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.”
International Affairs
January 21, 2014
On Sept. 10, 2013, I wrote in this space what I later spoke at MHSAA Update Meetings across Michigan: that we had to assure that the increasing numbers of international students who are arriving in Michigan do so without undue influence and without upsetting the competitive balance between MHSAA member schools in interscholastic athletics. Both matters concern me even more today than last fall.
A 1996 federal law allows international students to attend nonpublic schools for any number of years and to do so at reduced tuition, but the law limits international students’ attendance at public schools to one year and requires they make full payment of all fees and expenses. This is creating an unlevel playing field in school sports.
These aren’t J-1 visa foreign exchange students cleared and placed for a single academic year by programs that have been approved by the Council on Standards for International Educational Travel. These are students on F-1 visas, which increased from 6,541 in 2007 to 65,452 in 2012, arriving in dozens of different ways and remaining for two, three or four years. These are not "blind" placements; they are arranged.
By this means, some small private schools have been balancing their budgets by increasing their enrollments by 10 to 20 percent and even more with an influx of international students, while still remaining under the Class D or Division 4 maximum for MHSAA tournament classification.
And making matters much worse, a few private schools of all sizes are receiving especially talented or tall students through arrangements made by parents of players and/or others associated with their school and/or AAU and college programs.
When we learn, for example, that people with basketball connections are arranging for students to come to Michigan, when they are directing these students to schools where these adults have connections, when in some cases these people are paying portions of the tuition and/or providing for living arrangements for these students, we have undue influence, plain and simple. These students lose eligibility; the adults involved must be disassociated with the schools; and the schools are penalized if they haven’t handled things as they should have.
But this is just putting a patch on the bigger problem – which is placing the same limits on international student attendance, regardless of the type of visa they have, or the type of school in which they enroll.
By next August, this association must have a rule that provides immediate eligibility for one year for all international students (whether J-1 or F-1) who are placed blindly in schools through CSIET-listed programs; and if they remain beyond that one year, then they must sit out one year. All other international students, except those who relocate with their family unit, should have no eligibility at the varsity level at any time.