How primary care can contribute to good mental health in adults.

The need for support for good mental health is enormous. General support for good mental health is needed for 100% of the population, and at all stages of life, from early childhood to end of life. Focused support is needed for the 17.6% of adults who have a mental disorder at any time, including those who also have a mental health problem amongst the 30% who report having a long-term condition of some kind. All sectors of society and all parts of the NHS need to play their part. Primary care cannot do this on its own. This paper describes how primary care practitioners can help stimulate such a grand alliance for health, by operating at four different levels - as individual practitioners, as organisations, as geographic clusters of organisations and as policy-makers.

Promoting Mental Health and Preventing Mental Illness in General Practice.

This paper calls for the routine integration of mental health promotion and prevention into UK General Practice in order to reduce the burden of mental and physical disorders and the ensuing pressure on General Practice. The proposals & the resulting document (https://ethicscharity.files.wordpress.com/2015/09/rcgp_keymsg_150925_v5.pdf) arise from an expert 'Think Tank' convened by the London Journal of Primary Care, Educational Trust for Health Improvement through Cognitive Strategies (ETHICS Foundation) and the Royal College of General Practitioners. It makes 12 recommendations for General Practice: (1) Mental health promotion and prevention are too important to wait. (2) Work with your community to map risk factors, resources and assets. (3) Good health care, medicine and best practice are biopsychosocial rather than purely physical. (4) Integrate mental health promotion and prevention into your daily work. (5) Boost resilience in your community through approaches such as community development. (6) Identify people at increased risk of mental disorder for support and screening. (7) Support early intervention for people of all ages with signs of illness. (8) Maintain your biopsychosocial skills. (9) Ensure good communication, interdisciplinary team working and inter-sectoral working with other staff, teams and agencies. (10) Lead by example, taking action to promote the resilience of the general practice workforce. (11) Ensure mental health is appropriately included in the strategic agenda for your 'cluster' of General Practices, at the Clinical Commissioning Groups, and the Health and Wellbeing Board. (12) Be aware of national mental health strategies and localise them, including action to destigmatise mental illness within the context of community development.

How Ealing Health Networks can contribute to efficient and quality healthcare.

We describe how the formation of Health Networks in Ealing leads to improved outcomes for patients by the coordination of the care they receive by health and social care professionals.

Taking diabetes services out of hospital into the community.

We describe four stages of an initiative to co-create a shared care system to treat patients with diabetes out of hospital and in the community.

How Ealing Health Networks can contribute to efficient and quality healthcare.

We describe how the formation of Health Networks in Ealing leads to improved outcomes for patients by the coordination of the care they receive by health and social care professionals.

Taking diabetes services out of hospital into the community.

We describe four stages of an initiative to co-create a shared care system to treat patients with diabetes out of hospital and in the community.

Weight management in African-Americans using church-based community interventions to prevent type 2 diabetes and cardiovascular disease.

The purpose of this literature review was to examine the utilization of church-based interventions designed for African-Americans in the community for the management of overweight and obesity and prevention of type 2 diabetes and cardiovascular disease. PubMed, CINAHL, and Google scholar were searched using the following key search terms: type 2 diabetes, cardiovascular disease, prevention, management, African-Americans, Blacks, weight loss, weight management, church-based interventions, community interventions, faith-based interventions, and prayer. Sixteen primary studies were located and six met inclusion criteria. The studies were separated into two categories: faith-placed interventions or collaborative interventions. The overall results demonstrated significant weight loss ranging from 2.3 (SD = 4.1) pounds to 10.1 (SD = 10.3) pounds post-intervention. Further research is needed to understand interventions that are church-based and culturally sensitive for African-Americans. Weight management is important in order to decrease the morbidity and mortality related to type 2 diabetes and cardiovascular disease in the African-American population.

Depression and coping in heart failure patients: a review of the literature.

PURPOSE: The purpose of this article is to critically evaluate the evidence related to depression and coping in heart failure patients and determine if certain types of coping are more common in heart failure patients with depression. METHODS: A computer search of the literature from January 1996 through October 2008 was conducted. PubMed was searched using the following key search terms: congestive heart failure, heart failure, coping, and depression. Three independent reviewers met to discuss the studies, interpret findings, compare studies, and discuss recommendations. RESULTS: Coping strategies were found to be associated with depression in patients with heart failure. Adaptive coping such as active coping, acceptance, and planning tended to be used by more patients and were associated with less depression. Those who used more maladaptive methods of coping such as denial and disengagement had higher levels of depression. CONCLUSIONS: Further longitudinal research on depression and coping strategies and best treatment options for coping and depression in patients with heart failure are needed.

Diastolic heart failure: state of the science on best treatment practices.

PURPOSE: The purpose of this article is to increase awareness among nurse practitioners (NPs) of the current state of the science on diastolic heart failure (DHF), the American College of Cardiology (ACC) and the American Heart Association (AHA) guidelines for DHF, and pathophysiology, diagnosis, and nonpharmacological and pharmacological management of DHF. DATA SOURCES: The articles included in the review of the state of the science were retrieved by a search of PUBMED literature using the following key search terms: heart failure, diastolic heart failure, preserved systolic function, heart failure management, treatment of diastolic heart failure, treatment of diastolic dysfunction, and treatment of preserved systolic function. Current published guidelines from the ACC and AHA were reviewed to establish clinical recommendations for patients with DHF. CONCLUSIONS: The state of the science and clinical recommendations for DHF are in the early stages compared to those for systolic heart failure (SHF). The need for more randomized clinical trials on nonpharmacological and pharmacological management and the development of standardized guidelines for DHF patients are clearly apparent. IMPLICATIONS FOR PRACTICE: Both nonpharmacologic and pharmacologic management are effective and necessary to control the clinical signs and symptoms of DHF and improve overall quality of life. Successful tailoring of a treatment plan to suit each individual patient's needs and including the family are important for the NP to consider.