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  1. Article: QUALITY IMPROVEMENT: Supporting a hospital in difficulty: -experience of a '-buddying' agreement to implement a new medical pathway.

    Leach, Richard / Banerjee, Sandip / Beer, Gail / Tencheva, Svetka / Conn, Deidre / Waterman, Ashley / Parrott, Jackie / Gifford, Julie / Steddon, Simon / Abbs, Ian / Pritchard, Amanda / Kerr, Ron / Dwyer, Lesley / Hamilton-Fairley, Diana

    Future healthcare journal

    2019  Volume 6, Issue 1, Page(s) 67–75

    Abstract: Increased NHS regulation has identified many healthcare organisations with operational and/or financial difficulties. Although the causes are often complex, most cases are effectively managed internally with limited input from external agencies. How best ...

    Abstract Increased NHS regulation has identified many healthcare organisations with operational and/or financial difficulties. Although the causes are often complex, most cases are effectively managed internally with limited input from external agencies. How best to support the few organisations needing additional support has not been established. 'Buddying', in which senior clinical and managerial teams from a well performing organisation work with colleagues from an organisation in difficulty has been proposed as a potential solution. Previous reports suggest that these partnerships are generally valued by the organisation in difficulty but there is a paucity of measured operational benefit. In this article we present our experience of a 'buddying agreement' and its impact on the introduction of a new 'whole system' medical pathway (ie rotas, staffing, process) at an organisation in difficulty. We describe the process, problems, effect on operational performance, staff survey feedback six months post-implementation and the lessons learned.  Factors critical to success were good communication; clear responsibilities, common values and strong governance; incorporation into an effective local improvement programme; targeting of specific issues; ability to influence people and foster relationships; adequate 'manpower' and gradual transition to local 'ownership'.
    Language English
    Publishing date 2019-05-14
    Publishing country England
    Document type Journal Article
    ZDB-ID 3016427-8
    ISSN 2514-6653 ; 2514-6645
    ISSN (online) 2514-6653
    ISSN 2514-6645
    DOI 10.7861/futurehosp.6-1-67
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Case report: making the CONN-ection: two cases of persistent hypertension and hypokalaemia following renal transplantation.

    Kumar, Atul / Hubbard, Johnathan / Moonim, Mufaddal / Steddon, Simon / Goldsmith, David

    International urology and nephrology

    2011  Volume 44, Issue 5, Page(s) 1577–1580

    Abstract: Conn's syndrome following renal transplantation is extremely rare. Here, we present two cases of persistent hypertension and hypokalemia, emerging after kidney transplantation, which proved resistant to medical treatment. In both patients, biochemical ... ...

    Abstract Conn's syndrome following renal transplantation is extremely rare. Here, we present two cases of persistent hypertension and hypokalemia, emerging after kidney transplantation, which proved resistant to medical treatment. In both patients, biochemical investigations elicited massively elevated plasma aldosterone levels and suppressed renin activity. Abdominal MRI demonstrated a 90- and 20-mm right adrenal tumour in cases 1 and 2, respectively. For both patients, curative treatment was achieved via laparoscopic right adrenalectomy.
    MeSH term(s) Adrenal Gland Neoplasms/complications ; Adrenal Gland Neoplasms/diagnosis ; Adrenal Gland Neoplasms/surgery ; Adult ; Aged ; Female ; Humans ; Hyperaldosteronism/etiology ; Kidney Transplantation/adverse effects ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed
    Language English
    Publishing date 2011-03-04
    Publishing country Netherlands
    Document type Case Reports ; Journal Article
    ZDB-ID 204048-7
    ISSN 1573-2584 ; 0301-1623 ; 0042-1162
    ISSN (online) 1573-2584
    ISSN 0301-1623 ; 0042-1162
    DOI 10.1007/s11255-011-9924-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: New prospects for the management of renal bone disease.

    Steddon, Simon J / Fan, Stanley L S / Cunningham, John

    Nephron. Clinical practice

    2005  Volume 99, Issue 1, Page(s) c1–7

    Abstract: The last decade has been a remarkably productive one in the field of bone biology. New insights into the maintenance of a normal bone microenvironment have led to significant advances in our understanding of many important skeletal disorders, including ... ...

