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Background: The prevalence and impact of obesity on outcomes of atrial fibrillation (AF) ablation randomized controlled trials (RCTs) have not been well studied. Objective: To examine the proportion of participants with obesity enrolled in RCTs of AF ablation and outcomes of ablation when subgroup analysis of participants with obesity were available. Methods: We systematically searched PubMed and EMBASE for AF ablation RCTs published between January 1, 2015 to May 31, 2022. When body mass index (BMI) data were available, normal distribution was assumed and a z score was used to estimate the proportion of obesity. Results categorized by BMI or body weight status were reviewed. Authors were contacted for additional information. Results: Of 148 eligible RCTs with 30174 participants, 144 (97.30%) RCTs did not report the proportion of participants with obesity, while published information regarding BMI was available in 63.51%. Three trials excluded patients based on BMI. Using reported BMI, we estimated the proportion of participants with obesity varied greatly across these trials, ranging from 5.82%–71.9% (median 38.02%, interquartile 29.64%, 49.10%). Patients with obesity were represented in a greater proportion among trials conducted in North America (50.23%) and Asia (44.72%), compared to others (32.16%), p <.001. Subgroup analysis or analysis adjusting for BMI was reported in only 13 (8.78%) RCTs; four (30.77%) of these suggested that BMI or body weight might negatively affect primary outcomes. Conclusion: Obesity is a common comorbidity among AF patients. However, most AF ablation RCTs underreported the proportion of participants with obesity and its impact on the primary outcomes. [ABSTRACT FROM AUTHOR]

In this study we used criminal history data for three birth cohorts in New South Wales to estimate the prevalence of recorded family and domestic violence offending. Using an accelerated longitudinal design, we estimate that 6.3 percent of people born in New South Wales had been proceeded against by police for a family and domestic violence offence by age 37. The rate was significantly higher for men: 9.6 percent of men— one in 10—had been proceeded against for a family and domestic violence offence, compared with 3.0 percent of women (one in 33). Overall, 1.2 percent of people born in New South Wales were responsible for more than 50 percent of recorded family and domestic violence offences. Further, family and domestic violence offenders accounted for nearly half of all recorded offences by people in the birth cohort. This is the first estimate of the prevalence of recorded family and domestic violence offending in a population sample in Australia. This is an important step towards increasing the visibility of family and domestic violence perpetrators. [ABSTRACT FROM AUTHOR]

Simulation has been shown to improve communication and psychometric skills in advanced practice nursing students. Little is known about the impact of a simulation educational intervention with a faculty-facilitated debriefing on the preparation of novice nurse practitioner students for their first clinical practicum. This article describes the development of an educational intervention to accomplish this. The simulation education intervention was implemented with preclinical nurse practitioner students designed to improve their preparation for their first precepted clinical experience. Students were surveyed preintervention and postintervention to explore their self-perception of confidence and preparation for clinicals looking at six domains: health history, physical examination, diagnostics, differentials, final diagnosis, and plan of care. Quantitative results were statistically significant for each domain. Qualitative findings gave deeper insight into the students' perceptions of how the intervention prepared them for clinicals. Advanced practice educators can use educational interventions such as this to prepare students for their first clinical practicums. [ABSTRACT FROM AUTHOR]

Background and aims: Substance use treatment (SUT) has shown to be effective in reducing self‐reported offending; however, the association between SUT completion and criminal justice system (CJS) contact has been underexplored, especially in Latin America. This study aimed to estimate the association between SUT completion status and (1) any subsequent CJS contact and (2) CJS contact leading to imprisonment, at 1, 3 and 5 years post‐discharge, in Chile. Design: Retrospective cohort study using multivariable survival analysis based on linked administrative data from 2010 to 2019. Setting: This study took place in Chile, where SUT is available at no cost through Chile's publicly funded health‐care, and is provided in outpatient and inpatient modalities in public and private centres. Participants: A total of 70 854 individuals received their first SUT from 2010 to 2019. They were mainly males (76.3%), and their main substance used at admission was cocaine paste (39.2%). Measurements SUT completion status included completion, late dropout (≥ 3 months) and early dropout (< 3 months). Outcomes were (1) any CJS contact and (2) CJS contact leading to imprisonment after baseline treatment. We estimated the association between treatment completion and CJS contact through flexible parametric Royston−Parmar models while adjusting for several covariates. Findings Those who completed SUT (27.2%) were less likely to have any CJS contact at 5 years post‐SUT compared with those who dropped out late [with a gap of −9.5%, 95% confidence interval (CI) = −8.7, −10.3] and early (−11.2%, 95% CI = −10.1, −12.3). Also, those who completed SUT were less likely to have CJS contact leading to imprisonment at 5 years post‐SUT compared with those who dropped out late (−2.6%, 95% CI = −2.2, −3.1) and early (−4.0%, 95% CI = −3.3, −4.6). These differences were also observed at 1 and 3 years post‐SUT for each outcome. Conclusions: In Chile, completion of substance use treatment appears to be associated with lower probabilities of both any criminal justice system contact and contact leading to imprisonment. [ABSTRACT FROM AUTHOR]

