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Search Results (390)

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Keywords = professional agency

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17 pages, 220 KiB  
Article
Which Standards to Follow? The Plurality of Conventions of French Principals Within the School Organization
by Romuald Normand
Educ. Sci. 2025, 15(8), 998; https://doi.org/10.3390/educsci15080998 (registering DOI) - 5 Aug 2025
Abstract
This study examines the moral agency of French secondary school headteachers through the lens of the theory of conventions. Using qualitative data from interviews with fifteen headteachers involved in professional development, this study explores how these leaders justify their practices within a centralized, [...] Read more.
This study examines the moral agency of French secondary school headteachers through the lens of the theory of conventions. Using qualitative data from interviews with fifteen headteachers involved in professional development, this study explores how these leaders justify their practices within a centralized, bureaucratic, and hierarchical education system. It identifies a variety of conventions—civic, domestic, industrial, project, market, inspired, and fame—that headteachers draw on to navigate institutional constraints, manage professional relationships, and foster pedagogical and organizational change. Particular attention is given to how civic and domestic conventions shape leadership discourse and practices, especially regarding trust building, decision making, and reform implementation. We also compare the French context with international examples from the International Successful School Principalship Project (ISSPP), focusing on Nordic countries, where leadership emphasizes democratic participation, professional trust, and shared responsibility. This study underscores the uniqueness of the French leadership model, which resists managerial and market logics while remaining rooted in republican and egalitarian ideals. It concludes by advocating for a more context-aware, ethically grounded, and dialogical approach to school leadership. Full article
27 pages, 4239 KiB  
Article
Implementing Zero Trust: Expert Insights on Key Security Pillars and Prioritization in Digital Transformation
by Francesca Santucci, Gabriele Oliva, Maria Teresa Gonnella, Maria Elena Briga, Mirko Leanza, Marco Massenzi, Luca Faramondi and Roberto Setola
Information 2025, 16(8), 667; https://doi.org/10.3390/info16080667 - 5 Aug 2025
Abstract
As organizations continue to embrace digital transformation, the need for robust cybersecurity strategies has never been more critical. This paper explores the Zero Trust Architecture (ZTA) as a contemporary cybersecurity framework that addresses the challenges posed by increasingly interconnected systems. Zero Trust (ZT) [...] Read more.
As organizations continue to embrace digital transformation, the need for robust cybersecurity strategies has never been more critical. This paper explores the Zero Trust Architecture (ZTA) as a contemporary cybersecurity framework that addresses the challenges posed by increasingly interconnected systems. Zero Trust (ZT) operates under the principle of “never trust, always verify,” ensuring that every access request is thoroughly authenticated, regardless of the requester’s location within or outside the network. However, implementing ZT is a challenging task, requiring an adequate roadmap to prioritize the different initiatives in agreement with company culture, exposure and cyber posture. We apply multi-criteria decision analysis (MCDA) to evaluate the relative importance of various components within a ZT framework, using the Incomplete Analytic Hierarchy Process (IAHP). Expert opinions from professionals in cybersecurity and IT governance were gathered through structured questionnaires, leading to a prioritized ranking of the eight key ZT pillars, as defined by the Cybersecurity and Infrastructure Security Agency (CISA), Washington, DC, USA, along with a prioritization of the sub-elements within each pillar. The study provides actionable insights into the implementation of ZTA, helping organizations prioritize security efforts to mitigate risks effectively and build a resilient digital infrastructure. The evaluation results were used to create a prioritized framework, integrated into the ZEUS platform, developed with Teleconsys S.p.A., to enable detailed assessments of a firm’s cyber partner regarding ZT and identify improvement areas. The paper concludes by offering recommendations for future research and practical guidance for organizations transitioning to a ZT model. Full article
(This article belongs to the Section Information Security and Privacy)
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19 pages, 1223 KiB  
Article
Unorthodox? Sustainability as Discursive Guidepost for Creating Transformative Agency in Professional Communication Education
by Franzisca Weder and Penelope M. Kierans
Sustainability 2025, 17(15), 6878; https://doi.org/10.3390/su17156878 - 29 Jul 2025
Viewed by 183
Abstract
Based on recent work outlining the transformation of professional communicator roles and the desperate search for “curators” or “agents of change” in neighboring disciplines such as management, business and economics, sustainability studies and education, we present a systematic reflection of concepts in higher [...] Read more.
