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26. The Impact of the Duration of Antibiotic Therapy in Patients With Community-Onset Pneumonia on Readmission Rates: A Retrospective Cohort Study.

Author

Parshall, Daniel M., Sessa, Julia E., Conn, Kelly M., and Avery, Lisa M.

Subjects
ANTIBIOTICS, PNEUMONIA, STATISTICS, TIME, MULTIVARIATE analysis, MULTIPLE regression analysis, PATIENT readmissions, RETROSPECTIVE studies, RISK assessment, COMMUNITY-acquired infections, DESCRIPTIVE statistics, HOSPITAL care, LONGITUDINAL method
Abstract

Background: Recent publications have confirmed that 70% of hospitalized adults with uncomplicated community-acquired pneumonia and health-care-associated pneumonia are prescribed a duration therapy that exceeds current guideline recommendations. Objective: The primary objective is to evaluate the relationship between antibiotic duration and all-cause 30-day readmission rates. Secondary outcomes include pneumonia-specific 30-day readmission rate and identification of risk factors for readmission. Methods: Patients aged ≥18 years with a primary diagnosis of pneumonia from January 1, 2016, to December 31, 2016, were included in this single-center, retrospective cohort study. Patients were categorized by antibiotic therapy duration of ≤7 days (n = 139) or >7 days (n = 286), and outcomes were analyzed in both bivariate and multivariate models. A multivariate logistic regression was used to assess the relationship between all-cause 30-day readmission and antibiotic days. Results: Baseline characteristics were not significantly different between the 2 groups. All-cause 30-day readmission rates were 15.8% and 15.5% for patients who received ≤7 days versus >7 days of antibiotics, respectively (P =.95). Pneumonia-specific 30-day readmission occurred in 3.6% of patients who received antibiotics for ≤7 days compared to 3.5% of patients who received antibiotics for >7 days (P =.95). Multivariate logistic regression showed no statistically significant association between readmission rate and antibiotic duration of >7 days. Statistically significant risk factors for readmission identified by logistic regression include ≥3 hospital admissions within the previous year, a hematocrit <30% at discharge, a history of chronic obstructive pulmonary disorder (COPD), and weight. Conclusion: The use of prolonged antibiotic therapy for the treatment of community-onset pneumonia was not associated with a decrease in all-cause or pneumonia-specific 30-day readmission rates. [ABSTRACT FROM AUTHOR]

Published
2021
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37. The Relationship between parents' and children’s feelings of helplessness and the child's asthma symptoms

Author

Conn, Kelly M. (1972 - ), Swanson, Dena Phillips, Conn, Kelly M. (1972 - ), and Swanson, Dena Phillips

Abstract

Thesis (Ph. D.)--University of Rochester. Margaret Warner Graduate School of Education and Human Development, 2013., Managing chronic illnesses, such as asthma, includes implementing lifestyle and behavioral changes as well as coping strategies for emotional health. Research related to family functioning and its impact on asthma indicate that adverse family functioning such as negative family climate, family routines, and parent-child interactions may exacerbate children's asthma and are related to increased morbidity. Feelings of helplessness experienced within the family may further exacerbate symptoms. Based on the theory of learned helplessness, individuals who feel there is no connection between their behaviors and outcomes are passive, anxious, depressed, and do not perform well. These feelings have a powerful influence on behavior and emotion, thus, likely impacting asthma morbidity. Only a few studies have assessed feelings of helplessness among individuals with asthma, and no studies have assessed these feelings in young children using self-report. Additionally, little is known about the relationship between feelings of helplessness and asthma morbidity among young children. The objectives of this proposal were to: (1) survey parents and children independently regarding their emotions and feelings of helplessness specific to asthma and examine associations between parent and child report, (2) examine the relationship between parent's report of helplessness and the child's asthma symptoms, and to also examine the relationship between the child's report of helplessness and his/her asthma symptoms, and (3) assess the relationship between the interaction of parent and child helplessness and asthma symptoms using a model that includes main effects and the constructed interaction term. This study found a positive relationship between the child's feelings of helplessness and symptom free days indicating less feelings of helplessness as symptom free days increased. Parents' feelings of helplessness were not related to the child's symptoms. This relationship was true only among th

Published
2015

47. Behavior problems among inner-city children with asthma: findings from a community-based sample

Author

Halterman, Jill S., Conn, Kelly M., Forbes-Jones, Emma, Fagnano, Maria, Hightower, A. Dirk, and Szilagyi, Peter G.

Subjects
Asthma in children -- Risk factors, Asthma in children -- Research, Child psychopathology -- Causes of, Child psychopathology -- Research, City children -- Psychological aspects, City children -- Health aspects, City children -- Research, Family and marriage, Psychology and mental health
Published
2006

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