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r-acacaefjchdhadhjigkcdaehcfbabaehcfbabadjackaccaebbacghfafkkheacb ----vVjetyxa;oKlhCM Your subscription to our list has been confirmed. Thank you for subscribing! +16115134831 " Hello, Thanks for your email! We aim to respond to emails within one business day. In the meantime, here's a reference number: 324512435 If your issue can’t wait, please call our Support Team on 13 22 58 or our Sales Team on 13 19 17 and we’ll be happy to help. Kind regards Craig Levy Chief Operating Officer Online Support at iiHelp Select a category to get started: Internet Billing & Accounts Email & Hosting Phone Mobile Fetch TV " 403 ERROR The request could not be satisfied. --------------------------------------------------------------- The Amazon CloudFront distribution is configured to block access from your country. We can't connect to the server for this app or website at this time. There might be too much traffic or a configuration error. Try again later, or contact the app or website owner. If you provide content to customers through CloudFront, you can find steps to troubleshoot and help prevent this error by reviewing the CloudFront documentation. --------------------------------------------------------------- Generated by cloudfront (CloudFront) Request ID: aHl94ZEl8vwL49MNoAXaXgf_Zds6FyMb0u7q8OkFoDYY2iKU3G2Y7w== VERIFY YOUR EMAIL ACCOUNT Welcome to GlBre. To activate your tlNgT account you must first verify your email address by clicking this link. HAVING TROUBLE? If the link above did not work, you can copy and paste the full URL from your mail client into your web browser. The URL should be a single line, if your mail client splits it into multiple lines, copy and paste each line separately. ADDITIONAL ASSISTANCE Thank you for choosing LwlXW. You may reach Customer Support by visiting our Submit A Ticket page. ----UJfEvfUO;PsihfV Hi Kennedy, Thank you for reaching out. Before we can get a quote to you, there are a couple of questions we need to understand. 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Customer Services ----I1ZyFYLe;yvPVxZ Dear Student, Pursuant to the Abraham S. Fischler College of Education (FCE) Student Grievance Procedure, the Grievance Form is for use in filing a grievance when a satisfactory resolution is not achieved through a formal appeal. Please note that this form and any supporting documentation must be properly completed, received, and on file in the Office of Student Judicial Affairs (OSJA) within fifteen (15) days following receipt of correspondence disclosing the appeal committee’s decision, otherwise, the grievance will no longer be eligible for review. Students are encouraged to submit the Grievance Form, and any supporting documentation, well in advance of the fifteen (15) day deadline for submission. Should you have any questions or need assistance with the completion and/or submission of a grievance, please contact OSJA at 0089650225 (toll free at 925360 7907, ext. 56036) Sincerely, Office of Student Judicial Affairs Abraham S. Fischler College of Education ----jHeLQOuF;byVBXP Cardinal Station Newburg Center for Primary Care 215 Central Avenue, Suite 100 1941 Bishop Lane, Suite 900 215 Central Avenue, Suite 205 Louisville, KY 40208 Louisville, KY 40218 Louisville, Ky 40208 I:\FCM\Phyllis Harris\Forms\New Patient Pkg Components UofL Department of Family & Geriatric Medicine Dear New Patient, Welcome to your University of Louisville Physicians Family practice! We are offering patient-centered medical care and are enthusiastic about our relationships with our patients. In order to better serve your needs, we are enclosing several forms and ask that you completely fill each form out. The first sheet will help us learn more about you; please completely fill out this form about your family history. The next sheet is titled, “Authorization for the use and/or Disclosure of Protected Health Information”, and you will need to completely fill that out for our doctors to treat you to the best of their ability; it gives us permission to review your medical records from your previous primary medical facilities. Following, please completely fill out the Registration, Social Services & Consent Form. Next, you will find our Privacy Notice, followed by an acknowledgement that you have received and understand our Privacy Policies. Finally, the last form is the Office Acknowledgements and Policies form. Please read carefully and sign your name at the bottom of the letter. Please make sure to bring all of these forms with you to your first office visit. Do not mail them back to the office. Also, please remember to always bring your picture ID, current insurance cards and your co-payment. If your health insurance requires you to select a primary care doctor please do so prior to your office visit. Please bring in any and all medication you take, in their original bottles, to your appointment. If the patient is under 18 years of age he or she must be accompanied by an adult and will need to bring a copy of their current immunization certificate. Please arrive 15 minutes ahead of your scheduled appointment time so that if you have questions about these forms or we need more information, we can address it all prior to your appointment. We look forward to seeing you! University of Louisville Physicians UofL Family and Geriatric Medicine ----f4cKKHpu;NydoyN ----ExJDhabB;itbtue ----0KXTAPXg;UXjZsg ----oL0EdUpD;iqtesn ----grmDQGJk;rGqUMV ----uzrcVmK5;KwQREx ----3JQm37UH;RzuFzE ----sm;ulbf;sgn ----mQ;axad;tdb I will be out of the office from Tuesday, February 18 through Friday, February 21. I will have access to email and will reply if necessary. All other emails will be returned on Monday, February 24. Thank you! -- Services Manager Recreation 573-874-7202 div> ----JD6Lr95K;naaDbZ Dear Prospective Ed.D., Higher Education Strand Applicant: We are very pleased that you are interested in the Higher Education Strand of CCSU’s Doctor of Education (Ed.D.) in Educational Leadership, designed for current higher education professionals who aspire to leadership positions on college or university campuses. We look forward to receiving your application. As you complete your application, keep in mind the following admission criteria: 1. Master’s degree from an accredited institution of higher education in a discipline or professional field that is relevant to the Ed.D. in Educational Leadership. 2. A 3.00 or higher cumulative average (GPA) in all graduate coursework. 