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Staffing American schools with well-qualified teachers has long been a prominent issue in elementary and secondary education. Mathematics and science teachers are of particular interest because mathematics and science are core subjects in both elementary and secondary public schools. These subjects continue to attract attention as the need for individuals entering the workforce with advanced knowledge in these areas remains high. Maintaining a sufficient supply of mathematics and science teachers depends on both entry rates into these teaching fields and attrition from these fields. This Issue Brief reports on trends in the attrition of public school mathematics and science teachers over a 16-year period and examines the reasons given by mathematics and science teachers for leaving teaching employment. With the exception of leaving for better salary and/or benefits, no measurable differences were found between mathematics and science leavers and other leavers in the percentages rating the selected reasons for leaving as very important or extremely important. The percentage of public school mathematics and science teachers who left teaching employment did not change measurably between 1988-1989 and 2004-2005. However, the percentage of other public school teachers who left teaching employment did increase over the same period. (Contains 10 endnotes and 6 tables.)

This Issue Brief reports the timing of entry into special education and the number of grades in which students receive special education across the primary grades. About 12 percent of students receive special education in at least one of the grades: kindergarten, first, and third grade, including 16 percent of boys, 8 percent of girls, 18 percent of poor children, and 10 percent of nonpoor children. One in three students who receive special education in early grades, first receive special education in kindergarten. Half of those who begin special education in kindergarten are no longer receiving special education by third grade. In addition to students' gender and poverty status, results are presented separately for other student and school characteristics, including race/ethnicity and school control, urbanicity, region, and poverty concentration. Data for this brief come from the Early Childhood Longitudinal Studies, Kindergarten Class of 1998-99 (ECLS-K). (Contains 1 table and 4 endnotes.)

INTRODUCTION: The credibility of model-based economic evaluations of Alzheimer's disease (AD) interventions is central to appropriate decision-making in a policy context. We report on the International PharmacoEconomic Collaboration on Alzheimer's Disease (IPECAD) Modeling Workshop Challenge.METHODS: Two common benchmark scenarios, for the hypothetical treatment of AD mild cognitive impairment (MCI) and mild dementia, were developed jointly by 29 participants. Model outcomes were summarized, and cross-comparisons were discussed during a structured workshop.RESULTS: A broad concordance was established among participants. Mean 10-year restricted survival and time in MCI in the control group ranged across 10 MCI models from 6.7 to 9.5 years and 3.4 to 5.6 years, respectively; and across 4 mild dementia models from 5.4 to 7.9 years (survival) and 1.5 to 4.2 years (mild dementia).DISCUSSION: The model comparison increased our understanding of methods, data used, and disease progression. We established a collaboration framework to assess cost-effectiveness outcomes, an important step toward transparent and credible AD models.

Patients with highly active relapsing-remitting multiple sclerosis inadequately responding to first-line therapies (interferon-based therapies, glatiramer acetate, dimethyl fumarate, and teriflunomide, known collectively as "BRACETD") often switch to natalizumab or fingolimod. The aim was to estimate the comparative effectiveness of switching to natalizumab or fingolimod or within BRACETD using real-world data and to evaluate the cost-effectiveness of switching to natalizumab versus fingolimod using a United Kingdom (UK) third-party payer perspective. Real-world data were obtained from MSBase for patients relapsing on BRACETD in the year before switching to natalizumab or fingolimod or within BRACETD. Three-way-multinomial-propensity-score-matched cohorts were identified, and comparisons between treatment groups were conducted for annualised relapse rate (ARR) and 6-month-confirmed disability worsening (CDW6M) and improvement (CDI6M). Results were applied in a cost-effectiveness model over a lifetime horizon using a published Markov structure with health states based on the Expanded Disability Status Scale. Other model parameters were obtained from the UK MS Survey 2015, published literature, and publicly available UK sources. The MSBase analysis found a significant reduction in ARR (rate ratio [RR] = 0.64; 95% confidence interval [CI] 0.57-0.72; p < 0.001) and an increase in CDI6M (hazard ratio [HR] = 1.67; 95% CI 1.30-2.15; p < 0.001) for switching to natalizumab compared with BRACETD. For switching to fingolimod, the reduction in ARR (RR = 0.91; 95% CI 0.81-1.03; p = 0.133) and increase in CDI6M (HR = 1.30; 95% CI 0.99-1.72; p = 0.058) compared with BRACETD were not significant. Switching to natalizumab was associated with a significant reduction in ARR (RR = 0.70; 95% CI 0.62-0.79; p < 0.001) and an increase in CDI6M (HR = 1.28; 95% CI 1.01-1.62; p = 0.040) compared to switching to fingolimod. No evidence of difference in CDW6M was found between treatment groups

The medical response to mass casualty terrorist bombings (MCTB) has received extensive treatment in the trauma and emergency medicine literature over the past 25 years. An effective medical response must consider four fundamental aspects: (1) the objective of the response, (2) the typical injury pattern, (3) triage, and (4) the delivery of care. This report discusses the key components of each of these aspects, identifying points of consensus and contention and articulating unresolved research questions. Particular attention is given to the triage process because of its importance to the overall response and the array of differing opinions on how, where, and by whom it should be completed. Mathematical models of the trauma system during an MCTB are limited, but this approach offers the potential to answer many of the proposed research questions.

The research presented in this dissertation contributes to the growing literature on applications of operations research models to problems in healthcare through the development and analysis of mathematical models for two fundamental problems facing nearly all hospitals: the single-day surgery scheduling problem and planning for triage in the event of a mass casualty incident. Both of these problems can be understood as sequential decision-making processes aimed at prioritizing between different classes of patients under significant uncertainty and are modeled using stochastic dynamic programming. Our study of the single-day surgery scheduling problem represents the first model to capture the sequential nature of the operating room (OR) manager's decisions during the transition between the generality of cyclical block schedules (which allocate OR time to surgical specialties) and the specificity of schedules for a particular day (which assign individual patients to specific ORs). A case study of the scheduling system at the University of Maryland Medical Center highlights the importance of the decision to release unused blocks of OR time and use them to schedule cases from the surgical request queue (RQ). Our results indicate that high quality block release and RQ decisions can be made using threshold-based policies that preserve a specific amount of OR time for late-arriving demand from the specialties on the block schedule. The development of mass casualty incident (MCI) response plans has become a priority for hospitals, and especially emergency departments and trauma centers, in recent years. Central to all MCI response plans is the triage process, which sorts casualties into different categories in order to facilitate the identification and prioritization of those who should receive immediate treatment. Our research relates MCI triage to the problem of scheduling impatient jobs in a clearing system and extends earlier research by incorporating the important tra

Introduction: The credibility of model-based economic evaluations of Alzheimer's disease (AD) interventions is central to appropriate decision-making in a policy context. We report on the International PharmacoEconomic Collaboration on Alzheimer's Disease (IPECAD) Modeling Workshop Challenge. Methods: Two common benchmark scenarios, for the hypothetical treatment of AD mild cognitive impairment (MCI) and mild dementia, were developed jointly by 29 participants. Model outcomes were summarized, and cross-comparisons were discussed during a structured workshop. Results: A broad concordance was established among participants. Mean 10-year restricted survival and time in MCI in the control group ranged across 10 MCI models from 6.7 to 9.5 years and 3.4 to 5.6 years, respectively; and across 4 mild dementia models from 5.4 to 7.9 years (survival) and 1.5 to 4.2 years (mild dementia). Discussion: The model comparison increased our understanding of methods, data used, and disease progression. We established a collaboration framework to assess cost-effectiveness outcomes, an important step toward transparent and credible AD models.