Physical education teachers' attitudes toward inclusion of students with disabilities in Saudi Arabia.

The attitudes of physical education (PE) teachers toward inclusion are critical to the successful provision of inclusive teaching for students with disabilities. Therefore, the purpose of this study was to investigate the attitudes of Saudi Arabian PE teachers toward the inclusion of students with disabilities in PE classes and the effect of sociodemographic variables (e.g., gender and length of teaching experience) on their attitudes toward inclusion. A total of 1,314 PE teachers (M age = 41.09, SD = 9.40, females = 42.8%) completed the Arabic version of the Sentiments, Attitudes, and Concerns about Inclusive Education-Revised Scale (SACIE-R). Analyses found that, in general, PE teachers had moderately positive attitudes toward the inclusion of students with disabilities in PE lessons. A significant difference was found between the two genders in their attitudes toward inclusion. Specifically, female PE teachers demonstrated more positive attitudes toward inclusion than males. Multiple linear regression analysis, meanwhile, showed that the length of teaching experience and the experience of teaching a student with a disability were significant predictors of participants' attitudes toward inclusion. Our findings highlighted the importance of reconsidering the quality of PE teachers' experiences and interactions with students with disabilities as a means to improving their attitudes, which in turn would translate into successful inclusion.

Hepatitis A booster vaccination: is there a need?

Hepatitis A is one of the most common vaccine-preventable infectious diseases in the world. Effective vaccines against hepatitis A have been available since 1992, and they provide long-term immunity against the infection. However, there is no worldwide consensus on how long protection will last or whether there will be a need for hepatitis A virus (HAV) booster vaccinations in the future. In most countries, booster-vaccination policy is guided by manufacturers' recommendations, national authorities, or both. In June, 2002, a panel of international experts met to review the long-term immunogenicity and protection conferred by HAV vaccine in different population groups. Data have shown that after a full primary vaccination course, protective antibody amounts persist beyond 10 years in healthy individuals, and underlying immune memory provides protection far beyond the duration of anti-HAV antibodies. The group concluded that there is no evidence to lend support to HAV booster vaccination after a full primary vaccination course in a healthy individual. However, further investigations are needed before deciding if boosters can be omitted in special patient-groups.

Surveillance for rotavirus in Argentina.

Group A rotaviruses are the major cause of severe gastroenteritis in young children worldwide. Because rotavirus vaccination appeared imminent, a nationwide surveillance program was organized between October 1996 and October 1998 in the largest Argentine cities. Surveillance for disease burden, rotavirus detection, and rotavirus typing was undertaken at nine locations. Results showed rotavirus to be associated with 42% of diarrhea admissions. Although the prevalent G types changed from year to year, common G types were found in 96% of the cases and were usually associated with common P types. Uncommon G types, G9 and G5, were found at low prevalence and uncommon G/P combinations occurred at almost every study site. These data suggest that a rotavirus vaccine could substantially decrease the rotavirus disease burden in Argentina, but that introduction of a vaccine should be accompanied by a concurrent surveillance system.

In vivo emergence of drug-resistant mutations at less than 50 HIV-1 RNA copies/mL that are maintained at viral rebound in longitudinal plasma samples from human immunodeficiency virus type-1-infected patients on highly active antiretroviral therapy.

OBJECTIVE: Emergence of human immunodeficiency virus type-1 (HIV-1) genotypic drug resistance is generally attributed to noncompliance, poorly absorbed drugs, or drug-to-drug interaction. Attempts to determine emerging genotypic drug resistance from study subjects on highly active antiretroviral therapy (HAART) relied on insensitive polymerase chain reaction (PCR) techniques, revealing wild type HIV-1 or precursor resistant genotypes from few plasma samples successfully amplified with <50 copies/mL. STUDY DESIGN/METHODS: In this analysis, using Applied Biosystems' ViroSeq HIV-1 Genotyping Systems, Version 2.0 (Applied Biosystems, Foster City, CA, USA) and the supplemental, for research use only, nested PCR primers, genotypic drug resistance was determined in longitudinal plasma samples from 11 study subjects on HAART. RESULTS: In 4 of 11 study subjects, newly emerging genotypic primary resistant mutations were detected in plasma samples with <50 copies/mL. Most of these primary drug-resistant mutations were detected in subsequent longitudinal samples with detectable viral load (viral breakthrough). CONCLUSIONS: This analysis suggests sufficient viral replication <50 copies/mL to generate genotypic drug resistance in study subjects on suppressive HAART.

Molecular medicine: the present and the future.