3. Two or more letters of reference from leaders in postsecondary education familiar with your work. Ask your references to use the form on the next page. 4. Résumé that illustrates important work-related experiences with an emphasis on yo ur work as a leader at postsecondary institutions of higher education. 5. Acceptable scores on the General Test of the Graduate Record Examination (GRE) taken within five years of your application. 6. A personal statement covering six important topics: • Career goals • Intended area of individual specialization • Reasons for pursuing a doctorate • Commitment to residency requirements (one three-day weekend in the first spring semester, one full week each of the first, second, and third summer sessions) • Commitment to enrolling in two cohort courses each spring and fall semester • Commitment to summer enrollment during each 8-week summer session 7. If selected as a finalist, a satisfactory interview with the admissions committee. We accept new students in alternate years only. Applications are due by October 1, 2017. Admission standards are rigorous, and not everyone who meets our standards wil l be accepted. Please note that the admission process calls for submission of materials to two locations. The last page of this packet is a checklist of the various steps. Submit your Graduate Application and $50 application fee online. Transcripts from every college you have attended as an undergraduate and graduate student should be submitted to Graduate Admissions in 102 Barnard Hall. In addition you must send the following materials directly to the Ed.D. Program (attention Rouzan Kheranian) in 320 Barnard Hall: 1. Two letters of recommendation from educational leaders. Use the Reference Form (page 2 of this packet). 2. Your personal statement attached to the form on page 3 of this packet. 3. Your résumé. 4. Your GRE scores. When requesting that scores be sent, use GRE reporting code 3143 to assure that the Ed.D. office receives your scores. Cordially, Peter F. Troiano, Ph.D. Ed.D. Program Direct or, Higher Education Strand ----WcihLKGd;dDQZTB Re: Physicals Dear Parents/Guardians: Mandated by state law, all incoming Freshmen, rising Juniors and any other students participating in athletics are required to have a physical on file. These forms must be returned before August 1 (of the year in which students will be Freshmen, Juniors or playing sports). The required forms can be accessed on our Saint Dominic Academy website under the Athletics tab > Health Pack. They are also found under the Parents tab > Forms/Notices > Health Pack. In order to be compliant with the state, the physician completing the physical MUST complete the Cardiac Assessment Module. The date of completion of the module and signature of the physician must be present on the clearance form of the physical. Along with the Pre-Participation Physical Exam, there is a Pamphlet on “Sudden Cardiac Death” (also available on the website). The sign-off sheet must be completed by both the student and parent and submitted with the physical. Thank you fo r your cooperation in this matter. Sincerely, Donna Butto, RN School Nurse ■Preparticipation Physical Evaluation HISTORY FORM (Note: This form is to be filled out by the patient and parent prior to seeing the physician. The physician should keep a copy of this form in the chart.) Date of Exam ___________________________________________________________________________________________________________________ Name __________________________________________________________________________________ Date of birth __________________________ Sex _______ Age __________ Grade _____________ School _____________________________ Sport(s) __________________________________ Medicines and Allergies: Please list all of the prescription and over-the-counter medicines and supplements (herbal and nutritional) that you are currently taking Do you have any allergies? … Yes … No If yes, please identify specific allergy below. … Medicines … Pollens … Food … Stinging Insects Explain “Yes answers below. Circle questions you don’t know the answers to. GENERAL QUESTIONS Yes No 1. Has a doctor ever denied or restricted your participation in sports for any reason? 2. Do you have any ongoing medical conditions? If so, please identify below: … Asthma … Anemia … Diabetes … Infections Other: _______________________________________________ 3. Have you ever spent the night in the hospital? 4. Have you ever had surgery? HEART HEALTH QUESTIONS ABOUT YOU Yes No 5. Have you ever passed out or nearly passed out DURING or AFTER exercise? 6. Have you ever had discomfort, pain, tightness, or pressure in your chest during exercise? 7. Does your heart ever race or skip beats (irregular beats) during exercise? 8. Has a doctor ever told you that you have any heart problems? If so, check all that apply: … High blood pressure … A heart murmur … High cholesterol … A heart infection … Kawasaki disease Other: _____________________ 9. Has a doctor ever ordered a test for yo ur heart? (For example, ECG/EKG, echocardiogram) 10. Do you get lightheaded or feel more short of breath than expected during exercise? 11. Have you ever had an unexplained seizure? 12. Do you get more tired or short of breath more quickly than your friends during exercise? HEART HEALTH QUESTIONS ABOUT YOUR FAMILY Yes No 13. Has any family member or relative died of heart problems or had an unexpected or unexplained sudden death before age 50 (including drowning, unexplained car accident, or sudden infant death syndrome)? 14. Does anyone in your family have hypertrophic cardiomyopathy, Marfan syndrome, arrhythmogenic right ventricular cardiomyopathy, long QT syndrome, short QT syndrome, Brugada syndrome, or catecholaminergic polymorphic ventricular tachycardia? 15. Does anyone in your family have a heart problem, pacemaker, or implanted defibrillator? 16. Has anyone in your family had unexplained fainting, unexplained seizures, or near drowning? BONE AND JOINT QUESTIONS Yes No 17. Have you ever had an injury to a bone, muscle, ligament, or tendon that caused you to miss a practice or a game? 18. Have you ever had any broken or fractured bones or dislocated joints? 19. Have you ever had an injury that required x-rays, MRI, CT scan, injections, therapy, a brace, a cast, or crutches? 20. Have you ever had a stress fracture? 21. Have you ever been told that you have or have you had an x-ray for neck instability or atlantoaxial instability? (Down syndrome or dwarfism) 22. Do you regularly use a brace, orthotics, or other assistive device? 