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Davutoğlu says Armenian-Turkish relations may enter 'new era'
June 26, 2014 - 13:55 AMT
PanARMENIAN.Net - Foreign Minister Ahmet Davutoğlu has stated that Turkey believes Armenia and the Armenian diaspora will choose to take "bold steps like the one Prime Minister Recep Tayyip Erdoğan took in April", adding that if this happens the Turkish-Armenian relations will enter a "new era."
On the eve of the 99th anniversary of the Armenian Genocide, PM Erdoğan offered "condolences on behalf of the Turkish state to the grandchildren of Armenians who lost their lives in the context of the early 20th century."
In an article published in the spring edition of the Turkish Policy Quarterly journal, Davutoğlu said that Erdoğan's statement should be the "foundation for further steps."
"Erdoğan's message of condolence should not be seen as a conjunctural step. It should be seen as a prelude for transformation of minds and memories because this is not only an offer of condolence but also a sincere invitation to all parties to ensure a common future based on lasting peace," he said.
"A new and more grounded era of peace will reign between Turkey and Armenia if intellectuals and politicians do their part to overcome the psychological barriers on both sides and to build a 'just memory. Otherwise, both sides will inevitably be exploited by those who benefit from a sector that feeds off the status quo," he said.
"The 'unjust memory' created around the events of 1915 constitutes the most important example of this phenomenon as it mortgages the shared past and future of the Turks and Armenians," he added, urging "open and continuous dialogue between the two sides."
"The 'just memory' concept that we have frequently employed during this process is critically important. In order for Turks and Armenians to understand what each of them has experienced, it is essential that they respect one another's memory," Davutoğlu said.
The Armenian Genocide
The Armenian Genocide (1915-23) was the deliberate and systematic destruction of the Armenian population of the Ottoman Empire during and just after World War I. It was characterized by massacres, and deportations involving forced marches under conditions designed to lead to the death of the deportees, with the total number of deaths reaching 1.5 million.
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Seismic Protection Service said tremors were felt in Armenian towns of Stepanavan, Noyemberyan, Koghb and Koti.
The resolution urges Turkey and Armenia to "use the centenary of the Armenian Genocide to renew diplomatic relations."
The fish and the caviar will hit the markets in three and five years respectively, Golden Fish representatives said.
The OSCE Mission conducted planned monitoring of the line of contact between the NKR and Azerbaijani armed forces.
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Seeing What's Next: Using the Theories of Innovation to Predict Industry ChangeHardback
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- Publisher: Harvard Business Review Press
- Format: Hardback | 352 pages
- Dimensions: 155mm x 236mm x 36mm | 703g
- Publication date: 21 September 2004
- Publication City/Country: Boston, MA
- Sales rank: 218,946
Product description
Every day, individuals take action based on how they believe innovation will change industries. Yet these beliefs are largely based on guesswork and incomplete data and lead to costly errors in judgment. Now, internationally renowned innovation expert Clayton M. Christensen and his research partners Scott D. Anthony and Erik A. Roth present a groundbreaking framework for predicting outcomes in the evolution of any industry. Based on proven theories outlined in Christensen's landmark books The Innovator's Dilemma and The Innovator's Solution, Seeing What's Next offers a practical, three-part model that helps decision-makers spot the signals of industry change, determine the outcome of competitive battles, and assess whether a firm's actions will ensure or threaten future success. Through in-depth case studies of industries from aviation to health care, the authors illustrate the predictive power of innovation theory in action.
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Author information
Christensen is one of the brightest stars in business right now, and is recognized as one of the world's leading experts on innovation. He is the Robert and Jane Cizik Professor of Business Administration at Harvard Business School, with a joint appointment in Technology & Operations Management and General Management Scott D. Anthony is a Partner at Innosight LLC and Erik A. Roth is a consultant in McKinsey & Company's Boston office.
Table of contents
Section I: How to Use Theory to Analyze 1) Signals of Change; Where are the Opportunities? 2) Competitive Battles: How to Size Up Competitors 3) Firm Choices: Identifying What Choices Matter 4) Non-Market Factors Influence Innovation Section II: Theory-Based Analysis 5) Disruptive Diplomas - The Future of Education 6) Disruption Spreads Its Wings - The Future of Aviation 7) Whither Moore's Law? - The Future of Semiconductors 8) Healing the 800-Pound Gorilla - The Future of Health Care 9) Innovation Overseas - Using Theory to Assess Corporate and Country Strategies 10) Breaking the Wire - The Future of Telecommunications Conclusion: What's Next Appendix Glossary Index About the Authors

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Sunday, Aug. 02
Ma'an TV
Gaza Strip
Middle East
Latest News
Kerry pledges support for Egypt in Cairo talks
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Yemen PM returns to Aden from Saudi exile
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Iraqis vent rage at power shortages, 'corrupt' leaders
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Jerusalem faces largest surge in arrests since 2nd Intifada
Aug. 27, 2014 9:25 A.M. (Updated: April 28, 2015 8:35 P.M.)
By: Charlie Hoyle
BETHLEHEM (Ma'an) -- Palestinian communities in Jerusalem are experiencing the largest upsurge in detentions since the Second Intifada, with a marked increase in Israeli police brutality and the collective punishment of entire neighborhoods, local organizations say.
The mass detentions began following widespread demonstrations in the East Jerusalem neighborhood of Shufat after the murder of teenager Muhammad Abu Khdeir on July 2.
Since then, over 770 Palestinians have been detained in East Jerusalem, according to Addameer prisoner rights group.
The arrests in Jerusalem took place parallel to a wide-reaching detention campaign in the West Bank, which saw between 800-1,000 Palestinians detained following the kidnapping of three Israeli youths on June 12.
Although the majority have been released, police brutality, the bail conditions set for detainees and a system of closures on Palestinian areas have made life difficult for individuals and whole neighborhoods alike.
Around 70 Palestinians detained are still in police custody, with many transferred to detention cells in Lod after the Russian Compound in Jerusalem reached full capacity.
"It's collective punishment for all Jerusalem residents," Mahmoud Qaraeen from the Wadi Hilweh Information Center in Silwan told Ma'an.
"The clashes and demonstrations following the killing of (Muhammad) Abu Khdeir made the police angry, and they imposed collective punishment on all of East Jerusalem."
Israeli police have regularly closed off the neighborhoods of Issawiya and Silwan during the campaign, preventing residents from entering or exiting. Even workers from electricity and water companies have not been granted access, Qareen says.
Over 90 percent of the arrests happen during the night and the Wadi Hilweh Information Center reports that most of the time Israeli police officers do not know who they are coming to arrest. "They are not knocking," Qareen says, "they break the doors and enter."
"They break into the house and ask the mother or father: "Where are your children?" If they say they are sleeping, they ask their names, then choose which one to arrest."
Three weeks ago Israeli forces raided the Abbasi family house and couldn't decide which young family members to detain, so took all three to the police station, Qareen says.
Once detainees are released they can face heavy fines and Addameer says that the majority of detainees, mostly young men, face months of house arrest or are banned from certain areas of East Jerusalem, sometimes the areas in which they live.
Qareen says the campaign is deliberately intended to keep the Palestinian community "quiet."
"They want to make us live like we are in a hotel, just eating and sleeping and doing nothing else. If anyone stands up to the occupation, they make us a criminal."
Police brutality
The Association for Civil Rights in Israel has documented multiple cases of police brutality during the arrest campaign, and have called for an immediate review of the policy of officers wearing ski-masks during detentions.
In one arrest on July 11, masked police officers possessing no identification tags broke into the home of a 22-year-old resident of Issawiya at 3 a.m. and vandalized the house.
In another arrest on July 16, around 20 masked and armed policemen jumped over a fence and burst into a home in Shufat without identifying themselves. The Israeli officers handcuffed a 21-year-old man and covered his eyes with a cloth tied around his head.
ACRI also documented an incident in which the daughter of a Palestinian family opened the door to a masked officer in East Jerusalem, and was rifle-butted without provocation.
"Without faces and names, policemen are simply a group of unidentified, unknown gunmen barging into homes in the middle of the night – a practice characteristic of tyrannical regimes," ACRI Attorney Yusef Karram said.
There has also been an unprecedented increase in the use of "Skunk" water in the weeks following the murder of Abu Khdeir, which is rarely used in East Jerusalem, but commonplace in the West Bank.
Ronit Sela, East Jerusalem project director for ACRI, told Ma'an that Skunk water was used on the second floor of commercial and residential buildings in densely populated areas like Saladin and Zahra Street during times when there were no riots, leaving behind a foul-smelling stench for days.
The group also documented the use of sponge-coated bullets in Shufat, with one resident losing an eye after being hit during protests and three journalists shot in the head and face despite being clearly marked as press.
Perhaps the starkest incident involving masked police officers was the beating of US-Palestinian teenager Tariq Abu Khdeir, whose assault was captured on camera on July 5.
"The result is intimidation. It is intimidating to have police in your house anyway but more intimidating when it is done by masked people. Using masked police against civilians is a common practice in regimes that choose to intimidate their societies," Sela said.
Gavan Kelly, Addameer's international advocacy coordinator, says that along with the use of masked officers, a notable difference in the recent arrest campaign is the lack of official arrest warrants.
"We expect it to continue, it still ongoing. How long it will continue for will depend, there is a lag in between the waves of arrests. They draw up lists and interrogate them, it is a continuous process."
Kelly says that the mass arrests are a way of punishing the escalation in demonstrations and protests following the murder of Abu Khdeir, and also in relation to events in the occupied West Bank and the Israeli military offensive in Gaza.
Mass arrests are intended to have a "psychological impact not only on the individual, but also on the society as a whole," Kelly says.
"Israel thinks that they will be able to suppress resistance, but it has the opposite effect. It will encourage Palestinians to continue protesting."