Based on recent work outlining the transformation of professional communicator roles and the desperate search for “curators” or “agents of change” in neighboring disciplines such as management, business and economics, sustainability studies and education, we present a systematic reflection of concepts in higher education for sustainability and their (missing) fit to professional communication education in a world in crisis. The blind spots and challenges identified, especially from a communication perspective, will be filled with concepts from environmental communication pedagogy, pointing to the need for more participatory strategies and radicality in professional communication education. Concrete modalities of instruction will be discussed and supported by eight reconstruction interviews with pedagogues, educators and students from diverse cultural contexts involved in sustainability communication education. The findings show the need for more radical pedagogy and unorthodoxy. The paper finishes with suggestions for practices that materialize sustainability in co-created sites of change. Full article
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13 pages, 1885 KiB  
Article
Arts in Medicine Partnerships: Interdisciplinary Collaborations to Support Behavioral Health
by Gaelynn Patricia Wolf Bordonaro, Julie Galliart, Kate Van Steenhuyse, Haoyu Huang and Ash Tamzin
Behav. Sci. 2025, 15(8), 1030; https://doi.org/10.3390/bs15081030 - 29 Jul 2025
Viewed by 255
Abstract
The Emporia State University (ESU) /Kansas Arts Commission (KAC) Arts in Medicine Partnership exemplifies interdisciplinary collaboration and the capacity of art therapy to impact mental health and well-being. Through the partnership, art therapy services were offered to medical agencies across the state of [...] Read more.
The Emporia State University (ESU) /Kansas Arts Commission (KAC) Arts in Medicine Partnership exemplifies interdisciplinary collaboration and the capacity of art therapy to impact mental health and well-being. Through the partnership, art therapy services were offered to medical agencies across the state of Kansas. Participants included medical patients, families, caregivers, staff, and professionals. The article introduces (1) the profession of art therapy and the subspecialty of medical art therapy, (2) the ESU/KAC Arts in Medicine Partnership, (3) examples of positive psychology-informed arts-based experiences, and (4) a pilot study designed to explore the impact of group art therapy sessions with medical teaching faculty. Full article
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18 pages, 376 KiB  
Article
Resilience or Retreat? The Impact of COVID-19 on Entrepreneurial Intentions of Undergraduate Business Students
by Anas Al-Fattal and Michael Martin
COVID 2025, 5(8), 117; https://doi.org/10.3390/covid5080117 - 26 Jul 2025
Viewed by 218
Abstract
The COVID-19 pandemic fundamentally disrupted assumptions about entrepreneurship, career planning, and professional development. This study explored how the pandemic influenced the entrepreneurial intentions of undergraduate business students in the United States. Using a qualitative methodology based on in-depth interviews with 31 students at [...] Read more.
