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Biomedical subjects

G Ljunggren

Publications and source records attributed to G Ljunggren.

At least 19 recordsLinked to original sources
PubMed1992

Comparison between the Visual Analogue Scale (VAS) and the Category Ratio Scale (CR-10) for the evaluation of leg exertion.

Perceptual ratings given on the Visual Analogue Scale (VAS) and the Category Ratio Scale (CR-10) were compared in 24 healthy male volunteers (18-39 years) subjected to an exercise test using a bicycle ergometer. Ratings of leg exertion were made by means of the CR-10, the VAS and, as a complementary measure, the method of free magnitude estimation (ME). Blood lactate levels (BL) and heart rates (HR) were used as correlates to sensory perception. The correlation between the CR-10 ratings and BL at 180 W were .59 (p less than .01), and between VAS ratings and BL .45 (p less than .05). The corresponding correlations with HR were .64 (p less than 0.01) and .58 (p less than 0.01), respectively. No significant correlation was found for ME. It was concluded that both the CR-10 and the VAS scales were found to be useful for the psychophysical estimation of perceptual intensities. The CR-10 scale appeared to be slightly more efficient than the VAS and both these methods much better than ME. The advantage of the CR-10 scale might be due to a greater ability to discriminate at high intensity levels.

Adolescent↗
PubMed1992

Case-mix analyses in long-term care institutions in Stockholm.

In order to describe the patient case-mix in long-term care, several methods have been developed. One resource-based method, Resource Utilization Groups, RUGs, developed in New York and validated in several U.S. states, has also been validated in Stockholm and used there for studying various types of geriatric institutions. The variables used in this analysis, the distribution of the RUG categories, an ADL-index, and a case-mix index, show differences between geriatric departments, local nursing homes, mixed institutions, and private nursing homes. The geriatric departments show a high percentage of patients undergoing rehabilitation, a high case-mix index, and a relatively low ADL-index. In the local nursing homes, there is a majority of patients with behaviour problems and reduced physical functions. They show a low case-mix index but also a low ADL-index. Mixed institutions show results lying between these two types of institutions. The costs of the institutions, however, do not correlate well to the case-mix. This raises issues on efficiency and the need for new reimbursement models in geriatric care.

Activities of Daily Living↗
PubMed1991

Perceived exertion and physiological economy of competition walking, ordinary walking and running.

Four competition walkers performed competition walking, ordinary walking and running on a treadmill on two different occasions. During the two walking modes, the subjects performed maximal tests. During running, the session was terminated at a heart rate of 150 beats min-1 or an exertion rating--for either chest or leg--of 5 or higher. The tests commenced at 2.5 km h-1 and the velocity was increased by 2.5 km h-1 every 4 min. Measures of chest exertion and breathlessness, leg exertion, heart rate and blood lactate were taken every 4 min just prior to the velocity changes. The measured psychological and physiological variables were described by monotonously accelerating power functions with exponents around 2 for the perceptual variables at both walking modes. The heart rate growth for competition walking accelerated according to a function with an exponent of 1.7, which is lower than that for ordinary walking (2.0), but higher than that for running which is linear. No significant difference was found between maximal oxygen uptake when competition walking and running were compared. A second test was carried out so as to confirm the cross-over point for the heart rate curves in the two walking modes. The cross-over point for the two walking curves were determined to be at 8.6 km h-1.

Adolescent↗
PubMed1991

International comparison of long-term care: the need for resident-level classification.

Differences between long-term care facilities in Stockholm (1134 residents) and New York (95,000 residents statewide) were examined. The comparison employed a resident classification system, Resource Utilization Groups (RUG-II), which links individuals' characteristics to resource use. Distributions of Activity of Daily Living functionality and RUG-II categories demonstrated significant differences between these two populations, with the Stockholm facilities more akin to the heavier care skilled nursing facilities in New York. These differences may indicate different uses of long-term care beds in the United States and Sweden and demonstrate the need for resident-level classification systems in cross-national studies.

Activities of Daily Living↗
PubMed1988

Use of submaximal measures of perceived exertion during bicycle ergometer exercise as predictors of maximal work capacity.

Submaximal measures of perceived exertion, aches and pain in the legs, heart rate and blood lactate were made in a bicycle ergometer test. Their predictability of maximal work capacity, measured as Wmax, was studied. Twenty-eight males in good physical condition served as subjects and cycled in a graded exercise test up to a voluntary maximum. The reliability coefficients for both the psychophysical variables--measured on Borg's CR-10 scale--and heart rate were high. Provided that a proposed preliminary division of the subjects into subgroups with regard to their physical fitness was undertaken, the regression analyses showed that the psychophysical variables were the best predictors of Wmax. Linear and curvilinear predictions, graphic or calculated, had lower explained variance but also showed that the psychophysical variables are good predictors of maximal work capacity.

Adult↗
PubMed1987

Prolonged exercise at a constant load on a bicycle ergometer: ratings of perceived exertion and leg aches and pain as well as measurements of blood lactate accumulation and heart rate.

