Evaluation of opportunities to implement community-wide mass drug administration for interrupting transmission of soil-transmitted helminths infections in India.

BACKGROUND: The World Health Organization Neglected Tropical Disease (NTD) guidelines recommend control of soil transmitted helminth (STH)-associated morbidity with targeted deworming of preschool and school-aged children who are disproportionately affected by STH-associated morbidity. However, this strategy leaves many adults untreated and reinfection within communities perpetuates transmission even when mass drug administration (MDA) coverage of children is high. Evidence suggests that it may be possible to interrupt STH transmission by expanding MDA to a community-wide MDA (cMDA). METHODS: This multi-methods study of organizational readiness survey, key informant interviews, and program mapping, were conducted with government stakeholders in three Indian states, Goa, Sikkim, and Odisha, to assess readiness of the states for transitioning from school-based MDA to cMDA and identify opportunities to leverage existing infrastructure from other NTD programs like lymphatic filariasis (LF) for STH cMDA. PRINCIPAL FINDINGS: Overall, all three states indicated a highly favorable policy environment, effective leadership structure, adequate material resources, demonstrated technical capacity, and adequate community infrastructure needed to launch a STH cMDA program. The findings indicated a high-level of health system readiness to implement provided human resources and financial resources to deliver cMDA is strengthened. Areas with a significant overlap between LF and STH MDA platforms, particularly at the community-level, may be best primed for transitioning. Immunization, maternal child health, and non-communicable disease control programs were the other programs for possible integration of cMDA. States indicated having effective leadership structures in place at the state-level, however, engaging local leaders and community groups were considered crucial for successful implementation of cMDA. In-migration was a perceived challenge for estimating drug requirement and preventing possible stockouts. CONCLUSIONS: Findings from this study are intended to proactively support government decision making, prioritization, and program planning across heterogenous implementation contexts in India to speed the translation of research findings into practice. CLINICAL TRIAL REGISTRATION: NCT03014167; ClinicalTrials.gov.

Role Commitment and Acceptance in a Sport Context.

The objectives of this study were to (a) develop a conceptualization of role acceptance, later situated within the broader concept of role commitment, pertinent to the sport environment; (b) develop a measure integrating direct perceptions of role commitment and the bases of this variable; and (c) determine if role commitment could predict athletes' intentions to return. To accomplish these objectives, multiple methods were used across 4 projects that leveraged the extant literature on acceptance and commitment perceptions from sport and organizational psychology, engaged athletes in focus groups in a think-aloud protocol, and obtained responses on iterative versions of a new role-commitment questionnaire from over 700 athletes from a variety of competitive and developmental levels. Overall, this approach captured the bases of role commitment (affective, normative, and continuance perspectives), as well as direct perceptions of role commitment, and demonstrated an important link to intentions to return to sport.

Treatment of natural infestations of the biting louse (Werneckiella equi) on horses using triflumuron, a benzoylurea derivative insect growth regulator.

The horse biting louse (Werneckiella equi) is a common global equine ectoparasite. To our knowledge, benzoyl(phenyl)urea insecticides (triflumuron, diflubenzuron) commonly used as sheep lousicides, have not been evaluated for efficacy against W. equi. The aim of this study was to determine louse control efficacy, general wellness and dermal safety following triflumuron application as a backline pour-on to horses. Two efficacy trials using 25 adult naturally infested lousy horses, and a dermal safety trial using 10 adult louse-free horses were conducted over a 14-month period. Lousy animals were selected by assessment of their lice status prior to treatment. For the efficacy trial, the triflumuron product was applied at a dose of 2.5mg triflumuron per kg bodyweight (1 mL product per 10 kg bodyweight). For the safety study, triflumuron was applied at a 3x clinical dose of 7.5 mg triflumuron per kg bodyweight (3 mL product per 10 kg bodyweight). In our first efficacy trial, 100% lousicidal efficacy was achieved by day 44 post-treatment. In our second trial, no lice were identified on horses by day 71 post-treatment. In the safety trial, no adverse effects were seen. Results of this study demonstrate that the off-label, experimental pour-on application of triflumuron at 2.5 mg/kg bodyweight is convenient, highly effective and safe (at 3x the clinical dose) for the treatment of the horse biting louse, W. equi.

Temporal organization of the brain: Neurocognitive mechanisms and clinical implications.

The synchrony between the individual brain and its environment is maintained by a system of internal clocks that together reflect the temporal organization of the organism. Extending the theoretical work of Edelman and others, the temporal organization of the brain is posited as functioning through "re-entry" and "temporal tagging" and binds the wide range of possible times to a unified cognitive experience which is held in unison with the outside world. Dysfunction in this system is reflected in the temporal discord seen in cases of aging, sleep disorder, jet-lag, and shift-work, as well as in mental disorders and drug-induced changes in consciousness. The extent to which neuroendocrine structures contribute to the neurocognitive mechanisms which underlie consciousness has so far not been explored. Therefore, neuroendocrine mechanisms contributing to the temporal organization of the brain are reviewed. It is concluded that time-and its neuroendocrine correlate melatonin-is a binding principle for organizing conscious experience.