23. Do you have a bone, muscle, or joint injury that bothers you? 24. Do any of your joints become painful, swollen, feel warm, or look red? 25. Do you have any history of juvenile arthritis or connective tissue disease? MEDICAL QUESTIONS Yes No 26. Do you cough, wheeze, or have difficulty breathing during or after exercise? 27. Have you ever used an inhaler or taken asthma medicine? 28. Is there anyone in your fam ily who has asthma? 29. Were you born without or are you missing a kidney, an eye, a testicle (males), your spleen, or any other organ? 30. Do you have groin pain or a painful bulge or hernia in the groin area? 31. Have you had infectious mononucleosis (mono) within the last month? 32. Do you have any rashes, pressure sores, or other skin problems? 33. Have you had a herpes or MRSA skin infection? 34. Have you ever had a head injury or concussion? 35. Have you ever had a hit or blow to the head that caused confusion, prolonged headache, or memory problems? 36. Do you have a history of seizure disorder? 37. Do you have headaches with exercise? 38. Have you ever had numbness, tingling, or weakness in your arms or legs after being hit or falling? 39. Have you ever been unable to move your arms or legs after being hit or falling? 40. Have you ever become ill while exercising in the heat? 41. Do you get frequent muscle cramps when exercising? 42. Do you or someone in your family have sickle cell trait or disease? 43. Have you had any problems with your eyes or vision? 44. Have you had any eye injuries? 45. Do you wear glasses or contact lenses? 46. Do you wear protective eyewear, such as goggles or a face shield? 47. Do you worry about your weight? 48. Are you trying to or has anyone recommended that you gain or lose weight? 49. Are you on a special diet or do you avoid certain types of foods? 50. Have you ever had an eating disorder? 51. Do you have any concerns that you would like to discuss with a doctor? FEMALES ONLY 52. Have you ever had a menstrual period? 53. How old were you when you had your first menstrual period? 54. How many periods have you had in the last 12 months? Explain “yes” answers here I hereby state that, to the best of my knowledge, my answers to the above questions are complete and correct. Signature of athlete __________________________________________ Signature of parent/guardian ________________________________________ ____________________ Date _____________________ ©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment. HE0503 9-2681/0410 New Jersey Department of Education 2014; Pursuant to P.L.2013, c.71 ■Preparticipation Physical Evaluation THE ATHLETE WITH SPECIAL NEEDS: SUPPLEMENTAL HISTORY FORM Date of Exam ___________________________________________________________________________________________________________________ Name __________________________________________________________________________________ Date of birth __________________________ Sex _______ Age __________ Grade _____________ School _____________________________ Sport(s) __________________________________ 1. Type of disability 2. Date of disability 3. Classification (if available) 4. Cause of disability (birth, disease, accident/trauma, other) 5. List the sports you are interested in playing Yes No 6. Do you regularly use a brace, assistive device, or prosthetic? 7. Do you use any special brace or assistive device for sports? 8. Do you have any rashes, pressure sores, or any other skin problems? 9. Do you have a hearing loss? Do you use a hearing aid? 10. Do you have a visual impairment? 11. Do you use any special devices for bowel or bladder function? 12. Do you have burning or discomfort when urinating? 13. Have you had autonomic dysreflexia? 14. Have you ever been diagnosed with a heat-related (hyperthermia) or cold-related (hypothermia) illness? 15. Do you have muscle spasticity? 16. Do you have frequent seizures that cannot be controlled by medication? Explain “yes” answers here Please indicate if you have ever had any of the following. Yes No Atlantoaxial instability X-ray eva luation for atlantoaxial instability Dislocated joints (more than one) Easy bleeding Enlarged spleen Hepatitis Osteopenia or osteoporosis Difficulty controlling bowel Difficulty controlling bladder Numbness or tingling in arms or hands Numbness or tingling in legs or feet Weakness in arms or hands Weakness in legs or feet Recent change in coordination Recent change in ability to walk Spina bifida Latex allergy Explain “yes” answers here I hereby state that, to the best of my knowledge, my answers to the above questions are complete and correct. Signature of athlete __________________________________________ Signature of parent/guardian __________________________________________________________ Date _____________________ ©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports M edicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment. New Jersey Department of Education 2014; Pursuant to P.L.2013, c.71 ■Preparticipation Physical Evaluation PHYSICAL EXAMINATION FORM Name __________________________________________________________________________________ Date of birth __________________________ PHYSICIAN REMINDERS 1. Consider additional questions on more sensitive issues • Do you feel stressed out or under a lot of pressure? • Do you ever feel sad, hopeless, depressed, or anxious? • Do you feel safe at your home or residence? • Have you ever tried cigarettes, chewing tobacco, snuff, or dip? • During the past 30 days, did you use chewing tobacco, snuff, or dip? • Do you drink alcohol or use any other drugs? • Have you ever taken anabolic steroids or used any other performance supplement? • Have you ever taken any supplements to help you gain or lose weight or improve your performance? • D o you wear a seat belt, use a helmet, and use condoms? 