In the recent past, major achievements have been obtained in the understanding of the molecular defects at the basis of several different diseases. The field of 'Molecular Medicine' has thus become more solid, and several reports have been published linking the basic molecular investigation to the clinical practice. In line with this new approach to medicine a Symposium was organized where the linkage between investigations in basic science could be explored in view of clinical disorders, and vice versa. in Rosario, Argentina, September 9-11, 1999, molecular biologists, molecular pathologists and clinicians discussed the molecular defects possibly at the basis of some common diseases. This report summarizes the presentations and discussions during the symposium.

Epidemiology of gallstone disease in Argentina: prevalences in the general population and European descendants.

To assess gallstone disease prevalence in Argentina, a random sample of the Rosario City population was studied, considering already known associated factors, and analyzing ethnic groups living in the city. A total of 1,173 participants (69% response), both sexes, 20 years and older were studied. Each subject underwent an abdominal ultrasound examination, a blood test, and a standardized questionnaire. It was seen that gallstone disease prevalence (gallstones or cholecystectomy), overall was 20.5% (23.8% in women and 15.5% in men; (P = 0.0005), and was associated with age and body mass index in both sexes, and with pregnancy number and hypertriglyceridemia in women. As regards ancestors' nationalities, Italian and Spanish descendants presented higher prevalence rates for all age groups than those described in Italy and Spain. Thus far, in a subsample of 78% of nonparticipants submitted to a new home visit, presence of cholecystectomy or symptoms did not differ from participants, supporting the validity of our results.

[Rotavirus laboratory network: results after one year of observation]. / Red de laboratorios de Rotavirus: resultados del primer año de vigilancia.

Rotavirus is the most common cause of severe diarrhea in children and it has been estimated that in Argentina Rotavirus is responsible for 21,000 hospitalizations, 85,000 medical attentions and an annual medical cost of US$ 27 millions. Given that a Rotavirus vaccine is about to be approved, a laboratory network based surveillance system was organized. Herein, we present the results after one year of study. Severe diarrhea was responsible for 9% of pediatric hospitalizations and rotavirus was detected in 42.1% of the diarrhea cases. We estimated that Rotavirus causes 3.8% of pediatric hospitalizations. The number of diarrhea and Rotavirus diarrhea hospitalizations was greater during the first year of life (62% and 71.3%, respectively). The number of diarrhea hospitalizations during the December-May semester was significantly higher than the rest of the year. A Rotavirus diarrhea peak was detected between April and June. These results indicate that Rotavirus is the most important etiological agent of severe diarrhea in Argentine children and show the importance of performing Rotavirus diagnosis in every pediatric hospital. The additional costs will be compensated by many benefits such as better use of antibiotics, improved nosocomial spread control, better handling of hospital beds and of laboratory resources and of the hospitalized patient.

Red de laboratorios de Rotavirus: resultados del primer año de vigilancia / Rotavirus laboratory network: results after one year experience

Rotavirus es el principal agente productor de diarrea infantil y se ha estimado que provoca en Argentina 21.000 hospitalizaciones, 85.000 atenciones ambulatorias, y un costo mayor a los 27 millones de dolares anuales. Ante la inminente aprobación de una vacuna contra este patógeno se organizó un Sistema de Vigilancia Epidemiológica en base a una Red de laboratorios. Se presentan los resultados obtenidos luego del primer año de funcionamiento de esta Red. Se encontró que el 9 por ciento de la internación pediátrica es debido a diarrea aguda, y rotavirus se halló en el 42,1 por ciento de los casos estudiados. Se estimó que rotavirus provoca el 3,8 por ciento de las internaciones pediátricas. La internación por diarrea y la internación asociada a diarrea por rotavirus fue mayor en el primer año de vida (62 por ciento y 71,3 por ciento respectivamente). En el semestre de diciembre a mayo el número de internaciones por diarrea fue significativamente mayor que en el semestre restante. Se detectó un pico de diarreas por rotavirus entre abril y junio en las distintas Unidades centinelas. Estos resultados señalan a los rotavirus como el principal agente etiológico de la gastroenteritis infantil aguda en nuestro país y avalan la necesidad de incorporar su diagnóstico en todos los hospitales pediátricos. Los costos adicionales serán ampliamente superados por los beneficios relacionados con elmejor manejo de las camas hospitalarias, los recursos del laboratorio, y el paciente internado por diarrea, el uso correcto de antibióticos, y el control de la diseminación intrahospitalaria de rotavirus

Red de laboratorios de Rotavirus: resultados del primer año de vigilancia / Rotavirus laboratory network: results after one year experience

