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Biomedical subjects

T Combs-Orme

Publications and source records attributed to T Combs-Orme.

12 recordsLinked to original sources
PubMed1994

Assessing the health status of children entering foster care.

OBJECTIVE: Most research on health problems of children in foster care has been cross-sectional, resulting in overselection of children who have been in care long-term and underrepresentation of children who are in care for a short time. METHODOLOGY: This paper reports on the health of a large cohort of children who had complete health examinations at the time of entry into foster care in a middle-size city during a 2-year period. RESULTS: Results indicate that > 90% of the children had an abnormality in at least one body system, 25% failed the vision screen, and 15% failed the hearing screen. The children were also lighter and shorter than the norm. Mental health screening revealed that 75% had a family history of mental illness or drug or alcohol abuse. Of children older than 3 years of age, 15% admitted to or were suspect for suicidal ideation and 7% for homicidal ideation. Of the children younger than 5 years of age, 23% had abnormal or suspect results on developmental screening examinations. At the time of entry into foster care, 12% of the children required an antibiotic. More than half needed urgent or nonurgent referrals for medical services and, for children > 3 years of age, more than half needed urgent or nonurgent referrals for dental and mental health services. Just 12% of the children required only routine follow-up care. CONCLUSIONS: The high prevalence and broad range of health needs of children at the time they enter foster care necessitate the design and implementation of better models of health care delivery for children in foster care.

Adolescent↗
PubMed1988

Rehospitalization of very-low-birth-weight infants.

Very-low-birth-weight (VLBW) infants are at high risk of mortality, morbidity, and rehospitalization in the first years of life, but little information is available to predict which VLBW infants are likely to require rehospitalization. This study describes a sample of 79 VLBW infants cared for in a charity hospital. The sample was predominantly black, and the majority of the mothers were young and unmarried. Some of the infants were followed up by a multidisciplinary High-Risk Follow-up Clinic, and all were tracked until their second birthdays to determine the rate of rehospitalization. Using multiple regression, we present herein a model that accounts for 51% of the variance in rehospitalization; the model includes mother's age, education, and marital status; infant birth weight and gestational age; the use of prenatal care and the High-Risk Follow-up Clinic; and three quadratic terms. Although the significance of the quadratic factors in the model makes explanation of these results difficult, results suggest that the model can be used to predict whether infants will require rehospitalization in the first two years of life.

Follow-Up Studies↗
PubMed1985

The extent of long-term moderate drinking among alcoholics discharged from medical and psychiatric treatment facilities.

To assess the frequency of an evolution to stable moderate drinking among alcoholics coming to medical or psychiatric treatment facilities, we examined the five- to seven-year outcome for 1289 diagnosed alcoholics treated in our facilities during a two-year period (between 1973 and 1975). We obtained data from personal interviews, records, or both for 83 per cent of the sample. Only 1.6 per cent of the subjects met our definition of stable moderate drinking at follow-up, 15 per cent had become totally abstinent, and 4.6 per cent were mostly abstinent with occasional drinking. The only predictors of moderate drinking that we found were female sex and less severe alcoholism. The evolution to stable moderate drinking appears to be a rare outcome among alcoholics treated at medical or psychiatric facilities.

Adult↗
PubMed1985

Alcohol and strokes in young adults.

Current drinking, alcoholic binges, and a history of alcohol intoxication differentiated young stroke patients from older stroke patients and young medical control subjects. Acute heavy alcohol consumption may be an important element in the development of strokes among young adults.

Adult↗
PubMed1985

Occupational prestige and mortality in black and white alcoholics.

Mortality was studied in 1289 Black and White alcoholics. The overall proportion of mortality over 5-9 years was 22.0%. No overall differences were found between Black and White mortality rates by crude death proportions or standardized mortality ratios. Blacks were significantly younger at death than were Whites and were also significantly younger than Whites at admission to treatment. Occupational prestige was examined in the 374 Whites and 270 Blacks for whom an occupation was known, prestige being divided into high, medium and low categories. Blacks suffered significantly higher mortality in the high prestige group and Whites suffered significantly higher mortality in the middle prestige group. Alcoholics in the high prestige group suffered slightly greater mortality than alcoholics in the middle and lower groups. The results seem to indicate that although occupational prestige is an important variable in mortality among alcoholics, other variables that were not controlled in these analyses may also be important.