2. Consider reviewing questions on cardiovascular symptoms (questions 5–14). EXAMINATION Height Weight … Male … Female BP / ( / ) Pulse Vision R 20/ L 20/ Corrected … Y … N MEDICAL NORMAL ABNORMAL FINDINGS Appearance • Marfan stigmata (kyphoscoliosis, high-arched palate, pectus excavatum, arachnodactyly, arm span > height, hyperlaxity, myopia, MVP, aortic insufficiency) Eyes/ears/nose/throat • Pupils equal • Hearing Lymph nodes Heart a • Murmurs (auscultation standing, supine, +/- Valsalva) • Location of point of maximal impulse (PMI) Pulses • Simultaneous femoral and radial pulses Lungs Abdomen Genitourinary (males only)b Skin • HSV, lesions suggestive of MRSA, tinea corporis Neurologic c MUSCULOSKELETAL Neck Back Shoulder/arm Elbow/forearm Wrist/hand/fingers Hip/thigh Knee Leg/ankle Foot/toes Functional • Duck-walk, single leg hop aConsider ECG, echocardiogram, and referral to cardiology for abnor mal cardiac history or exam. bConsider GU exam if in private setting. Having third party present is recommended. cConsider cognitive evaluation or baseline neuropsychiatric testing if a history of significant concussion. † Cleared for all sports without restriction † Cleared for all sports without restriction with recommendations for further evaluation or treatment for _________________________________________________________________ ____________________________________________________________________________________________________________________________________________ † Not cleared † Pending further evaluation † For any sports † For certain sports _____________________________________________________________________________________________________________________ Reason ___________________________________________________________________________________________________________________________ Recommendations __________________________________________________________ _______________________________________________________________________ ________________________________________________________________________________________________________________________________________________ I have examined the above-named student and completed the preparticipation physical evaluation. The athlete does not present apparent clinical contraindications to practice and participate in the sport(s) as outlined above. A copy of the physical exam is on record in my office and can be made available to the school at the request of the parents. If conditions arise after the athlete has been cleared for participation, the physician may rescind the clearance until the problem is resolved and the potential consequences are completely explained to the athlete (and parents/guardians). Name of physician, advanced practice nurse (APN), physician assistant (PA) (print/type)_____________________________________________________ Date ________________ Address ____________ _______________________________________________________________________________________________ Phone _________________________ Signature of physician, APN, PA _____________________________________________________________________________________________________________________ ©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment. HE0503 9-2681/0410 I have examined the above-named student and completed the preparticipation physical evaluation. The athlete does not present apparent clinical contraindications to practice and participate in the sport(s) as outlined above. A copy of the physical exam is on record in my office and can be made available to the school at the request o f the parents. If conditions arise after the athlete has been cleared for participation, a physician may rescind the clearance until the problem is resolved and the potential consequences are completely explained to the athlete (and parents/guardians). New Jersey Department of Education 2014; Pursuant to P.L.2013, c.71 ■Preparticipation Physical Evaluation CLEARANCE FORM Name _______________________________________________________ Sex  M  F Age _________________ Date of birth _________________  Cleared for all sports without restriction  Cleared for all sports without restriction with recommendations for further evaluation or treatment for _______________________________________________ ___________________________________________________________________________________________________________________________  Not cleared  Pending further evaluation  For any sports  For certain sports ________________________________________________ _____________________________________________________ Reason ___________________________________________________________________________________________________________ Recommendations _______________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ I have examined the above-named student and completed the preparticipation physical evaluation. The athlete does not present apparent clinical contraindications to practice and participate in the sport(s) as outlined above. A copy of the physical exam is on record in my office and can be made available to the school at the request of the parents. If conditions arise after the athlete has been cleared for participation, the physician may rescind the clearance until the problem is resolved and the potential consequences are completely explained to the athlete (and parents/guardians). Name of physician, advanced practice nurse (APN), physician assistant (PA) ____________________________________________________ Date _______________ Address _________________________________________________________________________________________ Phone _________________________ Signature of physician, APN, PA _____________________________________________________________________________________________________ Completed Cardiac Assessment Professional De velopment Module Date___________________________ Signature_______________________________________________________________________________________ EMERGENCY INFORMATION Allergies ______________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ Other information _______________________________________ ________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ___________________________ ___________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________ ©2010 American Academy of Family Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine. Permission is granted to reprint for noncommercial, educational purposes with acknowledgment. New Jersey Department of Education 2014; Pursuant to P.L.2013, c.71 Stateof New Jersey DEPARTMENT OF EDUCATION HEALTH HISTORY UPDATE QUESTIONNAIRE Name of School __________________________________________________________________________________ To participate on a school-sponsored interscholastic or intramural athletic team or squad, each student whose physical examination was completed more than 90 d ays prior to the first day of official practice shall provide a health history update questionnaire completed and signed by the student’s parent or guardian. Student _________________________________________________________________ Age______ Grade ________ Date of Last Physical Examination_________________________________ Sport______________________________ Since the last pre-participation physical examination, has your son/daughter: 1. Been medically advised not to participate in a sport? Yes____ No____ If yes, describe in detail __________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ 2. Sustained a concussion, been unconscious or lost memory from a blow to the head? Yes____ No____ If yes, explain in detail_______________________________________________________________ ____________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ 3. Broken a bone or sprained/strained/dislocated any muscle or joints? Yes____ No____ If yes, describe in detail __________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ 4. Fainted or “blacked out?” Yes____ No____ If yes, was this during or immediately after exercise?