The COVID-19 pandemic fundamentally disrupted assumptions about entrepreneurship, career planning, and professional development. This study explored how the pandemic influenced the entrepreneurial intentions of undergraduate business students in the United States. Using a qualitative methodology based on in-depth interviews with 31 students at a public Midwestern university, the research interpreted student narratives through the lenses of effectuation theory, resilience theory, and the theory of planned behavior. Findings revealed that many participants reframed entrepreneurship as a strategy for navigating economic uncertainty and enhancing personal agency. Students reported valuing adaptability, resourcefulness, and opportunity recognition, often experimenting with side hustles during the pandemic as a means of resilience. Their entrepreneurial thinking shifted from purely economic motivations toward aspirations for flexibility, self-fulfillment, and purposeful work. The study highlights the formative role of crisis contexts in shaping entrepreneurial identity among emerging professionals. It suggests that entrepreneurship education should move beyond traditional models, fostering skills for navigating complexity and building resilience. In doing so, the findings contribute to broader conversations about youth entrepreneurship, post-pandemic career development, and the evolving demands of the labor market in times of disruption. Full article
(This article belongs to the Section COVID Public Health and Epidemiology)
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11 pages, 223 KiB  
Review
Review of Foodborne Botulism in the UK: 2006–2024
by Corinne Francoise Laurence Amar, Burhan Ahmed, Jonathan Finch, Dunstan Rajendram, Vanessa K. Wong and Gauri Godbole
Foods 2025, 14(15), 2584; https://doi.org/10.3390/foods14152584 - 23 Jul 2025
Viewed by 443
Abstract
Food-borne botulism is a rare but serious disease caused by ingestion of botulinum neurotoxin pre-formed in food by Clostridium botulinum. Between 2006 and 2009, no foodborne botulism cases were reported in the UK. However, the period from 2010 to 2024 saw 13 cases, [...] Read more.
Food-borne botulism is a rare but serious disease caused by ingestion of botulinum neurotoxin pre-formed in food by Clostridium botulinum. Between 2006 and 2009, no foodborne botulism cases were reported in the UK. However, the period from 2010 to 2024 saw 13 cases, encompassing seven separate incidents and two outbreaks, with no reported fatalities. Cases were predominantly linked to imported, home-made, and artisanal foods, occasionally to commercial products. Diagnostic and public health challenges include delayed clinical diagnosis, delayed sample collection, inadequate specimen volumes, and the frequent unavailability of suspected food sources, hampering epidemiological investigations. The UK has an extremely low incidence of foodborne botulism with an estimated rate of 0.001 cases per 100,000 people per year, but despite this low occurrence, food botulism remains a public health emergency as it requires timely treatment and rapid reactive intervention to be undertaken by multiple regulatory agencies. Continuous professional training of medical staff, up-to-date clinical guidance, rapid diagnostic, and food investigations are essential for optimising patient outcomes and prevention. Full article
(This article belongs to the Special Issue Feature Reviews on Food Microbiology)
14 pages, 271 KiB  
Article
Children Involved in Child Protection: Hostile Attitudes as a Form of Agency
by Silvia Fargion and Diletta Mauri
Soc. Sci. 2025, 14(8), 449; https://doi.org/10.3390/socsci14080449 - 23 Jul 2025
Viewed by 1088
Abstract
Introduction: It is widely acknowledged that good quality relationships between social workers and children are essential to children’s non-formal inclusion in child protection processes. However, research exploring the perspective of children has shown this relationship to be highly complex, particularly when children are [...] Read more.
Introduction: It is widely acknowledged that good quality relationships between social workers and children are essential to children’s non-formal inclusion in child protection processes. However, research exploring the perspective of children has shown this relationship to be highly complex, particularly when children are taken into care. Methods: This paper combines insights from two qualitative participatory studies conducted in Italy, both developed out of a collaboration between university, professional social work associations, and the Italian association of care leavers. The two projects explored, respectively, the perspectives of social workers on the one hand and of children in care and care leavers on the other regarding their relationship. Outcomes: The data reveal the complexity of the relationship between children and social workers, showing how both share a mirrored perception of it. Social workers recognise children’s negative feelings toward them and see them as inevitable, especially in cases of tense family dynamics. A relationship marked by hostile attitudes, anger, and distrust not only fuels social workers’ emotional struggles but also makes it harder to engage children effectively. While hostile attitudes and mistrust are often seen as obstacles to positive engagement, we advocate for recognising them not as barriers to be overcome but as realities to be acknowledged and addressed openly. This approach can create space for both children and practitioners to explore alternative forms of agency, fostering more meaningful participation. Full article
(This article belongs to the Section Childhood and Youth Studies)
28 pages, 19285 KiB  
Article
PV System Design in Different Climates: A BIM-Based Methodology
by Annamaria Ciccozzi, Tullio de Rubeis, Yun Ii Go and Dario Ambrosini
Energies 2025, 18(14), 3866; https://doi.org/10.3390/en18143866 - 21 Jul 2025
Viewed by 384
Abstract
One of the goals of Agenda 2030 is to increase the share of renewable energy in the global energy mix. In this context, photovoltaic systems play a key role in the transition to clean energy. According to the International Energy Agency, in 2023, [...] Read more.
