Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “THERAPEUTICS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMed2005

The egg-sharing model for human therapeutic cloning research: managing donor selection criteria, the proportion of shared oocytes allocated to research, and amount of financial subsidy given to the donor.

Recent advances in human therapeutic cloning made by Hwang and colleagues have opened up new avenues of therapy for various human diseases. However, the major bottleneck of this new technology is the severe shortage of human donor oocytes. Egg-sharing in return for subsidized fertility treatment has been suggested as an ethically justifiable and practical solution to overcome the shortage of donor oocytes for therapeutic cloning. Because the utilization of shared oocytes in therapeutic cloning research does not result in any therapeutic benefit to a second party, this would necessitate a different management strategy compared to their use for the assisted conception of infertile women who are unable to produce any oocytes of their own. It is proposed that the pool of prospective egg-sharers in therapeutic cloning research be limited only to younger women (below 30 years of age) with indications for either male partner sub-fertility or tubal blockage. With regards to the proportion of the shared gametes being allocated to research, a threshold number of retrieved oocytes should be set that if not exceeded, would result in the patient being automatically removed from the egg-sharing scheme. Any excess supernumerary oocyte above this threshold number can be contributed to science, and allocation should be done in a randomized manner. Perhaps, a total of 10 retrieved oocytes from the patient may be considered a suitable threshold, since the chances of conception are unlikely to be impaired. With regards to the amount of subsidy being given to the patient, it is suggested that the proportion of financial subsidy should be equal to the proportion of the patient's oocytes being allocated to research. No doubt, the promise of future therapeutic benefit may be offered to the patient instead of financial subsidy. However, this is ethically controversial because therapeutic cloning has not yet been demonstrated to be a viable model of clinical therapy and any promises made to the patient might turn out to be illusionary. Hence, it is proposed that a tangible financial subsidy on the medical fees might be the better option for the patient's welfare.

Cloning, Organism↗
PubMed2006

Usage of veterinary therapeutic antimicrobials in Denmark, Norway and Sweden following termination of antimicrobial growth promoter use.

Antimicrobial growth promoters (AGPs) were phased out in Denmark, Norway and Sweden in 1998-1999, 1995 and 1986, respectively. The annual usage of therapeutic antimicrobials in animals in Denmark almost doubled during the period when AGPs were phased out (1988-1999) and in the subsequent 2 years. The increase was mainly due to an increased consumption of therapeutic antimicrobials in weaning pigs. The annual increase in usage of therapeutic antimicrobials and the annual increase in numbers of slaughter-swine produced in Denmark correlates well, except for 1999 when AGP use was discontinued in weaning pigs, and the following year. In Norway, the usage of therapeutic antimicrobials in animals decreased by 39% from 1995 to 2000. During 2001-2003 the annual usage remained at the 2000-level. The annual numbers of slaughter-swine produced in Norway increased gradually by 10% after the AGP discontinuation (from 1995 to 2003). In Sweden, the usage of therapeutic antimicrobials in animals increased by 21% the first 2 years subsequent to the AGP ban (1986-1988), remained then constant until 1994; from 1994 to 2003 this usage declined by 47%. The initial increase was caused by increased use in broilers and in weaning piglets. The amounts used in animals in Sweden in 2003 were half of the amounts used in 1994. The annual numbers of slaughter-swine produced in Sweden declined gradually by 16% in the study period, although fluctuating. In Denmark, Norway and Sweden the number of dairy cattle and beef cattle declined only slightly in the various study periods while numbers of broilers produced increased notably, especially in Norway and Sweden. Following the termination of AGPs the total usage of antimicrobials (AGPs and therapeutic antimicrobials) in animals in Denmark declined 36% (from 1996 to 2003): in Norway this figure was 45% (from 1995 to 2003). In Sweden, the total usage of antimicrobials in animals in 2003 amounted to only one third of the amounts used in 1984 (decreased from 51 to 16 tonnes). Termination of AGPs was only a temporary risk factor for increased usage of therapeutic antimicrobials in food-animals in Sweden and Denmark; however, an exception might be usage in weaning piglets in Denmark. Furthermore, the discontinuation of AGP use has decreased the overall annual usage of antimicrobials in animals in Denmark, Norway and Sweden considerably.