___________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ 5. Experienced chest pains, shortness of breath or “racing heart?” Yes____ No____ If yes, explain__________________________________________________________________________________ _____________________________________________________________________________________________ 6. Has there been a recent history of fatigue and unusual tiredness? Yes____ No____ 7. Been hospitalized or had to go to the emergency room? Yes____ No____ If yes, explain in detail___________________________________________________________________________ _____________________________________________________________________________________________ _____________________________________________________________________________________________ 8. Since the last physical examination, has there been a sudden death in the family or has any member of the family under age 50 had a heart attack or “heart trouble?” Yes____ 9. Started or stopped taking any over-the-counter or prescribed medications? Yes____ No____ If yes, name of medication(s)___________________________________ ___________________________________ _____________________________________________________________________________________________ Date:________________________ Signature of parent/guardian ___________________________________________ PLEASE RETURN COMPLETED FORM TO THE SCHOOL NURSE’S OFFICE E14-00284 State of New Jersey DEPARTMENT OF EDUCATION Sudden Cardiac Death Pamphlet Sign-Off Sheet Name of School District:________________________________________________________________ Name of Local School: _________________________________________________________________ I/We acknowledge that we received and reviewed the Sudden Cardiac Death in Young Athletes pamphlet. Student Signature: _____________________________________________________________________ Parent or Guardian Signature:____________________________________________________________________________ Date:____________________________ New Jersey Department of Education 2014: pursuant to the Scholastic Student-Athlet Safety A ct, P.L. 2013, c71 E14-00395 SUDDEN CARDIAC DEATH IN YOUNG ATHLETES The Basic Facts on Sudden Cardiac Death in Young Athletes SUDDEN CARDIAC DEATH IN YOUNG ATHLETES S udden death in young athletes between the ages of 10 and 19 is very rare. What, if anything, can be done to prevent this kind of tragedy? Whatis sudden cardiac death in the young athlete? Sudden cardiac death is the result of an unexpected failure of proper heart function, usually (about 60% of the time) during or immediately after exercise without trauma. Since the heart stops pumping adequately, the athlete quickly collapses, loses consciousness, and ultimately dies unless normal heart rhythm is restored using an automated external defibrillator (AED). How common is sudden death in young athletes? Sudden cardiac death in young athletes is very rare. About 100 such deaths are reported in the United States per year. The chance of sudden death occurring to any individual high school athlete is about one in 200,0 00 per year. Sudden cardiac death is more common: in males than in females; in football and basketball than in other sports; and in African-Americans than in other races and ethnic groups. What are the most common causes? Research suggests that the main cause is a loss of proper heart rhythm, causing the heart to quiver instead of pumping blood to the brain and body. Thisis called ventricular fibrillation (ven- TRICK-you-lar fibroo-LAY-shun). The problem is usually caused by one ofseveral cardiovascular abnormalities and electrical diseases of the heart that go unnoticed in healthy-appearing athletes. The most common cause ofsudden death in an athlete is hypertrophic cardiomyopathy (hi-per-TRO-fic CAR- dee-oh-my-OP-a-thee) also called HCM. HCM is a disease of the heart, with abnormal thickening of the heart muscle, which can cause serious heart rhythm problems and blockagesto blood flow. This genetic disease runsin families and usually develops gradually over many years. The second most likely cause is congenital (con-JEN-it-al) (i.e., present from birth) abnormalities of the coronary arteries. This meansthat these blood vessels are connected to the main blood vessel of the heart in an abnormal way. This differsfrom blockagesthat may occur when people get older (commonly called“coronary artery disease,”which may lead to a heart attack). l Sudden Death in Athletes www.cardiachealth.org/sudden-death-inathletes l Hypertrophic Cardiomyopathy Association www.4hcm.org l American Heart Association www.heart.org Collaborating Agencies: American Academy of Pediatrics New Jersey Chapter 3836 Quakerbridge Road, Suite 108 Hamilton, NJ 08619 (p) 609-842-0014 (f) 609-842-0015 www.aapnj.org American Heart Association 1 Union Street, Suite 301 Robbinsville, NJ, 08691 (p) 609-208-0020 www.heart.org New Jersey Department of Education PO Box 500 Trenton, NJ 08625-0500 (p) 609-292-5935 www.state.nj.us/education/ New Jersey Department of Health P. O. Box 360 Tr enton, NJ 08625-0360 (p) 609-292-7837 www.state.nj.us/health Lead Author: American Academy of Pediatrics, New Jersey Chapter Written by: Initial draft by Sushma Raman Hebbar, MD & Stephen G. Rice, MD PhD Additional Reviewers: NJ Department of Education, NJ Department of Health and Senior Services, American Heart Association/New Jersey Chapter, NJ Academy of Family Practice, Pediatric Cardiologists, New Jersey State School Nurses Revised 2014: Christene DeWitt-Parker, MSN, CSN, RN; Lakota Kruse, MD, MPH; Susan Martz, EdM; Stephen G. Rice, MD; Jeffrey Rosenberg, MD, Louis Teichholz, MD; Perry Weinstock, MD Website Resources STATE OF NEW JERSEY DEPARTMENT OF EDUCATION Other diseases of the heart that can lead to sudden death in young people include: l Myocarditis (my-oh-car-DIE-tis), an acute inflammation of the heart muscle (usually due to a virus). l Dilated cardiomyopathy, an enlargement of the heart for unknown reasons. l Long QT syndrome and other electrical