Israeli court sentences 2 Palestinian teens to 4 months in jail
Israeli wardens assault PFLP leader in ongoing prison crackdown
Israeli forces detain Palestinian in Hebron
Palestinian prisoner held in solitary confinement for over 4 years
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Israeli forces shoot, kill Palestinian teen near Ramallah
July 31, 2015 | 10
Israeli forces kill Palestinian teen during arrest raid
July 27, 2015 | 7
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The Copyright Modernization Act received Royal Assent and became law on June 29, 2012
Christelle Gedeon: Gone are the days of mad scientists working secretly in the silos of their underground laboratories. Licensing is a mechanism by which inventors can leverage economic value from unused inventions. WIPO has come to the rescue with a website that can connect inventors with licence partners.
Within three months of the launch of the Internet 'pornography' domain '.xxx,' 10 cases have been launched against Web pirates registering sites on it using the names of reputable companies and people, insiders said on Monday
The federal government is — once again — one step closer to bringing in long-awaited changes to copyright legislation with a view to bringing it in line with the realities of the digital age. But controversy has swirled over the so-called "digital locks" provisions in the bill
An agreement between Nokia and Apple to settle all patent litigation between the companies may mark the beginning of a more aggressive shift into intellectual property rights (IPR) for both companies
Canada's pending and long-overdue new copyright legislation has some flaws that legislators must address, lawyers says. The Canadian Bar Association has even submitted a formal opposition to several of the sections in Bill C-32 on behalf of its 37,000-strong membership of lawyers, law professors and law students. The CBA points out that many of the […]
Other stores offer better deals on items like DVDs, diapers and designer clothing than Costco, but you can't beat the famously cheap hot dog and pop at its food court
CMHC, which controls a majority of the mortgage default insurance market, says that homeowners will be able to count all the income from rental units when qualifying for a loan
All those frequent-flyer points can pile up, especially now that airlines are making it harder than ever to redeem them for flights. Why not spend them on something really useful?
Post Arcade's junior reviewer gets a sneak peek at Disney Infinity 3.0 and its new toys…and informs her dad that he's buying all of them
The TSX has been weighed down the past year by commodities. But now it faces a new threat: foreign investors piling in to bet against Canada


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Star Tracks
Wilkinson spends quality time with hubby Hank Baskett and their 7-month-old in San Diego. Plus: Sandra & Louis, Nicole Richie, Jessica & Eric and more
Credit: Fame Pictures
Published: Monday Jul 12, 2010 | 05:00 PM EDT
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Tennessee Department of Economic and Community Development Commissioner Bill Hagerty announced that the communities of Clifton, Greenfield, Portland, Tracy City, Waynesboro and White Bluff have been selected to participate in the Tennessee Downtowns program. In its third round of participants, Tennessee Downtowns is a competitive community improvement program for cities and counties seeking to revitalize traditional commercial districts.
"Congratulations to each of the six communities selected to participate in this round of Tennessee Downtowns," Mr. Hagerty said. "A thriving commercial district can be an excellent driver of economic growth in our rural communities, and we are pleased to recognize those that are committed to reviving the downtown business area in their locale."
Tennessee Downtowns is a tiered program affiliated with the Tennessee Department of Economic and Community Development's Tennessee Main Street Program. Communities selected to participate in Tennessee Downtowns will form a volunteer committee of local citizens who will participate in a multi-month training curriculum supported by the National Main Street Center. The curriculum is designed to teach citizens about comprehensive, sustainable downtown revitalization and historic preservation. The training includes webinars, workshops and a $15,000 reimbursable grant to complete individualized downtown development projects.
The six selected communities are each home to downtown commercial districts established at least 50 years ago and have demonstrated their readiness to organize efforts for downtown revitalization based on the successful "Main Street Four-Point Approach to Downtown Revitalizationtm." The highly competitive selection process was based on five core criteria: historic resources, need (economic and physical), demonstrated local effort, overall presentation and probability of success.
July 30, 2015
Senator Lamar Alexander voted Thursday in committee for the bipartisan "Energy Policy Modernization Act of 2015," which passed the Senate Energy & Natural Resources Committee by a vote of ... (click for more)
Chief Justice Sharon G. Lee said the Tennessee Supreme Court will continue to serve at the same level of operation while the executive and legislative branches work out the details of appointing ... (click for more)
MON/ 8.3- Entrepreneur Bookkeeping 12:00 p.m. to 1:00 p.m. TN Small Business Development Center, 100 Cherokee Blvd, First Floor, 37405 Speakers: Lynn Talbott, PHR, HR Business Solutions, ... (click for more)
Senator Lamar Alexander voted Thursday in committee for the bipartisan "Energy Policy Modernization Act of 2015," which passed the Senate Energy & Natural Resources Committee by a vote of 18 to 4. The bill includes a number of proposals offered by Alexander. Sen. Alexander said: "I commend Chairman Murkowski's leadership of the Energy committee in crafting a bipartisan ... (click for more)
Chief Justice Sharon G. Lee said the Tennessee Supreme Court will continue to serve at the same level of operation while the executive and legislative branches work out the details of appointing and confirming a replacement for retiring Justice Gary R. Wade. "There have been many occasions with vacancies on this Court before – including in the last decade," Chief Justice ... (click for more)
Several sections of Chattanooga freeways will be completely closed Thursday night and early Friday for median repairs. TDOT Operations crews will be performing an emergency repair of a damaged median barrier wall on I-24 East at mile marker 178 on Thursday from 8 p.m. to Friday at 6 a.m. I-24 East will be completely closed at the high bridge at mile marker 178 beginning at ... (click for more)
A young man who was involved in an incident that led to a murder has been given diversion and praised for testifying against co-defendants. Criminal Court Judge Barry Steelman said a conviction for facilitation of an aggravated robbery can be expunged if Dustin Hayes gets in no further trouble for six years. The judge said, "We wouldn't be dealing with 40 shootings a year ... (click for more)
In this week's news cycle we have the international uproar over the killing of Cecil the lion. In the same time most national news outlet refuse to even mention the undercover videos of so call doctors and technicians discussing the harvesting, processing and sale of human baby body parts. The argument by those liberal, progressive Democrats has been that the "fetus" was ... (click for more)
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Are you Raimos Olomi?Claim your profile
Publications (26)189.4 Total impact
- SourceAvailable from: Bonnie Cundill
Article: Prescriber and patient-oriented behavioural interventions to improve use of malaria rapid diagnostic tests in Tanzania: facility-based cluster randomised trial[Show abstract] [Hide abstract]
ABSTRACT: The increasing investment in malaria rapid diagnostic tests (RDTs) to differentiate malarial and non-malarial fevers, and an awareness of the need to improve case management of non-malarial fever, indicates an urgent need for high quality evidence on how best to improve prescribers' practices. A three-arm stratified cluster-randomised trial was conducted in 36 primary healthcare facilities from September 2010 to March 2012 within two rural districts in northeast Tanzania where malaria transmission has been declining. Interventions were guided by formative mixed-methods research and were introduced in phases. Prescribing staff from all facilities received standard Ministry of Health RDT training. Prescribers from facilities in the health worker (HW) and health worker-patient (HWP) arms further participated in small interactive peer-group training sessions with the HWP additionally receiving clinic posters and patient leaflets. Performance feedback and motivational mobile-phone text messaging (SMS) were added to the HW and HWP arms in later phases. The primary outcome was the proportion of patients with a non-severe, non-malarial illness incorrectly prescribed a (recommended) antimalarial. Secondary outcomes investigated RDT uptake, adherence to results, and antibiotic prescribing. Standard RDT training reduced pre-trial levels of antimalarial prescribing, which was sustained throughout the trial. Both interventions significantly lowered incorrect prescribing of recommended antimalarials from 8% (749/8,942) in the standard training arm to 2% (250/10,118) in the HW arm (adjusted RD (aRD) 4%; 95% confidence interval (CI) 1% to 6%; P = 0.008) and 2% (184/10,163) in the HWP arm (aRD 4%; 95% CI 1% to 6%; P = 0.005). Small group training and SMS were incrementally effective. There was also a significant reduction in the prescribing of antimalarials to RDT-negatives but no effect on RDT-positives receiving an ACT. Antibiotic prescribing was significantly lower in the HWP arm but had increased in all arms compared with pre-trial levels. Small group training with SMS was associated with an incremental and sustained improvement in prescriber adherence to RDT results and reducing over-prescribing of antimalarials to close to zero. These interventions may become increasingly important to cope with the wider range of diagnostic and treatment options for patients with acute febrile illness in Africa. ClinicalTrials.gov (# NCT01292707 ) 29 January 2011.BMC Medicine 05/2015; 13(1):118. DOI:10.1186/s12916-015-0346-z · 7.28 Impact Factor
Article: Effi cacy and safety of RTS,S/AS01 malaria vaccine with or without a booster dose in infants and children in Africa: fi nal results of a phase 3, individually randomised, controlled trial[Show abstract] [Hide abstract]