Animal Diseases↗
PubMed1998

Preventing stroke recurrence in patients with patent foramen ovale: antithrombotic therapy, foramen closure, or therapeutic abstention? A decision analytic perspective.

Emphasis on the role of patent foramen ovale as a potential risk factor for ischemic paradoxical stroke has recently increased. Current therapeutic options for secondary stroke prevention include long-term antithrombotic therapies and invasive closure of the defect, but selective indications have not been evaluated. Therefore we developed a Markov-based decision analysis model for a hypothetical cohort of patients 55 years of age with presumed paradoxical embolism, measuring for each therapy the risks of stroke recurrence, treatment-related complications, and death after 5 years and the quality-adjusted life-years. Over a wide range of stroke risk recurrence (0.8% per year to 7% per year), the gain provided by closure of the defect exceeded the one obtained by other therapeutic options. When the risk exceeded 0.8% per year and 1.4% per year, respectively, this was also verified for anticoagulation and antiplatelet therapies compared with therapeutic abstention. Therapeutic abstention was the preferred strategy under 0.8% per year. Sensitivity analyses identified key parameters influencing the choice of therapy. These included estimates of stroke recurrence, bleeding rates, surgery-related case fatality rates, and age. Considering the risks of treatment and the devastating consequences of a recurrent stroke, our model suggests that if the estimated risk of paradoxical stroke recurrence is > 0.8% per year, therapeutic abstention becomes the worst option. Above this threshold secondary stroke prevention with anticoagulation therapy or surgical closure of the defect is the preferred strategy, and assessment of both the risk of stroke recurrence and the risk related to therapeutic options should guide individual therapeutic decision making.

Cardiac Surgical Procedures↗
PubMed1997

Therapeutic ERCP in outpatients.

BACKGROUND: We evaluated the safety of outpatient therapeutic ERCP since most complications are apparent within a few hours. METHODS: We reviewed 190 patients undergoing planned outpatient therapeutic ERCP from a cohort of 409 consecutive therapeutic ERCP procedures. Patients were selected for outpatient therapeutic ERCP based on relative good health and overnight accommodation near our institution. RESULTS: Outpatient therapeutic ERCPs included plastic biliary stent insertion (n = 71), biliary sphincterotomy (45), pancreatic stent insertion (28), Wallstent insertion (19), biliary balloon or catheter dilation (10), pancreatic balloon or catheter dilation (8), biliary stone extraction with prior sphincterotomy (7), pancreatic sphincterotomy (5), and duodenal ampullectomy (1). Admission was necessary in 31 (16%) because of complications in 22 (11.6%) and observation of post-ERCP symptoms in 9. Twenty-six (13%) of these patients were admitted directly from the endoscopy unit recovery room and 5 (3%) from home after a median interval of 24 hours following discharge (range 5 to 48 hours). Reasons for admission were pancreatitis in 17, hemorrhage in 3, cholangitis in 3, endoscopic but not clinical hemorrhage in 4, pain in 4, and vomiting in 1. Of the patients who were admitted from home, 3 had pancreatitis (following sphincterotomy in 1, pancreatic stenting in 1, pancreatic balloon dilation in 1) and 2 had hemorrhage (postsphincterotomy in 1 and ampullectomy in 1). In comparison, of the 219 consecutive inpatients undergoing therapeutic ERCP, 28 (13%) developed complications with 1 (0.4%) death. CONCLUSIONS: A policy of selective outpatient therapeutic ERCP, with admission reserved for those with established or suspected complication, appears to be safe and reduces health care costs.

