Haemoglobin, anaemia and haematological malignancies : the Tromsø study 1974-1995

Haemoglobin measurement is one of the most frequently performed laboratory tests. The haemoglobin level has well known variability according to age and gender [1- 3]. However, the reference values are often from elderly cross sectional studies of younger subjects, and may not reflect the populations’ actual distribution today. Several lifestyle factors, including body mass index (BMI) and smoking habits, are associated with haemoglobin [4-7]. The last decade’s changes in nutritional status and lifestyle may influence on the distribution of haemoglobin. Although the interpretation of the significance of high or low levels of haemoglobin is central in clinical settings, possible population based changes in haemoglobin distribution have not been subject to much study. Because haemoglobin levels predict mortality and morbidity [8-12], a population-based change in haemoglobin level could have significant implications for health. Little is known about the distribution of haematological malignancies within a general population. Since haematological malignancies comprise a heterogeneous group of conditions [13], with various grades of aggressiveness, several sources of information are needed to address the prevalence and incidence of the diseases. Automated blood cell count including haemoglobin measurement within a setting of a population study, could be one of these sources. The present thesis is from a population- based study of 20-49 year old men in 1974, and from a study of men and women more than 24 years in 1994-95

Borte bra, men hjemme best

Jeg var tre år og alene første gang jeg var i Oslo og på Rikshospitalet. Sykehuset syntes den gang at «barna var mye enklere å ha med å gjøre uten foreldrene». Kontrasten var stor da jeg 54 år senere kom tilbake til sykehuset, som nærmeste pårørende til en voksen sønn som skulle gjennomgå allogen stamcelletransplantasjon

Making shared decision-making (SDM) a reality: protocol of a large-scale long-term SDM implementation programme at a Northern German University Hospital

Introduction: Shared decision-making (SDM) is not yet widely used when making decisions in German hospitals. Making SDM a reality is a complex task. It involves training healthcare professionals in SDM communication and enabling patients to actively participate in communication, in addition to providing sound, easy to understand information on treatment alternatives in the form of evidence-based patient decision aids (EbPDAs). This project funded by the German Innovation Fund aims at designing, implementing and evaluating a multicomponent, large-scale and integrative SDM programme-called SHARE TO CARE (S2C)-at all clinical departments of a University Hospital Campus in Northern Germany within a 4-year time period. Methods and analysis S2C tackles the aforementioned components of SDM: (1) training physicians in SDM communication, (2) activating and empowering patients, (3) developing EbPDAs in the most common/relevant diseases and (4) training other healthcare professionals in SDM coaching. S2C is designed together with patients and providers. The physicians' training programme entails an online and an in situ training module. The decision coach training is based on a similar but less comprehensive approach. The development of online EbPDAs follows the International Patient Decision Aid Standards and includes written, graphical and video-based information. Validated outcomes of SDM implementation are measured in a preintervention and postintervention evaluation design. Process evaluation accompanies programme implementation. Health economic impact of the intervention is investigated using a propensity-score-matched approach based on potentially preference-sensitive hospital decisions. Ethics and dissemination Ethics committee review approval has been obtained from Medical Ethics Committee of the Medical Faculty of the Christian-Albrechts-University Kiel. Project information and results will be disseminated at conferences, on project-hosted websites at University Hospital Medical Center Schleswig Holstein and by S2C as well as in peer-reviewed and professional journals

Haemoglobin, anaemia and haematological malignancies : the Tromsø study 1974-1995

Haemoglobin measurement is one of the most frequently performed laboratory tests. The haemoglobin level has well known variability according to age and gender [1- 3]. However, the reference values are often from elderly cross sectional studies of younger subjects, and may not reflect the populations’ actual distribution today. Several lifestyle factors, including body mass index (BMI) and smoking habits, are associated with haemoglobin [4-7]. The last decade’s changes in nutritional status and lifestyle may influence on the distribution of haemoglobin. Although the interpretation of the significance of high or low levels of haemoglobin is central in clinical settings, possible population based changes in haemoglobin distribution have not been subject to much study. Because haemoglobin levels predict mortality and morbidity [8-12], a population-based change in haemoglobin level could have significant implications for health. Little is known about the distribution of haematological malignancies within a general population. Since haematological malignancies comprise a heterogeneous group of conditions [13], with various grades of aggressiveness, several sources of information are needed to address the prevalence and incidence of the diseases. Automated blood cell count including haemoglobin measurement within a setting of a population study, could be one of these sources. The present thesis is from a population- based study of 20-49 year old men in 1974, and from a study of men and women more than 24 years in 1994-95

The association between anemia and falls in community-living women and men aged 65 years and older from the fifth Tromsø Study 2001-02: a replication study

Background: Falls are common among elderly people, and the risk increase with age. Falls are associated with both health and social consequences for the patient, and major societal costs. Identification of risk factors should be investigated to prevent falls. Previous studies have shown anemia to be associated with increased risk of falling, but the results are inconsistent. The aim of this study was to investigate the association between anemia and self-reported falls among community-living elderly people. The study is a replication of the study by Thaler-Kall and colleagues from 2014, who studied the association between anemia and self-reported falls among 967 women and men 65 years and older in the KORA-Age study from 2009. Methods: We included 2441 participants (54% women) 65 years and older from the population-based Tromsø 5 Study 2001-2002. Logistic regression models were used to investigate the association between anemia (hemoglobin <12 g/ dL in women and <13 g/dL in men) or hemoglobin level and self-reported falls last year, adjusted for sex, age, medication use and disability. Further, associations between combinations of anemia and frailty or disability, and falls, were investigated. Results: No statistical significant associations were found between anemia and falls (OR 95% CI: 0.83, 0.50-1.37) or hemoglobin level and falls (OR, 95% CI: 0.94, 0.81-1.09), or with combinations of anemia and frailty or disability, and falls (OR, 95%: CI: 0.94, 0.40-2.22 and 0.78, 0.34-1.81, respectively). Conclusions: In this replication analysis, in accordance with the results from the original study, no statistically significant association between anemia or hemoglobin and falls was found among community-living women and men aged 65 years or older

Additional file 2: of The association between anemia and falls in community-living women and men aged 65 years and older from the fifth Tromsø Study 2001-02: a replication study

Comparison table of study sample characteristics by sex, mean (SD) or percentages (number of total number measured (n/N). The Tromsø 5 Study 2001-2002 and the KORA-Age Study 2009. Supplementary table of study characteristics in the Tromsø 5 Study and the KORA-Age Study, presenting the comparability between the studies. (PDF 167 kb