abnormalities of the heart which cause abnormal fast heart rhythms that can also run in families. l Marfan syndrome, an inherited disorder that affects heart valves, walls of major arteries, eyes and the skeleton. It is generally seen in unusually tall athletes, especially if being tall is not common in other family members. Are there warning signs to watch for? In more than a third of these sudden cardiac deaths, there were warning signs that were not reported or taken seriously. Warning signs are: l Fainting, a seizure or convulsions during physical activity; l Fainting or a seizure from emotional excitement, emotional distress or being startled; l Dizziness or lightheadedness, especially during exertion; l Chest pains, at rest or during exertion; l Palpitations- awareness of the heart beating unusually (skipping, irregular or extra beats) during athletics or during cool down periods after athletic participation; l Fatigue or tiring more quickly than peers; or l Being unable to keep up with friends due to shortness of breath. What are the current recommendations for screening young athletes? New Jersey requires all school athletes to be examined by their primary care physician (“medical home”) or school physician at least once per year. The New Jersey Department of Education requires use of the specific Annual Athletic Pre-Participation Physical Examination Form. This process begins with the parents and student-athletes answering questions about symptoms during exercise (such as chest pain, dizziness, fainting, palpitations or shortness of breath); and questions about family health history. The primary healthcare provider needs to know if any family member died suddenly during physical activity or during a seizure. They also need to know if anyone in the family under the age of 50 had an unexplained sudden death such as drowning or car accidents. This information must be provided annually for each exam because it is so essential to identify those at ri sk for sudden cardiac death. The required physical exam includes measurement of blood pressure and a careful listening examination of the heart, especially for murmurs and rhythm abnormalities. If there are no warning signs reported on the health history and no abnormalities discovered on exam, no further evaluation or testing is recommended. When should a student athlete see a heart specialist? If the primary healthcare provider or school physician has concerns, a referral to a child heart specialist, a pediatric cardiologist, is recommended. This specialist will perform a more thorough evaluation, including an electrocardiogram (ECG), which is a graph of the electrical activity of the heart. An echocardiogram, which is an ultrasound test to allow for direct visualization of the heart structure, will likely also be done. The specialist may also order a treadmill exercise test and a monitor to enable a longer recording of the heart rhythm. None of the testing is invasive or uncomfortable. Can sudden cardiac death be prevented just through proper screening? A proper evaluation should find most, but not all, conditions that would cause sudden death in the athlete. This is because some diseases are difficult to uncover and may only develop later in life. Others can develop following a normal screening evaluation, such as an infection of the heart muscle from a virus. This is why screening evaluations and a review of the family health history need to be performed on a yearly basis by the athlete’s primary healthcare provider. With proper screening and evaluation, most cases can be identified and prevented. Why have an AED on site during sporting events? The only effective treatment for ventricular fibrillation is immediate use of an automated external defibrillator (AED). An AED can restore the heart back into a normal rhythm. An AED is also life-saving for ventricular fibrillation caused by a blow to the chest over the heart (commotio cordis). E ffective September 1, 2014, the New Jersey Department of Education requires that all public and nonpublic schools grades K through 12 shall: l Have an AED available at every sports event (three minutes total time to reach and return with the AED); l Have adequate personnel who are trained in AED use present at practices and games; l Have coaches and athletic trainers trained in basic life support techniques (CPR); and l Call 911 immediately while someone is retrieving the AED. SUDDEN CARDIAC DEATH IN YOUNG ATHLETES 1 NJSIAA STEROID TESTING POLICY AND PARENT/GUARDIAN CONCUSSION POLICY ACKNOWLEDGMENT FORMS NJSIAA STEROID TESTING POLICY CONSENT TO RANDOM TESTING In Executive Order 72, issued December 20, 2005, Governor Richard Codey directed the New Jersey Department of Education to work in conjunction with the New Jersey State Interscholastic Athletic Association (NJSIAA) to develop and implement a program of random testing for steroids, of teams and individuals qualifying for championship games. Beginning in the Fall, 2006 sports season, any student-athlete who possesses, distributes, ingests or otherwise uses any of the banned substances on the attached page, without written prescription by a fullylicensed physician, as recognized by the American Medical Association, to treat a medical condition, violates the NJSIAA’s sportsmanship rule, and is subject to NJSIAA penalties, including ineligibility from competition. The NJSIAA will test certain randomly selected individuals and teams that qualify for a state championship tournament or state championship competition for banned substances. The results of all tests shall be considered confidential and shall only be disclosed to the student, his or her parents and his or her school. No student may participate in NJSIAA competition unless the student and the student’s parent/guardian consent to random testing. 