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1. Practitioners' Perspectives on Spatial Reasoning in Educational Practice from Birth to 7 Years

Author

Bates, Kathryn E., Williams, Ashley Y., Gilligan-Lee, Katie A., Gripton, Catherine, Lancaster, Andrea, Williams, Helen, Borthwick, Alison, Gifford, Sue, and Farran, Emily K.

Abstract

Background: There is a growing evidence base for the importance of spatial reasoning for the development of mathematics. However, the extent to which this translates into practice is unknown. Aims: We aimed to understand practitioners' perspectives on their understanding of spatial reasoning, the extent to which they recognize and implement spatial activities in their practice, and the barriers and opportunities to support spatial reasoning in the practice setting. Sample: Study 1 (questionnaire) included 94 participants and Study 2 (focus groups) consisted of nine participants. Participants were educational practitioners working with children from birth to 7 years. Methods: The study was mixed methods and included a questionnaire (Study 1) and a series of focus groups (Study 2). Results: We found that whilst practitioners engage in a variety of activities that support spatial reasoning, most practitioners reported little confidence in their understanding of what spatial reasoning is. Conclusion: Informative and accessible resources are needed to broaden understanding of the definition of spatial reasoning and to outline opportunities to support spatial reasoning.

Published
2023
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3. Hands-On: Investigating the Role of Physical Manipulatives in Spatial Training

Author

Gilligan-Lee, Katie A., Hawes, Zachary C. K., Williams, Ashley Y., Farran, Emily K., and Mix, Kelly S.

Abstract

Studies show that spatial interventions lead to improvements in mathematics. However, outcomes vary based on whether physical manipulatives (embodied action) are used during training. This study compares the effects of embodied and non-embodied spatial interventions on spatial and mathematics outcomes. The study has a randomized, controlled, pre-post, follow-up, training design (N = 182; mean age 8 years; 49% female; 83.5% White). We show that both embodied and non-embodied spatial training approaches improve spatial skills compared to control. However, we conclude that embodied spatial training using physical manipulatives leads to larger, more consistent gains in mathematics and greater depth of spatial processing than non-embodied training. These findings highlight the potential of spatial activities, particularly those that use physical materials, for improving children's mathematics skills.

Published
2023
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7. A Single Hospital-Wide Antibiogram is Insufficient to Account for Differences in Antibiotic Resistance Patterns Across Multiple ICUs

Author

Blackley, Shem K., primary, Lawrence, Jay, additional, Blevins, Addison, additional, Howell, Caroline, additional, Butts, Charles C., additional, Polite, Nathan M., additional, Capasso, Thomas J., additional, Bright, Andrew C., additional, Hall, Kayla A., additional, Haiflich, Andrew N., additional, Williams, Ashley Y., additional, Kinnard, Christopher M., additional, Mbaka, Maryann I., additional, Audia, Jonathon P., additional, Simmons, Jon D., additional, and Lee, Yannleei L., additional

Published
2024
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10. Admission Medication Reconciliation Discrepancies in Trauma Patients: Consistent Nursing Care May Not Be the Answer

Author

Gautreaux, Corinne E., primary, Robinson, Thomas W., additional, Dunbar, Elisabeth G., additional, Lee, Yann-Leei L., additional, Mbaka, Maryann, additional, Kinnard, Christopher M., additional, Bright, Andrew C., additional, Williams, Ashley Y., additional, Polite, Nathan M., additional, Capasso, Thomas J., additional, Simmons, Jon D., additional, and Butts, C. Caleb, additional

Published
2024
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11. Effects of the COVID-19 Pandemic on the Trauma Population in a Level 1 Trauma Center

Author

Michael, Javier A., primary, Roberts, Morgan E., additional, Haiflich, Andrew N., additional, Boyer, Edwin, additional, Capasso, Thomas J., additional, Butts, Charles C., additional, Bright, Andrew C., additional, Kinnard, Christopher M., additional, Simmons, Jon D., additional, Williams, Ashley Y., additional, Lee, Yannlei L., additional, Polite, Nathan M., additional, and Mbaka, Maryann I., additional

Published
2023
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12. A Multidisciplinary Approach for the Management of Portal Vein Thrombosis