Biliary Tract Diseases↗
PubMed2003

Therapeutic margin of budesonide in patients with mild to severe asthma.

BACKGROUND: The therapeutic margin of a drug is the difference between the optimal effective dose and the dose at which unacceptable adverse effects occur. This margin is particularly important in the case of therapies that are used long term for the control of chronic illnesses, such as inhaled corticosteroids (ICSs) in the treatment of asthma. Because data from controlled clinical studies indicate that the available ICSs have similar clinical efficacy, the safety profile is central to differentiating between them on the basis of their therapeutic margins. The main safety concern with long-term use and high doses of ICSs is systemic exposure that could result in such unwanted effects as cortisol suppression, a reduction in the final adult height of pediatric patients, and decreased bone mineral density. OBJECTIVE: This article reviews data from clinical trials, including long-term prospective studies, to compare the therapeutic margin of budesonide with those of other second-generation ICSs and to determine whether there are variations in the therapeutic margin with different delivery devices, severities of disease, or patient age. RESULTS: Based on the tolerability data for budesonide from short-term (6-12 wk) and long-term (1-9 y) studies in patients with mild to moderate persistent asthma, the dose-response and dose-tolerability curves for budesonide delivered by dry-powder inhaler can be plotted in parallel. The margin between these curves-the therapeutic margin-is favorable and consistent in pediatric and adult patients and at all degrees of asthma severity. Fewer tolerability data are available for other ICSS. CONCLUSION: Whereas budesonide has clinical efficacy similar to that of other currently available ICSs, it has a good safety profile-and hence a favorable therapeutic margin-that is supported by long-term clinical data. Budesonides favorable therapeutic margin is probably a result of its pharmacokinetic and physical properties.

Adult↗
PubMed1993

An analysis of therapeutic decision for scleritis.

PURPOSE: To compare the long-term efficacy of different systemic therapeutic regimens for patients with noninfectious anterior scleritis to establish guidelines for institution of therapy. METHODS: Therapeutic failure of systemic nonsteroidal anti-inflammatory drugs (NSAIDs), systemic steroidal anti-inflammatory drugs, and systemic nonsteroidal immunosuppressive drugs was evaluated in 132 patients with noninfectious anterior scleritis (diffuse, nodular, or necrotizing types). RESULTS: In patients with diffuse scleritis, therapeutic failure for initial regimens occurred in 7% of patients treated with NSAIDs, in 16% of patients treated with steroids, and in 27% of patients treated with immunosuppressive drugs. In patients with nodular scleritis, therapeutic failure for initial regimens occurred in 9% of patients treated with NSAIDs, in 28% of patients treated with steroids, and in 25% of patients treated with immunosuppressive drugs. Addition or substitution of steroids or immunosuppressive drugs as second- or third-line therapies helped control the scleritis. In patients with necrotizing scleritis, therapeutic failure for initial regimens occurred in 100% of patients treated with NSAIDs, in 91% of patients treated with steroids, and in 26% of patients treated with immunosuppressive drugs. CONCLUSIONS: In patients with diffuse and nodular scleritis, NSAIDs should be the initial choice; in case of therapeutic failure, steroids should be added or substituted as second-line therapy, tapering and discontinuing them as soon as possible while maintaining remission with continued NSAIDs; in case of therapeutic failure, immunosuppressive drugs should be added or substituted as third-line therapy. In patients with necrotizing scleritis, immunosuppressive drugs should be the initial choice.

Adolescent↗
PubMedDate not supplied

[Differences in therapeutic effort because of the socioeconomic level of patients with acute myocardial infarction].

