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PEMBERDAYAAN WIRAUSAHA IBU RUMAH TANGGA MELALUI PELATIHAN PEMBUATAN ANEKA OLAHAN IKAN AIR TAWAR DI KAMPUNG CILAMO, DESA GIRIMUKTI, KABUPATEN GARUT</text>
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                <text>Dari data monografi yang diperoleh, diketahui bahwa Desa Girimukti didominasi oleh penduduk yang bermata pencaharian sebagai petani, pedagang, beternak, bekerja di luar daerah. Dalam perkembangan usaha mikro dan menengah yang tercatat dari seluruh penduduk di Desa Girimkti, dari 2000 penduduk, tercatat 12 orang sebagai pelaku UMKM yang berfokus pada produksi makanan ringan sebagai makanan oleh-oleh yang dipasarkan di warung-warung dan di pusat oleh-oleh.  Pasal 1 UU tersebut menyatakan bahwa usaha mikro adalah usaha produktif milik orang perorangan dan/atau badan usaha perorangan yang memenuhi kriteria usaha mikro sebagaimana diatur dalam UU tersebut.</text>
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                <text> A Chef with fever and jaundice (E-Poster Presentations)</text>
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                <text>Introduction&#13;
Leptospirosis is one of the most widespread zoonosis. It is an under-reported infection, and there are no reliable global incidence &#13;
figures. A systematic review and modeling exercise estimated that more than one million human cases occur worldwide annually, &#13;
including almost 60,000 deaths. It is most prevalent in tropical regions but also occurs in temperate regions [1,2]. Regions with &#13;
the highest incidence of infections include South and Southeast Asia, Oceania, the Caribbean, parts of sub-Saharan Africa, and &#13;
parts of Latin America [3]. In the United States, the incidence of leptospirosis is relatively low (approximately 100 to 150 cases are &#13;
reported annually) [4]. Puerto Rico and Hawaii consistently report the most cases.&#13;
The most common animals that play an important role in the transmission of human leptospirosis are rodents, in particular rats &#13;
[5]. The infection is acquired by direct contact with infected urine and by indirect exposure or contact with contaminated water or &#13;
soil. Infection by rat urine is the more frequent form of infection [6].&#13;
Case Report&#13;
54 male chef by profession, known to have Pemphigus vulgaris and foliaceous on azathioprine presented with 5 days history of &#13;
fever which was accompanied with rigors and chills. The fever was not documented. He was taking paracetamol and limsip 4 &#13;
hourly and 2 hourly respectively. On day 5 he went to GP who noticed yellow discoloration of skin and eyes therefore referred him &#13;
to hospital. He did not report any sore throat or flu like symptoms. He did not report any cough, or phlegm, no shortness of breath, &#13;
no cerebrovascular, no bowel or bladder concerns.&#13;
He was on azathioprine, omeprazole and used to take steriods only when his pemphigus vulgaris worsens. He did not report any &#13;
allergies. He had no significant family history. He lives with his wife and kids. He had never drink alcohol and quit smoking 3 years &#13;
ago.&#13;
On examination he was tachycardiac with low blood pressure and his temperature was 38.7C. On general physical examination he &#13;
was jaundiced, had petechia on shins. However, there was no conjunctival pallor no, cyanosis no lymphadenopathy and no pedal &#13;
oedema.&#13;
His liver was 1.5cm below the costal margin and rest of the systemic examination was unremarkable.&#13;
Following this he had blood investigations and it revealed low platelets of 43, elevated bilirubin of 77, raised urea (8.7), creatinine &#13;
169 and GFR 39. His PT was prolong. His CRP was 236 and PCT of 32.5. Along with this his paracetamol was 22. His dipstick urine &#13;
was +++ protein and +blood. His CXR and ECG were unremarkable.&#13;
He was started on IV NAC along with intravenous fluids, and intravenous antibiotics which include gentamicin, metronidazole, &#13;
and amoxicillin. Further blood tests were requested including viral hepatitis screen, autoimmune and leptospirosis. &#13;
In view of low platelets and for the possibility of TTP/HUS the case was discussed with haematologist consultant but as LDH was &#13;
normal and he did not fulfil the criteria of TTP/HUS therefore this differential was ruled out.&#13;
His hepatitis A results were in keeping with previous hepatitis A exposure. His CMV IgG was positive, hepatitis B, C, E and HIV &#13;
were negative. Autoimmune liver screen was negative as well. However, his leptospirosis IgM and PCR was positive.&#13;
He was started on ceftriaxone and doxycycline and responded to the treatment and was safely discharged.&#13;
Discussion&#13;
