Major advances over the past decades have transformed the management landscape of neuromuscular disorders. Increased availability of genetic testing, innovative therapies that target specific disease pathways and mechanisms, and a multidisciplinary approach to care including both transitional and palliative care contribute to timely and more appropriate management of conditions that are associated with a severe disease burden and often also a reduction of life expectancy.

There is an increasing number of consensus recommendations/guidelines that are a useful adjunct for establishing a timely and accurate diagnosis, and enable prognostication of disease-related complications, are a guide for multidisciplinary care and treatment, and expedite initiation of disease-modifying interventions. A number of these guidelines have been referred to in various cases, such as myasthenia gravis (MG), myotonic dystrophy type 1 and 2, chronic inflammatory demyelinating neuropathies (CIDP), and Duchenne muscular dystrophy (DMD), to name a few.

This contribution analyzes the impact of digital health care on the European Union (EU) legislative framework concerning cross-border health care and the related reimbursement rules. Traditionally, cross-border health care concerns a situation where a patient crosses an internal EU border. However, with the introduction of digital health care, a patient is no longer required to move to receive cross-border health care. Under EU law, patients have two independent rights to reimbursement for medical expenses in a cross-border situation, embedded in Regulation 833/2004 on Social Security Systems and the Patients’ Rights Directive 2011/24. A striking difference between the Regulation and the Directive lies in the fact that the Directive explicitly addresses digital health care, referring to “telemedicine,” whereas the Regulation does not. Also, whereas under the Directive, cross-border health care is reimbursed at the home-state rate, under the Regulation, cross-border health care is reimbursed at the host-state rate, leaving room for forum shopping for advantageous reimbursement rates. However, as the Regulation refers to “travel” and “temporary residence” in the host state, such forum shopping would not be available for digital cross-border health care. This contribution focusses on these discrepancies between the Directive and the Regulation, and specifically on the consequences for the reimbursement of patients benefitting from cross-border digital health care. Digital and physical cross-border health care reimbursement opportunities are compared, and based on the outcomes, an assessment is made as to whether the Regulation should be updated to be suitable for digital health care.

Constant pivoting by clinical teams and leadership was required to provide quality care during the COVID-19 pandemic. We share the roadmap used by Mount Sinai Beth Israel Medical Center, an academic tertiary care facility in the East Village of Manhattan, which is part of the Mount Sinai Health System. Lessons learned are discussed in the response of this care facility to the overwhelming influx of patients. New York City became the epicenter of COVID-19 in the United States and the disease quickly overwhelmed one of the largest cities in the world, resulting in historical shut downs that impacted the infrastructure of the city. Clinical leaders needed to act quickly in order to prepare the facility for the surge of patients, which required the creation of more than double the normal capacity of medical/surgical beds and a tripling of the number of intensive care unit beds, which resulted in a tremendous need for supplies and equipment, especially ventilators. This chapter allows readers to follow the facility as the pandemic unfolded, showing the clinical challenges that were faced as information developed and guidance changed daily regarding best practices and methods to treat patients, protect staff, and stop the spread of the virus.

This introductory chapter sets out the need for a handbook of university mental health. It considers the health of staff alongside that of students, and that does not presume American systems of education and healthcare. Far more of the UK population expects to attend university, with a consequent expansion in the size and numbers of institutions. Financial constraints mean that universities can no longer run as elite communities of self-governing scholars, but are now governed according to business models, with implications for the wellbeing of all involved. In the context of population-wide increases in mental disorder and demand for treatment, more students than ever now disclose a psychiatric diagnosis. The recent COVID pandemic and lockdown disproportionately threatened the well-being of students and may have changed for good some of the ways in which education and healthcare are delivered. The author summarises her own personal and professional of UK university life and describes the motivation for embarking on the production of a single author handbook on this topic. A wide readership is welcomed to the book, which will provide a series of interlinked but standalone chapters to be consulted piecemeal as well as read as a whole.