OBJECTIVES: To assess the hypothesis of the existence of differential therapeutic effort according to the socioeconomic status of the patients admitted to the hospital by acute myocardial infarction. PATIENTS AND METHODS: We study retrospectively 592 patients admitted to the intensive care units from six public hospitals from the Spanish region of Valencia, using data from two cohort studies focused on the study of in-hospital inequalities in health. The socioeconomic status was measured using the British occupational classification. The therapeutic effort predicted for the severity of illness was determined using a regression model that included the logarithm of Therapeutic Intervention Scoring System (TISS) score as the dependent variable and Simplified Acute Physiology Score (SAPS) score and Killip group as predictors. The patients whose observed TISS was 3 or more pointless than predicted were considered as infra-treated. The effect of potential confounders was controlled using unconditional logistic regression analysis. RESULTS: The proportion of infra-treated patients was inversely related to socioeconomic status chi 2 for tendency = 4.31, P = 0.0378). The logistic regression analysis showed a negative association between age and therapeutic effort (p < 0.0001) but not between therapeutic effort and socioeconomic status, after controlling the effect of age (p = 0.2150). DISCUSSION: Our results suggest that older patients receive less relative therapeutic effort, measured by TISS score, than younger patients. The differential therapeutic effort observed in the crude analysis seem attributable to the higher age of the patients in the lower socioeconomic strata.

Age Factors↗
PubMed2000

The ineffectiveness of a non-weight based heparin regimen in achieving therapeutic activated partial thromboplastin time (aPTT) in acute coronary syndrome.

Although low molecular weight heparin (LMWH) is increasingly being used in the treatment of acute coronary syndrome (ACS), unfractionated intravenous (IV) heparin infusion is still widely used in Australian hospitals for the treatment of ACS. This paper evaluates the effectiveness of a non-weight based heparin regimen in achieving a therapeutic activated partial thromboplastin time (aPTT) within 24 hours of IV heparin commencement. A sequential retrospective chart review of 99 medical records of ACS patients in a district hospital in south western Sydney, Australia, was performed. These patients were prescribed IV heparin and did not receive thrombolytic or warfarin therapy. Only 35 per cent reached a therapeutic aPTT level within 24 hours of commencement of IV heparin therapy. Comparison of therapeutic aPTT and non-therapeutic aPTT groups revealed that body weight was the only factor that was significantly different in the two groups. Patients who reached the therapeutic aPTT threshold within 24 hours weighed significantly less (mean body weight: 70.3 kg versus 80.3 kg) than those who did not reach the therapeutic threshold within 24 hours of heparin commencement (t = 3.80, d.f. = 86, p < 0.001). Given that a significant proportion of patients who require IV heparin therapy exceed the 70 kg body weight, the findings from this study suggest that a non-weight based heparin regimen is ineffective in the rapid achievement of therapeutic aPTT.

Acute Disease↗
PubMed2006

Heparin dosing and therapeutic activated partial thromboplastin times (aPTT) in acute coronary syndrome (ACS).

This study assessed the current practices of heparin dosing and determined the extent of therapeutic activated partial thromboplastin times (aPTT) achieved, utilising a standard heparin nomogram in the coronary care unit and step-down cardiac ward of a health care facility in South Australia. The study also examined the effect of actual body weight (ABW), body mass index (BMI), smoking, concomitant intravenous glycerine trinitrate, age, gender and creatinine levels, individually, on the time taken to attain a therapeutic aPTT in acute coronary syndrome (ACS) patients receiving a heparin infusion. A retrospective correlational research design was utilised to include the collection of quantitative data from 66 men and women of all ages and background consecutively admitted into the coronary care unit and the step-down cardiac ward and receiving a continuous heparin infusion. The quantitative data included demographic details plus all information regarding treatment and results of heparin therapy from the patients' medical records. Descriptive analysis of the data revealed 32% of the participants attained a therapeutic level with the first aPTT taken and that, successively, 35% and 45% of the participants attained a therapeutic level with the second and third aPTT taken. The majority of participants were found to be outside of the therapeutic range at any one time during the study. A generalised linear model (log-binomial model) applied to the data revealed that increased ABW (p=0.002), creatinine levels (p=0.033) and, in particular, BMI (p=0.000) were significant risk factors that contributed to the failure of participants attaining a therapeutic aPTT level. Age (p=0.668), gender (p=0.623), smoking (p=0.993) and the use of concomitant intravenous glycerine trinitrate (p=0.897) did not have a significant effect on the time to reach a therapeutic aPTT. The results provide noteworthy information for the re-evaluation of the use of the standard heparin nomogram. A robust randomised clinical trial is required to further examine BMI as the best predictor for heparin requirements in ACS patients receiving a heparin infusion.

