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This study identifies students' academic trajectories in the middle grades relative to a set of college readiness benchmarks. We apply math and reading college readiness benchmarks to rich longitudinal data for more than 360,000 students across the nation. Student-level and school-level demographic characteristics significantly predict academic trajectories. Compared to White and Asian students, higher proportions of Black and Hispanic student are always off-track throughout middle school. Among students who started 6th grade on track, being male, Black, Hispanic, and attending schools with a higher percentage of low-income students are positively associated with falling off track.

In 2015 and 2016, Zika virus (ZIKV) swept through dengue virus (DENV) endemic areas of Latin America. These viruses are of the same family, share a vector and may interact competitively or synergistically through human immune responses. We examine dengue incidence from Brazil and Colombia before, during, and after the Zika epidemic. We find evidence that dengue incidence was atypically low in 2017 in both countries. We investigate whether subnational Zika incidence is associated with changes in dengue incidence and find mixed results. Using simulations with multiple assumptions of interactions between DENV and ZIKV, we find cross-protection suppresses incidence of dengue following Zika outbreaks and low periods of dengue incidence are followed by resurgence. Our simulations suggest correlations in DENV and ZIKV reproduction numbers could complicate associations between ZIKV incidence and post-ZIKV DENV incidence and that periods of low dengue incidence are followed by large increases in dengue incidence.

The rising cost of prescription drugs is a concern in the United States. To manage drug costs, insurance companies induce patients to choose less-expensive medications by making them pay higher copayments for more-expensive drugs, especially when multiple drug options are available to treat a condition. However, drug manufacturers have responded by offering copay coupons--coupons intended to be used by those already with prescription drug coverage. Recent empirical work has shown that such coupons significantly increase insurer costs without much benefit to patients, who incur lower out-of-pocket expenses with coupons but may eventually see higher costs passed to them. As a result, there is pressure from the insurance industry and consumer advocacy groups to ban copay coupons. In this paper we analyze how copay coupons affect patients, insurance companies, and drug manufacturers, while addressing the question of whether insurance companies would in fact always benefit from a copay coupon ban. We find that copay coupons tend to benefit drug manufacturers with large profit margins relative to other manufacturers, while generally, but not always, benefiting patients; insurer costs tend to increase with coupons from high-price drug manufacturers and decrease with coupons from low-price manufacturers. Although often helping drug manufacturers and increasing insurer costs, we also identify situations in which copay coupons benefit both patients and insurers. Thus, a blanket ban on copay coupons would not necessarily benefit insurance companies. In addition to the policy implications of our work, we make concrete managerial recommendations to insurers. We discuss how they should set formulary selection policies taking into account the fact that drug manufacturers may offer coupons; and we suggest how they can benefit from subsidizing coupons from drug manufacturers with low-price drugs, or from having drug manufacturers compete on price, to receive a favorable formulary position (i.e., copay). History: Accepted by Yossi Aviv, operations management. Funding: The research of X. Chao is supported in part by the National Science Foundation [Grants CMMI-1362619 and CMMI-1634676]. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2018.3123. Keywords: consumer behavior * Nash equilibrium * health care management, 1. Introduction The rising cost of healthcare in the United States has received considerable attention in recent years, and prescription drugs account for approximately 10% of overall healthcare spending. (1) [...]

Due to environmental extremes, as well as the nature of the work itself, wilderness first responders are at risk of incurring medical events in the line of duty. There currently do not exist standardized and scientifically supported methods to screen for a wilderness first responder's risk of incurring a medical event. We performed multiple scoping reviews using PubMed and CINAHL. The reviews covered six medical screening criteria based on previous recommendations from the National Fire Protection Association (NFPA) and the US Forest Service, and we grouped our reviews into two categories: articles that addressed objective screening criteria, and articles that addressed subjective findings with the first responder. Of the objective criteria, our reviews identified 21 articles addressing the ability to screen for risk of incurring a medical event by evaluation of a first responder's heart rate, 12 by blood pressure assessment, and 56 by assessment of body temperature. Of the subjective criteria we identified 19 articles focused on self-assessment, 34 articles on the use of standardized tools to assess for fatigue and sleepiness, and two articles on assessment of a first responder's urine to determine level of dehydration. We also identified seven additional articles through a hand search. Overall, there were 151 articles identified in our scoping reviews. These articles were largely of low quality, consisting mostly of case series without comparison groups. There is a dearth of high-quality research into the medical assessment of first responders. We recommend that this paper, and measures discussed within it, be used as a starting point in the development of an evidence-based assessment protocol for wilderness first responders. We also recommend the development of a national database of medical events incurred by wilderness first responders to facilitate higher-quality research of screening protocols in this community. [ABSTRACT FROM AUTHOR]