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The Kurt Cobain suicide crisis: perspectives from research, public health, and the news media.

The suicide of rock star Kurt Cobain in 1994 raised immediate concerns among suicidologists and the public at large about the potential for his death to spark copycat suicides, especially among vulnerable youth. The Seattle community, where Cobain lived and died, was especially affected by his sudden death. An overview of Cobain's life and death is presented and various crisis center and community-based interventions that occurred are discussed. Preliminary data collected from the Seattle Medical Examiner's Office and from the Seattle Crisis Center to assess the potential impact of Cobain's death on completed suicides and the incidence of suicide crisis calls are presented. The data obtained from the Seattle King County area suggest that the expected "Werther effect" apparently did not occur, but there was a significant increase in suicide crisis calls following his death. It is hypothesized that the lack of an apparent copycat effect in Seattle may be due to various aspects of the media coverage, the method used in Cobain's suicide, and the crisis center and community outreach interventions that occurred. The Cobain suicide and the role of media influence on copycat suicides are further discussed in commentaries from public health and news media perspectives.

Adult↗

Conquered by kindness.

While some hospital chains may seem like predators, that's not Quorum's style. The Brentwood, Tenn., system prefers to win friends and hospitals by highlighting its major strength: not-for-profit management.

Community-Institutional Relations↗

College of pharmacy-teaching hospital relationships: report of a survey.

The results of surveys conducted by the American Association of Colleges of Pharmacy (AACP) and the American Society of Hospital Pharmacists (ASHP) to investigate the extent and causes of problems in relationships between colleges of pharmacy and the pharmacy departments in their affiliated teaching hospitals are presented. For the AACP study, questionnaires were mailed to either the dean or the pharmacy practice department chairman of all 72 colleges, and a telephone interview was subsequently conducted with most of them. For the ASHP study, interviews were conducted with 67 directors of pharmacy in the colleges' principal affiliated teaching hospitals. Problems identified by the colleges related to quality or extent of services and finances. Most directors of pharmacy stated that they derived benefit from their affiliation with a college of pharmacy. The relationship between colleges of pharmacy and their teaching hospitals is relatively healthy and generally better than expected.

Faculty↗

Using DRGs in developing referral policies for coronary care within a local health district.

This paper presents the results of a study into some specific aspects of the management of coronary heart disease within one district health authority. In particular, it is concerned with the appropriate balance of inpatient coronary care between the district general hospital and community hospitals in the light of current and potential changes in the clinical management of coronary cases. The study is an example of a multidisciplinary approach to local health planning which is beginning to emerge within the Exeter Health District, the methodology of which may be applicable to client groups within the medical specialties other than coronary cases, such as strokes or respiratory disorders. It also illustrates the use of spatial analysis and diagnosis-related groups in local planning.

Coronary Care Units↗

Expanding service delivery: does it improve relationships among agencies serving homeless people with mental illness?

Enhancing interagency services integration for homeless people has been advocated as an approach for improving service delivery to this population. In contrast to system-level "top-down" interventions, this study examines the association of expanded funding of client-level homeless services, a "bottom-up" approach, with strengthening of interorganizational relationships. We compared Veterans Affairs/non-Veterans Affairs interagency relationships at VA facilities supporting community-oriented programs (N=72), at VA facilities supporting on-site internally focused homeless programs (N=10), and at facilities with no specialized homeless programs (N=47). VA facilities that supported community-oriented homeless programs enjoyed stronger VA-community agency relationships than the other two VA facility types. The study identifies an effective bottom-up resource-based approach to services integration.

Community Health Services↗

An academic health center-community partnership: the Morgantown Health Right free clinic.

This article reports the main findings of a descriptive study of the origin, structure, and evolution of the Morgantown Health Right (MHR) free clinic in Morgantown, West Virginia. The study was conducted between 1984 and 1995 to examine the organizational and operational features of this rural academic health center-community partnership. The MHR's longevity and provision of primary care without charge to low-income, uninsured, and underinsured residents of north central West Virginia are a function of its intimate relationship with the Robert C. Byrd Health Sciences Center of West Virginia University. Essential elements of this rural academic health center-community partnership include social commitment and voluntarism, shared community and faculty leadership, joint problem-oriented long-term planning, and interdisciplinary practice and training opportunities for faculty, residents, and students. Financial support for the MHR comes from a variety of public and private sources, and the clinic serves as a prototypic rural free health care provider by virtue of its social and fiscal sustainability. The MHR experience shows that, like inner-city counterparts, academic health center-community partnerships can enhance access to health care for rural underserved populations.

Academic Medical Centers↗

Baptist uses expansion, alliances to bypass Mayo Jacksonville beachhead.

What's a community hospital to do when the world-renowned Mayo Clinic comes to town? In Jacksonville, Fla., Baptist Medical Center is protecting its turf by strengthening its pediatrics partnerships with other healthcare organizations and by expanding its referral base.

Catchment Area, Health↗

Developing community-academic partnerships to enhance breast health among rural and Hispanic migrant and seasonal farmworker women.

PURPOSE/OBJECTIVES: To examine effective strategies for building community-academic partnerships for the promotion of breast cancer education and outreach among rural and Hispanic migrant and seasonal farmworker women, mostly from Mexican descent. DATA SOURCES: Published research and education articles and books, community-education models, personal experiences, and community key informant feedback. DATA SYNTHESIS: Effective community partnerships for enhanced education and outreach include a framework based on a network of partners with common goals, communication processes based on trust, and bilingual/bicultural and culturally competent staff. CONCLUSIONS: A sustainable community partnership can be achieved through systematic but flexible approaches to community planning. Involvement of community members in the development and implementation of education and screening activities helps ensure that community needs are met. Relationships based on mutual respect are key. IMPLICATIONS FOR NURSING PRACTICE: Nurses can act as catalysts through community capacity building to create community-academic partnerships to reach medically underserved populations with cancer screening, outreach, and education through the delivery of strategies that are based on common goals.

Academies and Institutes↗

International Conference on Harmonisation; guidance on E2E Pharmacovigilance Planning; availability. Notice.

The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "E2E Pharmacovigilance Planning." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance describes a method for summarizing the important potential and identified risks of a drug. It proposes a structure for a pharmacovigilance plan and sets out principles of good practice for the design and conduct of observational studies. The guidance is intended to aid in planning pharmacovigilance activities, especially in preparation for the early postmarketing period of a new drug.

Congresses as Topic↗

A framework for assessing practice-oriented scholarship in schools of public health.

Within many schools of public health, substantial ambiguity surrounds the process of defining and rewarding faculty contributions to practice-oriented scholarly activities. Ernest L. Boyer introduced a powerful and compelling new paradigm for assessing the core domains of scholarship: the scholarships of discovery, integration, teaching, and application. This article draws on Boyer's domains and his colleagues, Charles E. Glassick, and others' criteria for evaluating them in introducing a framework for assessing practice-oriented scholarship within schools of public health. The article presents concepts, content, and defining criteria of practice-oriented scholarship and identifies the principles that might guide tenure and promotion decisions related to it.

Career Mobility↗