Acute Disease↗
PubMed2005

Therapeutic vaccination for chronic infectious diseases: lessons from HIV-1.

Most therapeutic vaccines are usually divided into two groups according to their mode of action on immunity, based on the induction of either a Immoral response (antibodies) or a cellular response, mostly cytotoxic T lymphocytes (CTLs). The latter ones are in fact the most promising candidates for the treatment of cancer and chronic viral infections. However, we must admit that the design of such vaccines is far from being simple as the biology of the chronic infectious diseases involves complex issues such as viral latency, the existence of reservoirs or immune escape mechanisms. Furthermore, the concept of therapeutic vaccination implies that the host immune system is still competent for eliciting an immune response after vaccination, but patients suffering from chronic infectious diseases usually exhibit impaired immune defenses. To overcome this challenge, the actual tendency is to combine chemotherapy and therapeutic vaccination, playing around with schedules of vaccine administration and standard chemotherapy. To illustrate the different steps in the design and testing of a therapeutic vaccine, the human immunodeficiency virus (HIV-1) for which the efficacy of therapeutic vaccines is currently being evaluated, could serve as a model. Specific points like the rationale of using HIV-1 regulatory genes instead of structural genes, the possibility of using multiple injections of vaccine candidates or the importance of pre-existing immunity will be emphasized, together with the risks of inducing the emergence of new HIV-1 variants upon vaccine treatment of chronically infected HIV-1 patients. The current expertise in the field of therapeutic vaccines in chronically infected HIV-1 patients could be of interest for the design of a therapeutic vaccine for HBV infection.

AIDS Vaccines↗
PubMed2026

The Use of Deep Learning in RNA Therapeutic Development.

Ribonucleic acid (RNA)-based therapeutics have emerged as promising methods of disease treatment due to their ability to target the human genome and influence protein production, their versatility, and their relative lack of toxicity compared to other gene therapies. However, the RNA therapeutic design space is extremely large, encompassing multiple variables, including codon identities, secondary structure, and design of specific regions. RNA therapeutic optimization is difficult due to the impracticality of exploring such a vast design space experimentally. To address this limitation, deep learning methods have been employed to optimize RNA therapeutic development. In this review, we examine the application of deep learning models across three key aspects of RNA therapeutic development (RNA structure prediction, CRISPR activity, and RNA delivery), highlighting major contributions in these fields and analyzing how deep learning model architectures could affect model performance. We then discuss challenges associated with using deep learning for RNA therapeutics, such as computational and data limitations. Finally, we offer perspectives on areas for future exploration, such as emerging model architectures and methods of integration with more advanced high-throughput screening techniques. Ultimately, this review provides an overview of how deep learning is used in RNA therapeutic development and how it can evolve in the future.

Deep Learning↗
PubMed2006

The therapeutic relationship in the brief treatment of depression: contributions to clinical improvement and enhanced adaptive capacities.

