BACKGROUND: Approximately 70% of all suicides in patients aged >60 years are attributed to physical illness, with higher rates noted in patients with cancer. The purpose of the current study was to characterize suicide rates among patients with genitourinary cancers and identify factors associated with suicide in this specific cohort. METHODS: Patients with prostate, bladder, kidney, testis, and penile cancer were identified in the Surveillance, Epidemiology, and End Results database . Standardized mortality ratios (SMRs) and 95% confidence intervals (95% CIs) were calculated for each anatomic site. Multivariable logistic regression models generated odds ratios (ORs) for the identification of factors associated with suicide for each malignancy. RESULTS: There were 2268 suicides identified among 1,239,522 individuals with genitourinary malignancies observed for 7,307,377 person-years. The SMRs for patients with cancer were 1.37 for prostate cancer (95% CI, 0.99-1.86), 2.71 for bladder cancer (95% CI, 2.02-3.62), 1.86 for kidney cancer (95% CI, 1.32-2.62), 1.23 for testis cancer (95% CI, 0.88-1.73), and 0.95 for penile cancer (95% CI, 0.65-1.35). On multivariable analysis, male sex was found to be associated with odds of suicide among patients with bladder cancer (OR, 6.63) and kidney cancer (OR, 4.98). Increasing age was associated with suicide for patients with prostate, bladder, and testis cancer (OR range, 1.03-1.06). Distant disease was associated with suicide in patients with prostate, bladder, and kidney cancer (OR range,). Among patients with prostate, bladder, and kidney cancer, African American patients were less likely to commit suicide compared with white individuals (OR range, 0.26-0.46). CONCLUSIONS: Suicide in patients with genitourinary malignancies poses a public health dilemma, especially among men, the elderly, and those with aggressive disease. Clinicians should be aware of risk factors for suicide in these patients.

Historically, radial immunodiffusion (RID) has been the only method that directly measures IgG; however, recent studies have reported IgG concentrations in colostrum, milk, and plasma as measured using an ELISA. To our knowledge no comparison between RID and ELISA methods has been made for bovine colostrum or plasma. The objective of this study was to compare IgG concentrations measured by both methods in samples of bovine colostrum before and after heat treatment and bovine plasma. Concentration of IgG was quantified using a commercially available RID kit and a modified ELISA. Samples of bovine colostrum and plasma were collected from individual animals and colostrum was tested before and after heat treatment at 60°C for 30 min. All samples were tested using both methods. Pearson correlation coefficients were determined for RID and ELISA values from unheated colostrum, heat-treated colostrum, and plasma samples. Mixed models were used to determine the effect of assay on IgG measurement in colostrum and plasma and effect of heat treatment on IgG concentration in colostrum. A weak correlation was found between ELISA and RID results in plasma and unheated colostrum. Concentration of IgG was significantly lower in all sample types when measured by ELISA compared to RID. Thus, direct comparison of ELISA and RID results is not recommended. Colostrum IgG concentration significantly decreased after heat treatment as measured by ELISA, but means were not different when measured by RID. Correlation plots between colostrum values measured before and after heat treatment indicated changes in the colostrum protein matrix due to heat affected RID and ELISA assays differently. This investigation compared RID and ELISA results, but no conclusions could be drawn as to the accuracy of either assay.

This study examines the relationship between individual dissimilarity and perceptions of organizational inclusion. Data from a national survey of public agencies conducted in Florida and Texas show that gender dissimilarity is negatively associated with perceptions of inclusion and the negative relationship is more acute for men than for women. In contrast, tenure dissimilarity is positively related to perceptions of inclusion and this positive association is more acute for those with longer tenure than for those with shorter tenure. These results suggest that the effect of dissimilarity on the perception of inclusion depends on both the observability of individual-level characteristics and the status of the demographic group. In particular, dissimilarity along characteristics that are easily observable (such as gender) is more likely to influence perceptions of inclusion and dissimilarity is more influential for higher status groups (such as men or long-tenured employees).

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Public and private organizations deal closely with each other on regulatory issues. Newer forms of regulation rely on shared enforcement and supervisory responsibilities, regulatory negotiation, and other methods that try to get beyond remote public commands while maintaining effective public involvement. This article examines how regulators and firms deal with each other, the interdependence that forms between them in the course of their work, and the benefits and liabilities of the strong ties that may develop out of this interdependence. We use the securities industry as a context for discussion but indicate that the points apply more generally. We pay special attention to the potential benefits and risks of cohesive regulatory networks. Regular dealings among regulators and firms outside of regular rulemaking or enforcement proceedings enhance cooperation, reduce information disparities, strengthen regulatory cultures, and arguably lower the threshold of external pressure required to effect changes within firms. The conditions enhancing these benefits, however, also will restrict the flow of information, perspectives, and criticism from outsiders, potentially leading to erosion of performance standards and eventually serious problems. We describe the circumstances under which these tensions are more likely to be managed without damage from these problems and the broader implications for research and teaching in public management and policy.

This research examined the effects of several versions of capital penalty phase instructions on juror comprehension. Study One documented the impact of California's recently implemented "plain language" instruction. It showed that although the new instruction has clear advantages over the previous version, significant comprehension problems remain. Study Two evaluated several modified instructions designed to enhance comprehension. Participants heard either a standard patterned instruction or one of two alternatives-a psycholinguistically improved instruction, or a "pinpoint" instruction using case-related facts to illustrate key terms-in a simulated death penalty sentencing phase. Persons who heard modified instructions demonstrated higher levels of comprehension on virtually every measure as compared to those in the standard instruction condition.

Black Africans are one of the fastest growing immigrant and refugee populations in the United States, having increased by 100% in the 2000s. The purpose of this study was to gain an understanding of how Black African nurses experience nursing education within the United States. This qualitative study provided a rich description of the phenomenon. Nine Black African nurses from the midwestern United States participated. Five male and four female participants represented the countries of Sierra-Leone, Kenya, Liberia, Eritrea, and Ethiopia. Seven participants had been in the country less than 2 years, and two had been in the country less than 4 years. Optimistic determination was the essence of how participants adapted to challenges while in their nursing programs, and four themes emerged relating to academics, competing demands, culture, and relationships. Through an awareness of the unique needs of this student population, educators can develop strategies to improve retention.