Cardiac Screening
October 31, 2014
Sudden death among 12 to 25-year-olds is “a low event rate occurrence.”
“There is insufficient information to support the view that ECGs in asymptomatic young people for cardiac disease is appropriate or possible on a national basis for the United States, in competitive athletics or in the general population.”
“At present, there is no mechanism available in the United States to effectively create national programs of such magnitude, whether limited to athletics or including the wider population of all young people.”
“There is insufficient evidence that particularly large-scale/mass screening initiatives are feasible or cost effective within the current US healthcare infrastructure . . .”
“The ECG . . . cannot be regarded as an ideal or effective test when applied to large healthy populations.”
“An additional, but unresolved, ethical issue concerns whether students who voluntarily engage in competitive athletic programs should have advantage of cardiovascular screening, while others who choose not to be involved in such activities (but may be at the same or similar risk) are in effect excluded from the same opportunity.”
The AHA’s Sept. 14 AHA writing group “does not believe the available data support significant public health benefit from using the 12-lead ECG as a universal screening tool. The writing group, however, does endorse the widespread dissemination of automated external defibrillators which are effective in saving young lives on the athletic field and elsewhere.”
Transfers
January 10, 2017
When it comes to transfers, the staff of the Michigan High School Athletic Association gets lots of advice, but it comes from opposing directions.
One camp thinks MHSAA rules are inadequate. This group suggests that we expand the basic period of ineligibility from approximately 90 days to 180 days and/or it wants the MHSAA to eliminate most or all exceptions that allow for immediate eligibility of a transfer student.
This first camp is so frustrated with high-profile athletic-motivated or related transfers that they want to clamp down on all transfers.
The other camp thinks parents have the right and responsibility to send their children to any school they wish and have immediate access to the full benefits of that school’s curricular and extracurricular offerings.
This second camp is encouraged by the laws of Michigan which have gradually extended “schools of choice” as an option that all school districts may exercise. And this camp will be emboldened if the Secretary of Education under the new regime in Washington, D.C. is the long-time schools of choice advocate who has been nominated by the President-Elect for this position.
This second camp is on the right side of history, no matter how much I dislike it and no matter how convinced I am that the better way to have improved public education would have been to invest more in neighborhood schools. Improving them builds most communities. Ignoring them, as we have for 25 years, sends surrounding communities into downward spirals that worsen poverty and public health.
The ill-advised efforts to improve education by enticing students out of their neighborhoods to attend schools elsewhere has undermined “local ownership” in schools; and it has had the side effect of encouraging more transfers motivated by or related to athletics. Monitoring and managing such transfers is made more difficult by these educational reforms; but the new world will not tolerate transfer rules that are seen as too broad and contrary to what has become public policy, however poorly conceived and executed.
The fact is, the future of the transfer rule will be less about extending its reach and more about retaining its existence.