Leptospirosis is a zoonosis with protean with clinical manifestation caused by pathogenic spirochetes of the genus Leptospira. &#13;
Leptospira are spiral-shaped, highly motile aerobic spirochetes with 18 or more coils per cell. &#13;
The clinical course of leptospirosis is variable. Most cases are mild and self-limited or asymptomatic, whereas some are severe &#13;
and potentially fatal. Syndromes caused by leptospirosis are divided into two categories anicteric leptospirosis and icteric &#13;
leptospirosis. &#13;
Most of the symptomatic patients with leptospirosis have the anicteric form of disease. Anicteric leptospirosis has been &#13;
described as a biphasic illness, with an acute phase and an "immune" phase. Most patients never proceed to the immune phase &#13;
of illness. In some cases, the two phases may overlap clinically.&#13;
The acute phase of anicteric leptospirosis typically lasts two to nine days [4]. It usually begins 5 to 14 days after exposure, &#13;
although the incubation period can range from 2 to 30 days. The acute phase is characterized by acute febrile bacteraemia. 75 to &#13;
100 of patients have following clinical features which include abrupt onset of fever, rigors, myalgias (especially in the calves and &#13;
lower back), and headache [7]. Approximately half of the patients experience nausea, vomiting, and diarrhoea, and nonproductive &#13;
Abstract and Poster Presentations Book – EPIC24&#13;
77&#13;
cough. Rarely, rapidly progressive pulmonary haemorrhage can happen during the acute phase, although this is more commonly &#13;
seen with icteric leptospirosis. Symptoms include shortness of breath and haemoptysis. This presentation is associated a high&#13;
mortality rate.&#13;
Following the acute phase, a minority of patients with anicteric leptospirosis experience an "immune" phase characterized by &#13;
specific immune-mediated complications. Rarely, patients can present with the manifestations of the immune phase without &#13;
experiencing a preceding symptomatic acute phase. During the immune phase, leptospires are absent from the blood, and &#13;
antibodies to the organism are present. The organism may be detectable in the urine during this phase. &#13;
Icteric leptospirosis (Weils’s disease) occurs in approximately 5 to 10 percent of symptomatic leptospirosis cases and is a rapidly &#13;
progressive multisystem illness associated with mortality rates of 5 to 15 percent [9]. The symptoms associated with icteric &#13;
leptospirosis include fever, jaundice and renal failure. Pulmonary haemorrhage with ARDS, myocarditis with ECG changes and &#13;
rhabdomyolysis may also occur as part of this syndrome [10]. Conjunctival injection is also common.&#13;
The diagnosis is confirmed by a positive PCR of blood or urine or by positive serologic testing; rarely, a diagnosis is made by a &#13;
positive culture of blood or urine. Serologic tests measure specific immunoglobulin (Ig)M and IgG antibodies against Leptospira &#13;
organisms.&#13;
Leptospirosis is treated with antibiotics which in our case were ceftriaxone and doxycycline.&#13;
Conclusion&#13;
When a patient presents with fever and jaundice it is important to take the social history as well The profession in my case was &#13;
the clue that it could be leptospirosis.</text>
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                <text> DAMPAK PSIKOLOGIS PERAWAT DALAM MELAYANI PASIEN COVID-19 DI INSTALASI RAWAT INTENSIF PENYAKIT INFEKSI IMAGING (PIE)</text>
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                <text>Pendahuluan: Perawat merupakan salah satu tenaga kesehatan paling depan (frontline) &#13;
dalam melakukan perlawanan terhadap COVID-19. Beberapa rumah sakit melakukan &#13;
pengurangan jumlah kunjungan pasien, tetapi tidak pada ruang gawat darurat dan ruang &#13;
isolasi. Perawat yang bekerja di ruang tersebut memiliki risiko yang lebih besar untuk &#13;
berinteraksi dengan pasien atau penderita yang dicurigai positif COVID-19. Banyaknya &#13;
dampak yang dialami oleh seorang perawat yaitu, depresi, ansietas, Insomnia, dan tekanan &#13;
psikologis yang dialami perawat yang merawat pasien covid. Tujuan: Untuk mengetahui &#13;
Dampak psikologis dalam melayani pasien Covid-19. Metode: Penelitian ini di lakukan di &#13;
RS Rivai Abdullah Palembang dengan partisipan sebanyak 5 orang perawat ruangan. Jenis &#13;
penelitian ini adalah penelitian kualitatif dengan melihat fenomenologi dampak psikologis &#13;
perawat yang merawat pasien dengan covid-19. Hasil: Didapatkan 3 tema yaitu, Terpaksa &#13;
dan pasrah perasaan saat merawat pasien covid 19, Keputusasaan dan ketakutan sebagai &#13;
pemberi dampak sebagai perawat covid 19, Pencapaian dengan menerima sebagai &#13;
perawat covid 19. Kesimpulan: Hasil penelitian ini perawat mampu menilai dirinya sendiri &#13;
