Background To determine the prevalence of platelet dysfunction, using an end-point of assembly into a stable thrombus, following severe injury. Background: Although the current debate on acute traumatic coagulopathy (ATC) has focused on the consumption or inhibition of coagulation factors, the question of early platelet dysfunction in this setting remains unclear. Study Design Prospective platelet function in assembly and stability of the thrombus was determined within 30 minutes of injury using whole blood samples from trauma patients at the point of care employing thrombelastography (TEG)-based platelet functional analysis. Results There were 51 patients in the study. There were significant differences in the platelet response between trauma patients and healthy volunteers such that there was impaired aggregation to these agonists. In trauma patients, the median ADP inhibition of platelet function was 86.1% (IQR: 38.6–97.7%), compared to 4.2 % (IQR 0–18.2%) in healthy volunteers. Following trauma, the impairment of platelet function in response to AA was 44.9% (IQR 26.6–59.3%), compared to 0.5% (IQR 0–3.02%) in volunteers (Wilcoxon non parametric test p<0.0001 for both tests). Conclusions In this study, we show that platelet dysfunction is manifest following major trauma, before significant fluid or blood administration. These data suggest a potential role for early platelet transfusion in severely injured patients at risk for postinjury coagulopathy.

In the past few years, audience response technology (ART) has been widely adopted on college campuses, and is especially popular among instructors of large lecture classes. Claims regarding ART's benefits to students have received only limited empirical evaluation, and prior studies exhibit methodological limitations. The current study provides a multi-dimensional evaluation, utilizing a newly-developed measure, the Audience Response Technology Questionnaire (ART-Q). Data were provided at three points during a semester by undergraduate students (n = 854) who used ART in three large lecture university courses. Results indicate moderately positive evaluations of ART on some dimensions (e.g., ease of use, impact on attendance), with less positive evaluations on others (e.g., influence on preparation for class). These evaluations showed some variability across time of semester and course, but were not substantially affected by gender, ethnicity, or year in school. Findings are discussed with respect to the need for future research onIn the past few years, audience response technology (ART) has been widely adopted on college campuses. This type of instructional technology, also referred to as ''audience feedback,'' or ''clicker'' technology, as well as by a variety of brand names (e.g., the Classroom Performance System) has become especially popular among instructors of large lecture classes. Current ART packages with coordinated hardware and software allow instructors to ask varied types of questions, obtain immediate responses from students via their response devices (''clickers'' or ''remote controls''), and display the pattern of answers in a tabular or graphic format that preserves individual anonymity. Virtually any class size can be accommodated.Proponents of ART have asserted that the technology improves student engagement and learning (Ward 2003). Such claims, coupled with the desire to improve teaching effectiveness, have prompted many college instructors to incorporate ART into their classes, especially for large lectures in which student involvement and learning outcomes can be less than ideal. To date, studies of ART suggest that students do respond favorably to the technology. However, the number of studies is still relatively small. Further, these studies have limitations that recommend caution in generalizing their findings to the undergraduate student in large-lecture classes. Such limitations include studies of atypical students and classes, evaluations conducted after limited use of the technology, and assessment on a limited number of evaluative dimensions (e.g., Rice and Bunz 2006;Fitch 2004;Latessa and Mouw 2005). Thus, it is important that student experiences with ART receive more empirical evaluation.The current study was designed to respond to the limitations of prior research on ART by conducting a multi-dimensional evaluation of the technology by undergraduate students who used it in large lecture university courses over the duration of a semester. Importantly, the study not only provides a ...

A UDIENCE RESPONSE TECHNOLOGY (ART) has been widely adopted on college campuses, and prior research indicates that, on average, it receives positive evaluations from students. However, research has not yet examined how characteristics of students as learners influence their responses to ART. The current study examined aptitude for learning, objective learning (i.e., class performance), subjective learning (i.e., self-perceived learning), and conceptualizations of the learning process as influences on students' evaluation of ART. Students who had used ART over the course of a semester in one of three large lecture classes (N = 703) completed surveys assessing their learning characteristics, perceptions of ART influence on their attendance, motivation, and learning, liking for ART, and evaluations of the course and instructor. Controlling for course and instructor evaluations, aptitude and objective learning were weakly but negatively associated with evaluations of ART and subjective learning was positively associated with evaluations of ART. Further, different conceptualizations of learning have distinctive associations with ART evaluations. Discussion focuses on the implications of these findings for instructors' use of ART.

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

No abstract