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These examples show the condition technique used in pricing, but you will see it is used in many other areas of SAP For example, it is also used in account determination Whenever a transaction is posted to accounting, SAP must find (or determine) which account to post the revenues and discounts to There is, therefore, a determination procedure to find the accounts, called the account determination procedure This procedure contains a condition type to find which account to post to, based on the conditions of the sale The condition type searches all the records that contain accounts for conditions that match the sale in the order of the access sequence As soon as it finds a record that matches the conditions, it returns a condition value in this case, the general ledger account The condition technique is used because you may wish to post to different accounts under different conditions For example, sales of a certain material can go to one revenue account and sales of other materials to a different account; or export sales can go to one account, local sales to another account Depending on all these conditions (the material, types of sale, etc), SAP can find a different account The condition technique is used to find the right account under the right conditions

Transient or permanent brain dysfunction Cognitive impairment to varying degrees: may include impaired recall and recent memory, inability to focus attention, random psychomotor activity such as stereotypy, and problems in perceptual processing, often with psychotic ideation Emotional disorders frequently present: depression, anxiety, irritability Behavioral disturbances may include problems of impulse control, sexual acting-out, attention deficits, aggression, and exhibitionism

The organic problem may be a primary brain disease or a secondary manifestation of some general disorder All of the cognitive disorders show some degree of impaired thinking depending on the site of involvement, the rate of onset and progression, and the duration of the underlying brain lesion

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Emotional disturbances (eg, depression) are often present as significant comorbidities The behavioral disturbances tend to be more common with chronicity, more directly related to the underlying personality or central nervous system vulnerability to drug side effects, and not necessarily correlated with cognitive dysfunction The causes of cognitive disorders are listed in Table 25 11

The manifestations are many and varied and include problems with orientation, short or fluctuating attention span, loss of recent memory and recall, impaired judgment, emotional lability, lack of initiative, impaired impulse control, inability to reason through problems, depression (worse in mild to moderate types), confabulation (not limited to alcohol organic brain syndrome), constriction of intellectual functions, visual and auditory hallucinations, and delusions Physical findings will naturally vary according to the cause The EEG usually shows generalized slowing in delirium

centrate, maintain attention, and sustain purposeful behavior ( Sundowning mild to moderate delirium at night is more common in patients with preexisting dementia and may be precipitated by hospitalization, drugs, and sensory deprivation) There is a marked deficit of short-term memory and recall Anxiety and irritability are common Amnesia is retrograde (impaired recall of past memories) and anterograde (inability to recall events after the onset of the delirium) Orientation problems follow the inability to retain information Perceptual disturbances (often visual hallucinations) and psychomotor restlessness with insomnia are common Autonomic changes include tachycardia, dilated pupils, and sweating The average duration is about 1 week, with full recovery in most cases Delirium can coexist with dementia

Since it is dif cult to adhere to rule 3, and since once a reward is received it becomes an expectation, introduce lots of variety all the time (Bob Nelson s book, 1001 Ways to Reward Employees, is a great resource3) For example, some of my clients love to recognize extraordinary performance with a 111 percent lapel pin However, once an employee has received a 111 percent pin, the second one has a much lower perceived value This is why one of my clients reverted to the old Green Stamp approach that allows employees to exchange a speci c number of pins for increasingly more valuable prizes

(See also 4) Dementia is characterized by chronicity and deterioration of selective mental functions Onset is insidious over months to years in most cases Formal cognitive screens can quantify impairments and point to the need for further evaluation The Mini-Mental State Examination produces a numerical score with up to 30 points given for correct answers to questions (likely organic < 27 points) (see Figure 4 3) Specific cognitive assessment must be performed, since many patients are able to cover a deficit in routine conversation

Delirium (acute confusional state) is a transient global disorder of attention, with clouding of consciousness, usually a result of systemic problems (eg, drugs, hypoxemia) Onset is usually rapid The mental status fluctuates (impairment is usually least in the morning), with varying inability to con-

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