Three groups of severe mental illness have disproportionately high rates of suicide – Schizophrenia, bipolar disorder, and anorexia nervosa – but effective treatment can save lives. Despite more positive conversations about mental health, we often avoid the very mention of schizophrenia and psychotic disorders. It is impossible and unsafe to support a seriously mentally ill person unaided. Clinicians and lay carers need to be part of a mutually supportive network. Integrating care involves a series of permissions - preferably arranged in advance – to communicate with confidentiality, privacy and dignity. Effective treatment of acute psychoses involves thoughtful prescribing and monitoring of medication. It is understandable to feel angry and sad about having an illness that interrupts life and education. There are effective treatments even for the most severe mental illnesses that affect young students. However, it takes far longer to see recovery than with most physical conditions. Policies on admissions, fitness to study and time taken out of studies need to take account of this. Students usually need care to be transferred to the location of the family home and later back again. NHS teams may be able to use telemedicine to communicate with a distant University.

Advances in technology have virtually transformed communication and interaction modalities. Telemental health provides the advantages to reach those patients who may otherwise have limited mental health care delivery due to the lack of specialty professionals, limited financial resources to face costs and lost wages for travel to distant clinics, or go without services altogether. Remote technologies, including telemental health and telepsychiatry, broadly became a cost-effective and complementary tool to overcome restricted clinical practices, safely engage, and manage patients suffering with mental disorders who need care, support, and treatment. Although most research to date has demonstrated adequate comparability to traditional in-person modalities to deliver mental health care, there remain some concerns among professionals regarding the implementation of telemental health and telepsychiatry in routine clinical practice, as there may be a set of technological and logistic barriers as well as safety, privacy, and confidentiality issues to be addressed.

In many domains of life, COVID-19 has reshaped our understandings of the home as a space of work, education and care. This chapter explores the home as a site of abortion care, after the “home” was approved in countries worldwide as a place where doctors could virtually prescribe, and people could take abortion pills. The chapter explores different visions of abortion-at-home in the COVID-19 regulatory reforms, and different experiences and understandings of that care. Part I tracks the constructions of the home within a crisis management discourse, as favored in state justifications for the reforms. Motivated by a historic state of emergency, a temporary response to ensure access to care and to limit exposure to the virus, these reforms are characterized as pragmatic and conservative by enabling clinicians to safely administer an abortion with the same control brought into the home. Part II proposes an alternative legacy of the reforms by focusing on the agency of people in transforming their homes into places of care. While introduced of necessity, the home becomes a site of experimentation and improvisation informed by a home aesthetic unbounded by the regulated structures of medical care. Intersecting with the everyday tasks, products and people of home life, abortion care is opened to all forms of radical diversity, especially during a time when people are forming new relationships to their home and investing new meaning in it. The chapter concludes by imagining the future of abortion law born of public health need but habituated in the home.

What explains the variation in the ways countries and individuals have responded to the COVID-19 pandemic? Anti-mask protests in the United States, Germany, and England stand in stark contrast to socially-distanced protests in Serbia, Pakistan, and Mexico, where doctors and the public have demanded a more robust government response. Countries as diverse as New Zealand, Senegal, Vietnam, and South Korea have been praised for their effective responses to the pandemic, while Brazil, the United States, Mexico, and Sweden have seen their responses criticized both at home and abroad. Scholars of political culture see participating in anti-mask protests or the adoption of specific government response strategies as rooted in human attempts to make sense of the world that occur within particular cultural contexts. We develop a typology of “National Public Health Cultures,” drawing on legal, political, and social indicators measured prior to the pandemic. We use principal component analysis (PCA) along with the experiences of several key countries, including the United States, Germany, Mexico, South Korea, Kenya, and New Zealand, to develop our typology. A systematic analysis of national public health cultures improves our understanding of the varied responses to COVID-19 and integrates the proliferation of single-factor explanations of pandemic-handling success into a broader framework.