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Cardiac Screening

October 31, 2014

The American Heart Association has once again concluded that sophisticated and expensive heart screening is not practical or appropriate as a precondition for youth and young adults to participate in competitive organized sports.
On Sept. 14, 2014, the AHA online publication Circulation stated:

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.”

Patience

January 20, 2015

I found it amazing that an important "test" match in cricket last month between India and Australia was scheduled for three days but could last five days, or might end after two. This flexible scheduling is just part of the game.
On one day of that match, Australia was able to bat all morning, declare a lunch break, and then keep batting most of the afternoon before India ever had an opportunity to go on offense. When they finally did, India was already behind 400 and something to zero.
It was equally intriguing to watch the fastest two of the 117 yachts entered in the 70th Sydney to Hobart Yacht Race finish the more than 628-nautical mile course within 48 minutes of each other, but 11 hours before the third place yacht. And, two days before the last of the 103 finishers. 
I decided that Australian sports fans must have a different definition of drama, a lot more patience for events of long duration, and much more tolerance for events of indefinite length than we do in the USA. Perhaps it is in the DNA of Australians to be patient ... for they are certainly among the most polite populations I've encountered.
Perhaps all of this is inherent in the character of a country that is almost as large as the USA’s first 48 states but has only seven percent of the USA’s population. In fact, China's population increases each year by more people than the total population of Australia ... which may have something to do with 36 people being killed during a human stampede in Shanghai this past New Year’s Eve.