One of the goals of Agenda 2030 is to increase the share of renewable energy in the global energy mix. In this context, photovoltaic systems play a key role in the transition to clean energy. According to the International Energy Agency, in 2023, solar photovoltaic alone accounted for three-quarters of renewable capacity additions worldwide. Designing a performing photovoltaic system requires careful planning that takes into account various factors, both internal and external, in order to maximize energy production and optimize costs. In addition to the technical characteristics of the system (internal factors), the positions and the shapes of external buildings and surrounding obstacles (external factors) have a significant impact on the output of photovoltaic systems. However, given the complexity of these environmental factors, they cannot be treated accurately in manual design practice. For this reason, this paper proposes a Building Information Modeling-based workflow for the design of a photovoltaic system that can guide the professional step-by-step throughout the design process, starting from the embryonic phase to the definitive, and therefore more detailed, one. The developed methodology allows for an in-depth analysis of the shading, the photovoltaic potential of the building, the performance of the photovoltaic system, and the costs for its construction in order to evaluate the appropriateness of the investment. The main aim of the paper is to create a standardized procedure applicable on a large scale for photovoltaic integration within Building Information Modeling workflows. The methodology is tested on two case studies, characterized by different architectural features and geographical positions. Full article
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12 pages, 237 KiB  
Article
Teacher Self-Efficacy in Asthma Management in Elementary and Middle Schools
by Ethan Schilling, Stacey Neuharth-Pritchett, Sofia H. Davie and Yvette Q. Getch
Allergies 2025, 5(3), 25; https://doi.org/10.3390/allergies5030025 - 3 Jul 2025
Viewed by 502
Abstract
Background/Objectives: This study assessed teacher self-efficacy in school-based asthma management in two southern states in the United States. Current literature focuses primarily on supporting school-based asthma management, but few studies have focused on teacher self-efficacy in the asthma management process. Methods: With data [...] Read more.
Background/Objectives: This study assessed teacher self-efficacy in school-based asthma management in two southern states in the United States. Current literature focuses primarily on supporting school-based asthma management, but few studies have focused on teacher self-efficacy in the asthma management process. Methods: With data collected from a two-state survey of a randomly selected group of teachers in grades kindergarten to grade eight (n = 379), teachers’ demographic variables, general opinions about asthma management practices, and their self-perceptions on the Teacher Asthma Management and Information Seeking Scale, which assesses self-efficacy, were examined. Results: Teachers’ self-efficacy in managing asthma and seeking information was significantly higher among teachers who had completed in-service professional learning sessions and those who had access to community resources or links to community agencies. Additionally, teachers with personal experience of chronic illness, asthma, or allergies and those who had students with chronic illnesses in their classrooms reported higher self-efficacy scores. Conclusions: Findings suggest that providing professional learning about asthma for teachers, offering access to asthma action plans and community resources, and increasing awareness of chronic conditions and training for handling medical emergencies can enhance teachers’ self-efficacy and improve outcomes for students with chronic illnesses. Full article
(This article belongs to the Section Asthma/Respiratory)
16 pages, 541 KiB  
Review
Education-to-Work Transition Among the Youth in Post-Conflict Settings: A Review of the Roles of Individual Agency, Mental Health, and Psychosocial Well-Being
by Nathaniel Mayengo, Jane Namusoke, Henry Kibedi and Kennedy Amone-P’Olak
Soc. Sci. 2025, 14(7), 400; https://doi.org/10.3390/socsci14070400 - 25 Jun 2025
Viewed by 493
Abstract
Education-to-work transition among war-affected youth in post-conflict settings is fraught with challenges, not least compounded by the little attention placed on individual agency and mental health. This review examines the debate on war-affected youth skilling programmes in post-conflict settings, which neglect the roles [...] Read more.