Adult↗
PubMed1983

Alcohol and mortality. Diagnostic considerations.

Two hundred fifty of 1289 alcoholics died within eight years of treatment of alcoholism or its complications. Gastrointestinal and cardiovascular disorders were significantly greater among the group who died within one year of treatment. Other sex, age and racial differences were also significant.

Adult↗
PubMed1983

Violent deaths among alcoholics. A descriptive study.

In a follow-up study of 1289 alcoholics 6-9 years after treatment, 52 had died by violent means. Suicide and homicide were the leading causes of violent death, with deaths in fires and pedestrian accidents also occurring with some frequency.

Accidents, Home↗
PubMed1983

Differential mortality among alcoholics by sample site.

In a sample of 1,289 alcoholics from four clinical sites, the overall mortality rate after five to eight years of observation was 22.0 per cent, 3.1 times the expected rate. Patients from the medical and surgical services of a general hospital suffered 4.0 times the rate of expected mortality and died most often of medical causes associated with alcoholism. Patients of the public alcoholism ward had a mortality rate 3.3 times the expected rate and died of causes often associated with low social class. Private psychiatric patients had a mortality rate 2.3 times the expected rate, and psychiatric outpatients had an excess mortality ratio of 2.1. Sample site must be considered as a variable in the study of mortality among alcoholics.

Adult↗
PubMedDate not supplied

Infant mortality: priority for social work.

Despite a clear mandate and pressing social need, the social work profession has not adopted infant mortality as a clear priority in the 1980's. This failure to claim infant mortality as a professional priority occures in spite of evidence that the factors responsible for infant deaths may be especially appropriate for social work interventions. Social work has an important role in the reduction of preventable infant deaths, and many individual social workers already are active in perinatal social work and other specialities involved in saving infant lives. The profession should make a new commitment to this serious social problem.

Aid to Families with Dependent Children↗
PubMedDate not supplied

Alcohol, hypertension, and stroke.

The authors compared the drinking habits of stroke patients and controls who were matched for the variables of age, sex, race, and day of the week admitted to the hospital. Rates of alcoholism were similar in the two groups. However, stroke patients were more likely to be current drinkers than controls, and were more likely to have been drinking within 24 hr of admission to the hospital, most of them rather heavily. Among the stroke patients, alcoholism was associated with hypertension, with being a current drinker, and with drinking at index, i.e., within 24 hr of the first symptoms of stroke. Of those stroke patients who were drinking at index, there were significant associations with being black, alcoholic, and hypertensive. The implications of these findings are discussed.

Adult↗
PubMedDate not supplied

Effectiveness of home visits by public health nurses in maternal and child health: an empirical review.

The effectiveness of public health nursing in promoting maternal and child health through home visits is summarized from empirical studies published between 1960 and 1984. Eight reports identified through a comprehensive reference search were first classified according to the components of nursing service studied (assessment, teaching, counseling or support, referral, and clinical services). The results of each study were then analyzed for study population characteristics, the research design and statistical methods employed, the reliability of the measures used, significant treatment effects, sample size, and statistical power. The research is evenly divided among studies employing an experimental design, a quasi-experimental design, and samples of low-income and middle-income mothers. The reliability of the measures was, with one exception, not reported. All but one study had final sample sizes for treatment and control or comparison groups of fewer than 100 subjects. Four of the studies thus had sample sizes sufficiently large to detect a medium treatment effect; power calculations showed that none could measure a small treatment impact. Within the methodological limitations of these studies, our review found that under certain circumstances public health nurses can effectively impart health knowledge to high-risk mothers and can effect positive change in maternal attitudes and parenting practices that in turn can be associated with positive changes in infant health and development. Cumulative knowledge from this body of research suggests that a priority for future evaluations of public health nursing is development of theoretical frameworks that maximize the fit between the needs of the population served and the services provided and between the outcomes measured and the nursing services being assessed.

Adult↗