A point-prevalence survey of antimicrobial utilisation within New Brunswick hospitals to focus antimicrobial stewardship efforts and decrease low-value care.

Introduction: Il est important de minimiser le gaspillage et les risques associés aux soins sans valeur. La gestion de l’utilisation des antimicrobiens vise à optimiser leur emploi et doit être adaptée au milieu et à sa population. Objectifs: Évaluer les profiles d’utilisation actuels des antimicrobiens et fixer des objectifs pour les interventions en matière de gestion des antimicrobiens. Méthode: Vingt-et-un hôpitaux du Nouveau-Brunswick offrant des soins de courte durée en médecine générale, en chirurgie et en pédiatrie ont pris part à une enquête sur la prévalence ponctuelle. Tous les patients admis aux hôpitaux participants et ayant reçu au moins un antimicrobien systémique ont été inscrits à l’étude. Les principaux critères d’évaluation étaient le profil d’utilisation, selon l’indication et l’antimicrobien prescrit, le bienfondé de l’utilisation et la durée de la prophylaxie chirurgicale. Des statistiques descriptives et un test d’indépendance 2 furent utilisés pour l’analyse de données. Résultats: L’enquête a été menée de juin à août 2012. Un total de 2244 patients ont été admis pendant la durée de l’étude et 529 (23,6%) ont reçu un antimicrobien. Au total, 691 antimicrobiens ont été prescrits, soit 587 (85%) pour le traitement et 104 (15%) pour la prophylaxie. Les antimicrobiens les plus souvent prescrits pour le traitement (n=587) étaient des classes suivantes : quinolones (25,6%), pénicillines à spectre étendu (10,2%) et métronidazole (8,5%). Les indications les plus courantes du traitement étaient la pneumonie (30%), les infections gastro-intestinales (16%) et les infections de la peau et des tissus mous (14%). Selon des critères définis au préalable, 23% (n=134) des ordonnances pour le traitement étaient inappropriées et 20% (n=120) n’avaient aucune indication de documentée. Les domaines où les ordonnances étaient inappropriées étaient les suivants : défaut de passage de la voie intraveineuse à la voie orale (n=34, 6%), mauvaise dose (n=30, 5%), traitement d’une bactériurie asymptomatique (n=24, 4%) et doublement inutile (n=22, 4%). Dans 33% (n=27) des cas, les ordonnances pour la prophylaxie chirurgicale étaient pour une période de plus de 24 heures. Conclusions: Les résultats démontrent que les efforts de gestion des antimicrobiens doivent se concentrer sur les interventions conventionnelles de gestion de l’utilisation des antimicrobiens, l’amélioration de la documentation, l’optimisation de l’utilisation des quinolones et la réduction au minimum de la durée de la prophylaxie chirurgicale.

Six Mile Creek Presbyterian Church, Lancaster County, SC Records - Accession 194 - M86 (110)

The Six Mile Presbyterian Church, Lancaster County, SC Records consist of photocopies of a Six Mile Creek Presbyterian Church ledger, containing minutes of church meetings, registers of pastors, elders and deacons, minutes of the church session, registers of communicants, baptisms and deaths. Six Mile Presbyterian Church was started organized sometime around 1804. Included is a note stating the original ledger was rebound in 1971.

Banks Presbyterian Church History - Accession 195 - M87 (111)

The Banks Presbyterian Church History is a history written by Mrs. Lena P. Kell entitled “The Early History of Banks Presbyterian Church” describing the history of the church from 1870s to 1947. The church is located in Waxhaw, North Carolina near Fort Mill. (Photocopies)

Fishing Creek Presbyterian Church of Chester County Records

The Fishing Creek Presbyterian Church of Chester County Records include an historical statement (1839) on its origin and development by one of its pastors Rev. John B. Davies, and copies of entries for various sessions containing information on how the church handled misconduct of its members.

Grand Manan Island, New Brunswick, Passamaquoddy Bay, Maine and Saint Croix River, Nautical Chart, 1781 (Image 1 of 4) (Raster Image)

This layer is a georeferenced raster image of the untitled, historic nautical chart: [A chart of the Island of Grand Manan, Passamaquody Bay & River]. The map is [sheet 47] from the Atlantic Neptune atlas Vol. 3 : Charts of the coast and harbors of New England, from surveys taken by Samuel Holland and published by J.F.W. Des Barres, 1781. Scale [ca. 1:50,000]. This layer is image 1 of 4 total images of the four sheet source map, representing the northeast portion of the map. Covers coastline from Blacks Harbour to Haggertys Cove, New Brunswick, Canada and portion of Bay of Fundy. The image is georeferenced to the surface of the earth and fit to the 'World Mercator' (WGS 84) projected coordinate system. All map collar information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, or other information associated with the principal map. This map shows coastal features such as harbors, inlets, rocks, channels, points, coves, shoals, islands, and more. Includes also selected land features such as cities and towns, buildings. Depths shown by soundings. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection. The entire Atlantic Neptune atlas Vol. 3 : Charts of the coast and harbors of New England has been scanned and georeferenced as part of this selection.