Education-to-work transition among war-affected youth in post-conflict settings is fraught with challenges, not least compounded by the little attention placed on individual agency and mental health. This review examines the debate on war-affected youth skilling programmes in post-conflict settings, which neglect the roles of individual agency and mental health in the education-to-work transition. Building on Albert Bandura’s Self-Efficacy Theory (SET) and the Cumulative Stress Hypothesis (CSH), the review presents an integrated approach to skills development for improving education-to-work transition among war-affected youth. According to SET, the development of self-efficacy is anchored on enactive mastery, vicarious experience, verbal persuasion, and physiological arousal. Moreover, individual agency factors such as motivation, aspiration, goal orientation, active efforts, and alignment of intentions with skills are protective factors for effective education-to-work transition, but they are also eroded by the adverse consequences of violent conflicts. Similarly, the CSH also suggests that the effects of exposure to protracted violent conflicts are cumulative and may lead, in turn, to a plethora of mental health problems in the aftermath of violent conflicts. Mental health problems like depression, anxiety, and PTSD are linked to, inter alia, behaviours such as aggression, substance abuse, and apathy, all related to poor employment outcomes. To increase the employability of young people affected by war, skills training institutions and work settings need to prioritise the mental health and individual agency of the youth, as well as skills acquisition for specific trades. Consequently, we propose an integrated model of reintegrating war-affected and vulnerable youth anchored on professional technical and vocational skills training; recognition of individual agency; provision of mental and psychosocial support; and life skills training, all nested within the local economic realities. Full article
(This article belongs to the Special Issue Rethinking the Education-to-Work Transition for Young People)
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19 pages, 4192 KiB  
Article
Supporting Multilingual Students’ Mathematical Discourse Through Teacher Professional Development Grounded in Design-Based Research: A Conceptual Framework
by Margarita Jiménez-Silva, Robin Martin, Rachel Restani, Suzanne Abdelrahim and Tony Albano
Educ. Sci. 2025, 15(6), 778; https://doi.org/10.3390/educsci15060778 - 19 Jun 2025
Viewed by 606
Abstract
This conceptual paper presents a framework for supporting multilingual students’ mathematical discourse through teacher professional development grounded in design-based research (DBR). Drawing on sociocultural learning theory, the Integrated Language and Mathematics Project (ILMP) was co-developed with elementary educators to promote integrated instruction that [...] Read more.