Rotavirus es el principal agente productor de diarrea infantil y se ha estimado que provoca en Argentina 21.000 hospitalizaciones, 85.000 atenciones ambulatorias, y un costo mayor a los 27 millones de dolares anuales. Ante la inminente aprobación de una vacuna contra este patógeno se organizó un Sistema de Vigilancia Epidemiológica en base a una Red de laboratorios. Se presentan los resultados obtenidos luego del primer año de funcionamiento de esta Red. Se encontró que el 9 por ciento de la internación pediátrica es debido a diarrea aguda, y rotavirus se halló en el 42,1 por ciento de los casos estudiados. Se estimó que rotavirus provoca el 3,8 por ciento de las internaciones pediátricas. La internación por diarrea y la internación asociada a diarrea por rotavirus fue mayor en el primer año de vida (62 por ciento y 71,3 por ciento respectivamente). En el semestre de diciembre a mayo el número de internaciones por diarrea fue significativamente mayor que en el semestre restante. Se detectó un pico de diarreas por rotavirus entre abril y junio en las distintas Unidades centinelas. Estos resultados señalan a los rotavirus como el principal agente etiológico de la gastroenteritis infantil aguda en nuestro país y avalan la necesidad de incorporar su diagnóstico en todos los hospitales pediátricos. Los costos adicionales serán ampliamente superados por los beneficios relacionados con elmejor manejo de las camas hospitalarias, los recursos del laboratorio, y el paciente internado por diarrea, el uso correcto de antibióticos, y el control de la diseminación intrahospitalaria de rotavirus(AU)

Hepatitis B seroprevalence in Latin America.

The seroprevalence of hepatitis B was investigated in over 12,000 subjects in six countries of Latin America: Argentina, Brazil, Chile, the Dominican Republic, Mexico, and Venezuela. Each study population was stratified according to age, gender, and socioeconomic status. Antibodies against hepatitis B core antigen (anti-HBc) were measured in order to determine hepatitis B infection. The highest overall seroprevalence was found in the Dominican Republic (21.4%), followed by Brazil (7.9%), Venezuela (3.2%), Argentina (2.1%), Mexico (1.4%), and Chile (0.6%). In all the countries an increase in seroprevalence was found among persons 16 years old and older, suggesting sexual transmission as the major route of infection. In addition, comparatively high seroprevalence levels were seen at an early age in the Dominican Republic and Brazil, implicating a vertical route of transmission.

Red de laboratorios de Rotavirus: resultados del primer año de vigilancia. / [Rotavirus laboratory network: results after one year of observation]

Rotavirus is the most common cause of severe diarrhea in children and it has been estimated that in Argentina Rotavirus is responsible for 21,000 hospitalizations, 85,000 medical attentions and an annual medical cost of US$ 27 millions. Given that a Rotavirus vaccine is about to be approved, a laboratory network based surveillance system was organized. Herein, we present the results after one year of study. Severe diarrhea was responsible for 9

of pediatric hospitalizations and rotavirus was detected in 42.1

of the diarrhea cases. We estimated that Rotavirus causes 3.8

of pediatric hospitalizations. The number of diarrhea and Rotavirus diarrhea hospitalizations was greater during the first year of life (62

and 71.3

, respectively). The number of diarrhea hospitalizations during the December-May semester was significantly higher than the rest of the year. A Rotavirus diarrhea peak was detected between April and June. These results indicate that Rotavirus is the most important etiological agent of severe diarrhea in Argentine children and show the importance of performing Rotavirus diagnosis in every pediatric hospital. The additional costs will be compensated by many benefits such as better use of antibiotics, improved nosocomial spread control, better handling of hospital beds and of laboratory resources and of the hospitalized patient.

[Hepatitis A virus infection in children in Argentina: a pilot study]. / Infección por virus de hepatitis A (HAV) en niños en Argentina. Ensáyo piloto.

UNLABELLED: The severity and/or the prognostic of infections with the hepatitis A virus (HAV) is related to the age at which the infection occurs. Since transmission of the virus occurs by the fecal-oral route, the prevalence and age-relate incidence of infection is determined by the adequacy of sanitation hygienic measures and the socio economic level of exposed populations. Thus, the disease is having an increasing impact in developing countries with improving sanitary standards whereas inhabitants of industrialized countries are particularly at risk while visiting under-developed countries. We have established a cooperative group for the serologic study of children range between six months to ten years old, without sintomatology of acute hepatitis. The patients live in Buenos Aires, San Justo, Trelew, Rosario and Tucumán cities. We studied 3699 children. The specific Ab-antiHAV IgG were measured by enzyme immunoassay with commercial available kits (Organon and-or Abbott). The variable of study were age, sex and water quality. RESULTS: 45.19% were of San Justo, 26.15% of Rosario, 13% of Buenos Aires, 8.37% of Trelew and 7.29% of Tucumán. We observed the highest of possibility percentage (%POS) in Tucumán (81.4%), followed by San Justo (57.8%), Rosario (46.5%), Trelew (41.99%) and Buenos Aires (29.4%). In all the cities the lowest %POS was found in children under three years old. Between three and six years old the results were variable and an increase in %POS was observed related to the growth. The global %POS was 51.56%. CONCLUSIONS: This study confirms Argentina as a high endemic country for HAV infection. A global vaccination program is the only strategy that has the potential to prevent recurrent epidemics of hepatitis A and its erradication.