yang memiliki perasaan ketidakberdayaan, adanya konfilik batin, perasaan sepi yang &#13;
melanda, ketidakstabilan emosi</text>
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                <text>ISSN: 2301-8631 (Print) dan ISSN: 2654-8658 (Online)</text>
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                <text> Exploring Urinary Catheter-Related Complications and Contributing Factors in the Emergency Department of a Tertiary Care Hospital (E-Poster Presentations)</text>
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                <text>INTRODUCTION&#13;
The Emergency Department (ED) plays a crucial role in admitting many hospitalized patients, often needing to decide on urinary &#13;
catheter placement. While catheters help monitor urine output and alleviate urinary issues, they also pose safety risks. Ineffective &#13;
or unnecessary use can lead to discomfort, activity limitations, and significant healthcare burdens. Catheter-associated urinary &#13;
tract infections (CAUTIs) significantly contribute to hospital-acquired infections linked to indwelling urinary catheters (UCs). &#13;
Additionally, iatrogenic urethral injuries during UC insertion, with potential complications like acute gross hematuria and urethral &#13;
strictures, highlight the need for quality control measures during catheter insertion in the emergency department to mitigate risks.&#13;
METHOD&#13;
The research conducted at the Emergency Medicine department of Aga Khan University Hospital in Karachi spanned six months &#13;
from April 1st, 2022, to September 30th, 2022, following approval from the Ethical Review Committee. Utilizing a non-probability &#13;
consecutive sampling method, 202 patients were enrolled, with exhaustive medical histories collected, encompassing &#13;
demographics, admission diagnoses, laboratory analyses (including Urine Analysis), and complications associated with urinary &#13;
catheterization, along with potential contributing factors documented using a standardized proforma.&#13;
RESULTS&#13;
The study population displayed demographic diversity, with an average age of 60.79 years and a gender distribution of 47% male &#13;
and 54% female participants. Catheter-related issues were identified in 75% of cases, predominantly hematuria (59%) and &#13;
catheter-associated urinary tract infections (CAUTI) (53%). Urethral injury occurred in 1% of cases, with no instances of urethral &#13;
stricture. Additionally, four systematic factors within the ED were assessed, including prolonged hospitalization (6% of patients), &#13;
immobilization (13% of patients), urinary retention (4% of patients), and palliative care (7% of patients). &#13;
DISCUSSION&#13;
This study highlights healthcare providers' inadequate understanding of catheterization indications and the absence of a &#13;
monitoring protocol for unnecessary catheters. Preventing catheter-associated urinary tract infections (CAUTIs), significant &#13;
contributors to hospital-acquired infections, necessitates adherence to appropriate catheter use guidelines. Risk factors for &#13;
CAUTI include prolonged use (with up to 43.9–54% of catheter insertions deemed inappropriate), female gender, and the absence &#13;
of systemic antibiotics. Guidelines emphasize employing catheters only when medically indicated and promptly removing them &#13;
when unnecessary. Various researchers have reported similar and additional factors contributing to catheter-associated &#13;
complications. By identifying and addressing these factors, our study aims to facilitate the development of targeted interventions &#13;
to reduce complications and enhance patient outcomes in the emergency department.&#13;
CONCLUSION&#13;
This study emphasizes the high prevalence of catheter-related complications in the Emergency Department, urging targeted interventions for improved patient outcomes.</text>
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                <text>Naheed Habibullah,  Noor Baig</text>
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              <elementText elementTextId="128000">
                <text>Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD</text>
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              <elementText elementTextId="128001">
                <text> From Zero to Hero Medical Education LTD</text>
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                <text>10 July 2024. </text>
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                <text>Sri Wahyuni</text>
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                <text> Frequency Of Depressive Symptoms Among Patients With End-Stage Renal Disease (E-Poster Presentations)</text>