ABSTRACT: Summary Background The effi cacy and safety of the RTS,S/AS01 candidate malaria vaccine during 18 months of follow-up have been published previously. Herein, we report the fi nal results from the same trial, including the effi cacy of a booster dose. Methods From March 27, 2009, until Jan 31, 2011, children (age 5–17 months) and young infants (age 6–12 weeks) were enrolled at 11 centres in seven countries in sub-Saharan Africa. Participants were randomly assigned (1:1:1) at fi rst vaccination by block randomisation with minimisation by centre to receive three doses of RTS,S/AS01 at months 0, 1, and 2 and a booster dose at month 20 (R3R group); three doses of RTS,S/AS01 and a dose of comparator vaccine at month 20 (R3C group); or a comparator vaccine at months 0, 1, 2, and 20 (C3C [control group]). Participants were followed up until Jan 31, 2014. Cases of clinical and severe malaria were captured through passive case detection. Serious adverse events (SAEs) were recorded. Analyses were by modifi ed intention to treat and per protocol. The coprimary endpoints were the occurrence of malaria over 12 months after dose 3 in each age category. In this fi nal analysis, we present data for the effi cacy of the booster on the occurrence of malaria. Vaccine effi cacy (VE) against clinical malaria was analysed by negative binomial regression and against severe malaria by relative risk reduction. This trial is registered with ClinicalTrials.gov, number NCT00866619. Findings 8922 children and 6537 young infants were included in the modifi ed intention-to-treat analyses. Children were followed up for a median of 48 months (IQR 39–50) and young infants for 38 months (34–41) after dose 1. From month 0 until study end, compared with 9585 episodes of clinical malaria that met the primary case defi nition in children in the C3C group, 6616 episodes occurred in the R3R group (VE 36·3%, 95% CI 31·8–40·5) and 7396 occurred in the R3C group (28·3%, 23·3–32·9); compared with 171 children who experienced at least one episode of severe malaria in the C3C group, 116 children experienced at least one episode of severe malaria in the R3R group (32·2%, 13·7 to 46·9) and 169 in the R3C group (1·1%, –23·0 to 20·5). In young infants, compared with 6170 episodes of clinical malaria that met the primary case defi nition in the C3C group, 4993 episodes occurred in the R3R group (VE 25·9%, 95% CI 19·9–31·5) and 5444 occurred in the R3C group (18·3%, 11·7–24·4); and compared with 116 infants who experienced at least one episode of severe malaria in the C3C group, 96 infants experienced at least one episode of severe malaria in the R3R group (17·3%, 95% CI –9·4 to 37·5) and 104 in the R3C group (10·3%, –17·9 to 31·8). In children, 1774 cases of clinical malaria were averted per 1000 children (95% CI 1387–2186) in the R3R group and 1363 per 1000 children (995–1797) in the R3C group. The numbers of cases averted per 1000 young infants were 983 (95% CI 592–1337) in the R3R group and 558 (158–926) in the R3C group. The frequency of SAEs overall was balanced between groups. However, meningitis was reported as a SAE in 22 children: 11 in the R3R group, ten in the R3C group, and one in the C3C group. The incidence of generalised convulsive seizures within 7 days of RTS,S/AS01 booster was 2·2 per 1000 doses in young infants and 2·5 per 1000 doses in children. Interpretation RTS,S/AS01 prevented a substantial number of cases of clinical malaria over a 3–4 year period in young infants and children when administered with or without a booster dose. Effi cacy was enhanced by the administration of a booster dose in both age categories. Thus, the vaccine has the potential to make a substantial contribution to malaria control when used in combination with other eff ective control measures, especially in areas of high transmission.The Lancet 04/2015; 385:1581. · 45.22 Impact Factor
Article: Effect of context on respiratory rate measurement in identifying non-severe pneumonia in African children[Show abstract] [Hide abstract]
ABSTRACT: Objective Cough or difficult breathing and an increased respiratory rate for their age are the commonest indication for outpatient antibiotic treatment in African children. We aimed to determine if respiratory rate was likely to be transiently raised by a number of contextual factors in a busy clinic leading to inaccurate diagnosis.Methods Respiratory rates were recorded in children aged 2-59 months presenting with cough or difficulty breathing to one of the two busy outpatient clinics and then repeated at 10-minute intervals over 1 hour in a quiet setting.Results167 children were enrolled with a mean age of 7.1 (SD±2.9) months in infants and 27.6 (SD±12.8) months in children aged 12-59 months. The mean respiratory rate declined from 42.3 and 33.6 breaths per minute (bpm) in the clinic to 39.1 and 32.6 bpm after 10 minutes in a quiet room and to 39.2 and 30.7bpm (p<0.001) after 60 minutes in younger and older children respectively. This resulted in 11/13 (85%) infants and 2/15 (13%) older children being misclassified with non-severe pneumonia. In a random effects linear regression model the variability in respiratory rate within-children (42%) was almost as much as the variability between children (58%). Changing the respiratory rates cut-offs to higher thresholds resulted in a small reduction in the proportion of non-severe pneumonia mis-classifications in infants.Conclusion Noise and other contextual factors may cause a transient increase in respiratory rate and consequently misclassification of non-severe pneumonia. However, this effect is less pronounced in older children than infants. Respiratory rate is a difficult sign to measure as the variation is large between and within children. More studies of the accuracy and utility of respiratory rate as a proxy for non-severe pneumonia diagnosis in a busy clinic are needed.This article is protected by copyright. All rights reserved.Tropical Medicine & International Health 02/2015; 20(6). DOI:10.1111/tmi.12492 · 2.30 Impact Factor
Article: African Glucose-6-Phosphate Dehydrogenase Alleles Associated with Protection from Severe Malaria in Heterozygous Females in Tanzania[Show abstract] [Hide abstract]
ABSTRACT: Author Summary Glucose-6-phosphate dehydrogenase (G6PD) is an essential enzyme that protects red blood cells from oxidative damage. Numerous genetic variants of G6PD, residing in the X chromosome, are found among African populations: mutations causing A- deficiency can lead to serious clinical outcomes (including hemolytic anemia) but also confer protection against severe malaria. Epidemiological studies have used some of the genetic markers that cause A- deficiency to establish who is protected from severe malaria, with differing results. Whether females, with one or two copies of mutant genes, males with one copy, or both genders are protected is uncertain. This uncertainty is due to G6PD and malaria phenotypic complexity and misclassification, and to genetic differences between populations and the limited numbers of genetic markers (usually 2) considered. In this study we analysed more than 30 G6PD genetic markers in 506 Tanzanian children with severe malaria and 477 without malaria. We found that only females with one normal and one mutant copy of the gene (heterozygotes) were protected from severe malaria. Further, we established that the G6PD gene is under evolutionary pressure with the likely mechanism being selection by malaria. Our work demonstrates that studies of severe malaria and G6PD enzymatic function across African populations require, in addition to complete and accurate G6PD phenotypic classification, the identification and analysis of the full repertoire of G6PD genetic markers.PLoS Genetics 02/2015; 11(2):e1004960. DOI:10.1371/journal.pgen.1004960 · 8.17 Impact Factor
Article: USP38, FREM3, SDC1, DDC, and LOC727982 Gene Polymorphisms and Differential Susceptibility to Severe Malaria in TanzaniaThe Journal of Infectious Diseases 01/2015; DOI:10.1093/infdis/jiv192 · 5.78 Impact Factor
Dataset: Perinat
Article: Causes of perinatal death at a tertiary care hospital in Northern Tanzania 2000–2010: a registry based study[Show abstract] [Hide abstract]
ABSTRACT: Background Perinatal mortality reflects maternal health as well as antenatal, intrapartum and newborn care, and is an important health indicator. This study aimed at classifying causes of perinatal death in order to identify categories of potentially preventable deaths. Methods We studied a total of 1958 stillbirths and early neonatal deaths above 500 g between July 2000 and October 2010 registered in the Medical Birth Registry and neonatal registry at Kilimanjaro Christian Medical Centre (KCMC) in Northern Tanzania. The deaths were classified according to the Neonatal and Intrauterine deaths Classification according to Etiology (NICE). Results Overall perinatal mortality was 57.7/1000 (1958 out of 33 929), of which 1219 (35.9/1000) were stillbirths and 739 (21.8/1000) were early neonatal deaths. Major causes of perinatal mortality were unexplained asphyxia (n=425, 12.5/1000), obstetric complications (n=303, 8.9/1000), maternal disease (n=287, 8.5/1000), unexplained antepartum stillbirths after 37 weeks of gestation (n= 219, 6.5/1000), and unexplained antepartum stillbirths before 37 weeks of gestation (n=184, 5.4/1000). Obstructed/prolonged labour was the leading condition (251/303, 82.8%) among the obstetric complications. Preeclampsia/eclampsia was the leading cause (253/287, 88.2%) among the maternal conditions. When we excluded women who were referred for delivery at KCMC due to medical reasons (19.1% of all births and 36.0% of all deaths), perinatal mortality was reduced to 45.6/1000. This reduction was mainly due to fewer deaths from obstetric complications (from 8.9 to 2.1/1000) and maternal conditions (from 8.5 to 5.5/1000). Conclusion The distribution of causes of death in this population suggests a great potential for prevention. Early identification of mothers at risk of pregnancy complications through antenatal care screening, teaching pregnant women to recognize signs of pregnancy complications, timely access to obstetric care, monitoring of labour for fetal distress, and proper newborn resuscitation may reduce some of the categories of deaths.BMC Pregnancy and Childbirth 12/2012; 12(1):139. DOI:10.1186/1471-2393-12-139 · 2.15 Impact Factor
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ABSTRACT: Human genetic background strongly influences susceptibility to malaria infection and progression to severe disease and death. Classical genetic studies identified haemoglobinopathies and erythrocyte-associated polymorphisms, as protective against severe disease. High throughput genotyping by mass spectrometry allows multiple single nucleotide polymorphisms (SNPs) to be examined simultaneously. We compared the prevalence of 65 human SNP's, previously associated with altered risk of malaria, between Tanzanian children with and without severe malaria. Five hundred children, aged 1-10 years, with severe malaria were recruited from those admitted to hospital in Muheza, Tanzania and compared with matched controls. Genotyping was performed by Sequenom MassArray, and conventional PCR was used to detect deletions in the alpha-thalassaemia gene. SNPs in two X-linked genes were associated with altered risk of severe malaria in females but not in males: heterozygosity for one or other of two SNPs in the G6PD gene was associated with protection from all forms of severe disease whilst two SNPs in the gene encoding CD40L were associated with respiratory distress. A SNP in the adenyl cyclase 9 (ADCY9) gene was associated with protection from acidosis whilst a polymorphism in the IL-1α gene (IL1A) was associated with an increased risk of acidosis. SNPs in the genes encoding IL-13 and reticulon-3 (RTN3) were associated with increased risk of cerebral malaria. This study confirms previously known genetic associations with protection from severe malaria (HbS, G6PD). It identifies two X-linked genes associated with altered risk of severe malaria in females, identifies mutations in ADCY9, IL1A and CD40L as being associated with altered risk of severe respiratory distress and acidosis, both of which are characterised by high serum lactate levels, and also identifies novel genetic associations with severe malaria (TRIM5) and cerebral malaria(IL-13 and RTN3). Further studies are required to test the generality of these associations and to understand their functional consequences.PLoS ONE 10/2012; 7(10):e47463. DOI:10.1371/journal.pone.0047463 · 3.53 Impact Factor
