And to Your Left You\u27ll See... : Licensed Tour Guides, The First Amendment, and the Free Market

If you are a beer-lover visiting Washington, D.C., you might want to check out “DC Brew Tours,” a “beer tour company in the Capital region that offers daily brewery tours to Washington’s best breweries, brewpubs, and bars.” As you would expect, the tour includes samples of beer from a number of local craft breweries, as well as information about how each beer is made. What you might not expect, however, is that, until very recently, DC Brew tour guides were legally obligated to pass a written exam about the history of D.C., a topic which has little to do with the art of brewing craft beer, in order to obtain a license before providing any paid tours. When you think about the First Amendment and about those figures who helped challenge and shape First Amendment jurisprudence throughout history, who do you think of? Young men burning their draft cards, newspapers challenging prior restraint, students wearing armbands in protest, and, of course, tour guides. Yes, you read that correctly, tour guides. The freedom of speech is “America’s favorite freedom,” so when a law or a case erodes that freedom, it is important to pay attention

And to Your Left You\u27ll See... : Licensed Tour Guides, The First Amendment, and the Free Market

If you are a beer-lover visiting Washington, D.C., you might want to check out “DC Brew Tours,” a “beer tour company in the Capital region that offers daily brewery tours to Washington’s best breweries, brewpubs, and bars.” As you would expect, the tour includes samples of beer from a number of local craft breweries, as well as information about how each beer is made. What you might not expect, however, is that, until very recently, DC Brew tour guides were legally obligated to pass a written exam about the history of D.C., a topic which has little to do with the art of brewing craft beer, in order to obtain a license before providing any paid tours. When you think about the First Amendment and about those figures who helped challenge and shape First Amendment jurisprudence throughout history, who do you think of? Young men burning their draft cards, newspapers challenging prior restraint, students wearing armbands in protest, and, of course, tour guides. Yes, you read that correctly, tour guides. The freedom of speech is “America’s favorite freedom,” so when a law or a case erodes that freedom, it is important to pay attention

Soft Skills – The Missing Piece for Entrepreneurs to Grow a Business

Small businesses and entrepreneurial startups are continually cited as critical engines for economic and social growth and development of our country. Many municipalities and state governments provide tax incentives, low (or no) interest loans, infrastructure improvements and “economic gardening” – an economic development model with the fundamental idea that entrepreneurs drive economies. Economic gardening initiatives connect entrepreneurs to resources, assist with refining business models, encourage the development of essential infrastructure, assess competitive intelligence, and provide entrepreneurs with needed information. The authors suggest what is missing is assisting entrepreneurs with development of their interpersonal or soft skills

Total Colony-Forming Units Are a Strong, Independent Predictor of Neutrophil and Platelet Engraftment after Unrelated Umbilical Cord Blood Transplantation: A Single-Center Analysis of 435 Cord Blood Transplants

Graft failure occurs in approximately 20% of patients after unrelated umbilical cord blood transplantation (UCBT). This could be because of inadequate potency of the cord blood unit (CBU). To this end, we investigated the impact of graft characteristics on engraftment and survival of 435 primarily pediatric (median age: 5.3 years) patients receiving a single-unit unrelated UCBT after myeloablative conditioning from 2000 to 2008. Pre-cryopreservation (pre-cryo) graft characteristics were provided by the banks. Post-thaw parameters were measured on dextran/albumin-washed grafts. Post-thaw recovery of the colony-forming unit (CFU), a biological assay reflecting functional viability of the cord blood cells was the lowest percent age (median 21.2%, mean 36.5%) of the pre-cryo value, regardless of the bank of origin. The cumulative incidences of neutrophil and platelet engraftment were 76.9% (95%, confidence interval [CI], 71.3%-82.5%) and 55% (95% CI, 49.3%-60.7%), respectively. Univariate and separate multivariate models using pre-cryo and post-thaw datasets including clinical parameters identified predictors of engraftment and survival. In multivariate modeling, higher CFU dosing was the only pre-cryo graft characteristic predictive of neutrophil (P = .0024) and platelet engraftment (P = .0063). In the post-thaw model, CFU dose best predicted neutrophil and platelet engraftment (both P < .0001). Comparatively, CD34+ and total nucleated cell (TNC) were only weakly predictive in post-thaw neutrophil and platelet engraftment models, respectively. In conclusion, CFU dose is a strong independent predictor of engraftment after unrelated UCBT and should be used to assess potency when selecting CBUs for transplantation