Author

Sheppard, Kyle, primary, Roberts, Morgan E., additional, Bernard, Jonathan, additional, Wood, Brian, additional, Lee, Yannlei L., additional, Williams, Ashley Y., additional, Capasso, Thomas, additional, Butts, Caleb C., additional, Polite, Nathan, additional, Simmons, John D., additional, Bright, Andrew, additional, Kinnard, Christopher, additional, and Mbaka, Maryann, additional

Published
2023
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13. Identifying Radiographic and Clinical Indicators to Reduce the Occurrence of Nontherapeutic Laparotomy for Blunt Bowel and Mesenteric Injury

Author

Blackley, Shem K., primary, Smith, William C., additional, Lee, Yann-Leei, additional, Kinnard, Christopher, additional, Williams, Ashley Y., additional, Butts, Charles C., additional, Mbaka, Maryann I., additional, Haiflich, Andrew, additional, Bright, Andrew, additional, Simmons, Jon D., additional, and Polite, Nathan M., additional

Published
2023
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14. Blunt Cerebrovascular Injury (BCVI) Management: Is There a Right Answer?

Author

Barnes, Brandon Michael, primary, Bouillon, Victoria, additional, Haiflich, Andrew, additional, Butts, C. Caleb, additional, Capasso, Thomas, additional, Bright, Andrew, additional, Polite, Nathan, additional, Williams, Ashley Y., additional, Kinnard, Christopher, additional, Simmons, Jon D., additional, Lee, Yannlei L., additional, and Mbaka, Maryann, additional

Published
2023
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15. Social Determinants of Health Impact Physical Recovery After Blunt Injury

Author

Cockrell, Benjamin E., primary, Haiflich, Andrew N., additional, Lee, Yann-Leei L., additional, Kinnard, Christopher M., additional, Butts, Charles C., additional, Polite, Nathan M., additional, Mbaka, Maryann I., additional, Bright, Andrew C., additional, Simmons, Jon D., additional, and Williams, Ashley Y., additional

Published
2023
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19. Defining Pathogen and Susceptibility Patterns for Early Versus Late Ventilator Associated Pneumonia in Trauma Patients to Guide Empiric Treatment Decisions

Author

Alexander, Kaitlin M., Davis, S. Noelle, Butts, C. Caleb, Morgan, John, Croft, Leah K., Lee, Yann-leei L., Kinnard, Christopher M., Polite, Nathan M., Mbaka, Maryann I., Williams, Ashley Y., Barrington, Robert A., Audia, Jonathon P., and Simmons, Jon D.

Abstract

Introduction Studies have demonstrated that trauma patients with early-ventilator associated pneumonia (early-VAP, < 7 days) have decreased risk of methicillin-resistant Staphylococcus aureus(MRSA) and Pseudomonas aeruginosainfections. We hypothesize that routinely using broad-spectrum antibiotics is unnecessary to treat trauma patients with the diagnosis of early-VAP.Methods This retrospective cohort study included adult trauma patients with the diagnosis of VAP. The primary outcome was the presence of MRSA and/or P. aeruginosain patients with early- and late-VAP. Secondary outcomes included the bacterial susceptibility of pathogens to methicillin, ampicillin/sulbactam, ceftriaxone, piperacillin/tazobactam, and cefepime. Intensive care unit (ICU) and hospital length of stay (LOS), ventilator-free days, and in-hospital mortality were also collected.Results 164 patients met inclusion criteria, and 208 organisms (n = 90 early vs n = 118 late) were identified by respiratory culture. The incidence of MRSA and P. aeruginosain early-VAP was 7.7% (7/90) and 5.6% (5/90), respectively. The susceptibility of bacteria causing early-VAP to ampicillin/sulbactam and ceftriaxone was 73.3% (66/90) and 83.3% (75/90), respectively. Ventilator-free days at 30 days was similar between groups (P= .649). Patients with late-VAP spent more time in the ICU (P= .040); however, in-hospital mortality was higher in the early-VAP group (P= .012).Conclusions Ampicillin/sulbactam or ceftriaxone monotherapy did not provide reliable broad-spectrum coverage for early-VAP in our cohort. These findings highlight the importance of each institution performing a similar analysis to ensure adequate initial treatment of VAP.