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                <text>Introduction&#13;
End-stage renal disease (ESRD) patients undergoing haemodialysis face both physical and psychological challenges. Adherence &#13;
to strict treatment and dietary regimens is essential, yet the psychological burden, including depression, anxiety, and stress, can &#13;
complicate the management. Assessing the frequency and severity of depressive symptoms in this population is crucial for &#13;
optimizing patient care and outcomes.&#13;
Objective&#13;
This study aimed to assess the frequency of depressive symptoms among patients diagnosed with end-stage renal disease &#13;
(ESRD) in Nawabshah, Pakistan as well as to explore potential contributing factors.&#13;
Methods&#13;
This observational, single-centre study involved a sample of 100 ESRD patients undergoing haemodialysis, selected through &#13;
simple random sampling from Dialysis Centre of Peoples University of Medical &amp; Health Sciences for Women in Nawabshah, &#13;
Pakistan. Data was collected through structured interviews using validated questionnaires from December 1st, 2023, to February &#13;
10th, 2024. The severity of depressive symptoms was evaluated using the Depression, Anxiety, and Stress (DAS) scale v. 21. The &#13;
data was analysed using SPSS v. 25.&#13;
Results&#13;
The findings revealed a prevalence of moderate to severe depressive symptoms among the study participants. Furthermore, a &#13;
significant proportion (69%) of patients reported challenges with adhering to dietary restrictions. Despite long-term dialysate &#13;
usage (50% of respondents undergoing dialysis for over a year) and frequent dialysis sessions (83% receiving treatment twice &#13;
weekly), serum albumin and urea levels remained outside the normal range. Additionally, a high prevalence (91%) of hypertension &#13;
was reported among the patients.&#13;
Discussion&#13;
The study revealed a concerning prevalence of depressive symptoms among ESRD patients undergoing haemodialysis in &#13;
Nawabshah, Pakistan. Difficulties with dietary restrictions, suboptimal management of ESRD, and a high prevalence of &#13;
hypertension were noted. Integrating psychological support services into patient care is essential to address these challenges and &#13;
improve outcomes. Limitations include the study's observational nature and single-centre design. Future research should explore &#13;
longitudinal designs and objective measures of psychological distress.&#13;
Conclusion&#13;
The findings underscore the substantial occurrence of depressive symptoms among ESRD patients undergoing haemodialysis in &#13;
Nawabshah, Pakistan. This highlights the importance of addressing psychological well-being alongside medical management in &#13;
this patient population</text>
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                <text>Mahnoor Rehman, Priyanka Devi, </text>
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                <text>Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD</text>
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                <text>From Zero to Hero Medical Education LTD</text>
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                <text>Sri Wahyuni</text>
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                <text> KNOWLEDGE MANAGEMENT SYSTEM BUDIDAYA NILA ORGANIK MENGGUNAKAN MODEL SOCIALIZATION EXTERNALIZATION COMBINATION INTERNALIZATION BERBASIS WEB </text>
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                <text>Ikan nila (Oreochromis niloticus) adalah jenis ikan air tawar yang memiliki nilai ekonomis dan sering dibudidayakan oleh para pembudidaya ikan tawar di Indonesia. Saat ditinjau dalam hal pertumbuhan, ikan nila merupakan jenis ikan yang memiliki pertumbuhan yang sangat cepat dan dapat mencapai produktivitas cukup tinggi. Pengetahuan mengenai budidaya ikan nila bisa didapatkan baik di internet, e-book maupun jurnal dan penyuluhan. Tetapi hal tersebut kurang efektif, karena pengetahuannya tidak terstruktur dan tersebar. Maka perlu dibuatkan sebuah sistem budidaya ikan nila agar pemula yang ingin berbudidaya ikan nila bisa mengetahui pola managemen tersebut. Knowledge Management System (KMS) menawarkan pengetahuan yang memiliki klasifikasi diantaranya dapat berbagi pengetahuan melalui sebuah sistem aplikasi yang menyediakan fitur unduh ataupun fitur mengunggah. Penelitian ini menggunakan Socialization, Externalization, Combination, Internalization (SECI) model dan Knowledge Management System Life Cycle (KMSLC) dalam development. Hasil penelitian ini berupa aplikasi berbasis web yang telah di uji oleh pengguna dengan hasil pengujiannya dinyatakan baik. Fitur-fitur yang dimiliki oleh aplikasi ini seperti tambah pengetahuan, unduh pengetahuan, unggah pengetahuan, mencari pengetahuan, proses validasi pengetahuan serta tampilan yang mudah digunakan oleh pengguna.</text>