Article: Cause-specific neonatal mortality in a neonatal care unit in Northern Tanzania: a registry based cohort study[Show abstract] [Hide abstract]
ABSTRACT: The current decline in under-five mortality shows an increase in share of neonatal deaths. In order to address neonatal mortality and possibly identify areas of prevention and intervention, we studied causes of admission and cause-specific neonatal mortality in a neonatal care unit at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania. A total of 5033 inborn neonates admitted to a neonatal care unit (NCU) from 2000 to 2010 registered at the KCMC Medical Birth Registry and neonatal registry were studied. Clinical diagnosis, gestational age, birth weight, Apgar score and date at admission and discharge were registered. Cause-specific of neonatal deaths were classified by modified Wigglesworth classification. Statistical analysis was performed in SPSS 18.0. Leading causes of admission were birth asphyxia (26.8%), prematurity (18.4%), risk of infection (16.9%), neonatal infection (15.4%), and birth weight above 4000 g (10.7%). Overall mortality was 10.7% (536 deaths). Leading single causes of death were birth asphyxia (n = 245, 45.7%), prematurity (n = 188, 35.1%), congenital malformations (n = 49, 9.1%), and infections (n = 46, 8.6%). Babies with birth weight below 2500 g constituted 29% of all admissions and 52.1% of all deaths. Except for congenital malformations, case fatality declined with increasing birth weight. Birth asphyxia was the most frequent cause of death in normal birth weight babies (n = 179/246, 73.1%) and prematurity in low birth weight babies (n = 178/188, 94.7%). The majority of deaths (n = 304, 56.7%) occurred within 24 hours, and 490 (91.4%) within the first week. Birth asphyxia in normal birth weight babies and prematurity in low birth weight babies each accounted for one third of all deaths in this population. The high number of deaths attributable to birth asphyxia in normal birth weight babies suggests further studies to identify causal mechanisms. Strategies directed towards making obstetric and newborn care timely available with proper antenatal, maternal and newborn care support with regular training on resuscitation skills would improve child survival.BMC Pediatrics 08/2012; 12:116. DOI:10.1186/1471-2431-12-116 · 1.92 Impact Factor
Article: Association of sub-microscopic malaria parasite carriage with transmission intensity in north-eastern Tanzania[Show abstract] [Hide abstract]
ABSTRACT: In malaria endemic areas, individuals are frequently asymptomatic and may be undetected by conventional microscopy or newer, rapid diagnostic tests. Molecular techniques allow a more accurate assessment of this asymptomatic parasite burden, the extent of which is important for malaria control. This study examines the relative prevalence of sub-microscopic level parasite carriage and clonal complexity of infections (multiplicity of infection) over a range of endemicities in a region of north-eastern Tanzania where altitude is an established proxy of malaria transmission. The PCR prevalence was then compared against other measures of transmission intensity collected in the same area. This study used 1,121 blood samples collected from a previously conducted cross-sectional malario-metric survey during the short rainy season in 2001 from 13 villages (three at < 600 m, four at 600-1,200 m and six at > 1,200 m in altitude above sea level). Samples were analysed by PCR for carriage of parasites and multiplicity of infection. These data were compared with other measures of transmission intensity collected from the same area. Parasite prevalence was 34.7% by PCR and 13.6% by microscopy; a 2.5-fold difference in line with other recent observations. This fold difference was relatively consistent at the different altitude bands despite a marked decrease in parasite prevalence with altitude: < 600 m 70.9 vs 28.6, 600-1,200 m 35.5 vs 9.9, > 1,200 m 15.8 vs 5.9. The difference between parasite prevalence by PCR was 3.2 in individuals aged between 15 and 45 years (34.5 vs 10.9) compared with 2.5 in those aged 1-5 (34.0 vs 13.5) though this was not statistically significant. Multiplicity of infection (MOI) ranged from 1.2 to 3.7 and was positively associated with parasite prevalence assessed by both PCR and microscopy. There was no association of MOI and age.Village level PCR parasite prevalence was strongly correlated with altitude, sero-conversion rate and predicted entomological inoculation rate. Asymptomatic, low density, multi-clone malaria infection was common in this study area. These infections are important as potential contributors to the infectious reservoir of parasites and need to be identified by control programmes especially in this era where malaria elimination is a focus. High throughput standardized PCR approaches are needed to identify individuals who are malaria carriers.Malaria Journal 12/2011; 10:370. DOI:10.1186/1475-2875-10-370 · 3.49 Impact Factor
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ABSTRACT: Reduction in neonatal mortality has been slower than anticipated in many low income countries including Tanzania. Adequate neonatal care may contribute to reduced mortality. We studied factors associated with transfer of babies to a neonatal care unit (NCU) in data from a birth registry at Kilimanjaro Christian Medical Centre (KCMC) in Tanzania. A total of 21 206 singleton live births registered from 2000 to 2008 were included. Multivariable analysis was carried out to study neonatal transfer to NCU by socio-demographic factors, pregnancy complications and measures of the condition of the newborn. A total of 3190 (15%) newborn singletons were transferred to the NCU. As expected, neonatal transfer was strongly associated with specific conditions of the baby including birth weight above 4000 g (relative risk (RR) = 7.2; 95% confidence interval (CI) 6.5-8.0) or below 1500 g (RR = 3.0; 95% CI: 2.3-4.0), five minutes Apgar score less than 7 (RR = 4.0; 95% CI: 3.4-4.6), and preterm birth before 34 weeks of gestation (RR = 1.8; 95% CI: 1.5-2.1). However, pregnancy- and delivery-related conditions like premature rupture of membrane (RR = 2.3; 95% CI: 1.9-2.7), preeclampsia (RR = 1.3; 95% CI: 1.1-1.5), other vaginal delivery (RR = 2.2; 95% CI: 1.7-2.9) and caesarean section (RR = 1.9; 95% CI: 1.8-2.1) were also significantly associated with transfer. Birth to a first born child was associated with increased likelihood of transfer (relative risk (RR) 1.4; 95% CI: 1.2-1.5), while the likelihood was reduced (RR = 0.5; 95% CI: 0.3-0.9) when the father had no education. In addition to strong associations between neonatal transfer and classical neonatal risk factors for morbidity and mortality, some pregnancy-related and demographic factors were predictors of neonatal transfer. Overall, transfer was more likely for babies with signs of poor health status or a complicated pregnancy. Except for a possibly reduced use of transfer for babies of non-educated fathers and a high transfer rate for first born babies, there were no signs that transfer was based on non-medical indications.BMC Pregnancy and Childbirth 10/2011; 11:68. DOI:10.1186/1471-2393-11-68 · 2.15 Impact Factor
Article: Safety of the malaria vaccine candidate, RTS,S/AS01E in 5 to 17 month old Kenyan and Tanzanian Children.[Show abstract] [Hide abstract]
ABSTRACT: The malaria vaccine candidate, RTS,S/AS01(E), showed promising protective efficacy in a trial of Kenyan and Tanzanian children aged 5 to 17 months. Here we report on the vaccine's safety and tolerability. The experimental design was a Phase 2b, two-centre, double-blind (observer- and participant-blind), randomised (1∶1 ratio) controlled trial. Three doses of study or control (rabies) vaccines were administered intramuscularly at 1 month intervals. Solicited adverse events (AEs) were collected for 7 days after each vaccination. There was surveillance and reporting for unsolicited adverse events for 30 days after each vaccination. Serious adverse events (SAEs) were recorded throughout the study period which lasted for 14 months after dose 1 in Korogwe, Tanzania and an average of 18 months post-dose 1 in Kilifi, Kenya. Blood samples for safety monitoring of haematological, renal and hepatic functions were taken at baseline, 3, 10 and 14 months after dose 1. A total of 894 children received RTS,S/AS01(E) or rabies vaccine between March and August 2007. Overall, children vaccinated with RTS,S/AS01(E) had fewer SAEs (51/447) than children in the control group (88/447). One SAE episode in a RTS,S/AS01(E) recipient and nine episodes among eight rabies vaccine recipients met the criteria for severe malaria. Unsolicited AEs were reported in 78% of subjects in the RTS,S/AS01(E) group and 74% of subjects in the rabies vaccine group. In both vaccine groups, gastroenteritis and pneumonia were the most frequently reported unsolicited AE. Fever was the most frequently observed solicited AE and was recorded after 11% of RTS,S/AS01(E) doses compared to 31% of doses of rabies vaccine. The candidate vaccine RTS,S/AS01(E) showed an acceptable safety profile in children living in a malaria-endemic area in East Africa. More data on the safety of RTS,S/AS01(E) will become available from the Phase 3 programme.PLoS ONE 12/2010; 5(11):e14090. DOI:10.1371/journal.pone.0014090 · 3.53 Impact Factor
Article: Effect of nutrient deficiencies on in vitro Th1 and Th2 cytokine response of peripheral blood mononuclear cells to Plasmodium falciparum infection[Show abstract] [Hide abstract]
