OBJECTIVES To undertake a systematic review of the effectiveness and costs of different guideline development, dissemination and implementation strategies. To estimate the resource implications of these strategies. To develop a framework for deciding when it is efficient to develop and introduce clinical guidelines. DATA SOURCES MEDLINE, Healthstar, Cochrane Controlled Trial Register, EMBASE,...

In this constructivist grounded theory study, 12 White mental health counselors committed to antiracism were interviewed explore their professional identity development. The emergent theoretical model of antiracist counseling development is a multifaceted lifelong developmental process that manifests through personal and experiences enacted within actions.

School bullying can involve children in different ways, making them play different roles, among them, victims, bullies and bullyvictims. The aim of this study was to describe how bullying occurs in high social vulnerability schools of Florianópolis metropolitan area and the roles played by students in this phenomenon. Overall, 409 children and adolescents from the 3rd to 5th grades and of two p...

OBJECTIVES To investigate the effects of a multifaceted implementation strategy on behaviour, behavioural determinants, knowledge and awareness of healthcare workers regarding the use of recommendations to prevent hand eczema. METHODS The Hands4U study is a randomised controlled trial. A total of 48 departments (n=1649 workers) were randomly allocated to the multifaceted implementation strate...

Cancers of various organs have been categorized into distinct subtypes after increasingly sophisticated taxonomies. Additionally, within a seemingly homogeneous subclass, individual cancers contain diverse tumour cell populations that vary in important cancer-specific traits such as clonogenicity and invasive potential. Differences that exist between and within a given tumour type have hampered...

Mutations in the parkin gene are a common cause of autosomal recessive early-onset parkinsonism. Parkin functions as an E3 ubiquitin ligase where it can polyubiquitinate a number of its protein substrates, thus targeting them for degradation by the 26 S proteasomal complex. Recent studies have demonstrated that alternative modes of parkin-mediated ubiquitination may serve other non-degradative ...

Cancer is the second leading cause of death in the United States [1]. As of early 2014, there were approximately 14.5 million Americans living with a history of cancer. There are also 1.6 million new cases of cancer estimated to arise in 2015 [2]. While cancer is often generalized by the definition of abnormal cell growth and invasion, it is, in fact, a group of highly heterogeneous diseases. W...

The organization of discourse is multifaceted. Theories that take a single perspective on discourse structure, examining for example only goal satisfaction or textual coherence or ignoring the context in which a text was generated, will fail to identify the full functional significance of the content and organization of text. The task of generating coherent text to meet some communicative inten...

Bilateral carpal tunnel syndrome should prompt consideration of systemic diseases that infiltrate or impinge both canals (eg, rheumatoid arthritis, acromegaly, hypothyroidism, amyloidosis), although it is most frequently explained by a bilateral repetitive stress (eg, workplace typing). The development of upper extremity weakness suggests that an alternative condition such as cervical myelopath...

As HIV-positive children continue to gain more access to antiretroviral therapy and survive into young adulthood, caregivers face the difficult process of disclosing a child’s HIV status to that child. Although disclosure has many proven benefits for mental health, psychosocial development, caregiver well-being, treatment adherence and future planning, such a process is still often met with res...