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OBJECTIVE: The purpose of this study was to understand the uses of telehealth with justice-involved adults under community supervision with substance use problems, including their experiences during the pandemic. METHODS: Structured interviews were administered among 17 justice-involved adults under community supervision about their experiences with telehealth services to treat substance use disorders. Thematic coding was used for the analysis. RESULTS: We identified 5 primary themes: (1) knowledge about and experiences with telehealth services during the pandemic; (2) telehealth services available; (3) service changes during the pandemic; and (4) individual motivations around treatment-seeking behavior. CONCLUSION: Overall, our findings reveal that many individuals on probation or parole appreciate having access to telehealth and found that modality convenient for counseling services. Findings shed light on participants' understanding of telehealth, their experiences in using the modality, and how this modality may serve their needs in other ways. External and internal barriers to accessing telehealth are also discussed.

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This article provides an overview of Dr. Donna Rasin-Waters' career path and experiences providing telehealth at the Brooklyn Campus of the Veterans Affairs New York Harbor Healthcare Systems. Dr. Rasin-Waters, a psychologist and neuropsychologist with a specialty in geropsychology, began working toward the provision of evidence-based therapy via telehealth for Veterans in 2010. She believed that, in addition to rural communities, telehealth held utility for Veterans in densely populated areas, particularly for elderly adults with limited means for transportation. Since the COVID-19 pandemic, Dr. Rasin-Waters has seen a rapid boom in the use of telehealth for a variety of clinical activities with Veterans. This has further brought to light promising implications for the provision of remote mental health services, as well as important telehealth training and cultural considerations for clinicians. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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Vagus nerve stimulation (VNS) currently treats patients with drug-resistant epilepsy, depression, and heart failure. The mild intensities used in chronic VNS suggest that primary visceral afferents and central nervous system activation are involved. Here, we measured the activity of neurons in the nucleus of the solitary tract (NTS) in anesthetized rats using clinically styled VNS. Our chief findings indicate that VNS at threshold bradycardic intensity activated NTS neuron discharge in one-third of NTS neurons. This VNS directly activated only myelinated vagal afferents projecting to second-order NTS neurons. Most VNS-induced activity in NTS, however, was unsynchronized to vagal stimuli. Thus, VNS activated unsynchronized activity in NTS neurons that were second order to vagal afferent C-fibers as well as higher-order NTS neurons only polysynaptically activated by the vagus. Overall, cardiovascular-sensitive and -insensitive NTS neurons were similarly activated by VNS: 3/4 neurons with monosynaptic vagal A-fiber afferents, 6/42 neurons with monosynaptic vagal C-fiber afferents, and 16/21 polysynaptic NTS neurons. Provocatively, vagal A-fibers indirectly activated C-fiber neurons during VNS. Elevated spontaneous spiking was quantitatively much higher than synchronized activity and extended well into the periods of nonstimulation. Surprisingly, many polysynaptic NTS neurons responded to half the bradycardic intensity used in clinical studies, indicating that a subset of myelinated vagal afferents is sufficient to evoke VNS indirect activation. Our study uncovered a myelinated vagal afferent drive that indirectly activates NTS neurons and thus central pathways beyond NTS and support reconsideration of brain contributions of vagal afferents underpinning of therapeutic impacts.NEW & NOTEWORTHY Acute vagus nerve stimulation elevated activity in neurons located in the medial nucleus of the solitary tract. Such stimuli directly activated only myelinated vagal afferents but indirectly activated a subpopulation of second- and higher-order neurons, suggesting that afferent mechanisms and central neuron activation may be responsible for vagus nerve stimulation efficacy.

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