The Level of 7- and 8-Years Old Children Understanding of the Place Value Concept

Place value concept that learns especially in primary school ages is also the basis of many issues students will encounter throughout their learning lives. This research aims to developmentally determine understanding of the place value concept in early childhood. The model of research is a case study from qualitative research methods. The study group consists of 171 children (84 at the age of 7 and 87 at the age of 8) who study in three different public schools in January, in the 2020-2021 academic year in Ankara, Turkey, selected by criteria sampling from purposeful sampling methods. As a data collection tool, “place value worksheets” consisting of 25 questions developed by researchers were used. Data was collected online by classroom teachers through “EBA”. The content analysis method was used in the analysis of the data. Looking at the research results, it was observed that children gave meaning to the place value concept in seven categories. It was seen that seven years olds reached the lowest correct answer rate in the code "the ability to express the number whose resolution is given in terms of ones" in the category of "the ability to resolve". It was concluded that "the ability to write numbers between two numbers" code in "the ability to compare" category has the lowest correct response rate for eight years old children. Lower levels of seven years old student's understanding of the place value concept suggest that students' readiness levels are not sufficient at this age.

Improving Competence in Diagnosis, Referral and Initial Management of Acquired Hemophilia a through Online Interactive Case-Based Education

INTRODUCTION Diagnosing acquired haemophilia A (AHA) can be challenging due to a) it's rarity (~1.5 cases per million), and b) the range of nonspecific bleeding patterns that may present. Therefore, there is a substantial diagnostic delay and rate of misdiagnosis, leading to an increased risk of morbidity and mortality. This study was conducted to determine whether online interactive case-based independent medical education could improve clinicians' competence in identifying possible AHA, in appropriate referral to specialist centers and in initial management. METHODS Hematologists and emergency medicine (EM) physicians participated in a text, case-based activity and completed pre- and post-questions (Ma A. Active Bleeding in the ER and a Prolonged aPTT: What's Your Next Step? www.medscape.org/viewarticle/944112). Educational effect was assessed using a 3-question repeated-pair design with pre-/post-assessment. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating, and a McNemar's test was conducted at the learning objective level (5% significance level, P <.05). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses (<.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). Data were collected from 03/15/2021 to 06/14/2021. RESULTS Overall significant improvements at the aggregate level were seen after participation for hematologists (33% average correct response rate at pre-assessment vs 94% at post-assessment; P<.001, Cohen's d= 2.27, N=86), and EM physicians (24% average correct response rate at pre-assessment vs 80% at post-assessment; P<.001, Cohen's d= 1.30, N=102). Highly significant improvements were achieved with regards to recognizing symptoms of AHA, appropriate referral, and initial therapeutic management (figure). After participating, 37% of hematologists and 40% of pulmonologists had measurable improved confidence (both P<.001), resulting in 63% of hematologists and 46% of EM physicians who were mostly or very confident in identifying features consistent with a possible AHA diagnosis post-CME (vs 44% and 26% pre-CME respectively). CONCLUSIONS This study demonstrates the success of online, interactive case-based education in improving clinicians' competence in identifying patients with possible AHA, appropriate referral and initial treatment. Both improvement and reinforcement in the context of a linked learning assessment have been shown to positively correlate with increases in confidence as well as intention to make clinical practice changes (Lucero KS, Chen P. J Eur CME. 2020 Oct 12;9(1):1834759), suggesting that most clinicians who participated in this activity are likely to make improvements in their practice. This could lead to earlier appropriate treatment and improved overall outcomes for these patients. Figure 1 Figure 1. Disclosures Ma: Takeda: Honoraria, Research Funding; Accordant: Consultancy.

The Evaluation of Responses and Abilities of 119 EMTs to Perform Pediatric Triage

This study aimed to evaluate the pediatric triage performance of 119 Emergency Medicine Technologists (EMTs) at a fire station, based on mass casualty incident scenarios of a pediatric disaster, and to evaluate effective measures of response. EMTs (N = 58) at a provincial fire station participated in this study and were asked to complete three questionnaires: one ‘general characteristics’ questionnaire, one problem solving questionnaire, consisting of questions based on mass casualty incident scenarios, and a post-questionnaire to explore the necessity of pediatric triage based on their responses. We used SPSS to analyze the data. The EMT-paramedics’ scores were high and statistically significant (p < .002). All 48 questions concerning the three scenarios were converted to a score ranging from 0 to 100 with an average score of 70.92 and an average correct response rate of 70%. We also found that the participants’ rate of recognition of the pediatric triage tool was significantly lower than that of the adult tool (p < .030). The usage rate was also low, at approximately 19.09%. After solving the questionnaire problems, the respondents reported a significantly higher score concerning the necessity of the pediatric triage tools than before (p < .006). Firefighting departments integrate pediatric triage tools into the E-triage system. However, EMTs should receive continuous training and practice to improve their pediatric triage tool classification capabilities.

