pass the RD exam

Patients undergoingchemotherapy need to avoid what herbal supps/ supps in general ?

Echinacea, gingkobiloba, ginseng, green tea, soy isoflavonesupplements, valerian root, kava, grape seed, St. Johns Wort

The ETHNIC Model of culturally competent care

Explanation, Treatment, Healers, Negotiation,Intervention,Collaboration. How does a patient'sunderstanding of their illness and treatment fit with what is expected and accepted in their culture? How can we determine treatment options in a collaborative (not imposed) process? This model focuses on questions and conversations providers should have with patients to achieve theirgoals

Added Fiber to a tube feeding can

Formulas with added fiber contribute to normal bowel function•May clog tubes•Help patients with diarrhea and/or constipation

Class C Fire

-electrical fire -Short-circuited machinery or overloaded electrical cables -Water not used because it's conductiveAmmonium sulfate or carbon dioxide fire extinguishers can be used

optimal temperature for dry storage and shevling height

50°F -70°Fwith humidity of 50-60%.Shelving should be at least 6" off the floor, aisles should be wide enough for carts, and the area should be kept locked to prevent pilfering

Let's say you're cooking for a friend's birthday party next week. You set a budget of $15 per plate and expect 45 people to attend. You spent $550 on groceriesfor the party. How did you dofinancially,compared to your budget?

550 spent/45 plates= 12.22 How does the cost per meal compare to your budget? $12.22−$15=−$2.78($2.78𝑢𝑛𝑑𝑒𝑟𝑏𝑢𝑑𝑔𝑒𝑡)

cluster sampling

A probability sampling technique in which clusters of participants within the population of interest are selected at random, followed by data collection from all individuals in each cluster. For example, if you wanted to implement a healthy lunch initiative at local elementary school, it would be difficult to randomize each student. Instead, we call each school a "cluster" and we randomize each school to the intervention or not. Thus,the "unit of randomization" is the school.

Competitive Sealed Bidding

A process that enables the organization to acquire products and services at a good value.

When should parenteral nutrition be used? Metabolically unstable patient

Delay PN until condition is improved

17.A step at which control measures can be applied and is essential to eliminate a food safety hazard is: a.a critical limit b.a control point c.a critical control point d.None of the above

Answer: C.A critical control point is a control point at which steps must be taken to prevent or eliminate a food safety hazard. A critical limit is the maximum or minimum value to which a parameter will be controlled at a critical controlpoint.

11.Raw shelled eggs should be stored at _________ degrees F and pooled raw eggs should be stored at ___________ degrees F .a.41, 45 b.45, 45 c.45, 41 d.41, 41

Answer: C.Raw shelled eggs can be stored at 45 degrees F. However,pooled eggs must be stored at41 degrees F

Q: A budget prepared by upper management and given to operating units is what type of budget? a.Top-down budget b.Bottom-up budget c.Zero-based budget d.Fixed budget

a.Top-down budget

Strip warmers

are used to keep food on the line, or in a buffet, at the correct temperature.

Drawer warmers

are used to keep food warm and ready to serve.

Inventory turnover rate:

assess if there is efficient use of assets

Water extinguishers

Used for Class A fires to remove heat from burning materials

Investigators randomize patients to a rapid extubation protocol in the ICU or to standard procedure decide if the study design described is observational or experimental (O or E). Then identify the independent and dependent variablesand the specific study type.

Observational -prospective clinical. Independent: enteral feed within 8 days of admission, dependent -prealbumin at discharge.

the amount of osmotically active substances in a solution expressed as milliosmoles per liter of water (mOsm/L).Osmotically active substances increase the tonicity of solutions and cause osmosis. The main osmotically active substance in ECF is sodium.

Osmolality

Most foodborne illnesses resulting in hospitalization

Salmonella Norovirus Taxoplasma gondii E. coli (STEC)O157 Campylobacter spp.

Most foodborne illnesses resulting in death

Salmonella Taxoplasma gondii Listeria monocytogenes norovirus Campylobacter spp.

6.What are the Big Eight allergens? Which foods are the leading cause of allergic reactions in the US each year?