This conceptual paper presents a framework for supporting multilingual students’ mathematical discourse through teacher professional development grounded in design-based research (DBR). Drawing on sociocultural learning theory, the Integrated Language and Mathematics Project (ILMP) was co-developed with elementary educators to promote integrated instruction that simultaneously advances students’ mathematical understanding, language development, and cultural identity. The ILMP framework centers around three instructional pillars: attention to language, attention to mathematical thinking, and cultural responsiveness. Through collaborative inquiry cycles, educators engaged as learners, contributors, and designers of practice, iteratively enacting and reflecting on instructional strategies rooted in students’ linguistic and cultural assets. Teachers implemented discussion-rich mathematical tasks, supported by language scaffolds and culturally relevant contexts, to foster students’ mathematical reasoning and communication. This approach was particularly impactful for multilingual learners, whose language use and problem-solving strategies were both valued and elevated. This paper also discusses the opportunities and challenges of DBR and research–practice partnerships, including flexibility in implementation and navigating district-level priorities. Insights underscore the importance of practitioner agency, asset-based pedagogy, and the co-construction of professional learning. The ILMP framework offers a scalable, equity-oriented model for improving integrated language and mathematics instruction in diverse elementary classrooms and beyond. Full article
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24 pages, 366 KiB  
Article
Triadic Perspectives on Decision Making in Psychiatry: A Qualitative Study on Service Users, Caregivers and Healthcare Professionals in Latvia
by Solvita Olsena, Inese Stars, Elza Eliza Rozenberga, Karina Konstantinova and Ksenija Baidina
Healthcare 2025, 13(12), 1416; https://doi.org/10.3390/healthcare13121416 - 13 Jun 2025
Cited by 1 | Viewed by 740
Abstract
Background/Objectives: Decision making is fundamental to personal autonomy and person-centered, rights-based psychiatric care. This study explored the perceptions and experiences of decision making in psychiatric care from the perspectives of service users, caregivers, and healthcare professionals, identifying contexts that facilitate or hinder these [...] Read more.
Background/Objectives: Decision making is fundamental to personal autonomy and person-centered, rights-based psychiatric care. This study explored the perceptions and experiences of decision making in psychiatric care from the perspectives of service users, caregivers, and healthcare professionals, identifying contexts that facilitate or hinder these practices. Methods: An exploratory–descriptive qualitative design was applied, using semi-structured interviews with eight service users, six caregivers, and seven healthcare professionals (21 interviews in total). Data were transcribed verbatim and analyzed through inductive content analysis. Results: Four main categories were identified: (1) antecedents for decision making, (2) challenges in decision making, (3) consequences of decision making, and (4) recommendations for improvement. Conclusions: This study provides insight into how decisions in psychiatric care are made in Latvia, highlighting the legal, personal, and institutional factors influencing these processes. Participants offered valuable perspectives, identifying both facilitators and barriers to autonomous decision making, as well as suggesting necessary improvements. The findings suggest the need for legal reform and systemic improvements in practices that favor agency in decision making. Additionally, they underscore the importance of strengthening individual capacities to support meaningful collaboration among service users, caregivers, and healthcare professionals in making healthcare decisions that enhance the quality of care and well-being of people with mental health difficulties. Full article
(This article belongs to the Special Issue Mental Health and Health Care in Vulnerable Contexts)
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27 pages, 1258 KiB  
Article
Risk Mitigation Model for Addressing Contractual Claims Risk in Civil Infrastructure Projects in South Africa
by Awad Saad, Lance Wentzel, Julius Ayodeji Fapohunda and Rainer Haldenwang
Buildings 2025, 15(12), 2029; https://doi.org/10.3390/buildings15122029 - 12 Jun 2025
Viewed by 462
Abstract
The risks arising from contractual claims in the civil engineering construction industry in South Africa are a concern. Currently, there are no risk mitigation models available for managers to help reduce such risks. A theoretical risk mitigation model was developed from the literature [...] Read more.