Identification of Genes Associated with Human-Canine Communication in Canine Evolution.

The dog (Canis familiaris) was the first domesticated animal and hundreds of breeds exist today. During domestication, dogs experienced strong selection for temperament, behaviour, and cognitive ability. However, the genetic basis of these abilities is not well-understood. We focused on ancient dog breeds to investigate breed-related differences in social cognitive abilities. In a problem-solving task, ancient breeds showed a lower tendency to look back at humans than other European breeds. In a two-way object choice task, they showed no differences in correct response rate or ability to read human communicative gestures. We examined gene polymorphisms in oxytocin, oxytocin receptor, melanocortin 2 receptor, and a Williams–Beuren syndrome-related gene (WBSCR17), as candidate genes of dog domestication. The single-nucleotide polymorphisms on melanocortin 2 receptor were related to both tasks, while other polymorphisms were associated with the unsolvable task. This indicates that glucocorticoid functions are involved in the cognitive skills acquired during dog domestication.

POS1449 SEGMENTED SHORT-FORMAT ONLINE EDUCATION SIGNIFICANTLY INCREASES PREDICTION, PROGNOSIS, AND MANAGEMENT OF FIBROSING INTERSTITIAL LUNG DISEASE ASSOCIATED WITH CONNECTIVE TISSUE DISEASE

Background:Identifying fibrosing interstitial lung disease (ILD) at the earliest opportunity remains one of the most urgent challenges for the effective management of this potentially rapidly progressive and burdensome condition, which is frequently associated with several connective tissue diseases (CTDs). However, knowledge on how to identify early hallmarks and predictors of fibrosing ILD, as well as knowing which steps to take next is frequently lacking in clinical practice.Objectives:This study was conducted to determine whether online independent medical education could improve rheumatologists’ and pulmonologists’ knowledge and competence in identifying and managing progressive fibrosing ILDs earlier in the disease course.Methods:Rheumatologists and pulmonologists participated in five ~10-min presentations about the early identification of fibrosing ILD in patients with or without CTDs and completed all pre- and post-questions.1 The effects of the education on knowledge and competence were assessed using a 3-question, repeated pairs, pre-assessment/post-assessment study design. For all questions combined, the chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. The activity launched on October 9, 2020, and data were collected through December 18, 2020.Results:Overall significant improvements were seen after participation for both rheumatologists (average correct response rate of 28% at pre-assessment vs 74% at post-assessment; P<.001, representing a 165% relative percentage change [RPC]; N=39), and pulmonologists (average correct response rate of 39% at pre-assessment vs 67% at post-assessment; P<.001, representing a 72% RPC; N=102). Specifically, significant improvements were observed in clinicians’ knowledge of predictors of fibrosing ILD in patients with CTD, as well as competence in selecting the right HRCT parameters to assess prognosis and select a treatment approach to reduce the risk of disease progression (Figure 1).Figure 1.After participating in the activity, 59% of rheumatologists and 50% of pulmonologists had measurable improved confidence related to identifying early disease progression in patients with progressive fibrosing ILDs.Given the very low rates of correct responses at baseline regarding predictors of fibrosing ILD and assessing prognosis, it will be important to continue to reinforce these learnings in ongoing educational programs.Conclusion:This study demonstrates the success of segmented online education in improving rheumatologists’ and pulmonologists’ knowledge and competence in evaluating risk and prognosis of fibrosing ILD and managing patients with CTD-ILDs. This could lead to earlier changes in therapeutic approach for those with signs of progression and result in improved overall outcomes for these patients.References:[1]Kolb M, Maher T, Smith V, Jacob J, Rimekasten G. Catching and Managing Progressive Fibrosing Interstitial Lung Disease Progression Earlier. Launched: Oct 9, 2020. Data as of Dec 18, 2020. Available at www.medscape.org/viewarticle/938826Disclosure of Interests:Christy Rohani-Montez: None declared, Marinella Calle: None declared, Chris Allen: None declared, Toby Maher Speakers bureau: Astra Zeneca, Bayer, Blade Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Galapagos, Galecto, GlaxoSmithKline R&D, Indalo, IQVIA, Pliant, Respivant, Roche and Theravance, Consultant of: Astra Zeneca, Bayer, Blade Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Galapagos, Galecto, GlaxoSmithKline R&D, Indalo, IQVIA, Pliant, Respivant, Roche and Theravance, Grant/research support from: Astra Zeneca and GlaxoSmithKline R&D, Vanessa Smith Speakers bureau: Boehringer-Ingelheim Pharma GmbH&Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH&Co, Grant/research support from: Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer-Ingelheim, Pharma GmbH&Co, and Janssen-Cilag NV, Joseph Jacob Speakers bureau: Boehringer-Ingelheim; Roche, Consultant of: Boehringer-Ingelheim, Grant/research support from: GlaxoSmithKline, Gabriela Riemekasten Speakers bureau: AbbVie; Actelion; Boehringer-Ingelheim, Consultant of: Actelion; CellTrend; Janssen, Grant/research support from: AbbVie; Actelion, Martin Kolb Speakers bureau: AstraZeneca; Boehringer-Ingelheim; Novartis; Roche, Consultant of: AbbVie Inc.; Algernon Pharma; AstraZeneca;, Boehringer-Ingelheim; Cipla; Covance; EPG Health; Galapagos NV; Gilead; GlaxoSmithKline; Indalo; MitoImmune Therapeutics Inc; Novartis; Pieris; Prometic (now Liminal Biosciences); Roche; Third Pole Inc.; TwoXAR Inc., Grant/research support from: Boehringer-Ingelheim; GlaxoSmithKline; Novartis; Prometic; Roche; Avalyn

