25 minutes, respectively. Four main themes emerged: Communication, Screen optimization, Continuation postpandemic and Overall experience. All candidates preferred to continue an online format post pandemic for practical reasons e.g., avoiding travel and overnight stay, while all examiners preferred to go back to in-person Objective Structured Clinical Examination. However, continuation of online Clinical Formulation and Management Examination was agreed by both groups.

The participants were largely satisfied with the online examination but did not consider it equal to face-to-face for picking up nonverbal cues. Overall minimal technical issues were reported. These findings may be helpful to modify current psychiatry membership examinations or similar assessments in other countries and specialties.

Multicentre research databases can provide insights into healthcare processes to improve outcomes and make practice recommendations for novel approaches. Effective audits can establish a framework for reporting research efforts, ensuring accurate reporting, and spearheading quality improvement. Although a variety of data auditing models and standards exist, barriers to effective auditing including costs, regulatory requirements, travel, and design complexity must be considered.

The Congenital Cardiac Research Collaborative conducted a virtual data training initiative and remote source data verification audit on a retrospective multicentre dataset. CCRC investigators across nine institutions were trained to extract and enter data into a robust dataset on patients with tetralogy of Fallot who required neonatal intervention. Centres provided de-identified source files for a randomised 10% patient sample audit. Key auditing variables, discrepancy types, and severity levels were analysed across two study groups, primary repair and staged repair.

Of the total 572 study patients, data from 58 patients (31 staged repairs and 27 primary repairs) were source data verified. Amongst the 1790 variables audited, 45 discrepancies were discovered, resulting in an overall accuracy rate of 97.5%. High accuracy rates were consistent across all CCRC institutions ranging from 94.6% to 99.4% and were reported for both minor (1.5%) and major discrepancies type classifications (1.1%).

Findings indicate that implementing a virtual multicentre training initiative and remote source data verification audit can identify data quality concerns and produce a reliable, high-quality dataset. Remote auditing capacity is especially important during the current COVID-19 pandemic.

The clinical profile of Aboriginal and Torres Strait Islander adults admitted to hospital with neurological injury is not well documented. Understanding these profiles may enable health professionals to provide more culturally responsive health care for this patient group. This study aimed to report the clinical profile of Aboriginal and Torres Strait Islander adults admitted to a regional Queensland hospital due to stroke or traumatic brain injury (TBI).

A 2-year retrospective medical record review of Aboriginal and Torres Strait Islander adults (≥18 years) admitted to a regional Queensland hospital with principal diagnoses of stroke or TBI.

There were 132 Aboriginal and Torres Strait Islander adult stroke (51.5%) or TBI (48.5%) admissions. The mean ages were 56.7 years for stroke and 42.7 years for TBI. The majority of patients (83.3%) were of Aboriginal descent with others identifying as Torres Strait Islander only, or both Aboriginal and Torres Strait Islander. Patients were from 26 diverse home locations across northern Australia, primarily Outer Regional or Remote/Very Remote geographical locations. All patients’ language backgrounds were documented as English only. Over 90% of stroke and 50% of TBI patients presented with medical co-morbidities.

Patients had diverse geographical locations and cultural backgrounds, with many likely impacted by dislocation from home and country, as well as potential delays in receiving treatment. Despite this diversity, English was documented in patients’ medical records as their only language. The majority of patients also presented with multiple medical co-morbidities. Health professionals should consider these factors to ensure patients receive optimum and culturally responsive health care.

To examine the feasibility of using point-of-sale data to assess dietary quality of food sales in remote stores.

A multi-site cross-sectional assessment of food and nutrient composition of food sales. Point-of-sale data were linked to Australian Food and Nutrient Data and compared across study sites and with nutrient requirements.

Remote Aboriginal Australia.

Six stores.

Point-of-sale data were readily available and provided a low-cost, efficient and objective assessment of food and nutrient sales. Similar patterns in macronutrient distribution, food expenditure and key food sources of nutrients were observed across stores. In all stores, beverages, cereal and cereal products, and meat and meat products comprised approximately half of food sales (range 49–57 %). Fruit and vegetable sales comprised 10·4 (sd 1·9) % on average. Carbohydrate contributed 54·4 (sd 3·0) % to energy; protein 13·5 (sd 1·1) %; total sugars 28·9 (sd 4·3) %; and the contribution of total saturated fat to energy ranged from 11·0 to 14·4 % across stores. Mg, Ca, K and fibre were limiting nutrients, and Na was four to five times higher than the midpoint of the average intake range. Relatively few foods were major sources of nutrients.

Point-of-sale data enabled an assessment of dietary quality within stores and across stores with no burden on communities and at no cost, other than time required for analysis and reporting. Similar food spending patterns and nutrient profiles were observed across the six stores. This suggests potential in using point-of-sale data to monitor and evaluate dietary quality in remote Australian communities.

On 09 April 2004, Typhoon Sudal struck the Island of Yap in the Federated States of Micronesia (FSM). Over 90% of homes, public utilities, and public property were damaged or destroyed. Nearly 10% of the population was displaced to shelters, and the majority of the population was without drinking water or power. United States disaster workers were deployed to Yap for three months to assist in the recovery and relief efforts.

The objective of this study was to evaluate the acute healthcare needs of the US disaster relief population serving in a remote setting with limited medical resources.

A retrospective chart review of all disaster relief workers presenting to an emergency clinic in Yap during the disaster relief effort from April 2004–July 2004 was performed. Investigators extracted demographic data, chief complaints, medical histories, medical management, disposition, and outcome data from the clinic charts.

Together, the 60 disaster workers present on Yap during the relief effort made 163 patient contacts in the disaster emergency clinic. A total of 92% of patient contacts were for minor medical complaints or minor trauma, 13% were for upper-respiratory infections, 9% were for gastrointestinal illness, and 9% were for dermatological problems. Eight percent of visits were for serious medical problems or trauma. Life-threatening illnesses or injuries did not occur.

Disaster relief workers on Yap frequently utilized the disaster relief clinic. In general, disaster workers remained healthy during the relief effort in Yap, and most injuries and illnesses were minor. On-site medical providers resulted in rapid care and stabilization, and after treatment, disaster workers were able to return to duty.

The Telemedicine Spacebridge, a satellite-mediated, audio-video-fax link between four United States and two Armenian and Russian medical centers, permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa.

During 12 weeks of operations, 247 Armenian and Russian and 175 American medical professionals participated in 34 half-day clinical conferences. A total of 209 patients were discussed, requiring expertise in 20 specialty areas.

Telemedicine consultations resulted in altered diagnoses for 54, new diagnostic studies for 70, altered diagnostic processes for 47 and modified treatment plans for 47 of 185 Armenian patients presented. Simultaneous participation of several US medical centers was judged beneficial; quality of data transmission was judged excellent.

These results suggest that interactive consultation by remote specialists can provide valuable assistance to on-site physicians and favorably influence clinical decisions in the aftermath of major disasters.