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.”
Towns Without Schools
September 18, 2015
"I forget the names of towns without rivers" is the opening line of a poem by Richard Hugo published in 1984, and recited by my fly fisherman son as he guided me on the Muskegon River last month.
My son thinks about rivers, while I think about schools. And my mind quickly converted the poetic line to, "I forget the names of towns without schools." I do. And I don't think I'm alone in this sentiment.
As I drive the length and width of Michigan's two peninsulas, I pass through many towns where school buildings have been converted to other uses or, more often, sit idle, surrounded by under-used commercial areas and vacant housing. I tend to forget the names of those towns.
Schools have been the anchor to, and given identity to, small towns throughout Michigan, and to the neighborhoods of larger towns. As schools have consolidated during the past two generations, many of the towns that lost their schools have also lost their identity and much of their vitality. The school consolidation movement that stripped towns and neighborhoods of their "brand" was supposed to improve access to broader and deeper curriculum choices for students and reduce the financial costs of delivering world-class education to local classrooms.
That's admirable. But of course, that thinking preceded the Internet which now allows students attending schools of any size in any place to receive any subject available in any other place in our state, nation or the world, and to do so without students being bused hither and yon and at much lower overhead compared to past delivery systems.
If we want to rejuvenate our state, returning schools to the center of small towns and neighborhoods will be central to our strategy. Both the technology and the teaching are available to do so in every corner of our state. It's the money spent on transporting children that's wasted; not the money on teaching those children in neighborhood facilities.