2 NJSIAA Banned-Drug Classes 2012 - 2013 The term “related compounds” comprises subs tances that are included in the class by their pharmacological action and/or chemical structure. No substance belonging to the prohibited class may be used, regardless of whether it is specifically listed as an example. Many nutritional/dietary supplements contain NJSIAA banned substances. In addition, the U. S. Food and Drug Administration (FDA) does not strictly regulate the supplement industry; therefore purity and safety of nutritional dietary supplements cannot be guaranteed. Impure supplements may lead to a positive NJSIAA drug test. The use of supplements is at the student-athlete’s own risk. Student-athletes should contact their physician or athletic trainer for further information. The following is a list of banned-drug classes, with examples of banned substances under each class: (a) Stimulants (b) Anabolic Agents (c) Diuretics (d) Peptide Hormones & Analogues: Amiphenazole anabolic steroids acetazolamide corticotrophin (ACTH) amphetamine androstenediol bendroflu methiazide human chorionic gonadotrophin (hCG) bemigride androstenedione benzhiazide leutenizing hormone (LH) benzphetamine boldenone bumetanide growth hormone (HGH, somatotrophin) bromantan clostebol chlorothiazide insulin like growth hormone (IGF-1) caffeine1 (guarana) dehydrochlormethyl- chlorthalidone chlorphentermine testosterone ethacrynic acid All the respective releasing factors cocaine dehydroepiandro- flumethiazide of the above-mentioned substances cropropamide sterone (DHEA) furosemide also are banned: crothetamide dihydrotestosterone (DHT) hydrochlorothiazide erythropoietin (EPO) diethylpropion dromostanolone hydroflumenthiazide darbypoetin dimethylamphetamine epitrenbolone methyclothiazide sermorelin doxapram fluoxymesterone metolazone ephedrine gestrinone polythiazide (ephedra, ma huang) mesterolone quinethazone ethamivan methandienone spironolactone ethylamphetamine methenolone triamterene fencamfamine methyltestosterone trichlormethiazide meclofenoxate nandro lone and related compounds methamphetamine norandrostenediol methylenedioxymethamphetamine norandrostenedione (MDMA, ecstasy) norethandrolone methylphenidate oxandrolone nikethamide oxymesterone pemoline oxymetholone pentetrazol stanozolol phendimetrazine testosterone2 phenmetrazine tetrahydrogestrinone phentermine (THG) phenylpropanolamine trenbolone picrotoxine and related compounds pipradol prolintane strychnine synephrine (citrus aurantium, zhi shi, bitter other anabolic agents orange) and related compounds (e) Definitions of positive depends on the following: 1 for caffine – if the concentration in urine exceeds 15 micrograms/ml 2 for testosterone – if administration of testosterone or use of any other manipulation has the result of increasing the ratio of the total concentration of testosterone to that of epitestosterone in the urine of greater than 6:1, unless there is evidence that this ratio is due to a physiological or pathological condition. 3 NJSIAA PARENT/GU ARDIAN CONCUSSION POLICY ACKNOWLEDGMENT FORM In order to help protect the student athletes of New Jersey, the NJSIAA has mandated that all athletes, parents/guardians and coaches follow the NJSIAA Concussion Policy. A concussion is a brain injury and all brain injuries are serious. They may be caused by a bump, blow, or jolt to the head, or by a blow to another part of the body with the force transmitted to the head. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or bump on the head could be serious. You can’t see a concussion and most sports concussions occur without loss of consciousness. Signs and symptoms of concussion may show up right after the injury or can take hours or days to fully appear. If your chil d/player reports any symptoms of concussion, or if you notice the symptoms or signs of concussion yourself, seek medical attention right away. Symptoms may include one or more of the following: 1. Headache 2. Nausea/vomiting 3. Balance problems or dizziness 4. Double vision or changes in vision 5. Sensitivity to light or sound/noise 6. Feeling of sluggishness or fogginess 7. Difficulty with concentration, short-term memory, and/or confusion 8. Irritability or agitation 9. Depression or anxiety 10.Sleep Disturbance Signs observed by teammates, parents and coaches include: 1. Appears dazed, stunned, or disoriented 2. Forgets plays or demonstrates short-term memory difficulties (e.g. is unsure of the game, score, or opponent) 3. Exhibits difficulties with balance or coordination 4. Answers questions slowly or inaccurately 5. Loses consciousness 6. Demonstrates behavior or personality changes 7. Is unable to recall events prior to or after the hit 4 What can happen if my child/p layer keeps on playing with a concussion or returns too soon? Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often under report symptoms of injuries. And concussions are no different. As a result, education of administrators, coaches, parents and students is the key for student-athletes’ safety. If you think your child/player has suffered a concussion Any athlete even suspected of sufferin g a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear. Close observation of the athlete should continue for several hours. An athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time and may not return to play until the athlete receives written clearance from a physician trained in the evaluation and management of concussions that states the student athlete is asymptomatic at rest and may begin the graduated return to play protocol. The graduated return to play protocol is a series of six steps, the first being a completion of a full day of normal cognitive activities without re-emergence of symptoms. Day 2: light aerobic exercise, keeping the student’s heart rate PALM SPRINGS HIGH SCHOOL 2401 BARISTO, PALM SPRINGS, CA 92262 www.palmspringshighschool.org www.pshscounselors.us DEAR INCOMING FRESHMEN, WELCOME TO PALM SPRINGS HIGH SCHOOL! We look forward to meeting you and having you as part of our #TRIBE Class of 2024, Indians! Coming to a new school with new people, a new schedule, and new classes can be stressful! To ensure you are ready to enjoy the new school year the Palm Springs High School Counseling Department will be calling you directly to discuss your Course Selections as an incoming Freshmen. We have five high school counselors: Mr. Steven Aviña, Ms. Christina Aviña, Mrs. Rosa Corona, Mrs. Cindy Jara, and Ms. Jocelyn Polite to discuss all academies, classes, and programs with you. First, we are asking you to join Class of 2024 Google Classroom join code p5iwguz. Fill out the Class of 2024 informational survey; next review the Class of 2024 Course Offering Booklet, Class of 2024 Google Slide presentation and 9th grade course selection sheet in preparation for one of our counselor’s to call you. Do not forget to check out Palm Springs High School and PSHS counselors website, twitter page @PSHSCOUNSELING for updates and information. Thank you, Class of 2024 Indians, for your patience and understanding through this time #TRIBE. Sincerely, Palm Springs High School Counseling Department Mr. Steven Aviña, Counselor Ms. Christina Aviña, Counselor Mrs. Rosa Corona, Counselor Mrs. Cindy Jara, Counselor Ms. Jocelyn Polite, Counselor Palm Springs High School