Barriers and solutions to addressing tobacco dependence in addiction treatment programs.

Despite the high prevalence of tobacco use among people with substance use disorders, tobacco dependence is often overlooked in addiction treatment programs. Several studies and a meta-analytic review have concluded that patients who receive tobacco dependence treatment during addiction treatment have better overall substance abuse treatment outcomes compared with those who do not. Barriers that contribute to the lack of attention given to this important problem include staff attitudes about and use of tobacco, lack of adequate staff training to address tobacco use, unfounded fears among treatment staff and administration regarding tobacco policies, and limited tobacco dependence treatment resources. Specific clinical-, program-, and system-level changes are recommended to fully address the problem of tobacco use among alcohol and other drug abuse patients

European integration in crisis?:Of supranational integration, hegemonic projects and domestic politics

The European Union is facing multiple challenges. Departing from mainstream theory, this article adopts a fresh approach to understanding integration. It does so by taking two theoretical steps. The first introduces the structure–agency debate in order to make explicit the relationship between macro-structures, the institutional arrangements at European Union level and agency. The second proposes that the state of integration should be understood as the outcome of contestation between competing hegemonic projects that derive from underlying social processes and that find their primary expression in domestic politics. These two steps facilitate an analysis of the key areas of contestation in the contemporary European Union, illustrated by an exploration of the current crisis in the European Union, and open up the development of an alternative, critical, theory of integration

Information and Multi-Period Optimal Income Taxation with Government Commitment

The optimal income taxation problem has been extensively studied in one- period models. When consumers work for many periods, this paper analyzes what information, if any, that the government learns about abilities in one period can be used in later periods to attain more redistribution than in a one- period world. liken the government must commit itself to future tax schedules, the gains cane from relaxing self-selection constraints by intertemporal nonstationarity. The effect of nonstationarity is analogous to that of randomization in one-period models. In a model with two ability classes it is shown that the key use of information is that only a single lifetime self-selection constraint for each type of consumer must be imposed. Sane necessary and sufficient conditions for randomization or nonstationarity are given. The planner can make additional use of the information when individual and social rates of time discounting differ. In this case, the limiting tax schedule is a nondistorting one if the government has a lower discount rate than individuals.

Prevention of Peritonitis in Peritoneal Dialysis

Reducing the frequency of peritonitis for patients undergoing peritoneal dialysis ( PD ) continues to be a challenge. This review focuses on recent updates in catheter care and other patient factors that influence infection rates. An experienced nursing staff plays an important role in teaching proper PD technique to new patients, but nursing staff must be cognizant of each patient's unique educational needs. Over time, many patients become less adherent to proper dialysis technique, such as washing hands or wearing a mask. This behavior is associated with higher risk of peritonitis and is modifiable with re‐training. Prophylactic antibiotics before PD catheter placement can decrease the infection risk immediately after catheter placement. In addition, some studies suggest that prophylaxis against fungal superinfection after antibiotic exposure is effective in reducing fungal peritonitis, although larger randomized studies are needed before this practice can be recommended for all patients. Over time, exit site and nasal colonization with pathogenic organisms can lead to exit‐site infections and peritonitis. For patients with S taphylococcus aureus colonization, exit‐site prophylaxis with either mupirocin or gentamicin cream reduces clinical infection with this organism. Although there are limited data for support, antibiotic prophylaxis before gastrointestinal, gynecologic, or dental procedures may also help reduce the risk of peritonitis.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99100/1/sdi12114.pd

Annual Survey of Virginia Law: Health Law

During the past year, the Commonwealth of Virginia has experienced numerous developments in health law on all three major legal fronts-legislative, judicial, and administrative law. These developments have covered a range of health law topics, including everything from revisions to the public certificate of need process for health care facilities and the regulation of body-piercing of minors on the legislative front, to key decisions regarding the scope of the Virginia Birth-Related Neurological Injury Compensation Act and the Health Care Decisions Act on the judicial front, to action on the regulatory front regarding independent external appeals ofhealth plan denials and hospice care under the Medicaid program. This article offers a summary of some of the most significant developments in health law in each of these three legal arenas during the past year

Business Warehouse Modeling Using SAP: Simulating A Business Case To Apply Strategic Enterprise Management To Accounting

The goal of this research project is to develop a simulation model specifically for the Management Accounting Information Systems course – an SAP enabled course for junior Accounting majors at Saint Joseph's University. The purpose of this simulation is to present students with a set of business scenarios, and have the students make a knowledgeable decision using SAP Business Warehouse software. The scenarios will act as a simplified replication of the business environment; thus, they will provide the students with an integrated learning experience. They will make business decisions to ensure the profitability and cash flow of a corporation. While making these decisions, students participate in the application and analysis provided by PC4YOU, which is a simulated company within SAP for demonstration and education purposes. Eventually, the students will need to justify the existence of their strategic plans by evaluating benefits of the system using the reporting tools available within SAP. To provide a “learning by doing” experience, the scenarios will be used to demonstrate the reporting functionality within PC4YOU, the simulated company integrated into the SAP SEM system. Today’s global economy is putting a premium on the ability of students to evaluate a broad range of decisions in collaboration with adaptive supply chains. A critical component of the evolving accounting curriculum lies in the ability to extend students beyond the numbers to evaluate the effective and efficient delivery of these supply chains