ABSTRACT: An appropriate balance between pro-inflammatory and anti-inflammatory cytokines that mediate innate and adaptive immune responses is required for effective protection against human malaria and to avoid immunopathology. In malaria endemic countries, this immunological balance may be influenced by micronutrient deficiencies. Peripheral blood mononuclear cells from Tanzanian preschool children were stimulated in vitro with Plasmodium falciparum-parasitized red blood cells to determine T-cell responses to malaria under different conditions of nutrient deficiencies and malaria status. The data obtained indicate that zinc deficiency is associated with an increase in TNF response by 37%; 95% CI: 14% to 118% and IFN-gamma response by 74%; 95% CI: 24% to 297%. Magnesium deficiency, on the other hand, was associated with an increase in production of IL-13 by 80%; 95% CI: 31% to 371% and a reduction in IFN-gamma production. These results reflect a shift in cytokine profile to a more type I cytokine profile and cell-cell mediated responses in zinc deficiency and a type II response in magnesium deficiency. The data also reveal a non-specific decrease in cytokine production in children due to iron deficiency anaemia that is largely associated with malaria infection status. The pathological sequels of malaria potentially depend more on the balance between type I and type II cytokine responses than on absolute suppression of these cytokines and this balance may be influenced by a combination of micronutrient deficiencies and malaria status.Malaria Journal 06/2010; 9(Suppl 2):162. DOI:10.1186/1475-2875-9-162 · 3.49 Impact Factor
Article: Alterations in early cytokine-mediated immune responses to Plasmodium falciparum infection in Tanzanian children with mineral element deficiencies: a cross-sectional survey[Show abstract] [Hide abstract]
ABSTRACT: Deficiencies in vitamins and mineral elements are important causes of morbidity in developing countries, possibly because they lead to defective immune responses to infection. The aim of the study was to assess the effects of mineral element deficiencies on early innate cytokine responses to Plasmodium falciparum malaria. Peripheral blood mononuclear cells from 304 Tanzanian children aged 6-72 months were stimulated with P. falciparum-parasitized erythrocytes obtained from in vitro cultures. The results showed a significant increase by 74% in geometric mean of TNF production in malaria-infected individuals with zinc deficiency (11% to 240%; 95% CI). Iron deficiency anaemia was associated with increased TNF production in infected individuals and overall with increased IL-10 production, while magnesium deficiency induced increased production of IL-10 by 46% (13% to 144%) in uninfected donors. All donors showed a response towards IL-1beta production, drawing special attention for its possible protective role in early innate immune responses to malaria. In view of these results, the findings show plasticity in cytokine profiles of mononuclear cells reacting to malaria infection under conditions of different micronutrient deficiencies. These findings lay the foundations for future inclusion of a combination of precisely selected set of micronutrients rather than single nutrients as part of malaria vaccine intervention programmes in endemic countries.Malaria Journal 05/2010; 9:130. DOI:10.1186/1475-2875-9-130 · 3.49 Impact Factor
Article: WHO guidelines for antimicrobial treatment in children admitted to hospital in an area of intense Plasmodium falciparum transmission: prospective study[Show abstract] [Hide abstract]
ABSTRACT: To assess the performance of WHO's "Guidelines for care at the first-referral level in developing countries" in an area of intense malaria transmission and identify bacterial infections in children with and without malaria. Prospective study. District hospital in Muheza, northeast Tanzania. Children aged 2 months to 13 years admitted to hospital for febrile illness. Sensitivity and specificity of WHO guidelines in diagnosing invasive bacterial disease; susceptibility of isolated organisms to recommended antimicrobials. Over one year, 3639 children were enrolled and 184 (5.1%) died; 2195 (60.3%) were blood slide positive for Plasmodium falciparum, 341 (9.4%) had invasive bacterial disease, and 142 (3.9%) were seropositive for HIV. The prevalence of invasive bacterial disease was lower in slide positive children (100/2195, 4.6%) than in slide negative children (241/1444, 16.7%). Non-typhi Salmonella was the most frequently isolated organism (52/100 (52%) of organisms in slide positive children and 108/241 (45%) in slide negative children). Mortality among children with invasive bacterial disease was significantly higher (58/341, 17%) than in children without invasive bacterial disease (126/3298, 3.8%) (P<0.001), and this was true regardless of the presence of P falciparum parasitaemia. The sensitivity and specificity of WHO criteria in identifying invasive bacterial disease in slide positive children were 60.0% (95% confidence interval 58.0% to 62.1%) and 53.5% (51.4% to 55.6%), compared with 70.5% (68.2% to 72.9%) and 48.1% (45.6% to 50.7%) in slide negative children. In children with WHO criteria for invasive bacterial disease, only 99/211(47%) of isolated organisms were susceptible to the first recommended antimicrobial agent. In an area exposed to high transmission of malaria, current WHO guidelines failed to identify almost a third of children with invasive bacterial disease, and more than half of the organisms isolated were not susceptible to currently recommended antimicrobials. Improved diagnosis and treatment of invasive bacterial disease are needed to reduce childhood mortality.BMJ (online) 03/2010; 340:c1350. DOI:10.1136/bmj.c1350 · 16.38 Impact Factor
Article: Effect of nutrient deficiencies on in vitro T<sub>h</sub>1 and T<sub>h</sub>2 cytokine response of peripheral blood mononuclear cells to Plasmodium falciparum infection[Show abstract] [Hide abstract]
ABSTRACT: Abstract Background An appropriate balance between pro-inflammatory and anti-inflammatory cytokines that mediate innate and adaptive immune responses is required for effective protection against human malaria and to avoid immunopathology. In malaria endemic countries, this immunological balance may be influenced by micronutrient deficiencies. Methods Peripheral blood mononuclear cells from Tanzanian preschool children were stimulated in vitro with Plasmodium falciparum -parasitized red blood cells to determine T-cell responses to malaria under different conditions of nutrient deficiencies and malaria status. Results The data obtained indicate that zinc deficiency is associated with an increase in TNF response by 37%; 95% CI: 14% to 118% and IFN-γ response by 74%; 95% CI: 24% to 297%. Magnesium deficiency, on the other hand, was associated with an increase in production of IL-13 by 80%; 95% CI: 31% to 371% and a reduction in IFN-γ production. These results reflect a shift in cytokine profile to a more type I cytokine profile and cell-cell mediated responses in zinc deficiency and a type II response in magnesium deficiency. The data also reveal a non-specific decrease in cytokine production in children due to iron deficiency anaemia that is largely associated with malaria infection status. Conclusions The pathological sequels of malaria potentially depend more on the balance between type I and type II cytokine responses than on absolute suppression of these cytokines and this balance may be influenced by a combination of micronutrient deficiencies and malaria status.Malaria Journal 01/2010; · 3.49 Impact Factor
Article: α+-Thalassemia protects against anemia associated with asymptomatic malaria: evidence from community-based surveys in Tanzania and Kenya[Show abstract] [Hide abstract]
ABSTRACT: In hospital-based studies, alpha(+)-thalassemia has been found to protect against severe, life-threatening falciparum malaria. alpha(+)-Thalassemia does not seem to prevent infection or high parasite densities but rather limits progression to severe disease--in particular, severe malarial anemia. We assessed to what extent alpha(+)-thalassemia influences the association between mild, asymptomatic Plasmodium falciparum infection and hemoglobin concentration. The study was based on 2 community-based surveys conducted among afebrile children (0.5-8 years old; n=801) in Kenya and Tanzania. Among children without inflammation (whole-blood C-reactive protein concentration <or=10 mg/L), P. falciparum infection was associated with only small reductions in hemoglobin concentration, and effects were similar across alpha-globin genotypes. By contrast, the reduction in hemoglobin concentration associated with P. falciparum infection accompanied by inflammation was larger and strongly depended on genotype (normal, -21.8 g/L; heterozygous, -16.7 g/L; and homozygous, -4.6 g/L). Relative to children with a normal genotype, this difference in effect was 5.1 g/L (95% confidence interval [CI], -1.0 to 11.1 g/L) for heterozygotes and 17.2 g/L (95% CI, 8.3 to 26.2 g/L) for homozygotes (estimates are adjusted for study site, age, height-for-age z score, and iron deficiency). alpha(+)-Thalassemia limits the decline in hemoglobin concentration that is associated with afebrile infections, particularly those that are accompanied by inflammation.The Journal of Infectious Diseases 08/2008; 198(3):401-8. DOI:10.1086/589884 · 5.78 Impact Factor
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ABSTRACT: In Africa antimalarials are often prescribed when malaria is unlikely, a problem that is becoming critical as more expensive antimalarials replace established drugs. However, little is known about what drives the overuse of antimalarials. We conducted this study to explore to what extent current prescribing behaviour in hospitals is driven by patient demand. Consultations were observed followed by exit interviews with patients or caretakers. Five district hospitals where microscopy was routinely available were selected in areas of low (n = 3) and high (n = 2) malaria transmission in north-eastern Tanzania. All outpatient consultations during the study period were observed (n = 669). Those sent for a malaria blood slide or treated with antimalarials presumptively were interviewed (n = 326). At the end of the study, clinicians were interviewed for their opinions on the use of antimalarials. Patients were not observed to demand antimalarials from clinicians, but occasionally asked for a malaria slide. Patient satisfaction on exit was similar between those prescribed antimalarials and those not prescribed antimalarials, but more patients or carers expressed satisfaction when the patient had been tested than when not. Clinicians rarely reported perceiving patient demand for antimalarials and asserted that such demand for medication would not affect their prescribing behaviour. Patient demand was not found to be driving the over-prescription of antimalarials found in the hospitals in our setting. To the contrary, the involvement of patients may provide an opportunity to improve prescribing practice if their expectations for testing and treatment in line with test results can be effectively communicated to clinicians.Health Policy and Planning 06/2008; 23(3):170-8. DOI:10.1093/heapol/czm046 · 3.00 Impact Factor
Article: Clinical assessment and treatment in paediatric wards in the north-east of the United Republic of Tanzania[Show abstract] [Hide abstract]