Homebound patients’ perspectives on technology and telemedicine: A qualitative analysis

Telemedicine holds promise in bridging the gap between homebound patients and high quality health care, but uptake of such technology remains limited. Qualitative interviews conducted with 17 homebound patients found two major barriers to telemedicine. First, participants who lack familiarity with technology are hesitant about telemedicine, as baseline use of technology in the home is limited, participants did not feel capable of learning, and the advantages of telemedicine were unclear. Second, homebound patients place a high value on in- office visits due to therapeutic benefit, face-to-face communication, and the social aspect of medical appointments

Hybrid Online Delivery of a Pharmacy Residency and Fellowship Elective Course

&nbsp; Objective: To describe and evaluate the transition of a pharmacy residency and fellowship (PRF) elective course to a hybrid online platform. Innovation: In 2016, the 1-credit hour PRF elective was transitioned from a live, synchronous course to a hybrid online platform. Over the course of the semester, students completed eight modules along with assignments that pertained to a different component of PRF. Course grades and evaluations, as well as PRF placement rates, were compared between 2015 (live, synchronous course) and 2016 (hybrid online course). There were no differences in overall course grades or student evaluations of individual relevant course objectives between the two course formats. However, more students rated the course as excellent during the 2015 live, synchronous course. Placement rates were similar between students who took the course in 2015 and 2016. Critical Analysis: Following the transition of a PRF elective to a hybrid online platform, course grades, evaluation of individual relevant course objectives, and PRF placement rates remained similar to previous years. Creative educational venues can help meet the student demand while simultaneously allowing faculty to manage their time. However, instructors should balance this with desire of students to have more face-to-face in class time. &nbsp; &nbsp; Type: Not

Leading Learning Networks in Education

This study is one of the main outcomes of Leading Learning by Networking, an Erasmus+ project. It concerns the management of learning networks in schools with regard to the mission of these networks in the context of growing diversity. The text consists of three main parts. The opening chapter is of theoretical study, dealing with the term Professional learning networks and various factors that facilitate this form of collaboration in schools. Attention is also paid to the role of headteachers in the creation of and support for learning networks. The second part is a summary of the results of a qualitative research, which was carried out by means of interviews, aimed at recognition of some aspects of networking in selected schools in the partner countries. Part three describes a range of data obtained from a questionnaire survey on headteachers’ needs and experience in the management of learning networks

Patient- and Trial-Specific Barriers to Participation in Cardiovascular Randomized Clinical Trials

OBJECTIVES: The purpose of this study was to quantitatively examine the association of patient- and trial-specific factors with participation in cardiovascular randomized clinical trials. BACKGROUND: Randomized clinical trials are central to evidenced-based medicine, but low patient participation rates and potentially modifiable barriers are not well understood. METHODS: At a large U.S. academic health system, we examined screening logs from December 1, 2005, to February 28, 2011, from 15 cardiovascular randomized clinical trials. We identified 655 patients who were screened and potentially eligible for participation in at least 1 trial. We used multivariable Poisson regression to quantify the risk of not participating in a trial associated with patient- and trial-specific factors. RESULTS: The median age was 63 years (interquartile range: 54 to 72), 35% were women, and the median Charlson Index was 2 (interquartile range: 1 to 5). Forty-two percent of patients did not participate in a trial. In multivariable regression (C-Index 0.85), trial-specific factors strongly associated with not participating included intensive trial-related testing (relative risk [RR]: 1.89; 95% confidence interval [CI]: 1.63 to 2.20) and anticipated trial participation >6 months (RR: 4.10; 95% CI: 2.30 to 7.29). Patient-specific factors associated with not participating included older age (RR: 1.23; 95% CI: 1.11 to 1.36, per 10-year increase if age ≥65 years), out-of-state residence (RR: 1.26; 95% CI: 1.04 to 1.54), and female sex (RR: 1.17; 95% CI: 1.01 to 1.35). Race was not associated with participation. CONCLUSIONS: While patient-specific factors were associated with not participating in cardiovascular trials, longer trial duration and intensive trial-related testing were most strongly associated with risk for patients not participating. Innovative trial designs fostering convenience may most enhance trial participation