    Abstract The last decade has been a remarkably productive one in the field of bone biology. New insights into the maintenance of a normal bone microenvironment have led to significant advances in our understanding of many important skeletal disorders, including renal osteodystrophy. Novel targets for therapeutic manipulation have been exposed and encouraging progress made towards new treatments. In addition, just as clinical studies have alerted us to the potential hazards of vascular calcification, basic science has unearthed the intimate nature of the relationship between the previously separate disciplines of bone and vascular biology. The clinical nephrologist, however, may be forgiven a little cynicism at this point. If such progress has been made, why do the same proverbial difficulties confront us in day-to-day practice? Control of phosphate remains inadequate, despite a literature which constantly reaffirms its crucial importance, and parathyroid hyperplasia seems inevitable in many patients. Furthermore, even the satisfaction of successful control of serum parathyroid hormone concentration must now be tempered by disquiet regarding the skeletal and cardiovascular consequences of oversuppression. This review aims to provide an update of the latest developments in relevant skeletal research and to assess how recently acquired knowledge may improve clinical nephrological practice over the next five years.
    MeSH term(s) Animals ; Bone Remodeling/physiology ; Calcium/blood ; Carrier Proteins/physiology ; Chronic Kidney Disease-Mineral and Bone Disorder/diagnostic imaging ; Chronic Kidney Disease-Mineral and Bone Disorder/physiopathology ; Chronic Kidney Disease-Mineral and Bone Disorder/therapy ; Cinacalcet Hydrochloride ; Humans ; Hyperparathyroidism/drug therapy ; Hyperplasia ; Membrane Glycoproteins/physiology ; Naphthalenes/therapeutic use ; Osteoclasts/physiology ; Parathyroid Glands/pathology ; Parathyroid Hormone/blood ; Parathyroidectomy ; RANK Ligand ; Radiography ; Receptor Activator of Nuclear Factor-kappa B ; Vitamin D/analogs & derivatives
    Chemical Substances Carrier Proteins ; Membrane Glycoproteins ; Naphthalenes ; Parathyroid Hormone ; RANK Ligand ; Receptor Activator of Nuclear Factor-kappa B ; TNFRSF11A protein, human ; TNFSF11 protein, human ; Vitamin D (1406-16-2) ; Cinacalcet Hydrochloride (1K860WSG25) ; Calcium (SY7Q814VUP)
    Language English
    Publishing date 2005
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 207121-6
    ISSN 1660-2110 ; 1423-0186 ; 2235-3186 ; 1660-8151 ; 0028-2766
    ISSN (online) 1660-2110 ; 1423-0186 ; 2235-3186
    ISSN 1660-8151 ; 0028-2766
    DOI 10.1159/000081787
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Vitamin D analogues: how do they differ and what is their clinical role?

    Steddon, S J / Schroeder, N J / Cunningham, J

    Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

    2001  Volume 16, Issue 10, Page(s) 1965–1967

    MeSH term(s) Animals ; Chronic Kidney Disease-Mineral and Bone Disorder/drug therapy ; Chronic Kidney Disease-Mineral and Bone Disorder/physiopathology ; Drug Design ; Humans ; Hyperparathyroidism, Secondary/drug therapy ; Hyperparathyroidism, Secondary/physiopathology ; Uremia/drug therapy ; Uremia/physiopathology ; Vitamin D/analogs & derivatives ; Vitamin D/physiology ; Vitamin D/therapeutic use
    Chemical Substances Vitamin D (1406-16-2)
    Language English
    Publishing date 2001-10
    Publishing country England
    Document type Editorial ; Review
    ZDB-ID 90594-x
    ISSN 1460-2385 ; 0931-0509
    ISSN (online) 1460-2385
    ISSN 0931-0509
    DOI 10.1093/ndt/16.10.1965
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: New Prospects for the Management of Renal Bone Disease

    Steddon, Simon J. / Fan, Stanley L.S. / Cunningham, John

    Nephron Clinical Practice

    2005  Volume 99, Issue 1, Page(s) c1–c7

    Abstract: The last decade has been a remarkably productive one in the field of bone biology. New insights into the maintenance of a normal bone microenvironment have led to significant advances in our understanding of many important skeletal disorders, including ... ...