ABSTRACT: We assessed paediatric care in the 13 public hospitals in the north-east of the United Republic of Tanzania to determine if diagnoses and treatments were consistent with current guidelines for care. Data were collected over a five-day period in each site where paediatric outpatient consultations were observed, and a record of care was extracted from the case notes of children on the paediatric ward. Additional data were collected from inspection of ward supplies and hospital reports. Of 1181 outpatient consultations, basic clinical signs were often not checked; e.g. of 895 children with a history of fever, temperature was measured in 57%, and of 657 of children with cough or dyspnoea only 57 (9%) were examined for respiratory rate. Among 509 inpatients weight was recorded in the case notes in 250 (49%), respiratory rate in 54 (11%) and mental state in 47 (9%). Of 206 malaria diagnoses, 123 (60%) were with a negative or absent slide result, and of these 44 (36%) were treated with quinine only. Malnutrition was diagnosed in 1% of children admitted while recalculation of nutritional Z-scores suggested that between 5% and 10% had severe acute malnutrition; appropriate feeds were not present in any of the hospitals. A diagnosis of HIV-AIDS was made in only two cases while approximately 5% children admitted were expected to be infected with HIV in this area. Clinical assessment of children admitted to paediatric wards is disturbingly poor and associated with missed diagnoses and inappropriate treatments. Improved assessment and records are essential to initiate change, but achieving this will be a challenging task.Bulletin of the World Health Organisation 03/2008; 86(2):132-9. DOI:10.1590/S0042-96862008000200015 · 5.11 Impact Factor
Article: a+- Thalassemia Protects against Anemia Associated with Asymptomatic Malaria: Evidence from Community-Based Surveys in Tanzania and Kenya[Show abstract] [Hide abstract]
ABSTRACT: Background. In hospital-based studies, ¿+-thalassemia has been found to protect against severe, life-threatening falciparum malaria. ¿+-Thalassemia does not seem to prevent infection or high parasite densities but rather limits progression to severe disease¿in particular, severe malarial anemia. We assessed to what extent ¿+-thalassemia influences the association between mild, asymptomatic Plasmodium falciparum infection and hemoglobin concentration. Methods. The study was based on 2 community-based surveys conducted among afebrile children (0.5¿8 years old; ) in Kenya and Tanzania. Results. Among children without inflammation (whole-blood C-reactive protein concentration 10 mg/L), P. falciparum infection was associated with only small reductions in hemoglobin concentration, and effects were similar across ¿-globin genotypes. By contrast, the reduction in hemoglobin concentration associated with P. falciparum infection accompanied by inflammation was larger and strongly depended on genotype (normal, ¿21.8 g/L; heterozygous, ¿16.7 g/L; and homozygous, ¿4.6 g/L). Relative to children with a normal genotype, this difference in effect was 5.1 g/L (95% confidence interval [CI], ¿1.0 to 11.1 g/L) for heterozygotes and 17.2 g/L (95% CI, 8.3 to 26.2 g/L) for homozygotes (estimates are adjusted for study site, age, height-for-age z score, and iron deficiency). Conclusions. ¿+-Thalassemia limits the decline in hemoglobin concentration that is associated with afebrile infections, particularly those that are accompanied by inflammation.
Top Journals
Kilimanjaro Christian Medical CollegeMoschi, Kilimanjaro, Tanzania
London School of Hygiene and Tropical Medicine
London, ENG, United Kingdom
- Faculty of Infectious and Tropical Diseases
Kilimanjaro Christian Medical CentreMoschi, Kilimanjaro, Tanzania


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This property allows you to book online with a credit card. After submitting a reservation request, the owner or manager has 24 hours to accept, at which time your card will be charged and you will receive an email confirmation
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"This rental home is more than advertised. It is walking distance to beach , trolley is easy transportation around the beach. Pool is relaxing and clean. House is large and very accommodating for our large family. It's on a quiet street and if you want music and atmosphere, it's a short ride or walk away. I would recommend this vacation rental to anyone.we will be back. Thank you for the wonderful week."Guest: Pat H. Date of Stay: March 2015 Review Submitted: April 13, 2015View listing
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Benadryl (Diphenhydramine) as a night time sleep aid.
Can you take fluoxetine and benadyl together?
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- 22 May 2010 by nogeb
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- fluoxetine
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Carey's Unfinished FurnitureRead MoreFind affordable and multifunctional furniture pieces, such as tables and sofa, at Carey's Unfinished Furniture in Fairview. Whether you need a new bathroom storage unit or plan on doing a complete remodel, you can't go wrong with the vast selection of furnishings featured. Make your living room more homey and comfortable with some new furniture from here, such as living room furniture. You'll be the most popular one at the office when you replace old furniture with some of the trendiest offerings at store. When you're ready for some decoration inspiration, head on over to this store and browse the bedroom furniture options, such as dressers, bed frames, and bedroom furniture. When backyard festivities are on the brain, patio furniture is your next stop. Browse the selection available to find the set that's right for you. If you're in the market for some new wall decor, be sure to clear some space for items like curtains and mirrors. Take any space and complete it with a beautiful new piece of art. Quality decorations go a long way when it comes to making a home your own, so start with rugs, throw pillows, and vases. If you're driving, you'll be able to use a nearby parking lot. With helpful staff and a simply exquisite selection of pieces, Carey's Unfinished Furniture in Fairview is your best choice in furniture.21414 NE Sandy BlvdFairview, OR US
Amish Workbench Furniture Co.Read MoreIs it time you gave your home a makeover? Find a generous selection of top-notch furniture at Amish Workbench Furniture Co. in Troutdale. Make sure everything in your bathroom matches and browse the furniture selection for all the best designs. Dress up your new bedroom with some trendy furniture items from here, such as bedroom furniture. You'll love the look of your brand new office when you outfit its furniture with the selection at store. For a style that suits your backyard, browse the selection of patio furniture before the sun goes down. Give some life to your living room with some brand new furniture from here, such as living room furniture. Even if your aesthetic tastes are as different as can be, you and your loved ones will fulfill all your home decorating needs with items like rugs, throw pillows, and vases. Satisfy your creative vision with a stunning sculpture. Nobody likes looking at a blank slate, so consider hanging a little something on your wall. Pieces like curtains and mirrors are just a few suggestions from here you're sure to love. Drivers will find quick and easy parking just around the corner from Amish Workbench Furniture Co. With helpful staff and a simply exquisite selection of pieces, Amish Workbench Furniture Co. in Troutdale is your best choice in furniture.253 E Historic Columbia River HwyTroutdale, OR US
Kitchen CollectionRead MoreAdd a chic and stylish touch to your pad with a new furniture set from Kitchen Collection in Troutdale. If you're looking for the best office furniture at the right price, you'll definitely want to go to store first. Bring some extra life to your bedroom with a new furniture set from here, such as bedroom furniture. When you're ready to spruce up your bathroom's design, check out the furnishings on display. This store has a huge furniture selection, including living room furniture. When backyard festivities are on the brain, patio furniture is your next stop. Browse the selection available to find the set that's right for you. Say bye to bare walls and empty space. Just a few of the pieces here that will work well in almost any room include rugs, throw pillows, and vases. Wall decorations such as curtains and mirrors are sure to catch your eye, so stop in and see what else is on hand. Pushing the boundaries of conventional artwork, this Kitchen Collection features one-of-a-kind pieces that will easily dress up any room. Park your car in one of their many available spaces. So liven up your home with a brand new one-of-a-kind furniture set from Kitchen Collection in Troutdale.450 NW 257th AveTroutdale, OR US
Le Gourmet ChefRead MoreFrom the moment you enter Le Gourmet Chef in Troutdale, your imagination will come to life as you plan out new designs with their stock of furnishings. Looking for gifts for people at home? Le Gourmet Chef is the shop to visit to ensure you get the best commemorative trinkets in Troutdale. Le Gourmet Chef has so many great gift baskets that would make the perfect hostess gift. Surprise your loved ones with a one-of-a-kind food basket from the makers at Le Gourmet Chef in Troutdale. Update your kitchen with some of the latest kitchen gadgets and tools available. At Le Gourmet Chef, you can find ample parking that is readily available any time of day. Stop by Le Gourmet Chef in Troutdale today for a new furniture set and go home with something you will love to lounge on.450 NW 257th AveTroutdale, OR US
Premier Investments InternationalRead MoreDecorate your body with the gems for sale in Premier Investments International's jewelry bazaar in Portland. Skip the hassle of circling the block for parking and park in one of the great options near Premier Investments International. From classic cuts to modern makes, just remember that Premier Investments International will handle all of your jewelry needs.219 E Historic Columbia River HwyPortland, OR US
Goodell's Heritage UpholsteryRead MoreWith so many items to choose from, the peak of antique allure is found in the trove of Goodell's Heritage Upholstery in Washougal. No matter what time of day you visit Goodell's Heritage Upholstery, you can find easy in-and-out parking for your hot ride.1708 E StWashougal, WA US


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Hotel La Noria
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Travel Blogs from San Cristobal de las Casas
San Cristobal
Set in a beautiful highland valley, San Cristobal de las Casas is a charming town full of artesian markets, international cuisine, and colourful cobblestone streets. The cooler mountain climate was also a welcome relief from the blistering heat of the Pacific coast. We spent quite a while here sampling fine local coffee and exploring the surrounding forests, talking tours through crocodile inhabited rivers, visiting beautifully serene lakes, and hiking up to stunning ...
