Black and Hispanic households tend to live in much poorerneighborhoods than White households with the same income.

Despite the success of the Civil Rights movement in mostly eliminating official segregation in the 1960s, racial residential and economic segregation remains a huge problem in the US. In new research, Lindsay Fox and colleagues find that households of different races, but the same income, live in very different neighborhoods. She writes that the typical White household is in a neighborhood with a median income 40 percent higher than that of the typical Black househol

Dollars for Degrees: Financial Aid and its Impact on Post-Secondary Degree Completion in Texas

Researchers have begun to investigate more deeply the specific effects of rising college costs, increasing debt, and the impact of financial aid on degree completion. Specifically, this paper describes the various sources and types of financial aid available to postsecondary students in Texas, how financial aid is packaged at different types of institutions, and the effects of financial aid types and packages on post-secondary persistence and completion. An appendix contains additional detail on federal, state, institutional and private aid sources as well as a list of the advisors, interviewees, and focus group members we spoke with during our research. While this paper focuses on financial aid in Texas given GTF's state-based purview, we believe many of the lessons are applicable across the country

Dollars for Degrees: Structuring Post-Secondary Scholarships to Increase Student Success

This report explores how funders can structure their scholarship awards and provide access to key non-financial supports to improve post-secondary persistence and completion

Synthesis and Biological Evaluation of a Novel C8-Pyrrolobenzodiazepine (PBD) Adenosine Conjugate. A Study on the Role of the PBD Ring in the Biological Activity of PBD-Conjugates

Here we sought to evaluate the contribution of the PBD unit to the biological activity of PBD-conjugates and, to this end, an adenosine nucleoside was attached to the PBD A-ring C8 position. A convergent approach was successfully adopted for the synthesis of a novel C8-linked pyrrolo(2,1-c)(1,4)benzodiazepine(PBD)-adenosine(ADN) hybrid. The PBD and adenosine (ADN) moieties were synthesized separately and then linked through a pentynyl linker. To our knowledge, this is the first report of a PBD connected to a nucleoside. Surprisingly, the compound showed no cytotoxicity against murine cells and was inactive against Mycobacterium aurum and M. bovis strains and did not bind to guanine-containing DNA sequences, as shown by DNase I footprinting experiments. Molecular dynamics simulations revealed that the PBD–ADN conjugate was poorly accommodated in the DNA minor groove of two DNA sequences containing the AGA-PBD binding motif, with the adenosine moiety of the ligand preventing the covalent binding of the PBD unit to the guanine amino group of the DNA duplex. These interesting findings shed further light on the ability of the substituents attached at the C8 position of PBDs to a ect and modulate the biological and biophysical properties of PBD hybrids

Out-of-pocket healthcare expenditure in Australia: trends, inequalities and the impact on household living standards in a high-income country with a universal health care system

Background: Poor health increases the likelihood of experiencing poverty by reducing a person's ability to work and imparting costs associated with receiving medical treatment. Universal health care is a means of protecting against the impoverishing impact of high healthcare costs. This study aims to document the recent trends in the amount paid by Australian households out-of-pocket for healthcare, identify any inequalities in the distribution of this expenditure, and to describe the impact that healthcare costs have on household living standards in a high-income country with a long established universal health care system. We undertook this analysis using a longitudinal, nationally representative dataset - the Household Income and Labour Dynamics in Australia Survey, using data collected annually from 2006 to 2014. Out of pocket payments covered those paid to health practitioners, for medication and in private health insurance premiums; catastrophic expenditure was defined as spending 10% or more of household income on healthcare. Results: Average total household expenditure on healthcare items remained relatively stable between 2006 and 2014 after adjusting for inflation, changing from $3133 to$3199. However, after adjusting for age, self-reported health status, and year, those in the lowest income group (decile one) had 15 times the odds (95% CI, 11.7-20.8) of having catastrophic health expenditure compared to those in the highest income group (decile ten). The percentage of people in income decile 2 and 3 who had catastrophic health expenditure also increased from 13% to 19% and 7% to 13% respectively. Conclusions: Ongoing monitoring of out of pocket healthcare expenditure is an essential part of assessing health system performance, even in countries with universal health care

Advancing Good Governance: How Grantmakers Invest in the Governance of Nonprofit Organizations

Over the last decade, growing numbers of nonprofit organizations and grantmakers have recognized the need for capacity-building in nonprofit organizations. In 2006, U.S. funding for capacity-building topped $1 billion -- a 126% increase over 2000. Leadership capacity has received particular attention, but utilizing the board of directors has often been overlooked. Today, nonprofits and grantmakers are seeking to leverage the inherent assets of these governing groups. This report represents a revealing overview of nonprofit grantmaking in the new economy

Evidence of overuse? Patterns of obstetric interventions during labour and birth among Australian mothers

