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Brian Clemency, Colleen Clemency Cordes, Heather A Lindstrom, Jeanne M Basior, Deborah P Waldrop
OBJECTIVES: What patients intend when they make health care choices and whether they understand the meaning of orders for life-sustaining treatment forms is not well understood. The purpose of this study was to analyze the directives from a sample of emergency department (ED) patients' MOLST forms. PROCEDURES: MOLST forms that accompanied 100 patients who were transported to an ED were collected and their contents analyzed. Data categories included age, gender, if the patient completed the form for themselves, medical orders for life-sustaining treatment including intubation, ventilation, artificial nutrition, artificial fluids or other treatment, and wishes for future hospitalization or transfer...
September 27, 2016: Journal of the American Medical Directors Association
Signe de Place Knudsen, Inge Eidemak, Stig Molsted
Health related quality of life (HRQOL) has become a recognized outcome in studies of the treatment of patients undergoing hemodialysis (HD). The aim of this study was to assess changes in HRQOL reported by two different samples of patients undergoing HD in the same dialysis center in 2002 and 2015. Two samples of patients from the same Danish dialysis center completed the HRQOL questionnaire Kidney Disease Quality of Life version 1.3 in 2002 (n = 71) and 2015 (n = 81), respectively. The associations between KDQOL summery scores and the time frame were analyzed in multivariable regression analyses...
September 2016: Renal Failure
Henrik Hansen, Nina Føns Johnsen, Stig Molsted
BACKGROUND: Promotion of a healthy lifestyle and non-pharmacological interventions in the treatment of chronic obstructive pulmonary disease (COPD) has received great attention in recent decades. The aim of this study was to investigate trends in leisure time physical activity (PA), smoking, alcohol consumption and body mass index (BMI) from 2000 to 2010 in Danish individuals with and without COPD. METHODS: Analyses were based on data provided by The Danish Health and Morbidity's three cross-sectional surveys from 2000, 2005 and 2010...
2016: BMC Pulmonary Medicine
Ishani Ganguli, Eva Chittenden, Vicki Jackson, Alexa B Kimball
BACKGROUND: Early conversations between clinicians and patients about goals of care may improve patients' quality of life and prevent nonbeneficial care near the end of life, but these conversations are limited in frequency and scope. To address this issue, clinicians are increasingly asked to use standardized medical order forms, like the Medical Orders for Life-Sustaining Treatment (MOLST), to document end-of-life conversations and to help ensure that patients' wishes are realized. In kind, the Centers for Medicare and Medicaid Services recently decided to reimburse physicians as well as nurse practitioners and physician assistants for these conversations...
June 15, 2016: Journal of Palliative Medicine
Alison E Turnbull, Margaret M Hayes, Mohamed D Hashem, Dale M Needham
RATIONALE: Legal documents similar to the Maryland Medical Orders for Life-Sustaining Treatment (MOLST) form requiring physician endorsement are increasingly used by critically ill patients. OBJECTIVES: To evaluate whether an interactive, online training module on completion and interpretation of the MOLST form leads to a sustained increase in knowledge among house staff. METHODS: Pre/post survey of 329 house staff at Johns Hopkins Hospital who admit and discharge patients between June 2014 and July 2015...
June 2016: Annals of the American Thoracic Society
Osama W Amro, Malar Ramasamy, James A Strom, Daniel E Weiner, Bertrand L Jaber
BACKGROUND: The Renal Physicians Association's clinical practice guideline recommends that physicians address advance care planning with dialysis patients. However, data are lacking about how best to implement this recommendation. STUDY DESIGN: Quality improvement project. SETTINGS & PARTICIPANTS: Nephrologists caring for patients treated with maintenance hemodialysis at 2 dialysis facilities identified patients who might benefit most from advance care planning using the "surprise" question ("Would I be surprised if this patient died in the next year?")...