Using data from the National Institute of Mental Health Treatment for Depression Collaborative Research Program, the authors examined the impact on treatment outcome of the patient's perception of the quality of the therapeutic relationship and contribution to the therapeutic alliance. Shared variance with early clinical improvement was removed from these relationship measures. Multilevel modeling demonstrated that a perceived positive therapeutic relationship early in treatment predicted more rapid decline in maladjustment subsequent to the relationship assessment. This effect occurred equally across all 4 treatment conditions. A positive early therapeutic relationship also predicted better adjustment throughout the 18-month follow-up as well as development of greater enhanced adaptive capacities (EAC). Controlling a wide range of patient characteristics did not eliminate the effects of the therapeutic relationship on rate of improvement during treatment and on EAC. Thus, independent of type of treatment and early clinical improvement, the therapeutic relationship contributes directly to positive therapeutic outcome.

Adaptation, Psychological↗
PubMed2006

A randomized controlled trial of the therapeutic workplace for community methadone patients: a partial failure to engage.

The Therapeutic Workplace is an employment-based treatment for drug addiction that uses wages for work to reinforce drug abstinence. The Therapeutic Workplace has promoted abstinence from heroin and cocaine in treatment-resistant mothers in methadone treatment. This study attempted to replicate that effect in crack cocaine users recruited from community-based methadone programs. Participants were randomly assigned to a Therapeutic Workplace (n=22) or usual care control (n=25) group. Therapeutic Workplace participants were invited to work in the workplace and earn vouchers every weekday for 9 months contingent on documented opiate and cocaine abstinence. The two groups did not differ significantly on measures of cocaine or opiate use collected during study participation. Daily attendance and urinalysis results of the Therapeutic Workplace group were analyzed, and only 7 of the 22 participants initiated consistent periods of abstinence and workplace attendance. Two individuals gained access to the workplace on a few days, and 9 participants attempted to gain access to the workplace but never provided a drug-negative urine sample. Possible reasons for differences between the current study and the previous Therapeutic Workplace study are considered. Procedures that increase participant contact with the Therapeutic Workplace and its reinforcement contingencies might increase the likelihood of these individuals being successful in the treatment program.

Adolescent↗
PubMed2002

Complexities in ETS-domain transcription factor function and regulation: lessons from the TCF (ternary complex factor) subfamily. The Colworth Medal Lecture.

The ETS-domain transcription factor family can be divided into a series of subfamilies. Elk-1 represents the founding member of the ternary complex factor (TCF) subfamily. By focusing on the TCF subfamily, we can demonstrate the complexities that exist in the function and regulation of ETS-domain transcription factors. This article focuses on Elk-1 in detail and summarizes the functions of other TCFs. The key themes covered include the domain structure of the TCFs, the mechanisms of complex formation with serum response factor, regulation of TCFs by mitogen-activated protein kinase cascades, and transcriptional regulatory properties of the TCFs. Finally, the emerging role of the TCFs in vivo is discussed. A picture is developing indicating that, while these proteins exhibit significant sequence and functional conservation, key differences in their structure and regulation are being identified which may relate to unique functions of these proteins in vivo.

Amino Acid Sequence↗
PubMed2002

An adventure in biotechnology: the development of haemophilia A therapeutics -- from whole-blood transfusion to recombinant DNA to gene therapy.

The past decade has seen an explosion in the number of therapeutic proteins available for a wide spectrum of diseases. Some of these proteins are obtained from human plasma. Examples of these therapeutic proteins are albumin, intravenous immunoglobulins and prothrombin complex concentrates. The majority of new therapeutic proteins are, however, derived via recombinant DNA technology. There are other examples where the first therapeutic preparation was a crude preparation derived from plasma or tissue and where subsequent development has resulted in a recombinant form of the therapeutic protein. This article focuses on the development of therapeutics for the treatment of haemophilia A (deficiency of Factor VIII activity). The progression from crude plasma fractions to monoclonal-purified preparations to the more recent development of therapeutic concentrates via recombinant DNA technology is described in some detail. Finally, the current status of gene therapy for haemophilia A is evaluated. Both technical issues as well as market forces are described, as both have had significant impact on the product-development process.

Blood Transfusion↗
PubMed1997

Therapeutic drug monitoring of gentamicin: a 6-year follow-up audit.