The risks arising from contractual claims in the civil engineering construction industry in South Africa are a concern. Currently, there are no risk mitigation models available for managers to help reduce such risks. A theoretical risk mitigation model was developed from the literature and validated through partial least squares structural equation modelling (PLS-SEM), using primary questionnaire data obtained from 166 respondents drawn from a pool of South African construction industry professionals, including project directors, project managers, supervisors, consultants, and contractors. The descriptive results indicate significant patterns, trends, and distributions of the variables across the three constructs in the study. The PLS-SEM results indicate that factors causing contractual claims risk in civil infrastructure projects have a significant relation to the impact of risk occurrence on these projects, influencing the strategies to be implemented to mitigate such risks. The PLS-SEM results also indicate a significant direct relation between the factors causing contractual claims risk and the strategies to be implemented to mitigate risks, thus implying that the holistic adaptation of the PLS-SEM (risk mitigation model) by construction industry professionals in South Africa should reduce contractual claims risk in civil infrastructure projects. The findings serve as a valuable guide not only to construction industry professionals but also to government agencies such as the Department of Public Works and Infrastructure. Full article
(This article belongs to the Section Construction Management, and Computers & Digitization)
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22 pages, 706 KiB  
Article
Privacy Ethics Alignment in AI: A Stakeholder-Centric Framework for Ethical AI
by Ankur Barthwal, Molly Campbell and Ajay Kumar Shrestha
Systems 2025, 13(6), 455; https://doi.org/10.3390/systems13060455 - 9 Jun 2025
Viewed by 749
Abstract
The increasing integration of artificial intelligence (AI) in digital ecosystems has reshaped privacy dynamics, particularly for young digital citizens navigating data-driven environments. This study explores evolving privacy concerns across three key stakeholder groups—young digital citizens, parents/educators, and AI professionals—and assesses differences in data [...] Read more.
The increasing integration of artificial intelligence (AI) in digital ecosystems has reshaped privacy dynamics, particularly for young digital citizens navigating data-driven environments. This study explores evolving privacy concerns across three key stakeholder groups—young digital citizens, parents/educators, and AI professionals—and assesses differences in data ownership, trust, transparency, parental mediation, education, and risk–benefit perceptions. Employing a grounded theory methodology, this research synthesizes insights from key participants through structured surveys, qualitative interviews, and focus groups to identify distinct privacy expectations. Young digital citizens emphasized autonomy and digital agency, while parents and educators prioritized oversight and AI literacy. AI professionals focused on balancing ethical design with system performance. The analysis revealed significant gaps in transparency and digital literacy, underscoring the need for inclusive, stakeholder-driven privacy frameworks. Drawing on comparative thematic analysis, this study introduces the Privacy–Ethics Alignment in AI (PEA-AI) model, which conceptualizes privacy decision-making as a dynamic negotiation among stakeholders. By aligning empirical findings with governance implications, this research provides a scalable foundation for adaptive, youth-centered AI privacy governance. Full article
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15 pages, 304 KiB  
Review
Improving the Dosing Schedules of Targeted Anticancer Agents
by Dominique Levêque
Pharmaceuticals 2025, 18(6), 848; https://doi.org/10.3390/ph18060848 - 6 Jun 2025
Viewed by 746
Abstract
Beyond developing new agents, cancer treatment can also be optimized by modifying the dosing regimen of approved drugs. Academic teams have experimented with different ways of improving drug regimens, leading to off-label practices for therapeutic and/or economic purposes, and currently, drug regulatory agencies [...] Read more.
Beyond developing new agents, cancer treatment can also be optimized by modifying the dosing regimen of approved drugs. Academic teams have experimented with different ways of improving drug regimens, leading to off-label practices for therapeutic and/or economic purposes, and currently, drug regulatory agencies have begun to reappraise this often-neglected topic. This concept also considers the patient’s perspective in terms of quality of life and convenience, including the concept of time toxicity. Overall, the optimization of drug dosing of anticancer agents may be viewed on three sides: the improvement of the benefits/risks balance (patient), the improvement of the convenience of the treatment (patient, healthcare professionals), and the mitigation of the financial impact (health insurance, patient). Examples of dose reassessments of targeted therapies (approved since 1997) are chosen to illustrate the context. Suboptimal/overdosed regimens are found for certain molecularly targeted agents, mostly based on the ancient concept of maximum tolerated dose in oncology. This underlines the lack of comparative effective dose trials before approval. Fortunately, dosing regimens of newly approved molecularly targeted agents is going to evolve with the hope of more convenient and better tolerated treatments. This optimization will bring greater benefit to patients and to healthcare professionals but without addressing the economic issue. Full article
(This article belongs to the Special Issue Therapeutic Drug Monitoring and Adverse Drug Reactions: 2nd Edition)
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