Slowing it down
... arriving at the gardens, it was far from obvious that they were open; I almost turned around and left before I spotted someone official working there to sell me a ticket. He was very nice and spoke a little English, and spent some time showing me around and explaining the various orchids and other plant species they had on the trails and in the greenhouse. There were a handful of other tourists there, but the whole thing felt a bit unfinished and ...
Zocalo and around
... along less interesting streets, past lots of trash and a few happy drunks emerging from various dives. It was still crowded but certainly less so than in the main square. We walked and walked until we reached Tlatelolco Plaza. Emily gave us a brief history of the 1968 massacre that happened here, which is memorialized by a plaque on the square.
We walked through the temple ruins, which were free to visit (at least today). We were the only ones viewing, and I have to say ...
¡Holy Guacamole!
... then met one of Matt`s Mexican friends, Lluis, who lives in Mexico City and we went out for a few beers with lime and salt, followed by scrumptious guacamole, cheese stuffed jalopenos and tacos for dinner! It was great to catch up with Lluis as we hadn`t seen each other for a few years since he was studying in Australia.
Our next stop is Puebla! A two hour (?) bus ride away! But first, let�s eat more chillis!
Teotihua... what???
... your shoelaces, put sunscreen (SPF 200 if you find) and get ready to walk!
This is an enormous archeological site in the Basin of Mexico, just 30 miles (48 km) northeast of Mexico City, containing some of the largest pyramidal structures built in the pre-Columbian Americas. The name means "where man met the gods."
Get prepared to be run over by locals trying to ...


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Inside Out: more than just a blockbuster hit
30 July 2015 5:45 PM
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29 July 2015 1:36 PM
Win Riki-Oh The Story Of Ricky on Blu-ray
29 July 2015 1:26 PM
Documentaries about Video Games and Online Games
29 July 2015 1:19 PM
Win Salute! Sun Yat Sen on DVD
27 July 2015 11:14 PM
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Cameron ready to sail Titanic 3DJames Cameron, director of not just one but the two highest grossing box office films in the world, 'Titanic' (1997) and 'Avatar' (2009) has revealed that he intends to convert his drama romance starring Leonardo DiCaprio and Kate Winslet into a 3D feature (like Avatar) for a April 2012 release, in time for the 100th anniversary of the ship's fateful voyage from Southampton, England.
Avatar DVD/Blu-Ray Launch EventsThis Sunday the box office breaking Avatar is releases on DVD and Blu-ray, and Twentieth Century Fox are marking the occasion with a few special events.
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Oscars 2010 AnalysisSo the night has finally passed and we all finally know who won what at the 2010 Academy Awards. But who were the real winners and losers last night? For those of you who didn't manage to stay up during the wee hours to watch last night's ceremony or for those who don't have the [...]
The Hurt Locker Defeats Avatar at The OscarsTom Hanks wasted no time in announcing that The Hurt Locker was this year's Best Picture at The Academy Awards, beating James Cameron's hotly tipped Avatar. Director Kathryn Bigelow barely had time to get off the stage after being awarded the Oscar for Best Director before she was back on it to receive the biggest award of the night.
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Governor McCrory Announces Reopening Of Bonner Bridge
Updated: 12/15/2013 - North Carolina officials say the Bonner Bridge on the Outer Banks is reopening.
Updated: 12/15/2013 - North Carolina officials say the Bonner Bridge on the Outer Banks is reopening.
Posted: 12/15/2013 - Severe weather, including a possible tornado, caused "major damage" to several homes and brought down power lines in Palm Coast, Florida, late Saturday, officials said.
Updated: 12/15/2013 - American Red Cross disaster workers responded to an apartment fire in Goldsboro Saturday morning.
Updated: 12/15/2013 - The tornado watch has been cancelled
Updated: 12/14/2013 - The Beaufort Police Department says that a man out on bond for a pharmacy robbery held up another one on Friday night.
Updated: 12/15/2013 - Officials say that a man shot in the head earlier this year during a robbery in Fountain has died.
Updated: 12/14/2013 - It wasn't inclement weather that led to the postponement of one area Christmas parade.
Updated: 12/14/2013 - Several local high school football teams are vying for state titles. See who was able to pull out a big win.
Updated: 12/14/2013 - A Richlands man is behind bars, accused of murder in Carteret County.
Posted: 12/14/2013 - More than 200 volunteers will join forces on Saturday, December 14, to build a new playground at the Oakcrest Complex.
Updated: 12/14/2013 - Greenville police are investigating a robbery from overnight Friday.
Updated: 12/13/2013 - Some Greenville shoppers are on edge after a fatal hit and run in the parking lot of the East 10th Street Walmart coupled with recent cases of armed and attempted armed robberies in store parking lots.
Updated: 12/13/2013 - Lakeforest Elementary school started doing emergency drills last year, after a gunman walked into Sandy Hook Elementary and opened fire, killing 6 adults and 20 children.
Updated: 12/16/2013 - High pressure will build in the area, leading to mostly sunny skies throughout eastern Carolina on Monday.
Posted: 12/13/2013 - With the Bonner Bridge closed for repairs, the N.C. Division of Motor Vehicles is working with the ferry division of the N.C. Department of Transportation to provide service to residents of Hatteras Island.
Updated: 12/13/2013 - A Greenville woman is facing drug charges after she was arrested in Washington.
Updated: 12/13/2013 - Five star high school football recruit Kentavius Street out of J.H. Rose High School has verbally committed to play college football at N.C. State.
Updated: 12/13/2013 - Tarboro Police Chief Damon Williams says a man demanded money from a teller around 9:45 a.m. Friday.
Updated: 12/13/2013 - Two people were hurt after a crash involving an ambulance and two cars at a busy Greenville intersection Friday morning.
Posted: 12/13/2013 - Deputies said a Greenville woman is now facing assault and child abuse charges.
Posted: 12/13/2013 - Congratulations to East Carolina University students who will turn their tassels to alumni status Friday.
Posted: 12/13/2013 - Greenville police have arrested a 22-year-old man for armed robbery.
Posted: 12/13/2013 - Dispatchers said firefighters in Pinetops were working to knock down flames at a home early Friday morning.
Updated: 12/13/2013 - Officers are now investigating the third case this week of someone held up at knifepoint in the city of Greenville.
Updated: 12/13/2013 - Troopers say two accused drunk drivers wrecked at the same time, knocking down two power poles, forcing the NCDOT to close the road for repairs.


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Sterling & Amethyst Duo Ring
Roll over image to zoom in
Twin pieces of classic amethyst mirror each other for a captivating effect, transforming two of earth's offerings into a graceful work of art.
- Sterling & amethyst
- Handmade in and fairly traded from Bolivia
Due to natural stone, colors may vary.
Ring Sizing: Please choose between U.S.A. ring sizes 6, 7, 8, 9, or 10. For conversions to other countries' ring sizes, see our Ring Sizes Page.
For bulk pricing on these and other items, please contact our Customer Service department at firstname.lastname@example.com.
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March 22, 2015 - Love mine wear it everyday for almost a month!
February 1, 2015 - It's a lovely ring and it fits. I did not know that several people complained about the stones falling out. I'll have to watch for that. I wear it only when I go out for dinner with GNO, our girls' night out group. I like purple so the stones suit.
October 19, 2014 - It's pretty, amethyst is my birthstone, but they are very pale. Wore it two weeks in a row, neither of the stones fell out like some reviewers did. Best thing is that if helped feed animals.
October 8, 2014 - I purchased this ring about a month ago. I thought it was really beautiful ring. The stones were a little light in color and it runs small but I still liked the ring. I wore the ring daily and today one of the stones fell out I am so disappointed and will be returning the ring for a refund.
October 1, 2014 - The first time I wore it one of the stones fell out. I called customer service and they sent a replacement. If this one has a stone fall out I will ask for a refund.
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The Big Bang Theory Wristband Set
(approx. $13.92 or €12.63)
- Out of Stock - Product Discontinued
- Wristband
- Product Code: 61607
Accessorise your arms with some Big Bang brilliance with these awesome wristbands! Featuring some of your favourite characters, quotes and quips from The Big Bang Theory, the designs include "Bazinga!" and "I am immune to your sarcasm". Officially licensed.


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Jennifer didn't believe my place overlooks the ocean, so I called her bluff and brought her to see it. Since my roommates weren't around, I tapped that ass on the balcony with a drone spying on all of our fun.