is dedicated to preparing all students to be responsible, productive members of society, and lifelong learners, by providing for their intellectual, personal, and career development.July 29, 2020 Dear UPHS Families, Welcome to the 2020-2021 school year. We are excited about the upcoming school year, and we look forward to meeting all the new students who have chosen to join our Panda Family. We hope you and your family enjoyed your summer vacation and had some family fun. We want to share a few items regarding the upcoming school year. The UPHS Office reopened at 8 am on July 29th. The first day back to school (virtually through distance learning) for students will be Wednesday, August 5th at 8:30 am. This will be a very unique start to the school year. Per Assembly Bill 77, all schools must adhere to the following: 1.) Daily live interaction will be required; 2.) Student attendance is mandatory, and 3.) All students must receive a minimum of 240 minutes of daily instruction. UPHS will be following this Assembly Bill. With regard to technology and devices, UPHS will provide laptops and hotspots to any students who submitted a request for these items (See the survey emailed to all UPHS families). UPHS will begin the school year online per the California Governor’s order. On August 5th at 8:30 am, students will log into their Homeroom class via Zoom. Students will receive an email with the link to their teacher’s Homeroom class on Tuesday, August 4th. Please make sure your UPHS student checks their email each day. Students and teachers will be utilizing Zoom as the platform to meet as a class. For the first three days (August 5-7), students will only be attending their Homeroom class for 30-45 minutes. The Homeroom class will provide time for UPHS students to meet their Homeroom teacher, make some friends, and learn about various policies and procedures relevant to the 2020-2021 school year. Students will learn how distance learning will work this semester, how to access each of their teacher’s Google website and Google classroom. This will also give students time to learn about “virtual” life at UPHS. The UPHS Leadership students will be planning different “virtual” activities to help all new Pandas and returning Pandas feel connected to our PANDA FAMILY! Per the state of California, a weekly engagement record will be kept for each student. This means students will follow their daily class schedule beginning Monday, August 10th. Students will be required and expected to follow the UPHS Bell Schedule by logging into Zoom for each of their classes every day. Class schedules will be released via Powerschool on Tuesday, August 4th (after 4:00 pm). Students will also receive an email with their PowerSchool login information on August 4th. PowerSchool login information will also be mailed to all parents/guardians. Teachers will use their class websites (UPHS Staff webpage) to post the needed information for students to join their Zoom classroom. We understand this will be a challenge for some families, and we ask that our students do their very best to be “in class” next week. We will be patient with all students, and we ask all students and families to be patient with all of the UPHS faculty and staff, as this is also challe nging for all of us. This year we will be utilizing Powerschool for parents and students to review/complete the start of school forms. Parents/Guardians, and students will fill out/acknowledge these forms online and receive a receipt showing these forms have been submitted. Families no longer have to print and sign hard copies of the start of school forms and turn these forms into the office. Later this month, all UPHS families will have access to and be able to download the UPHS Parent/Student Handbook from the UPHS School Information Website. This handbook contains all the information/policies used and followed at UPHS. The handbook will be posted on the UPHS School Information Web Site once it has been approved by TCOE. We ask all UPHS families to review the handbook, as knowledge of the items in the handbook ensures a successful school year. Also, all families are required to sign an acknowledgment page stating they have read and understood the handbook during the first month of school. As a reminder, all students who wish to enroll in a COS college class must not have any D’s or F’s and must maintain a 95% attendance throughout each semester. College of the Sequoias starts on Monday, August 17th. Students do need to check their COS email and their Canvas to access information from COS and from their COS professors. Additionally, students need to know if their class is synchronous or asynchronous. This information can be found on the COS website by clicking on ‘Class Search’ and then clicking on the link cos.edu/fall2020. Due to the COVID-19, parents/guardians and students are not allowed on the COS campus. Teachers have been directed to keep their doors locked and the UPHS Office will be locked as well. If a parent or a student needs help or needs to speak with someone directly, they must call the office and either speak with that person over the phone or make an appointment to meet on Zoom. Please encourage your student to reach out to their teachers and friends. The Panda Buddies and the Leadership students will be reaching out to all new and returning students. These connections with other students will be important for students to invest in and maintain, as we are all working in this new “virtual” world of schooling. One nice feature of Zoom is that one can join with their cell phone either using video or calling a specific phone number. Eventually, all students will only be able to log into Zoom using their uphsconnect.org email. Please ask your student to check their email daily (this is the main form of communication used at UPHS) for information about the beginning of school and their UPHS classes. Start of School Events: The first day of UPHS classes – August 5th@8:30 am PSO Meeting VIA Zoom -- August 11th The First day of COS classes – August 17th We look forward to seeing everyone online Wednesday, August 5th at 8:30 am. The faculty and staff will have organized “virtual” activities and ice breakers in order for all students to have a positive start to the 2020-2021 school year. All information about UPHS is located on the UPHS School Information Web Site. Please bookmark the link and visit the site often. We will be sending more information to all families via email and text messages. Please, keep an eye on your email. Sincerely, Eric Thiessen Principal