Assessing the Stiffness Perception of Acupressure Massage Beginning Learners: A Pilot Study

Visually impaired licensed therapists must have the ability to perceive stiffness through their fingertips in the school for the blind. The teachers strive to provide careful introductory education based on a quantitative assessment of new students’ basic stiffness perception. However, assessment materials to help teachers understand new students’ stiffness perception are lacking. This study aimed to develop suitable fundamental assessment materials that visually impaired licensed teachers could use to quantitatively assess the difference in the stiffness perception ability of beginning learners in the early stages of learning. They were asked to discriminate the presented materials one at a time, which consisted of thermoplastic elastomers with different degrees of stiffness. We used these materials to compare the beginning learners’ ability to perceive stiffness with that of teachers and found that teachers answered correctly at an overall significantly higher rate. Specifically, the teachers’ correct response rate (78.8%) for the stiffness perception of all presented stimuli was approximately 15% higher than the beginning learners’ correct response rate (64.2%). These results revealed areas of stiffness that are difficult for beginning learners to identify.

An Evaluation of the Therapeutic Nutrition Knowledge of Belizean Nurses

In Belize, patients rely on nurses for nutritional guidance on non-communicable diseases in the Caribbean. The objectives of this study were to quantify the therapeutic nutritional knowledge of 198 Belizean nurses using the Al-Shwaiyat questionnaire. The mean correct response rate for the therapeutic nutritional knowledge was suboptimal (53.30%±17.20). Nurses in the West region of the country had the highest mean knowledge scores on nutrition and diabetes 75.41±20.10, p=0.003; on nutrition and cardiovascular diseases 57.23±10.90, p=0.000; and in overall knowledge 62.34±9.76 p=0.000. Nurses without a diagnosis of diabetes had higher mean knowledge scores on a) nutrition and diabetes 63.86±26.07, p=0.001; b) nutrition and obesity questions 49.55±20.80, p=0.004; c) nutrition and cardiovascular disease 53.30±15.70, p=0.007 and d), overall mean 55.24±16.67, p=0.000. There is a need to address the low levels of knowledge of Belizean nurses.

Knowledge, attitude, and practices regarding COVID-19: A study on workers from a food industry in Bangladesh.

While people around the world are terrified of the global pandemic coronavirus disease 2019 (COVID-19) and no registered vaccine is out yet, undertaking preventive safety measures are said to be the only way to stay away from it. Peoples adherence to these measures is broadly dependent on their knowledge, attitude, and practices (KAP). The present study was designed to evaluate workers knowledge, attitude, and practices from a food industry in Dhaka, Bangladesh, towards COVID-19. A number of 155 respondents took part in this online-based study. The information was acquired online from the participants through a questionnaire prepared in Google form. With a correct response rate of about 90% on average (knowledge 89.7%, attitude 93%, practices 88.2%), the participants showed a good level of KAP regarding COVID-19. However, education and working experiences had a significant association with the total KAP scores (p < 0.05). Further KAP studies in different generic food industries in Bangladesh should be carried out to bring a more precise picture for ensuring the level of workplace and workers safety.

