Target behaviors definition

The acronym "SOON" depicted in Figure 8.8 reviews the key aspects of developing adequate definitions of critical behaviors to target for a DO IT process. You are ready for the observation phase when you have a checklist of critical behaviors with definitions that are Specific, Observable, Objective, and Naturalistic. We have already considered most of the characteristics of behavioral definitions implied by these key words, and examples of behavioral checklists are provided later in this chapter, as well as in Chapter 12 on "safety coaching."... 

The PBPK model development for a chemical is preceded by the definition of the problem, which in toxicology may often be related to the apparent complex nature of toxicity. Examples of such apparent complex toxic responses include nonlinearity in dose-response, sex and species differences in tissue response, differential response of tissues to chemical exposure, qualitatively and/or quantitatively difference responses for the same cumulative dose administered by different routes and scenarios, and so on. In these instances, PBPK modeling studies can be utilized to evaluate the pharmacokinetic basis of the apparent complex nature of toxicity induced by the chemical. One of the values of PBPK modeling, in fact, is that accurate description of target tissue dose often resolves behavior that appears complex at the administered dose level. 

By definition all hormones affect the behavior of their target cells. Examples of the interplay between endocrine disturbances and their biochemical consequences are provided by some of the diseases of the thyroid, which directly affects basal metabolic rate, and diabetes mellitus, where glucose metabolism is deranged. 

Additional information from the parent(s) or primary care taker(s) should include the child s medical and developmental history and the family s history of mental disorders and stressors. Reports of the direct observation of the youngster s behavior from the parent(s) or primary caretaker(s), school personnel, and others who have had contact with the child can help guide the definition of the most pressing target symptoms. 

The time for antidepressant onset of effect in BN is unclear. In the absence of data, the definition of a therapeutic trial from the depression hterature (4 to 8 weeks at a therapeutic dose) should be used. Since the majority of subjects will not experience a complete remission, and there are few data on predictors of response or whether switching to another class will improve response, a clear and specific target should be stated initially. Eor example, will the medication be continued if the patient has a 50% reduction in binge-purge episodes, or if abstinence from such behavior is the ultimate therapeutic goal. Optimal duration of treatment after response is also poorly defined. Most clinicians will treat for 6 months to 1 year and then re-evaluate the need for ongoing treatment. The evidence is mixed as to whether any early benefit is sustained, hence the decision to continue treatment should be made based on both initial response and the maintenance of that benefit. If the symptoms return within a few months after the antidepressant is discontinued, then the treatment may need to be reinitiated. 

---