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However, this is not the same planning cycle that academics are saying to discard This planning cycle becomes more of an industrial engineering activity of determining the quantity relationships and microstandards for the cost center and process drivers Once these are established, actual quantities and dollars can be measured against target Doing so requires variances to be analyzed to determine if the difference is due to a market shift or if a standard needs to be updated Because the focus is on target costs for actual quantity consumption, the second easiest way to pad the budget is identified when the actual quantities being consumed are nowhere near what the cost centers or processes said they would need With this inefficiency highlighted, changes can be made to reflect a more realistic representation of true requirements and the microstandard for the driver rate.

Screening is used to identify individuals who have alcohol-related problems or who are at risk for such problems A number of standardized instruments are available to help the clinician screen for alcohol problems The CAGE, MAST, TWEAK, and AUDIT are commonly used for adults and are considered to be acceptably reliable and valid in a variety of situations (Connors, 1995; Crowe et al, 1997; Allen et al, 1995) Preference for screening measures will vary between individual clinicians and different settings Decisions should be based on the kind of population being assessed, amount of time and resources available, clinical or community setting and goals of screening Providing personal and nonconfrontational feedback to clients regarding screening results can be a signi cant component of brief intervention When a screening result alerts the clinician to a potential alcohol problem, a more exhaustive assessment is in order.

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Figure 32.4 A nished sheet cake marked off into portions and decorated so each portion is identical.

Prior to the year 2000, there was a huge rush to partially install or completely implement enterprise resource planning (ERP) tools. This push was driven primarily by the need to replace non-Y2K-compliant software packages or outdated technology platforms. After the turn of the millennium, organizations were drawn to customer-related and Internet supporting software applications and implementations, thus pulling the focus away from backroom automation and transactional execution, at least temporarily. While the rush for Internet marketplaces, business to business (B2B), portals, and e-commerce is well founded and can provide huge benefits, to get the most from these tools, the backroom costing engine needs to be fully in force to support them. These new software applications provide greater access for the internal user to more information and other users, such as suppliers and customers. Easier and quicker access to information can mean more business and opportunities, but it does not guarantee that the new business will be profitable or the relationship cost justified. To be profitable, a company must be very focused on determining whom to do business with and in what manner. This boom in software and hardware technology is akin to immediately laying thousands of new highways and different transportation modes, thus gaining access to an unlimited numbers of people and places. But several questions still beg to be answered. Where should we as a business go Do we have the resources to get there Whom should we go with How much will it cost us The companies that will benefit the most from all the technology advances will be the ones that can quickly and accurately identify, from all of the new information and opportunities, which business should be pursued and what unprofitable ventures should be left for competitors to chase after.

This gives a greater understanding of how much drinking is taking place and how drinking ts into the client s activities, resources and relationships A myriad of psychometric instruments have been designed to aid the clinician in this endeavor Structured diagnostic interview instruments are designed to help clinicians formally diagnose alcohol dependence and alcohol abuse according to the categorical DSMIV (Structured Clinical Interview for DSM-IV; First et al, 1995) and ICD (Composite International Diagnostic Interview, Robins et al, 1988) systems Before selecting and using a diagnostic measure, clinicians must be clear about what constructs are to be measured and what the purpose of measurement is Individual cases may call for different assessment instruments or measures (Maisto & McKay, 1995) Whether the assessment is for clinical or research purposes will in uence the choice of the diagnostic instrument.

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