July 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Janette N Evans, Lisa S Ball, Camille P Wicher
BACKGROUND: When an outpatient in a northeastern cancer institute requested a Medical Orders for Life-Sustaining Treatment (MOLST) form, the state's approved resuscitation form in all settings, none were available. A project was undertaken to institute MOLST forms into policy and routine practice. Research supports early discussions of end-of-life care in patients with cancer and the use of MOLST as an effective tool. OBJECTIVES: The purpose of this article is to discuss the initiation and facilitation of MOLST implementation into practice and policy at a cancer institute...
February 2016: Clinical Journal of Oncology Nursing
Patricia A Bomba, Katie Orem
This article reviews the lessons learned from the development and implementation of New York's community approach to advance care planning (ACP) as a wellness initiative and the key components of the complementary programs: Community Conversations on Compassionate Care (CCCC) and Medical Orders for Life-Sustaining Treatment (MOLST). Shared, informed medical decision-making is a patient-centered process that is critical to ensuring patient preferences for care are honored at the end of life. Providers must be trained, qualified, and comfortable with the discussions needed for effective shared, informed medical decision-making...
January 2015: Annals of Palliative Medicine
Stig Molsted, Jesper Løvind Andersen, Adrian Paul Harrison, Inge Eidemak, Abigail Louise Mackey
INTRODUCTION: The aim of this study was to assess the effect of high-intensity resistance training on satellite cell (SC) and myonuclear number in the muscle of patients undergoing dialysis. METHODS: Patients (n = 21) underwent a 16-week control period, followed by 16 weeks of resistance training 3 times weekly. SC and myonuclear number were determined by immunohistochemistry of vastus lateralis muscle biopsy cross-sections. Knee extension torque was tested in a dynamometer...
November 2015: Muscle & Nerve
Anne Sofie Molsted Wanscher, Michael Williamson, Tasja Wainani Ebersole, Werner Streicher, Mats Wikström, Giuseppe Cazzamali
Insulin-like growth factor binding proteins (IGFBPs) display many functions in humans including regulation of the insulin-like growth factor (IGF) signaling pathway. The various roles of human IGFBPs make them attractive protein candidates in drug discovery. Structural and functional knowledge on human proteins with therapeutic relevance is needed to design and process the next generation of protein therapeutics. In order to conduct structural and functional investigations large quantities of recombinant proteins are needed...
April 2015: Protein Expression and Purification
Stig Molsted, Nina Føns Johnsen, Ole Snorgaard
AIMS: In recent decades there has been an increased focus on non-pharmacological treatment of diabetes. The aim of this study was to investigate trends in leisure time physical activity (PA), smoking, body mass index (BMI), and alcohol consumption reported in 2000, 2005 and 2010 by Danish subjects with diabetes. METHODS: Data comprised level of leisure time PA (inactive; moderate active; medium active; high active); smoking; BMI; and alcohol consumption, provided by The Danish Health and Morbidity Surveys...
August 2014: Diabetes Research and Clinical Practice
Stig Molsted, Jesper L Andersen, Inge Eidemak, Adrian P Harrison, Niels Jørgensen
BACKGROUND: We investigated serum testosterone and insulin-like growth factor 1 (IGF-1) levels' associations with muscle fibre size and resistance training in male dialysis patients. METHODS: Male patients were included in a 16-week control period followed by 16 weeks of resistance training thrice weekly. Blood samples were obtained to analyse testosterone, luteinizing hormone (LH), IGF-1, and IGF-binding protein 3. Muscle fibres' size was analysed in biopsies from m...
2014: BioMed Research International
Stig Molsted, Pia Eiken, Jesper L Andersen, Inge Eidemak, Adrian P Harrison
Background. The aim of this study was to investigate IL-6 and 25-hydroxyvitamin D (25-OH D) associations with muscle size and muscle function in dialysis patients. Methods. Patients were included in a 16-week control period followed by 16 weeks of high-intensity resistance training thrice weekly. IL-6 and 25-OH D were analysed after an over-night fast. Muscle fibre size was analysed in biopsies from m. vastus lateralis. Muscle power was tested using a Leg Extensor Power Rig. Results. Patients (n = 36) with IL-6 ≥ 6...