Infeccion por virus de hepatitis A (HAV) en ninos en Argentina: ensayo piloto / Hepatitis A virus infection in children in Argentina: a pilot study

Objetivos: Determinar la curva de infección del HAV en niños menores de diez años. Establecer estrategias de vacunación en la Argentina. Material y Métodos: se etableció un grupo cooperativo para el rastreo serológico de niños entre los seis meses y los diez años de edad, sin sintomatología y/o cuadro clínico de hepatitis aguda, tomando como grupo inicial de trabajo a Centros de las ciudades de Bs. As., San Justo (Pcia, de Bs. As.), Trelew (Chubut), Rosario (Santa Fe) y Tucumán. Se estudiaran 3699 niños para Anti-HAV-IgG por ELISA (Oragnon y Abbott). Las variables de inclusión fueron: edad, sexo y calidad de agua. Resultados: 45.19 por ciento de las muestras fueron de San Justo, 26.15 por ciento de Rosario, 13 por ciento de Buenos Aires, 7.29 por ciento de Tucumán y 8.37 por ciento de Trelew. 1) Se observó el mayor porcentaje de positividad (porcentajePOS) en Tucuman (81.4 por ciento) seguido por San Justo (57.8 por ciento) y Rosario (44.3 por ciento). 2) En todas las ciudades los menores porcentajePOS correspondieron a menores de tres años. 3) La mayor dispersión del porcentajePOS ocurre entre los tres y seis años de edad. 4) en todo el muestreo se observó un valor creciente de porcentajePOS con pendientes similares, excepto para Trelew, donde aparece un pico a los cuatro años atribuíble a las características de la muestra. 5) El porcentajePOS global para la muestra fue de 51.56 por ciento. Conclusiones: 1) Este trabajo demuestra que nuestro país es de alta endemicidad para la infección por HAV. 2) La vacunación a corta edad sería la estrategia más adecuada para el control de la hepatitis A y la erradicación de la infección por el HAV.

Infeccion por virus de hepatitis A (HAV) en ninos en Argentina: ensayo piloto / Hepatitis A virus infection in children in Argentina: a pilot study

Objetivos: Determinar la curva de infección del HAV en niños menores de diez años. Establecer estrategias de vacunación en la Argentina. Material y Métodos: se etableció un grupo cooperativo para el rastreo serológico de niños entre los seis meses y los diez años de edad, sin sintomatología y/o cuadro clínico de hepatitis aguda, tomando como grupo inicial de trabajo a Centros de las ciudades de Bs. As., San Justo (Pcia, de Bs. As.), Trelew (Chubut), Rosario (Santa Fe) y Tucumán. Se estudiaran 3699 niños para Anti-HAV-IgG por ELISA (Oragnon y Abbott). Las variables de inclusión fueron: edad, sexo y calidad de agua. Resultados: 45.19 por ciento de las muestras fueron de San Justo, 26.15 por ciento de Rosario, 13 por ciento de Buenos Aires, 7.29 por ciento de Tucumán y 8.37 por ciento de Trelew. 1) Se observó el mayor porcentaje de positividad (porcentajePOS) en Tucuman (81.4 por ciento) seguido por San Justo (57.8 por ciento) y Rosario (44.3 por ciento). 2) En todas las ciudades los menores porcentajePOS correspondieron a menores de tres años. 3) La mayor dispersión del porcentajePOS ocurre entre los tres y seis años de edad. 4) en todo el muestreo se observó un valor creciente de porcentajePOS con pendientes similares, excepto para Trelew, donde aparece un pico a los cuatro años atribuíble a las características de la muestra. 5) El porcentajePOS global para la muestra fue de 51.56 por ciento. Conclusiones: 1) Este trabajo demuestra que nuestro país es de alta endemicidad para la infección por HAV. 2) La vacunación a corta edad sería la estrategia más adecuada para el control de la hepatitis A y la erradicación de la infección por el HAV. (AU)