Background and aims: Substance use treatment (SUT) has shown to be effective in reducing self-reported offending; however, the association between SUT completion and criminal justice system (CJS) contact has been underexplored, especially in Latin America. This study aimed to estimate the association between SUT completion status and (1) any subsequent CJS contact and (2) CJS contact leading to imprisonment, at 1, 3 and 5 years post-discharge, in Chile. Design: Retrospective cohort study using multivariable survival analysis based on linked administrative data from 2010 to 2019. Setting: This study took place in Chile, where SUT is available at no cost through Chile's publicly funded health-care, and is provided in outpatient and inpatient modalities in public and private centres. Participants: A total of 70 854 individuals received their first SUT from 2010 to 2019. They were mainly males (76.3%), and their main substance used at admission was cocaine paste (39.2%). Measurements: SUT completion status included completion, late dropout (≥ 3 months) and early dropout (< 3 months). Outcomes were (1) any CJS contact and (2) CJS contact leading to imprisonment after baseline treatment. We estimated the association between treatment completion and CJS contact through flexible parametric Royston --Parmar models while adjusting for several covariates. Findings: Those who completed SUT (27.2%) were less likely to have any CJS contact at 5 years post-SUT compared with those who dropped out late [with a gap of -9.5%, 95% confidence interval (CI) = -8.7, -10.3] and early (-11.2%, 95% CI = -10.1, -12.3). Also, those who completed SUT were less likely to have CJS contact leading to imprisonment at 5 years post-SUT compared with those who dropped out late (-2.6%, 95% CI = -2.2, -3.1) and early (-4.0%, 95% CI = -3.3, -4.6). These differences were also observed at 1 and 3 years post-SUT for each outcome. Conclusions: In Chile, completion of substance use treatment appears to be associated with lower probabilities of both any criminal justice system contact and contact leading to imprisonment. [ABSTRACT FROM AUTHOR]

BackgroundThe interrelationship of left ventricular hypertrophy (LVH) with ejection fraction (EF) and their impact on mortality in non-dialysis-dependent chronic kidney disease (NDD-CKD) is unclear.MethodsWe examined the associations of EF and LVH with all-cause mortality in a historic cohort of 650 male US veterans with moderate-to-advanced NDD-CKD. EF and LVH were examined both separately and after categorizing patients according to their concomitant EF and presence/absence of LVH. Associations with mortality were examined in Cox models with adjustments for demographics, blood pressure, comorbidities, smoking status, medication use and biochemical characteristics.ResultsEF 50% even after multivariable adjustments [multivariable adjusted hazard ratio, 95% confidence interval (CI): 2.83 (1.86-4.30) and 1.38 (1.06-1.78), P < 0.001 for linear trend]. LVH in itself was not associated with mortality [multivariable adjusted hazard ratio, 95% CI: 0.83 (0.66-1.05), P = 0.12], but the presence of LVH combined with an EF 50% + LVH, EF ≤ 50%-LVH and EF ≤ 50% + LVH, compared to EF >50%-LVH: 0.84 (0.63-1.13), 1.36 (1.00-1.83) and 1.62 (1.07-2.46)].ConclusionsLow EF is associated with higher mortality in patients with NDD-CKD. In the presence of a low EF, LVH is also associated with higher mortality. Clinical trials are needed to determine if interventions targeting patients with low EF and LVH can lower mortality in NDD-CKD.