2014: BioMed Research International
Edward Martin, James McDonald
No abstract text is available yet for this article.
May 2014: Rhode Island Medical Journal
Deborah P Waldrop, Brian Clemency, Eugene Maguin, Heather Lindstrom
BACKGROUND: Prehospital emergency providers (emergency medical technicians [EMTs] and paramedics) who respond to emergency calls for patients near the end of life (EOL) make critical decisions in the field about initiating care and transport to an emergency department. OBJECTIVE: To identify how a sample of prehospital providers learned about EOL care, their perceived confidence with and perspectives on improved preparation for such calls. DESIGN: This descriptive study used a cross-sectional survey design with mixed methods...
March 2014: Journal of Palliative Medicine
Deborah Waldrop, Brian Clemency, Eugene Maguin, Heather Lindstrom
The nature of emergency end-of-life calls is changing as people live longer and die from chronic illnesses. This study explored prehospital providers' perceptions of (1) end-of-life 911 calls, (2) the signs and symptoms of dying, and (3) medical orders for life sustaining treatment (MOLST). The exploratory-descriptive pilot study was survey based and cross-sectional. Calls to nursing homes occur most often, (47.8% every shift). The MOLST was seen infrequently (57.9% rarely never). The most frequent signs and symptoms of dying were diagnosis (76%), hospice involvement (82%), apnea (75%), mottling (55%), and shortness of breath (48%)...
March 2015: American Journal of Hospice & Palliative Care
Lotte Prescott, Inge Eidemak, Adrian P Harrison, Stig Molsted
PURPOSE: This study aimed to compare sexual dysfunction in Danish female predialysis patients with chronic kidney disease (CKD) stage 4-5 with age-matched healthy women in Denmark. METHODS: Twenty-seven adult female predialysis patients (CKD stage 4-5 ~ creatinine clearance ≤ 30 ml/min) without diagnosed depression and 54 randomly assigned healthy female controls completed the questionnaires Female Sexual Function Index, Female Sexual Distress Scale, and the Major Depression Inventory...
May 2014: International Urology and Nephrology
Louise Claudius Riis, Inger Kjær, Kirsten Mølsted
OBJECTIVE: To analyze dental deviations in three cleft groups and relate findings to embryological neural crest fields (frontonasal, maxillary, and palatal). The overall purpose was to evaluate how fields are involved in different cleft types. DESIGN: Retrospective audit of clinical photographs, radiographs, dental casts, and medical records. PATIENTS: Ninety individuals (30 cleft lip, 30 cleft palate, and 30 combined cleft lip and palate), aged 5-27 years...
April 2014: Journal of Plastic Surgery and Hand Surgery
Stig Molsted, Jesper L Andersen, Inge Eidemak, Adrian P Harrison
AIM: The aim of this study was to investigate the effects of high-load resistance training on the rate of force development and neuromuscular function in patients undergoing dialysis. METHODS: Twenty-nine patients were tested before and after 16 weeks of resistance training. The rate of force development was tested using the Good Strength dynamometer chair. Muscle strength and neuromuscular function in the m. Vastus lateralis was estimated using electromyography in a one repetition maximum test during dynamic knee extension and during a 20 s isometric knee extension with 50% of the one repetition maximum load...
December 2013: Nephrology
Stig Molsted, Adrian P Harrison, Inge Eidemak, Flemming Dela, Jesper L Andersen
BACKGROUND/AIMS: The aim of this controlled study was to investigate the effect of high-load strength training on glucose tolerance in patients undergoing dialysis. METHODS: 23 patients treated by dialysis underwent a 16-week control period followed by 16 weeks of strength training three times a week. Muscle fiber size, composition and capillary density were analyzed in biopsies obtained in the vastus lateralis muscle. Glucose tolerance and the insulin response were measured by a 2-hour oral glucose tolerance test...
2013: Nephron. Clinical Practice
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