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The Evidence Speaks (March 2017)

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We’re proud to introduce our Evidence Speaks series, a recurring feature highlighting the latest in CHÉOS research. This series features summaries of select publications as well as in-depth features on the latest work from our investigators.

In the early days of CHÉOS, the Centre had a series known as “The Evidence Speaks,” a monograph series to keep media and the research community up-to-date with CHÉOS’ current research results in the health outcomes field.

Kopec JA, Cibere J, Li LC, Zhang C, Barber M, Qian H, Wong H, Steininger G, Prlic H, Simatovic J, Ratzlaff C, Sayre EC, Ye J, Forster BB, Esdaile JM, IMPAKT-HIP Study Team. Relationship between physical activity and hip pain in persons with and without cam or pincer morphology: A population-based case-control study. Osteoarthritis Cartilage. 2017 Feb 20 epub ahead of print. doi:10.1016/j.joca.2017.02.795.

CHÉOS Scientists Drs. Linda Li and Hubert Wong, as part of the IMPAKT-HiP Study Team, recently co-authored a study looking at the relationship between physical activity (PA) and persistent or recurrent hip pain in young and middle-aged people. More specifically, the study looked at how a clinical diagnosis of cam or pincer morphology (CPM) affects this relationship. A cam morphology refers to an abnormal flattening of the femoral neck while a pincer morphology is when the acetabulum (socket) covers too much of the femoral head; both can result in femoroacetabular impingement which may lead to osteoarthritis (OA). Five-hundred participants between the ages 20 and 49 were included: 269 with hip pain and 231 controls. The study found a dose-response relationship between risk of hip pain and amount of PA per year, including work, domestic, and recreational activities. For a given increase in PA, the risk for hip pain increased to a greater extent in people with CPM than those without. The relationship between hip pain and domestic PA was only seen in those with CPM. Cam or pincer morphology did not modify the relationship between recreational activity and hip pain. This study is a valuable addition to the understanding of the connection between hip pain and PA and the implications of CPM in combination with activity type.

To MJ, Palepu A, Matheson FI, Ecker J, Farrell S, Hwang SW, Werb D. The effect of incarceration on housing stability among homeless and vulnerably housed individuals in three Canadian cities: A prospective cohort study. Can J Public Health. 2017 Mar 1;107(6):e550-5.

Of the over 250,000 Canadians that are incarcerated annually, roughly 30 per cent do not have a home to return to following their release. Dr. Anita Palepu, CHÉOS Scientist, recently co-authored a study investigating the effect of incarceration on housing stability. This study collected survey data from homeless and vulnerably housed adults enrolled in the Health and Housing in Transition (HHiT) Study in Vancouver, Toronto, and Ottawa. Incarceration in the past 12 months and injection drug use in the past 3 months were self-reported at baseline, 1-year follow up, and 2-year follow up. Participants who reported incarceration at any visit were less likely to be housed during the two-year follow up period, even after controlling for age, sex, ethnicity, injection drug use, and other confounding factors. This study highlights the importance of addressing mental health concerns, post-discharge planning, and development of housing strategies like the “Housing First” approach for incarcerated Canadians.

Sladen DP, Gifford RH, Haynes D, Kelsall D, Benson A, Lewis K, Zwolan T, Fu QJ, Gantz B, Gilden J, Westerberg B, Gustin C, O’Neil L, Driscoll CL. Evaluation of a revised indication for determining adult cochlear implant candidacy. Laryngoscope. 2017 Feb 24 epub ahead of print. doi:10.1002/lary.26513.

CHÉOS Scientist Dr. Brian Westerberg recently collaborated with hearing specialists from across the United States to assess the use of a word recognition test to determine candidacy and success for cochlear implantation. The study enrolled twenty-one adults who were deafened post-lingually (after they learned to speak) and met study implantation criteria using the Consonant-Nucleus-Consonant (CNC) monosyllabic word test. By comparing performance on several postoperative hearing tests, the authors showed that the CNC test was more clinically useful than the standard Hearing in Noise Test (HINT) for assessing implantation success and long-term performance. The study also showed that the FDA’s current adult cochlear implant candidacy criteria may be too strict and that a monosyllabic word test should be used in place of the current sentence recognition test.

Padfield GJ, Steinberg C, Swampillai J, Qian H, Connolly SJ, Dorian P, Green MS, Humphries KH, Klein GJ, Sheldon R, Talajic M, Kerr CR. Progression of paroxysmal to persistent atrial fibrillation: Canadian Registry of Atrial Fibrillation 10-Year follow up. Heart Rhythm. 2017 Feb 21 epub ahead of print. doi:10.1016/j.hrthm.2017.01.038.

Along with a number of Canadian cardiologists and researchers, Dr. Karin Humphries published a paper investigating the long-term progression of atrial fibrillation (AF). Atrial fibrillation—a rapid, irregular heartbeat—typically progresses from one that is temporary and spontaneously resolves (paroxysmal AF) to one that is persistent. Atrial fibrillation is associated with both morbidity and mortality and shows increasing incidence rates around the world. The study authors enrolled 755 patients using the Canadian Registry of Atrial Fibrillation, a registry that tracks the progression of patients diagnosed with their first episode of AF. After 10 years of follow-up, 30 per cent of patients died and one-third of patients progressed from paroxysmal AF to persistent AF. Factors that were associated with progression to persistent AF were increasing age, mitral regurgitation, aortic stenosis, left ventricular hypertrophy, and left atrial dilatation. The researchers also found that a history of angina (chest pain) was associated with a lower rate of AF progression, perhaps due to an increase in detection during medical examination or as a result of medication for other heart problems.

Health research in the heart of Vancouver