BACKGROUND AND OBJECTIVE: In 1984 a therapeutic drug monitoring (TDM) service was established in Hospital Universiti Sains Malaysia (HUSM) and gentamicin concentrations were measured and used to design optimal regimens for the antibiotic. In this study we report on a 6-year follow-up audit since our first assessment of the service. METHOD: Records of 733 requests for gentamicin monitoring were reviewed. RESULTS: Of the 592 patients involved, 39% were neonates and 42% were adults. Peak gentamicin concentrations were within the therapeutic range in 65% of the patients at first monitoring and 79% of the corresponding trough concentrations were within the non-toxic range. After dosage adjustment, 81% of the peak concentrations were within the therapeutic range and trough concentrations rose to levels regarded as toxic in 7% of patients. In patients with therapeutic peak concentrations at the first monitoring point, the average duration of gentamicin therapy was statistically shorter than in those patients who failed to achieve a therapeutic peak concentration. The distribution of gentamicin peak and trough concentrations in terms of therapeutic ranges were also better than those found in 1990. CONCLUSION: TDM for gentamicin is well accepted in HUSM and its application has contributed to improved gentamicin administration. Furthermore, our physicians are now able to choose more appropriate dosage regimens for their patients because the majority of gentamicin concentrations attained even at the first monitoring were within the therapeutic range.

Adult↗
PubMed1989

Occupational exposure limits for therapeutic substances.

Few therapeutic substances have occupational exposure limits (OELs) set by regulatory bodies and reliance is often placed on in-house OELs derived from a formula based on the therapeutic dose. This mode of derivation relies on assumptions about pharmacokinetics, pharmacodynamics and risk acceptability which might not be soundly based for occupational health purposes. Pharmacodynamic evidence shows that occupational exposure to airborne therapeutic substances can be associated with a much higher risk of an adverse health effect especially on the lungs or skin than by their therapeutic administration. Pharmacokinetic studies indicate that for certain therapeutic substances occupational exposure by inhalation results in a more rapid and complete systemic absorption than a similar dose administered (usually orally) for therapeutic purposes. These and other considerations are used to develop a systematic strategy for deriving OELs for therapeutic substances. The first stage of this consists of a qualitative assessment and ranking of likely occupational health effects. This is based on pharmacological studies, analogy and specific workplace studies. Subsequently assessment of the relevant pharmacological data together with environmental monitoring and exposure-linked health surveillance provides the quantitative data for the setting of appropriate OELs.

Drug Industry↗
PubMed1989

Follow-up of maladjusted academically underachieving children treated in a therapeutic community.

Follow-up studies present many difficulties and variables of which the researcher must be aware. They include finding the subjects--in this case children--who are being followed-up and seeking their cooperation in participating in a follow-up scheme. They also include considering the population that one is treating and most especially the duration and severity of the disturbance and how this could well affect the outcome of treatment in a therapeutic community and, eventually, the success or failure after such youngsters leave the therapeutic community. The skill and dedication of treatment being given in the therapeutic community and how this affects outcome once the child leaves the community is also important. The fact that some individuals who leave are withdrawn before it is felt they are ready may mean that incomplete treatment leads to poor outcomes anyway. Also the events that occur after leaving the treatment centre are of particular importance. These may be beneficial or harmful to the individual, increasing or decreasing the chances of rehabilitation. This is the most difficult aspect to control and hence the child who has done well during treatment in a therapeutic community may encounter extreme stresses after leaving. This may result in a poor outcome that is not attributable to what was done in the therapeutic community. This study showed that those children or adolescents with severe problems who were not rejected by the therapeutic community and who received the support of the Local Authority, parents etc. were likely to be more effective in adjusting to life outside the therapeutic community in due course. Those who were able to manipulate the system by turning one professional against another, however, were more likely to experience failure subsequently in late adolescence and as young adults.

Adaptation, Psychological↗