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                <text>Fajar bagus W</text>
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                <text> PROFITABILITAS MERUPAKAN SINYAL PENTING YANG MENJELASKAN NILAI PERUSAHAAN</text>
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                <text>This research expands previous research which has examined the factors that influence company value on the Indonesian Stock Exchange. Purpose: This research wants to show that the elements of financial reports provide signals for investors in making investment decisions. This research aims to examine the influence of profitability, solvency and &#13;
liquidity on company value. Method: This research used 120 samples from 40 companies listed in the LQ45 company category during 2020- 2022. Profitability is measured by the ROA ratio, solvency is measured by the Debt Ratio (DR), and liquidity is measured by the Current Ratio (CR). Analysis: the research model was tested using multiple linear&#13;
regression. Results and Discussion: Profitability has a positive and significant effect on company value, while the solvency and liquidity variables have an insignificant effect on company value. The results of this research imply that company profitability is an important signal for investors in managing investments in the capital market and for&#13;
determining company value.</text>
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                <text>Felista Mardiana Tae Nahak, Efraim Ferdinan Giri</text>
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                <text>http://jam.stieykpn.ac.id/index.php/jam/issue/view/146</text>
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                <text>STIE YKPN Yogyakarta</text>
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                <text>Agustus 2023</text>
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                <text>Sri Wahyuni</text>
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                <text>ISSN 2621-7880 (Online) /1978-3116 (Cetak)</text>
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                <text>Indonesian</text>
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                <text>Jurnal Akuntansi dan Manajemen STIE YKPN Yogyakarta 2023</text>
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        <name>company value</name>
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        <name>Profitability</name>
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        <name>solvency</name>
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                  <text>Prosiding 3rd Emergency Physician's International Conference</text>
                </elementText>
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                  <text>Sri Wahyuni</text>
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                <text> Should every Emergency Department by using a Modified Early Obstetric Warning Score? (Oral Presentations)</text>
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          <element elementId="49">
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                <text>Modified Early Obstetric Warning Score</text>
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                <text>Introduction&#13;
In the UK, between January 2023 to January 2024, the number of patients waiting 12 or more hours in emergency departments &#13;
(EDs) from the decision made to admit increased by 27%. For the women awaiting an obstetric or gynaecological bed, the use of &#13;
an effective early warning score is crucial in recognising deteriorating patients. The MBRRACE (Mothers and Babies: Reducing Risk &#13;
through Audits and Confidential Enquiries across the UK) 2023 report recommends that we must use a national Maternity Early &#13;
Warning Score to monitor all pregnant women wherever in the hospital they receive care, including the ED.&#13;
Aims&#13;
Compare the use of the Modified Early Obstetric Warning Score (MEOWS) to the National Early Warning Score 2 (NEWS2) in a UK &#13;
ED that currently does not used a modified early warning score for pregnant women.&#13;
Evaluate the differences made by using a modified, instead of national, and the impact on pregnant women's care, escalation and &#13;
management in the ED.&#13;
Method&#13;
A retrospect cohort study over a 3-month period in a UK district general hospital ED (September – December 2022).&#13;
Cerner FirstNet Electronic Medical Records were used to identify a final cohort of 48 women. Patients initial stay was analysed &#13;
