PubMed · 8415097
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Advances in understanding of the spectrum of clinical presentations of patients with systemic and cutaneous necrotizing vasculitis as well as further work on pathogenesis of these conditions has helped with diagnosis of these conditions. Therapies for systemic and cutaneous necrotizing vasculitis are based on disease extent, severity, and concomitant conditions in the individual patient. Future multicenter and multidisciplinary studies will provide improved treatments for these challenging clinical situations.
The major advances in dermatologic surgery for this period reside in the areas of diagnosis and management of cutaneous melanoma, laser surgery, tumescent liposuction, and tumorigenesis. A closer look at these advances is presented.
In 1990, after twenty years of service, the psychiatrist who had been Director of Psychiatric Services at Alpha Hospital decided to take an early retirement. What followed was a dramatic leadership struggle, which peaked with the resignation (in the summer of 1992) of most of the hospital's psychiatrists. In the years since, there has been a great deal of healing. The psychiatrists are all back at work. Joint leadership of the services is established under the direction of a (psychiatrist) Clinical Director and a (non-psychiatrist) Administrative Director. Management of the programs and services has been reorganized to a much more efficient and effective system. And feelings among the key players are more trusting and collaborative. This paper will explore how this crisis may be understood in terms of change theory. It will also outline the process utilized to resolve the crisis, and will draw implications for other mental health administrators who, in these times of rapid and dramatic change, will undoubtedly confront similar challenges.