Reducing therapeutic inertia in type 2 diabetes.

Background: Therapeutic inertia describes a failure to establish appropriate treatment targets and escalate treatment to achieve those targets. This inertia can be measured, and evidence of this inertia is present in approximately one-third of diabetes management consultations. This inertia describes a failure in the system to produce change, rather than assigning fault to the physician or patient.

Psychological triage in general practice.

Background: Triage involves matching resources to the patient - based on limited information - as quickly as possible. Principles from triage can be applied to the assessment and management of patients with psychological distress.

Objective: This article describes four steps in triage - once significant distress is identified: assessing the severity, looking for indicators that point to a diagnosis, formulating a working diagnosis, and treating the distress.

Vitamin D - a review.

Background: Vitamin D status affects musculoskeletal health. More recently, the nonmusculoskeletal actions of vitamin D have become increasingly documented including endocrine effect on kidneys and intestine, local autocrine effects on cell differentiation, proliferation and immune modulation, and cell membrane effects including promotion of the intestinal absorption of calcium and the secretion of insulin.

Objective: This article discusses the actions, sources and measurement of vitamin D, and the treatment of established deficiency.