using NEWS2 score including initial warning score at triage, score at decision to admit/discharge, frequency of vital sign &#13;
observations, recommended escalation of care, length of stay and reattendance. The MEOWS was then applied to the same &#13;
patient attendance.&#13;
Results&#13;
In 44% of cases, the MEOWS indicated that the patient needed a greater frequency of observation than recommended by patient &#13;
NEWS2. 10% of women represented with the same presentation within 7 days following discharge. Of these, 90% had a MEOWS &#13;
that advised obstetric discussion that they did not have. MEOWS recommends evaluation for proteinuria if &gt;20weeks gestation &#13;
and lochia if up to 6 weeks postpartum. Only 16% of women were evaluated for this during their ED stay.&#13;
Conclusion&#13;
Physiological response to acute illness can be modified by pregnancy and therefore leaves the NEWS2 inappropriate. Using the &#13;
MEOWS not only triggered more frequent observations, but also triggered for obstetric review when NEW2 did not. This may have&#13;
not only picked up on deteriorating patient earlier, but also prevented recurrent attendances in the ED.</text>
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            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127778">
                <text>Rebecca Talbutt , Rachel Hodgson,  Jessica Oscroft</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="127779">
                <text>Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD</text>
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          <element elementId="45">
            <name>Publisher</name>
            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="127780">
                <text>From Zero to Hero Medical Education LTD</text>
              </elementText>
            </elementTextContainer>
          </element>
          <element elementId="40">
            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127781">
                <text>10 Juli 2024</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="37">
            <name>Contributor</name>
            <description>An entity responsible for making contributions to the resource</description>
            <elementTextContainer>
              <elementText elementTextId="127782">
                <text>Sri Wahyuni</text>
              </elementText>
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          </element>
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            <description>The file format, physical medium, or dimensions of the resource</description>
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                <text>PDF</text>
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            </elementTextContainer>
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            <elementTextContainer>
              <elementText elementTextId="127784">
                <text>English</text>
              </elementText>
            </elementTextContainer>
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            <name>Type</name>
            <description>The nature or genre of the resource</description>
            <elementTextContainer>
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                <text>Text</text>
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            <element elementId="50">
              <name>Title</name>
              <description>A name given to the resource</description>
              <elementTextContainer>
                <elementText elementTextId="127741">
                  <text>Prosiding 3rd Emergency Physician's International Conference</text>
                </elementText>
              </elementTextContainer>
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            <element elementId="37">
              <name>Contributor</name>
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              <elementTextContainer>
                <elementText elementTextId="127742">
                  <text>Sri Wahyuni</text>
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            <description>A name given to the resource</description>
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                <text> Using clinical photographs to improve dermatological care in the acute setting (E-Poster Presentations)</text>
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          <element elementId="49">
            <name>Subject</name>
            <description>The topic of the resource</description>
            <elementTextContainer>
              <elementText elementTextId="128162">
                <text>clinical photographs, dermatological care, acute setting</text>
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            <name>Description</name>