Grand Manan Island, New Brunswick, Passamaquoddy Bay, Maine and Saint Croix River, Nautical Chart, 1781 (Image 2 of 4) (Raster Image)

This layer is a georeferenced raster image of the untitled, historic nautical chart: [A chart of the Island of Grand Manan, Passamaquody Bay & River]. The map is [sheet 48] from the Atlantic Neptune atlas Vol. 3 : Charts of the coast and harbors of New England, from surveys taken by Samuel Holland and published by J.F.W. Des Barres, 1781. Scale [ca. 1:50,000]. This layer is image 2 of 4 total images of the four sheet source map, representing the southeast portion of the map. Covers portin of the coastline of Grand Manan Island, New Brunswick, Canada and Bay of Fundy. The image is georeferenced to the surface of the earth and fit to the 'World Mercator' (WGS 84) projected coordinate system. All map collar information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, or other information associated with the principal map. This map shows coastal features such as harbors, inlets, rocks, channels, points, coves, shoals, islands, and more. Includes also selected land features such as cities and towns, buildings. Depths shown by soundings. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection. The entire Atlantic Neptune atlas Vol. 3 : Charts of the coast and harbors of New England has been scanned and georeferenced as part of this selection.

Grand Manan Island, New Brunswick, Passamaquoddy Bay, Maine and Saint Croix River, Nautical Chart, 1781 (Image 3 of 4) (Raster Image)

This layer is a georeferenced raster image of the untitled, historic nautical chart: [A chart of the Island of Grand Manan, Passamaquody Bay & River]. The map is [sheet 49] from the Atlantic Neptune atlas Vol. 3 : Charts of the coast and harbors of New England, from surveys taken by Samuel Holland and published by J.F.W. Des Barres, 1781. Scale [ca. 1:50,000]. This layer is image 3 of 4 total images of the four sheet source map, representing the southwest portion of the map. Covers portions of the coastline of Grand Manan Island, New Brunswick, Canada, coast of northern Maine, and Bay of Fundy. The image is georeferenced to the surface of the earth and fit to the 'World Mercator' (WGS 84) projected coordinate system. All map collar information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, or other information associated with the principal map. This map shows coastal features such as harbors, inlets, rocks, channels, points, coves, shoals, islands, and more. Includes also selected land features such as cities and towns, buildings. Depths shown by soundings. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection. The entire Atlantic Neptune atlas Vol. 3 : Charts of the coast and harbors of New England has been scanned and georeferenced as part of this selection.

Grand Manan Island, New Brunswick, Passamaquoddy Bay, Maine and Saint Croix River, Nautical Chart, 1781 (Image 4 of 4) (Raster Image)

This layer is a georeferenced raster image of the untitled, historic nautical chart: [A chart of the Island of Grand Manan, Passamaquody Bay & River]. The map is [sheet 50] from the Atlantic Neptune atlas Vol. 3 : Charts of the coast and harbors of New England, from surveys taken by Samuel Holland and published by J.F.W. Des Barres, 1781. Scale [ca. 1:50,000]. This layer is image 4 of 4 total images of the four sheet source map, representing the northeast portion of the map. Covers Cobscook Bay, Maine, Passamaquoddy Bay, and Saint Croix River, Maine and New Brunswick, Canada. The image is georeferenced to the surface of the earth and fit to the 'World Mercator' (WGS 84) projected coordinate system. All map collar information is also available as part of the raster image, including any inset maps, profiles, statistical tables, directories, text, illustrations, or other information associated with the principal map. This map shows coastal features such as harbors, inlets, rocks, channels, points, coves, shoals, islands, and more. Includes also selected land features such as cities and towns, buildings. Depths shown by soundings. This layer is part of a selection of digitally scanned and georeferenced historic maps from The Harvard Map Collection. The entire Atlantic Neptune atlas Vol. 3 : Charts of the coast and harbors of New England has been scanned and georeferenced as part of this selection.

Chattel exemptions from writs of execution in Alberta, British Columbia, Manitoba, New Brunswick, Newfoundland, Nova Scotia, Ontario, Prince Edward Island, Quebec, Saskatchewan and Yukon Territory,

Mode of access: Internet.

The ministry of reconciliation, its authority and responsibility : the primary charge delivered to the clergy of Indiana, delivered in St. Paul's Church, New Albany, at the opening of the Annual Diocesan Convention, on Thursday, May 11, 1854 /

Mode of access: Internet.

Choice recipes : contributed by the Women's Society of the Fairmount Presbyterian Church.

Includes household hints; sample menus; recipes for French, Swedish, German, Chinese, and Italian dishes; sample recipes: Frozen cheese salad, Chicken chow mein, Buster Brown cake.

Journal of the Legislative Council of the province of New Brunswick .

Each volume contains Appendix.

Annual report of the Board of Foreign Missions of the Presbyterian Church in the U.S.A.

Description based on: 77th (1913-1914)