Understanding forensic psychiatry in healthcare practices and collaboration between legal nurse consultants and physicians.

In 2000, the Institute of Medicine stunned many professionals with their published report that noted the vast number of deaths that occur each year in hospitals across the United States which reach as many as 98,000. Therefore, it comes as no surprise that the healthcare arena faces litigious issues regularly, with some specialties budgets being significantly impacted by the cost of maintaining liability insurance. Legal Nurse Consultants and forensic physicians working in tandem but who work independently from treating clinicians can carry out forensic independent medical examinations (IME). This can help to assess the validity of malpractice claims, including issues of causation and degree of injuries claimed due to the incident(s) and recommend treatment strategies where appropriate. Reviews can cover a wide range of issues such as a person's past or current testamentary capacity, a prisoner or an accused person's mental health and/or mental impairment where necessary sending them for more assessment or treatment outside prison. This article argues that independent medical reviews are a useful tool that can assist the civil and criminal courts processes.

Mental Health Care Disparities Now and in the Future.

In 2014, the USA spent $3 trillion dollars in health care the most per capita in the world. However, the USA lacks universal health coverage, and lags behind other highly developed and wealthy countries in life expectancy (even some "non wealthy" countries have better outcomes). The USA also has deficits in other health outcome measures. Health care costs in the USA continue to rise annually and many patients receive only mediocre care. In addition, clear disparities exist across different communities, socioeconomic groups, and race and ethnicity groups. As a result, individuals with mental illness are at an increased risk of being homeless, committing suicide, and having problems maintaining a job. This paper will address mental health disparities and review the efforts some states are taking to improve the lifesaving services offered to citizens with mental illness, in order for them to recover and reach their full potentials.

Early Combination Therapy for Type 2 Diabetes Mellitus and Common Comorbid Mental Disorders.

The relationship between type 2 diabetes mellitus and antipsychotic use by schizophrenia patients is recognized but not well understood. This article reviews the literature regarding metabolic interactions, pathological pathways, and protocols for screening, monitoring, and using combination therapy for individuals with type 2 diabetes mellitus and common comorbid mental health conditions. Because primary care physicians manage patients with both mental and general medical illnesses, such as diabetes, understanding their perspectives on the challenges and facilitators of the care of these patients is critical to improving clinical outcomes. Although the relationship between type 2 diabetes mellitus and antipsychotic use by schizophrenia patients has been recognized, clinical guidelines for their treatment are not recent. Individuals with mental disorders present a vulnerable population with high medical needs that are often mistreated or missed. Given the significant contribution of metabolic syndrome and comorbid diabetes mellitus to morbidity and mortality of such patients, ongoing primary care should be coordinated between general practitioners and mental health professionals to prevent serious complications and adverse medication side effects.

A culturally targeted self-management program for African Americans with type 2 diabetes mellitus.

Inadequate knowledge of the influence of lifestyle on clinical outcomes contributes to the difficulties many African Americans experience with type 2 diabetes mellitus (T2DM). This pilot study examined a 12-week church-based culturally targeted diabetes self-management education (DSME) intervention for middle-aged and older African Americans with T2DM. Quantitative data were collected at baseline and at 12 weeks and included questionnaires and anthropometric measures. There were significant increases in medication adherence (p = .006), healthy eating (p = .009), and foot care adherence (p = .003). The intervention had a clinically significant effect on systolic blood pressure, blood lipids, physical activity, and waist circumference. Church-based culturally targeted DSME interventions may result in improved outcomes for African-American adults with T2DM. The authors discuss the value of community-based interventions that target behavioural changes in populations of chronically ill patients, particularly those who historically have been disenfranchised and/or underserved.