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£850 pcm
4 bedroom detached house to rent Bamburgh Court, Ingleby BarwickWe strongly recommend an early inspection of this attractive four bedroom detached home occupying a favoured cul de sac location with garage and gardens. The property is available immediately on an unfurnished basis and features gas central heating and upvc double glazing, ground floor cloakroom... More details ›
£550 pcm
2 bedroom end of terrace house to rent Ickworth Court,Ingleby Barwick,TS17What fees can I expect to pay if I rent a property with Robinsons?Upon you deciding on the property, Robinsons will provide you with a Tenancy Subject To Contract form which lists the services we provide and the fees that are payable.Current fee scales are shown below. At any time you are interes More details ›
£800 pcm
4 bedroom detached house to rent Brough Field CloseIngleby BarwickTS17 5ATWe are pleased to offer this 4 Bed Detached Property situated in a popular area of Lowfields, Ingleby Barwick. Property Benefits from DG, GCH, Gardens to Front & Rear, Driveway, Garage More details ›
Reduced on 28/07/2015 by Acorn Lettings & Sales, Stockton-On-Tees. Call: 01642 268106 Local call rate
£850 pcm
4 bedroom detached house to rent Nevern Crescent,Ingleby Barwick,TS17A four double bed det property for Let on a unfurnished basis. Briefly comprising, Ent/hallway, Cloakroom/wc, Lounge, Dining Room, Conservatory, Kitchen/breakfast Room and utility. To the first floor landing is the master bedroom with dressing area and en-suite facili More details ›
£495 pcm
2 bedroom apartment to rent Hadleigh Walk, Ingleby Barwick, TS17 5GWWe are pleased to offer this 2 Bed Top Floor Luxury Apartment situated in Ingleby Barwick, Stockton On Tees. Property Benefits from DG, GCH, Allocated Parking, Intercom System. More details ›
£750 pcm
4 bedroom detached house to rent Hasguard Way, Ingleby Barwick,TS17 5HGAcorn Lettings are pleased to offer this 4 Bed Detached Property situated in an ever popular area of Ingleby Barwick, Stockton on Tees. Property Benefits from DG, GCH, Gardens to Front & Rear, Driveway, Garage. More details ›
£625 pcm
3 bedroom terraced house to rent Hatchlands Park, BroomhillSuperbly presented three bedroomed property which offers living accommodation over three stories in this popular area of Ingleby Barwick close to local schools, shops & amenities. This property also boasts gas central heating, double glazing, entrance porch, lounge, guest cloak, kitchen/diner... More details ›
£625 pcm
3 bedroom semi-detached house to rent Avebury Close, TS17We are delighted to offer to the rental market this very well presented three bedroom semi detached house. Offerd for Let on an Unfurnished basis and is ideally located being close to schooling and amenities. The floorplan briefly comprises of; Entrance vestibule, lounge/dining room, a beautifully f More details ›
£525 pcm
2 bedroom apartment to rent LONGLEAT WALK, Ingleby Barwick, TS17* Lettings & Co welcomes this second floor unfurnished 2 bed apartment to rent situated in the popular area of Ingleby Barwick, Stockton on Tees. More details ›
£875 pcm
4 bedroom detached house to rent Church Field Way, Broom Hill, Ingleby Barwick, TS17Beautifully presented four bedroomed detached family home in the popular Broom Hill area, very close to outstanding schools. To let immediately on an unfurnished basis. On the ground floor, the Karndeaned hallway leads to the double door dining room with bay window, cloakroom/WC, lounge with electri More details ›
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Files » Skyrim » Audio, sound and music
0 8Arrow Combat MusicArrow Combat Music.Released: 30/07/2015 - 03:02PMUpdated: 30/07/2015 - 03:11PM
by lolikus9999
0 6Big Bad Wolf ShoutReplaces unrelenting force with big bad wolf shoutReleased: 30/07/2015 - 08:41AMUpdated: 30/07/2015 - 10:44AM
by Sox4life
31 341Music Mods MergedThis mod merges multiple music mods into one.Released: 27/07/2015 - 09:56PMUpdated: 30/07/2015 - 01:03AM
by IAreBob
1 11NUMBRA's Skyrim Tribute RemixA remix/tribute I made for the game we all know and love in my own unique musical style.Released: 14/07/2015 - 07:01PMUpdated: 14/07/2015 - 10:51PM
by NUMBRAOfficial
1 38Fight for JusticePiano - Instrumental duet. For U.S.A National Day. Can be used in Skyrim battle field.Released: 04/07/2015 - 06:22AMUpdated: 05/07/2015 - 02:51AM
by royalfootguard
28 405Metal Skyrim Music ReplacerReplaces the default battle music and Inn music with metal.Released: 02/07/2015 - 06:31PMUpdated: 02/07/2015 - 10:34PM
by ZabtheKabbit
73 4,104The Witcher 3 Music OverhaulReleased: 30/06/2015 - 12:50PMUpdated: 08/07/2015 - 08:59PM
by mwjr
7 109Pinkie Pie Jump SoundsReplaces the normal jumping sounds with the sound effects of Pinkie Pie hoppingReleased: 28/06/2015 - 06:17PMUpdated: 28/06/2015 - 06:17PM
by EvilMcSheep
7 124TheTouchAdds the song "The Touch", from the original Transformers Movie, by Stan Bush, to the game. It is specifically a dragon combat track, and will randomly play when a dragon appears. This mod does not replace or modify any of the original music, so don't panic if it doesn't immideatley plReleased: 26/06/2015 - 06:41AMUpdated: 26/06/2015 - 06:41AM
by Lioness446
0 11Polish Nord Commander male voice for Additional Player Voices modPolish male Nord commander voice for "Additional Player Voices for Skyrim" ************************************************************* This small mod adding Polish voice for player from original Nord commander voice( from Polish version of Skyrim ). This is only .wav files. You need *AdReleased: 25/06/2015 - 08:44PMUpdated: 25/06/2015 - 09:27PM
by CeZaR95
21 257No Acoustics (Performance Friendly Interiors)Removes the Reverberation Effect from InteriorsReleased: 25/06/2015 - 12:04PMUpdated: 28/06/2015 - 09:22AM
by DreezNation
2 24No More Bee SoundsRemoves bees buzzing sound from the game.Released: 25/06/2015 - 08:05AMUpdated: 25/06/2015 - 08:08AM
by GracefulGopher
1 26No More Bug in Jar SoundsRemoves the buzzing noises for the bugs in jars.Released: 25/06/2015 - 07:51AMUpdated: 25/06/2015 - 08:08AM
by GracefulGopher
2 46Rattle Me Bones Skeleton Sound ReplacementMod what you want just don't rattle me bones!Released: 23/06/2015 - 10:16AMUpdated: 25/06/2015 - 05:57AM
by SasoriNagashi1
2 44Main Music by Setvi and Drenai - Musique Principale par Setvi et Drenai - TES5Replace the main menu music by a song of the French Folk Metal band Drenaï, a tribute band to David Gemmell. Remplace le morceau du menu principal par un morceau du groupe de Folk Metal Français Drenaï, un groupe hommage (tribute) à David Gemmell.Released: 18/06/2015 - 05:19PMUpdated: 25/07/2015 - 08:42PM
by SETVI
5 142Chavvy MudcrabsCauses mudcrabs to speak like chavs.Released: 17/06/2015 - 12:27AMUpdated: 17/06/2015 - 12:27AM
by boteman
10 250Star Wars Wookie Sound for bearsWhen a bear is hurt it makes the sound of a wookie from Star wars.Released: 10/06/2015 - 08:52PMUpdated: 10/06/2015 - 08:52PM
by Thedevilsdevil
5 178Funny Swearing Mudcrab Audio OverhaulA small mod that makes mudcrabs swear in a weak irish accent.
Why?
Because, why not?Released: 10/06/2015 - 11:59AMUpdated: 10/06/2015 - 11:59AM
by ProfFoxyPantz
2,447 50,570Immersive MusicImmersive Music adds a large quantity of carefully handpicked musical tracks to Skyrim.Released: 05/06/2015 - 02:32PMUpdated: 16/06/2015 - 06:56PM
by hothtrooper44
2 40Doge Sounds Replacer- much innovation. 2edgy.Replaces Dog Sounds with Montage Parody Voice. (Illuminati Voice)Released: 04/06/2015 - 09:22AMUpdated: 11/06/2015 - 01:02PM
by rocketturtah15
274 5,382Witcher 3 MusicAdds music from Witcher 3.Released: 02/06/2015 - 04:50AMUpdated: 11/06/2015 - 10:03PM
by Karle94
33 600Higher pitched female shout voicesIncreases the pitch of female shouts. Based on elf voice.Released: 27/05/2015 - 07:13PMUpdated: 27/05/2015 - 10:47PM
by gosthy
16 178Roosters At Dawn FixUpdated scripts for Roosters at Dawn. Optional updated esp for USKP compatibility.Released: 27/05/2015 - 06:15AMUpdated: 27/05/2015 - 06:29AM
by shadohuntr1
53 1,633Za Warudo (Slow Time Shout)All rights of the sound sample reserved to Capcom® Muda! Muda! Muda! Muda!Released: 24/05/2015 - 02:19AMUpdated: 14/06/2015 - 04:33AM
by esteban9417
4 44This Means War - A7X MainMenu ThemeChanges the MainMenu music to a cover of This Means War by GuitarHero0650 on YouTubeReleased: 23/05/2015 - 04:34AMUpdated: 23/05/2015 - 04:34AM
by AfterlyfeUnicorn
37 344Vindsvept Music ReplacerThis mod replaces music with that of Vindsvepts!Released: 21/05/2015 - 03:05AMUpdated: 23/05/2015 - 11:08PM
by Deaxiou
18 338Dragon Combat - Metal Music ReplacerThis mod replaces the dragon combat themes of skyrim.Released: 18/05/2015 - 08:31PMUpdated: 18/05/2015 - 08:34PM
by erdelf
207 2,216Improved Combat MusicWith this mod, combat in skyrim will get much more exciting and epic, since music always does a big role in games. This mod improves all combat music in skyrim (except 2 boss tracks, since they already are very epic) and comes with an esp. UPDATE TO V. 2.0! This mod improves the dynamics of the soundtracks and fixes some things onReleased: 18/05/2015 - 03:38PMUpdated: 24/05/2015 - 03:39PM
by skorcorks
0 0Japanese voicechanges npc's spoken language into japanese and the subtitles is still in englishReleased: 11/05/2015 - 07:07AMUpdated: 11/05/2015 - 07:07AM
by chowyuncong123
5 67Tay Zonday - Skyrim Main Theme as main menu musicReplaces main menu music with Tay Zonday's "Dragonborn" remix.Released: 04/05/2015 - 03:49AMUpdated: 05/05/2015 - 03:56AM
by Pash17V