Published
2023
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20. Defining Pathogen and Susceptibility Patterns for Early Versus Late Ventilator Associated Pneumonia in Trauma Patients to Guide Empiric Treatment Decisions

Author

Alexander, Kaitlin M., primary, Davis, S. Noelle, additional, Butts, C. Caleb, additional, Morgan, John, additional, Croft, Leah K., additional, Lee, Yann-leei L., additional, Kinnard, Christopher M., additional, Polite, Nathan M., additional, Mbaka, Maryann I., additional, Williams, Ashley Y., additional, Barrington, Robert A., additional, Audia, Jonathon P., additional, and Simmons, Jon D., additional

Published
2022
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21. Diencephalic storm in trauma patients: Is it really that rare

Author

Bright Andrew C, Quang Celia Y, Blair Scott G, Polite Nathan M, Alexander Kaitlin M, Haiflich Andrew, Butts C Caleb, L Lee Yann-leei, Kinnard Christopher M, Mbaka Maryann I, Williams Ashley Y, and Simmons Jon D

Subjects
Pharmacology
Abstract

Introduction: Diencephalic storm is characterized by extreme episodic catecholamine release in the presence of a stressor and it is usually refractory to standard antihypertensives. The treatment of choice during the crisis is propofol and the best preventative measure is to remove the stressor (i.e. ventilator). Case presentation: A 32-year-old male sustained 2nd and 3rd degree burn to 25 percent of the body surface area that included a severe inhalation component. The patient was admitted to the Burn Intensive Care Unit at the Arnold Luterman Regional Burn Center in Mobile, AL. The patient had frequent episodes (3-5 per day) of severe agitation that were accompanied by extreme tachycardia of > 200 beats per minute and hypertension (280/140). The inciting event was often endotracheal suctioning, but less noxious stimulation also resulted in similar episodes. During these episodes, the patient had significantly elevated catecholamine levels that improved after extubation. The patient’s symptoms were refractor to standard antihypertensives but immediately resolved when given propofol. Further episodes of the diencephalic storm were treated successfully with propofol. Once the patient was removed from mechanical ventilation, there were no further episodes. Conclusion: Diencephalic Storm may be difficult to diagnose due to a lack of familiarity with this rare entity. Any patient with severe agitation combined with the effects of episodic large catecholamine surges should be considered to have Diencephalic Storm. The standard immediate treatment is propofol due to the lack of responsiveness of standard antihypertensives and the removal of the stressor.

Published
2022

24. Diabetes in Trauma Patients: A Potential Gateway to a Medical Home

Author

Hart, Kaylee, Thames, Margaret A, Massey, Ashley Caroline, Capasso, Thomas, Lee, Yannlei L, Mbaka, Maryann, Kinnard, Christopher M., Bright, Andrew C., Williams, Ashley Y., Polite, Nathan M., Simmons, Jon D., and Butts, C. Caleb

Abstract

Background Diabetes is a major determinant of health outcomes. Trauma patients are disproportionately from lower socioeconomic status, where lack of access to health care prevents timely treatment. Trauma centers could play a role in identifying patients in need of improved glucose management, but the current burden of disease is not known. We assessed the incidence of patients in need of intervention that presented to a level 1 trauma center over a 6-month period.Methods A retrospective chart review over 6 months of all trauma patients admitted to a level 1 trauma center was performed. Patients’ past medical history (PMH), medication reconciliation, and hemoglobin A1c (HbA1c) were recorded on initial assessment; patients <18 years old, lacking an HbA1c, or missing PMH were excluded. Patients with PMH of diabetes or antihyperglycemic use were classified by HbA1c: well-controlled ≤8.0% or poorly controlled >8.0%. Patients with no history of diabetes or antihyperglycemic use were classified based on their HbA1c: non-diabetic <5.7%, pre-diabetic 5.7-6.4%, and undiagnosed diabetic ≥6.5%.Results Overall, 1377 patients were identified. After exclusion criteria, 903 patients were classified as follows: 593 (66%) non-diabetics, 160 (18%) pre-diabetics, and 150 (17%) diabetics. Fifteen diabetics were undiagnosed; 39 of the diagnosed diabetics were poorly controlled. Including pre-diabetics, a total of 214 (24%) trauma patients were in need of improved glycemic control.Discussion One in four trauma patients would benefit from improved outpatient glycemic management, representing a missed opportunity for preventative health care. Trauma centers should develop strategies to meet this need as part of their post-discharge care.

Published
2024
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