BackgroundAtrial fibrillation (AF) is the most common sustained cardiac arrhythmia resulting in mortality and morbidity. Gaps in oral anticoagulation and education of patients regarding AF have been identified as areas that require improvement.Methods and ResultsA before‐and‐after study of 433 patients with newly diagnosed AF in the 3 emergency departments in Nova Scotia from January 1, 2011 until January 31, 2014 was performed. The “before” phase underwent the usual‐care pathway for AF management; the “after” phase was enrolled in a nurse‐run, physician‐supervised AF clinic. The primary outcome was a composite of death, cardiovascular hospitalization, and AF‐related emergency department visits. A propensity analysis was performed to account for differences in baseline characteristics.ResultsA total of 185 patients were enrolled into the usual‐care group, and 228 patients were enrolled in the AF clinic group. The mean age was 64±15 years and 44% were women. In a propensity‐matched analysis, the primary outcome occurred in 44 (26.2%) patients in the usual‐care group and 29 (17.3%) patients in the AF clinic group (odds ratio 0.71; 95% CI [0.59, 1]; P=0.049) at 12 months. Prescription of oral anticoagulation was increased in the CHADS 2 ≥2 group (88.4% in the AF clinic versus 58.5% in the usual‐care group, P<0.01).ConclusionsAdoption of this integrated management approach for the burgeoning population of AF may provide an overall benefit to cardiovascular morbidity and mortality.

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Students with attention-deficit/hyperactivity disorder (ADHD) are frequently provided a separate room in which to take exams, to reduce external distractions. However, little research has explored the efficacy of this accommodation. In the present study, college students with ( n = 27) and without ( n = 42) ADHD diagnoses were administered two parallel forms of a timed silent reading comprehension test, one in a classroom with other students, and one in a private, proctored setting. A two-way analysis of variance found no significant main effects for either ADHD status or test setting on performance, and no significant interaction between the factors either. However, inspection of student-level data and exploration of continuous relationships between self-reported ADHD symptoms and test performance patterns suggested that separate room accommodations may be beneficial for a subgroup of students with ADHD.