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.”
Making a Statement
June 17, 2015
Amid the horrific destruction of Baghdad, the conductor of the Iraqi National Symphony Orchestra, Karim Wasfi, is making a statement. Mr. Wasfi has been carrying a chair and his beloved cello to the exact locations where violence occurs, very shortly after it occurs, and he plays.
With the roar of car bombs still ringing in ears and rubble still smoking, Wasfi plays. He told National Public Radio: “The other side chose to turn every element, every aspect of life in Iraq into a battle zone. I chose to turn every corner of Iraq into a spot for civility, beauty and compassion.”
The response of this single citizen to the catastrophic chaos in his city and country is especially powerful because of the beauty of his music amidst the brutality of civil war; but neither his gift nor the jolting juxtaposition should cause us to miss the message that our response to overwhelming problems could be and should be like his, even if less newsworthy from the perspective of a national radio broadcast. For example ...
- We can wring our hands in despair that the Earth’s increasingly polluted air, land and waters are so far gone and the problem is of such great scale that nothing we could ever do will change things; or, we can choose to turn every corner of our little slice of the physical world into a less polluted place. We can make a statement.
- We can weep over the slaughter of elephants, the leveling of mountains or the razing of forests or jungles by crooks or corporations that cannot see the consequences of their reckless avarice; or, we can choose to make our neighborhoods spots of beauty, conservation and sustainability. A statement.
- We can cry ourselves to sleep over humanity’s inhumanity to those who look, dress or worship differently; or, we can choose to make our little community a welcoming place for refugees where long-suffering and persecuted people can feel safe and hopeful. A statement.
- And we can become frustrated that the values of school sports are so regularly undermined by the excesses of youth, college, professional and international sports that it feels hopeless to hang onto what we believe; or, we can choose to devote ourselves to maintaining our little niche of the sports world as a more principled place ... where scholarship, sportsmanship, safety and a sensible scope are recognizable and reliable core values. A statement.
The great conductor carrying his chair and cello to the rubble is real. It’s also a metaphor which reminds the rest of us of other daunting problems and the opportunity each individual person has to make a meaningful response – a clear statement – where we live, work and play.