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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.”

Change for Worse

November 25, 2014

I recall a toaster that was handed down from my parents when my wife and I were first married and in need of everything. It was already an antique, but it worked just fine, popping nicely browned bread with efficiency.
Some years later, we handed that toaster down to another generation; and we have missed its iconic look and quick, quality performance. No toaster we’ve had since has matched that model.
Recently we purchased a new dishwasher to replace one that was at least 25 years old. The new appliance is advertised as more energy efficient, with the features now required by the government in order to be more environmentally friendly. But the fact is, it runs twice as long and works half as well, often requiring a second wash to adequately clean the dishes.
You would think these earlier disappointments would have taught us; but even more recently we purchased a new washer and new dryer . . . energy efficient, of course . . . with all the required environmental improvements included. But again, the washer runs twice as long as the model it replaced. The dryer does too, and the clothes remain damp after repeating the maximum drying time . . . twice.
All of which proves the point that change is not always good.
People who proclaim that the world is changing and that we must change too are not always on the higher ground. Change is as often bad as it is good; and change often needs to be confronted, and thwarted.
Much of the change that has come to our homes has not improved our daily lives. Much of the change that has come to our schools has not improved the quality of education our children receive. Much of the change that has come to school sports has done much to harm and little to help educational athletics.
We must ignore the hype and point out the pitfalls of the shiny new products and promotions. Saying “No” to change is sometimes the boldest and best leadership we can provide for school-sponsored sports.