    Institution Department of Renal Medicine and Transplantation, Bart’s and the London NHS Trust Department of Nephrology, The Middlesex Hospital, University College London Hospitals, London, UK
    Abstract The last decade has been a remarkably productive one in the field of bone biology. New insights into the maintenance of a normal bone microenvironment have led to significant advances in our understanding of many important skeletal disorders, including renal osteodystrophy. Novel targets for therapeutic manipulation have been exposed and encouraging progress made towards new treatments. In addition, just as clinical studies have alerted us to the potential hazards of vascular calcification, basic science has unearthed the intimate nature of the relationship between the previously separate disciplines of bone and vascular biology. The clinical nephrologist, however, may be forgiven a little cynicism at this point. If such progress has been made, why do the same proverbial difficulties confront us in day-to-day practice? Control of phosphate remains inadequate, despite a literature which constantly reaffirms its crucial importance, and parathyroid hyperplasia seems inevitable in many patients. Furthermore, even the satisfaction of successful control of serum parathyroid hormone concentration must now be tempered by disquiet regarding the skeletal and cardiovascular consequences of oversuppression. This review aims to provide an update of the latest developments in relevant skeletal research and to assess how recently acquired knowledge may improve clinical nephrological practice over the next five years.
    Keywords Osteodystrophy ; Adynamic bone disease ; Bone remodelling ; Calcium ; Phosphorus ; Vitamin D
    Language English
    Publishing date 2005-01-14
    Publisher S. Karger AG
    Publishing place Basel, Switzerland
    Document type Article
    Note Minireview
    ZDB-ID 207121-6
    ISSN 1660-2110 ; 1423-0186 ; 2235-3186 ; 1660-8151 ; 0028-2766
    ISSN (online) 1660-2110 ; 1423-0186 ; 2235-3186
    ISSN 1660-8151 ; 0028-2766
    DOI 10.1159/000081787
    Database Karger publisher's database

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  6. Article ; Online: New Prospects for the Management of Renal Bone Disease

    Steddon, Simon J. / Fan, Stanley L.S. / Cunningham, John

    Nephron Clinical Practice

    2005  Volume 99, Issue 1, Page(s) c1–c7

    Abstract: The last decade has been a remarkably productive one in the field of bone biology. New insights into the maintenance of a normal bone microenvironment have led to significant advances in our understanding of many important skeletal disorders, including ... ...

    Abstract The last decade has been a remarkably productive one in the field of bone biology. New insights into the maintenance of a normal bone microenvironment have led to significant advances in our understanding of many important skeletal disorders, including renal osteodystrophy. Novel targets for therapeutic manipulation have been exposed and encouraging progress made towards new treatments. In addition, just as clinical studies have alerted us to the potential hazards of vascular calcification, basic science has unearthed the intimate nature of the relationship between the previously separate disciplines of bone and vascular biology. The clinical nephrologist, however, may be forgiven a little cynicism at this point. If such progress has been made, why do the same proverbial difficulties confront us in day-to-day practice? Control of phosphate remains inadequate, despite a literature which constantly reaffirms its crucial importance, and parathyroid hyperplasia seems inevitable in many patients. Furthermore, even the satisfaction of successful control of serum parathyroid hormone concentration must now be tempered by disquiet regarding the skeletal and cardiovascular consequences of oversuppression. This review aims to provide an update of the latest developments in relevant skeletal research and to assess how recently acquired knowledge may improve clinical nephrological practice over the next five years.
    Keywords Osteodystrophy ; Adynamic bone disease ; Bone remodelling ; Calcium ; Phosphorus ; Vitamin D
    Language English
    Publisher S. Karger AG
    Publishing place Basel
    Publishing country Switzerland
    Document type Article ; Online
    ZDB-ID 207121-6
    ISSN 1660-2110 ; 1423-0186 ; 0028-2766 ; 1660-8151 ; 1660-2110 ; 0028-2766 ; 1660-8151
    ISSN (online) 1660-2110 ; 1423-0186
    ISSN 1660-2110 ; 0028-2766 ; 1660-8151
    DOI 10.1159/000081787
    Database Karger publisher's database

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