Background: There is global concern for the overuse of obstetric interventions during labour and birth. Of particular concern is the increasing amount of mothers and babies experiencing morbidity and mortality associated with caesarean section compared to vaginal birth. In high-income settings, emerging evidence suggests that overuse of obstetric intervention is more prevalent among wealthier mothers with no medical need of it. In Australia, the rates of caesarean section and other obstetric interventions are rising. These rising rates of intervention have been mirrored by a decreasing rate of unassisted non-instrumental vaginal deliveries. In the context of rising global concern about rising caesarean section rates and the known health effects of caesarean section on mothers and children, we aim to better characterise the use of obstetric intervention in the state of Queensland, Australia by examining the characteristics of mothers receiving obstetric intervention. Identifying whether there is overuse of obstetric interventions within a population is critical to improving the quality, value and appropriateness of maternity care. Methods: The association between demographic characteristics (at birth) and birth delivery type were compared with chi-square. The percentage of mothers based on their socioeconomic characteristics were reported and differences in percentages of obstetric interventions were compared. Multivariate analysis was undertaken using multiple logistic regression to assess the likelihood of receiving obstetric intervention and having a vaginal (non-instrumental) delivery after accounting for key clinical characteristics. Results: Indigenous mothers, mothers in major cities and mothers in the wealthiest quintile all had higher percentages of all obstetric interventions and had the lowest percentages of unassisted (non-instrumental) vaginal births. These differences remained even after adjusting for other key sociodemographic and clinical characteristics. Conclusions: Differences in obstetric practice exist between economic, ethnic and geographical groups of mothers that are not attributable to medical or lifestyle risk factors. These differences may reflect health system, organisational and structural conditions and therefore, a better understanding of the non-clinical factors that influence the supply and demand of obstetric interventions is required

A review of the impact of financing mechanisms on maternal health care in Australia

Background: The World Health Organization states there are three interrelated domains that are fundamental to achieving and maintaining universal access to care - raising sufficient funds for health care, reducing financial barriers to access by pooling funds in a way that prevents out-of-pocket costs, and allocating funds in a way that promotes quality, efficiency and equity. In Australia, a comprehensive account of the mechanisms for financing the health system have not been synthesised elsewhere. Therefore, to understand how the maternal health system is financed, this review aims to examine the mechanisms for funding, pooling and purchasing maternal health care and the influence these financing mechanisms have on the delivery of maternal health services in Australia. Methods: We conducted a scoping review and interpretative synthesis of the financing mechanisms and their impact on Australia’s maternal health system. Due to the nature of the study question, the review had a major focus on grey literature. The search was undertaken in three stages including; searching (1) Google search engine (2) targeted websites and (3) academic databases. Executive summaries and table of contents were screened for grey literature documents and Titles and Abstracts were screened for journal articles. Screening of publications’ full-text followed. Data relating to either funding, pooling, or purchasing of maternal health care were extracted for synthesis. Results: A total of 69 manuscripts were included in the synthesis, with 52 of those from the Google search engine and targeted website (grey literature) search. A total of 17 articles we included in the synthesis from the database search. Conclusion: Our study provides a critical review of the mechanisms by which revenues are raised, funds are pooled and their impact on the way health care services are purchased for mothers and babies in Australia. Australia’s maternal health system is financed via both public and private sources, which consequentially creates a two-tiered system. Mothers who can afford private health insurance – typically wealthier, urban and non-First Nations women - therefore receive additional benefits of private care, which further exacerbates inequity between these groups of mothers and babies. The increasing out of pocket costs associated with obstetric care may create a financial burden for women to access necessary care or it may cause them to skip care altogether if the costs are too great

Twittering on about mental health: is it worth the effort?

The medical community disseminates information increasingly using social media. Randomised controlled trials are being conducted in this area to evaluate effectiveness of social media with mixed results so far, but more trials are likely to be published in the coming years. One recent twitter randomised control trial using Cochrane Schizophrenia Group reviews suggests that tweets increase the hits to the target web page by about threefold and time spent on the web page is also increased threefold when referrals come in via twitter. These are early findings and need further replication. Twitter appeals to professionals, entertainers and politicians among others as a means of networking with peers and connecting with the wider public. Twitter, in particular, seems to be well placed for use by the medical community and is effective in promoting messages, updating information, interacting with each other locally and internationally and more so during conferences. Twitter is also increasingly used to disseminate evidence in addition to traditional media such as academic peer-reviewed journals. Caution is required using twitter as inadvertent tweets can lead to censure. Overall, the use of twitter responsibly by the medical community will increase visibility of research findings and ensure up to date evidence is readily accessible. This should open the door for further trials of different social media platforms to evaluate their effectiveness in disseminating accurate high-quality information instantaneously to a global audience