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.”
The Subjunctive
January 3, 2014
As a frequent traveler to foreign lands and also as a college English major and high school English teacher, my ears perked up when a speaker said recently that there are some languages that, unlike English, do not have the subjunctive verb mood or mode. I love the subjunctive!
That’s the mood of what might have been, the speaker said. For example, “Had I studied harder, I would have received a better grade.” And “If I were you, I would have studied much longer.”
The subjunctive can also be the mood of excuses, I thought. For example, “If the official hadn’t made that traveling call, we would have won the game.” But I digress.
The subjunctive verb mood is used for the hypothetical. This makes it most valuable as a mindset before taking any action. It helps one think of unintended consequences.
But the subjunctive mood is also useful for the remedial: “If we had done this or that differently then, perhaps the result would have been better.”
Thinking in the subjunctive mood as we plan before initiatives, and then also as we evaluate after plans have been rolled out, are the one-two punch of effective project management.
What we must avoid, however, is thinking of the subjunctive as the mood of regrets. “If only I had . . .” And then doing nothing to try to change the future.
As we think about the year just past and about the year ahead, let’s use the subjunctive mood for its better purposes – planning and evaluation, not excuses and regrets.