To study changes over time during prolonged exercise on a bicycle ergometer at a constant load, 22 healthy males rated perceived exertion as well as aches and pain in the legs, and measurements were taken on blood lactate accumulation and heart rate (HR). The prolonged exercise was carried out at WOBLA (the power level eliciting a blood lactate concentration of 4 mmol X l-1). All four measured variables, ratings of perceived exertion, ratings of aches and pain in the legs, blood lactate accumulation, and HR, grew systematically according to negatively accelerating functions. HR showed more of a steady state, whereas all the other three variables grew continuously over time. Three subgroups were identified related to the blood lactate response after 15 min at WOBLA: elevated (greater than 5 mmol X l-1), intermediate (3.5-4.9 mmol X l-1), and low (less than 3.4 mmol X l-1). It was suggested that a major contribution to the discrepancies in blood lactate between the subgroups after 15 min was partly due to insufficient warming up, which was 5 min at 20 W as compared with the final power level (WOBLA), which differed between 140 and 260 W. After 15 min both rated perceived exertion and rated aches and pain in the legs were related to the corresponding blood lactates. It was suggested that rated perceived exertion and rated aches and pain in the legs partly reflected the degree of "anaerobic" metabolism measured as blood lactate.

Adult↗
PubMed1985

The increase of perceived exertion, aches and pain in the legs, heart rate and blood lactate during exercise on a bicycle ergometer.

This study was designed to show the general increase in perceived exertion, perception of aches or pain in the legs, heart rate (HR), and blood lactate, and the covariance between these variables during bicycle ergometer work, and to describe individual differences both within and between power levels by testing a large group (28 male students). Estimates of perceived exertion and feelings of aches or pain in the legs were recorded using Borg's category-ratio scale (CR-10). The subjects were tested with a stepwise increase of power levels with 40 W increments up to a voluntary maximum. Though HR increases fairly linearly with power, the other variables follow positively accelerating functions with exponents of about 1.6-2 for the perceptual variables, and an exponent of about 3 for blood lactate. The results from the 8 most fit subjects could be described in the same way as for the whole group except for blood lactate, where there was a need to include a threshold value (b), that, together with a rest value (a), shows the starting point of the function (R = a + c(W - Wo)n). The data support the idea that a combination of heart rate and blood lactate is a better predictor of perceived exertion and feelings of aches and pain in the legs, than is each of the single physiological variables taken alone.

Adult↗
PubMed1984

Quality of diagnoses and cost of managing anemia in four countries.

An earlier study of non-hospitalized Swedish patients suggested frequent overprescribing of iron tablets and frequently uncertain diagnoses of iron deficiency. For this reason, a record audit was performed of 202 patients hospitalized because of iron deficiency anaemia or pernicious anemia in an English, a French, three Swedish, and a US teaching hospitals. Results are difficult to interpret because of the limited extent of this study and because differences between hospitals are as great as those between countries. Nevertheless, the Swedish hospital seemed to have 37% longer duration of stays (p less than 0.05), it spent only 16% of the total hospitalization cost for diagnostic studies as compared to 22-35% for the other hospitals, and it had numerically, but not significantly increased percentages both of uncertain diagnoses and of unidentified causes of the iron deficiency. For comparable time periods the hospitals with the longest length of stay also had the highest percentage of uncertain diagnoses (p less than 0.001). After the local publication of the first reports in 1978-1981, an improvement in the percentage of uncertain diagnoses was found in the Swedish hospital, which suggests that quality evaluation can lead to quality assurance.

Anemia, Hypochromic↗
PubMed1979

Overprescribing iron tablets to elderly people in Sweden.

Iron should not be prescribed to middle-aged men or older women with anaemia unless the possibility that the iron deficiency is caused by a gastrointestinal tumour has been considered. Thus the prescribing of iron to elderly people was investigated by studying four different prescription statistics and by reviewing records. Over one in 10 women aged over 65 were prescribed iron tablets. Men and women in the oldest age groups were prescribed iron most frequently. The reasons for prescribing iron were examined at a rural health centre. Out of 327 records of patients who were prescribed iron during 1975, 157 were randomly selected and reviewed. Only 18 out of 48 (38%) patients aged 45-75 (men) and 55-75 (women) and 29 out of 109 (27%) aged over 75 years had probable or possible iron-deficiency anaemia as established from the records. Only nine (19%) of the younger patients had a plausible reason for the anaemia other than a bleeding tumour. Ten (9%) of the older patients were considered to be inoperable cases. Thus, according to the records, only 18 (17%) of the patients over 75 years and nine (19%) of those in the younger age group have been prescribed iron. About 70% of all the patients were considered not to have iron deficiency; 7% had had iron deficiency previously, and 20% probably had anaemia as a result of chronic disease; for 43% no real reason for the iron prescription could be found in the record. Thus it is concluded that iron is overprescribed in Sweden, particularly for elderly people. It should not be prescribed until the possibility of a bleeding gastrointestinal tumour has been excluded.

Aged↗