Awareness of basic knowledge of hand hygiene practices among Chinese healthcare workers: a questionnaire-based survey

Objectives Hand hygiene is a key measure for the prevention and control of healthcare-associated infection. We investigated the level of awareness of the basic concepts surrounding hand hygiene among healthcare workers in China to inform future targeted hand hygiene promotion activities. Methods An online questionnaire survey comprising 10 single/multiple-choice questions was conducted from April to June 2018 in 30 provinces and municipalities in three regions of China. Logistic analysis was performed to identify differences between regions, types of hospitals, healthcare workers categories, clinical departments, and gender. Results A total of 52,286 responses were received. Among these, 45,455 (86.94%) were included in the final analysis. The overall correct response rate was 26.53%. Eastern China demonstrated a better knowledge than other regions. Respondents in primary care facilities had a higher correct response rate than other types of hospitals and logistics staff had the highest correct response rate than other professional groups. Among clinical departments, staff in the outpatient/emergency room had the highest rate of correct responses. Conclusion Large differences exist in the basic knowledge of hand hygiene across different regions in China and knowledge levels need to be specifically strengthened among secondary care facilities, nurse professionals, gynaecology/obstetrics/paediatric departments and infection control units.

Effectiveness of Interactive Case-Based Online Education in Improving Attp Diagnosis and Treatment Selection

INTRODUCTION The prompt recognition and treatment of acquired thrombotic thrombocytopenic purpura (aTTP) is critical to prevent life-threatening consequences; however, this condition continues to be under-diagnosed and associated with significant mortality. Reducing mortality rates and improving outcomes is dependent on clinician awareness of aTTP diagnostic features, and on prompt implementation of evidence-based treatment approaches. OBJECTIVES This study was conducted to determine whether online case-based independent medical education could improve hematologists' and emergency medicine specialists' competence in identifying key diagnostic features of aTTP and selecting an initial treatment approach; and knowledge regarding recent clinical data on aTTP treatment. METHODS Hematologists and emergency medicine physicians electively participated in a 15-minute, case-based interactive online independent medical education activity on aTTP (Coppo P. Fatigue, Bruises, and Thrombocytopenia: What's Your Next Step? Launched: 1/30/2020. Data as of 4/22/2020. Available at www.medscape.org/viewarticle/923316). The effects of the education on knowledge and competence were assessed using a 3-question, repeated pairs, pre-assessment/post-assessment study design. For all questions combined, the chi-square test assessed differences from pre- to post-assessment. P values &lt;.05 are statistically significant. The activity launched on January 30, 2020 and data were collected through April 22, 2020. RESULTS Overall significant improvements were seen after participation for both hematologists (average correct response rate of 33% at pre-assessment vs 82% at post-assessment; P&lt;.001, N=124), and emergency medicine physicians (average correct response rate of 18% at pre-assessment vs 73% at post-assessment; P&lt;.001, N=45). Specifically, there were significant improvements in recognizing laboratory findings indicative of a TTP diagnosis; selecting a triplet regimen as initial therapy for aTTP, based on current data; and understanding possible treatment-related adverse event expectations (Figure). After participating in the activity, 44% of hematologists and 84% of emergency medicine physicians had measurable improved confidence related to their ability to manage patients presenting with signs and symptoms of aTTP. Despite the increases in knowledge and confidence observed, the baseline rates of correct responses were low; therefore, ongoing education will be needed to reinforce knowledge and competence. Reinforcement is an important outcome from education that keeps clinicians' practices up-to-date (Lucero KS, Dunn S. Available at: http://almanac.acehp.org/p/bl/et/blogid=2&blogaid=599. Accessed June 11, 2020). CONCLUSIONS This study demonstrates the success of online, interactive case-based education in improving hematologists' and emergency medicine specialists' knowledge and competence in diagnosing and managing aTTP. This could lead to earlier diagnosis and a more widespread adoption of a new standard of aTTP treatment to improve overall outcomes for these patients. Figure Disclosures Coppo: Octapharma: Consultancy; Roche: Consultancy, Research Funding, Speakers Bureau; Sanofi: Consultancy, Speakers Bureau; Takeda: Consultancy, Speakers Bureau; Alexion Pharmaceuticals, Inc.: Consultancy, Research Funding, Speakers Bureau.