            <description>An account of the resource</description>
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              <elementText elementTextId="128163">
                <text>Introduction/ Objective&#13;
The Dermatology team at our NHS DGH Trust requests that every inpatient e-referral to Dermatology, is accompanied by a clinical &#13;
photo. Our Quality Improvement Project focuses on improving the referral system, by ensuring it is user-friendly and effective with &#13;
the aim of reducing the time taken for specialist advice, ultimately improving patient care.&#13;
Methods&#13;
Using a Plan-Study-Do-Act (PDSA) methodology, we undertook a baseline audit of the electronic referrals sent to the Dermatology &#13;
department over a 2-month period. We applied an exclusion and inclusion criteria. We used Microsoft excel to undertake our data &#13;
analysis. We then created a survey and collected the responses from both junior doctors and the Dermatology team, so we could &#13;
ensure our interventions were tailored to the needs of both the users and the team receiving the electronic referrals.&#13;
As a result of our baseline audit, we worked with both IT and Dermatology to introduce a system called MedXnote, this a software &#13;
within the Microsoft Teams app. It enables photographs to be taken safely within the app on a personal device, without saving to &#13;
the device. These photos then upload directly to EDMS, a system which is already used in this hospital for Echocardiogram &#13;
reports, which all members of the MDT can access via the online documentation system. We undertook a teaching session, &#13;
created a user guide which was circulated by posters on the wards, e-mail and published on the Trust Intranet.&#13;
Initial Results of Baseline Audit&#13;
Our junior doctor survey identified issues with data governance and confidentiality within the current process of uploading clinical &#13;
photos to e-referrals. Further to this, we found 67% of junior responses stated there could be a delay in completing dermatology &#13;
referrals due to difficulties in attaching photos. Within the baseline audit undertaken over a 2 month period, only 45% of referrals &#13;
were accompanied by a clinical photo. Having a photo attached was shown to significantly reduced the time taken for specialist &#13;
advice to be given.&#13;
Conclusions&#13;
We will be undertaking our 2nd cycle of data collection post-intervention, to review the effectiveness of our initial interventions. &#13;
The ability to attach clinical photos to a patient’s electronic referrals, has the scope to improve patient care, by acting as an &#13;
efficient triage tool for referrals, providing virtual advice where possible and highlighting the need for an urgent face-to face review &#13;
when required. Medxnote has potential to be utilised in the Acute setting to expedite advice, including discharge where appropriate and providing continuity between the MDT.</text>
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            <name>Creator</name>
            <description>An entity primarily responsible for making the resource</description>
            <elementTextContainer>
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                <text>Dr Emily Taylor, Dr Nikita Cliff-Patel</text>
              </elementText>
            </elementTextContainer>
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          <element elementId="48">
            <name>Source</name>
            <description>A related resource from which the described resource is derived</description>
            <elementTextContainer>
              <elementText elementTextId="128165">
                <text>Ibrahim, H. A. K. (Ed.). (2024). Abstract and Poster Presentations Book: 3rd Emergency Physician’s International Conference (EPIC24), 10 July 2024. From Zero to Hero Medical Education LTD</text>
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            <description>An entity responsible for making the resource available</description>
            <elementTextContainer>
              <elementText elementTextId="128166">
                <text>From Zero to Hero Medical Education LTD</text>
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            <name>Date</name>
            <description>A point or period of time associated with an event in the lifecycle of the resource</description>
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              <elementText elementTextId="128167">
                <text>10 July 2024. </text>
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            <elementTextContainer>
              <elementText elementTextId="128168">
                <text>Sri Wahyuni</text>
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