Managerial competences in public organisations: the healthcare professionals' perspective.

Background: Human resources play a critical role in encouraging efficient performance within organisations, especially for public healthcare organisations, where competences of staff are key aspects of the quality of services provided. In this context, the enhancement of competences are strategic objectives for Human Resources Management (HRM) in order to achieve excellent and lasting results. However, competences of healthcare professionals are both clinical and managerial.

The management of acute thermal injuries to the upper extremity.

In summary, although thermal injuries of the upper extremity can produce permanent functional compromise, intelligent management of burns of the hands and fingers can produce fully functional and cosmetically acceptable hands. When the dorsal aspects of the hands alone are injured by thermal insult, the immediate excision of the burned tissue and replacement by split-thickness skin grafts will produce functional and esthetically satisfying results. Should immediate excision and grafting be contraindicated because of massive burns of the body, management by application of topical antibacterial agents and dressings is possible.

Scanning electron microscopic study of long flexors in human fingers.

A scanning electron microscopic (SEM) study of the digital long flexors of the human hand has provided a greater magnification and an increased resolution that facilitated the study of the architecture and the correlation of their structure to their functional activity. The observations are comparable to reports based on gross anatomic and light microscopic studies previously reported by others.

Isolated pathological fracture of the capitate bone. A case report.

Isolated fracture of the capitate bone is rare, but an isolated pathological fracture due to leprosy has not been previously reported. Although varying degrees of trauma is implied to be associated with fractures, this case illustrates a pathological fracture of the capitate apparently due solely to a specific disease. Fracture has occurred without a history of trauma and there has been no displacement of the fragments on x-rays over a period exceeding ten years even though it has been subjected to unrestricted activities by the patient who has clinically inactive disease.

The histomorphology of the elastic tissue system in the skin of the human hand.

This study compares the effectiveness of the Verhoeff and Puchtler-Sweat resorcin fuschin methods of staining the elastic tissue of palmar and dorsal skin specimens of the human hand. The resorcin stain demonstrates the "oxytalan" fibres of the elastic tissue system in the dermal papillary layer of the palmar skin. Oxytalan fibres are not generally demonstrated by the Verhoeff method and are not demonstrated in the dorsal skin specimens.

Skeletal deformities of the denervated hand in Hansen's disease.

Skeletal deformities of the denervated hand are subtle in their development and pose a more formidable problem than do primary deformities of Hansen's disease. Basic osseous changes consist of concentric, longitudinal, or the longitudinal varying methods of absorption. Knowledge of their pathogenesis provides the basis for their management.

Tendon plasticity-a property applicable to reconstructive surgery of the hand.

A study carried out by light and electron microscopy of the behaviour of different tendons when subjected to lateral stretching and longitudinal splitting. Tendons like the FDS are more resistant to lateral stretching and show greater shredding. The structure of the tendon shows criss-crossing of the fibrils, necessary to stand up to the greater stress to which the tendon is normally exposed.

Ultrastructural features of adult human tendon.

A variety of human tendons have been studied at the electron microscope level. The fibers of these tendons are composed of collagen fibrils that average 1,750 A and 600 A in diameter. A third population that measures 100 A in diameter may represent immature collagen or filaments that are incorporated into tendon elastic fibers.

Ultrastructure of keloid: an unusual incident involving lepromatous leprosy.

A patient with lepromatous leprosy developed keloids on the dorsum of both arms in response to ulcerations due to acute erythema nodosum leprosum reactions. Electron microscopic examination of the keloidal dermis showed a morphology indicative of increased production of normal collagen fibrils. The greatest cellular changes from normal were in fibroblasts which were enlarged due to increased amounts of rough endoplasmic reticulum and extensive Golgi complexes.

Mean circadian cosinors of vital signs, performance of blood and urinary constituents in patients with leprosy.

We have herewith examined the characteristics of circadian rhythms in patients with lepromatous leprosy, active or inactive, allowing a comparison with corresponding properties of rhythms in healthy subjects mapped earlier. Group results were illustrated by cosinor plots, produced directly on microfilm by computer. Eventually such reference standards in the form of cosinors, among other displays, notably of waveform, may be individualized and carried on a person's health record.