Background: Iron deficiency, anemia, and iron excess have been associated with altered hearing functions in children and adults. Animal studies suggest that iron deficiency during pregnancy negatively affect fetal auditory development. The relationship between maternal iron status and auditory functions in healthy term newborns has not been clearly elucidated among humans. The goal of this pilot study was to determine the relationship between markers of iron status during pregnancy and brainstem auditory function in healthy neonates. Methods: Pregnant women who gave birth at the Montfort Hospital were recruited to take part in this study (n=6). Within two weeks after birth, their newborn’s hearing function was assessed by wave amplitude, latency and inter-latency from the Auditory Brainstem Response (ABR) test. Markers of iron status, namely hemoglobin (Hb) and mean corpuscular volume (MCV), were collected retrospectively for the first and second trimester from the women’s medical chart. Results: Overall, no significant relationship was observed between maternal Hb and MCV concentrations and newborns auditory function. Although two significant Spearman correlations were observed (MCV and inter-latency I-V; r=0.87; p=0.005 and Hb and amplitude V; r=0.89; p=0.04), these findings may be due to chance because of multiple testing and the small sample size. Conclusion: Although iron is a key nutrient involved in the brain and auditory system development, we were not able to demonstrate a relationship between iron status during pregnancy and newborn hearing function. Prospective or intervention studies with a larger sample size and with more specific iron markers (ex. ferritin) are required to confirm these findings.

Sickle cell disease is a disabling chronic autosomal recessive blood disease characterized by abnormal hemoglobin, pain crises, and frequent emergency department visits. Adherence to hydroxyurea therapy has been shown to improve these patient outcomes. Guided by the theory of comfort, the purpose of this project was to determine if an educational intervention would increase adherence to hydroxyurea therapy in pediatric patients between 2 and 17 years of age recruited from an urban university hospital hematology clinic. The RE-AIM model was used to support the translation of evidence and the change process. An educational video produced by AFLAC was viewed by patients' parents 4 weeks after enrollment into this pretest/posttest design project. A total of 22 African-American parent participants completed the 8-item Morisky Medication Adherence Scale at baseline and again at 8 weeks to assess hydroxyurea adherence. The Short Test of Functional Health Literacy in Adults tool was used to assess parents' health learning needs; all parents met the adequate literacy level at baseline. Using t test statistics, no statistically significant differences were found pretest to posttest on the Morisky Medication Adherence Scale scores, mean corpuscular hemoglobin, and fetal hemoglobin percentages. Wilcoxon Signed Rank tests showed no significant differences in emergency room visits nor number of pain crisis. Although no significant changes emerged in short-term hematologic findings, emergency room visits, and pain crises, social change in the health care setting was promoted by confirming parents were able to understand education and a high level of hydroxyurea adherence was maintained; literature indicated that long-term adherence to hydroxyurea limits severe attacks.

Complete blood count (CBC) analysis, often provided by an automated hematology analyzer, is a fundamental diagnostic test for evaluating a patient’s overall health status as a tool in diagnosing various medical conditions. CBC provides insights into the composition of the blood cells with parameters such as Mean Corpuscular Volume (MCV) and Hemoglobin (HGB). MCV represents the average size and volume of red blood cells, while HGB indicates the oxygen-carrying capacity of the blood. Different technologies are used in hematology analyzers, such as the impedance method and spectrophotometry, to achieve precise measurements of MCV and HGB. However, exploring other methodologies is of interest to potentially reduce instrument complexity and cost. Flow cytometry, based on light scatter, provides detailed information on the characteristics of individual cells and is commonly used in CBC analysis to differentiate white blood cells and reticulocytes. However, while the potential of this method for investigating MCV and HGB levels is well established, it is of significant interest to determine if the measurement techniques can be streamlined from three to one by solely using flow cytometry in this prototype analyzer. In this thesis, the possible use of measuring MCV and HGB using a flow cytometry system based on optical scatter data from a prototype hematology analyzer has been examined. The need to sphere the red blood cells before the measurements have also been investigated to evaluate reagent needs. The results have been evaluated based on the correlation factor, accuracy and precision of the proposed optical method. It is shown that the optical method in this thesis, can be used to measure MCV and HGB. However, the necessity of sphering the cells remains. Furthermore, a comparison is made between the optical method and the Sysmex XN-1000 to evaluate the accuracy of the obtained values. Finally, possible improvements and future work are suggested. / Blodstatus, utförd av automatiserade hematologiinstrument, är ett grundlägggande diagnostiskt test för att utvärdera en patients allmänna hälsotillstånd som ett verktyg för att diagnostisera olika medicinska tillsånd. Blodstatus ger inblick i blodets sammansättning med parameterar som Medelvolym av röda blodkroppar (MCV) och Hemoglobin (HGB). MCV representerar den genomsnittliga storleken och volymen av röda blodkroppar, medan HGB indikerar blodets syrebärande förmåga. Olika metoder används i hematologiinstrument, såsom impedansmetoden och spektrofotometri för att mäta MCV och HGB värden. Undersökning med hjälp av andra metoder för mätning av dessa parameter är dock utav intresse för att potentiellt minska instrument komplexitet och kostnader. Flödescytometri, baserad på ljusspridning, ger detaljerad information om egenskaperna hos enskilda celler och används ofta för att differentiera vita blodkroppar och reticulocyter. Även om potentialen att undersöka MCV- och HGB-nivåer med denna metod redan är väletablerad, är det av betydande intresse att undersöka om man kan minska mätmetoderna från tre till en, genom att enbart använda flödescytometri i detta prototypinstrument. I detta examensarbete har möjligheten att mäta MCV och HGB med hjälp av flödescytometri baserat på optisk spridningsdata från en prototyp hematologiinstrument undersökts. Behovet av att ”sfära” de röda blodkropparna innan mätningarna har också undersökts för att utvärdera reagensbehov. Resultaten har utvärderats utifrån den förslagna optiska metodens korrelationsfaktor, noggrannhet och precision. Resultatet visar att den optiska metoden som presenteras i denna uppsats, kan användas för att mäta MCV och HGB. Dock kvarstår behovet av att ”sfära” cellerna. Dessutom görs en jämförelse mellan den optiska metoden och Sysmex XN-1000 för att utvärdera noggrannheten hos de erhållna värdena. Till sist ges förslag på möjliga förbättringar och vidareutveckling av den optiska metoden för framtiden.