The Big Eight allergens are eggs, fish, milk, peanuts, shellfish, soy, tree nuts and wheat. Peanuts and tree nuts are responsible for over 80% of all food-allergy related deaths in the US and most of the non-fatal allergic reactions

To calculate osmolarity, multiply

dextrose g/L by 5, amino acid g/L by 10 and add 300-400 for vitamins and minerals. Remember, lipids don't contribute to osmolarity

centralized organization

A structure in which top-level managers delegate little authority to lower levels Good for :•Established & detailed processes •Close control of operations •Uniformity of policies, practices, and procedures •Better use of centralized and/or specialized experts

Total assets:

indicate monetary value of a property beyond any amounts owed -everything a company owns,including liabilities

edema stage 2+

moderatley severe pitting edema 6mm depression that last more than 1 min

publication bias

the tendency for journals to publish positive findings but not negative or ambiguous ones

Gastroparesis

when the stomach isn't moving food through the stomach and into the duodenum

Category B Bio-terrorism

•Moderately easy to disseminate •Moderate morbidity rates •Low mortality rates •Require enhanced disease surveillance and specific enhancements in CDC's diagnostic capacity

Table d'hôte menu

a bit more upscale than prix fixe, may vary entrée price

Total Quality Management (TQM)

a management philosophy that focuses on satisfying customers through empowering employees to be an active part of continuous quality improvement These 8 aspects are key to TQM:23 •Customer-focused •Strategic approaches •Total employee involvement •Continuous improvement •Process-centered •Fact-based •Integrated system•Communication

systems analysis

a method of problem solving or decision making that applies sytem thinking to management organizations

Liquidity ratio:

ability to meet short-term debts

sampling error

an error that occurs when a sample somehow does not represent the target population

Bain Marie Heater (food rethermalizer)

can be used to heat sink water or to heat a Bain Marie

quality is defined by

customer satisfaction

Current ratio:

divide current assets bycurrent liabilities. Represents an organization's ability to meet current financial obligations(bill-paying activity). Used by creditors to determine if an organization has sufficient assets to repay debts over the next 12 months. A current ratio greater than 1 indicates anability to pay bills when due and over the next 12 months

Wait service- Russian

food is prepared and portionedin the kitchen on a serving platter and then plated for the customer at the table

16 gauge prep table/work area

gereral use

alkalemia is when pH

is greater than 7.45.

Holding cabinets .

keep food at the right temperature

The 5 management functions are:

planning, organization, staffing, directing, and controlling.

Wait service- French

portions are brought tocustomers on a platter delivered to customers while the chief server "completes a table" by carving, deboning, or creating a sauce table-side

Dry powder extinguishers

separatefuel and oxygen or remove heatusing sodium chloride, sodium carbonate, copper, graphite, or other materials. They are for Class D fires only.

Assets-to-liabilities ratio:

the percentage of assets divided by debt

Retarder proofers

will refrigerate dough and then heat it for proofing.

B-needs (being needs)

The highest level of Maslow's Hierarchyof Needs is self-actualization(achieving your full potential) also called the self-fulfillment needs.In contrast to D-needs, self-actualizationincludesB-needs(being needs). These motivationsare increasedas lower needs are met

Incidence

The number or rate of new cases of a particular condition during a specific time.

cost per meal formula

Cost of food sold / total meals served

define Management Functions directing

Directing -usingleadership and management styles; using motivation and communication

information on how operations worked or failed, or how they should be changed or modified to restore equilibrium(can be internal or external)

Feedback

Nasoduodenal (ND) and Nasojejunal (NJ)

Flexible tube is fed through the nose, down the back of the throat, and terminates in the small intestine. OK to use for a few weeks

Nasogastric (NG)

Flexible tube threaded through the nose down the back of the throat and into the stomach Use X-ray to verify placement prior to the first feed Check residuals before bolus feeds and every 3-5 hours for continuous feeds, and consider raising the head of the bed 30 degrees to reduce the risk of regurgitation

nasogastric (NG) tube

Flexibletubeisfed through the nose, down the back of throat,and terminates in the stomach. OK to use for a few weeks

four compartment sink

Four compartment sinks are used to scrape food waste, wash, rinse, and sanitize separately.

Why does pancreatic juice have bicarbonate in it?

Gastric acid has a pH of about 2which is extremely acidic. The chyme that enters the small intestine needs to be neutralized for several reasons: so that the digestive enzymes can work properly and to avoid damage to the intestinal mucosa

Patients with ER+ breast cancer need to avoid what herbal supps/ supps in general ?

Ginseng, soy isoflavone supplements, dong quai, gingko biloba, ginseng, licorice root, alfalfa, red clover, black cohosh, indole-3-carbinol, chasteberry

EAL; Evidence Analysis Library evidence grade 1

Grade I: Good / Strong -"The evidence consists of results from studies of strong design for answering the question addressed. The results are both clinically important and consistent with minor exceptions at most. The results are free of serious doubts about generalizability, bias, and flaws in research design. Studies with negative results have sufficiently large sample sizes to have adequate statistical power.

EAL; Evidence Analysis Library evidence grade 2

Grade II: Fair -"The evidence consists of results from studies of strong design answering the question addressed, but there is uncertainty attached to the conclusion because of inconsistencies among the results from different studies or because of doubts about generalizability, bias, research design flaws, or adequacy of sample size. Alternatively, the evidence consists solely of results from weaker designs for the questions addressed, but the results have been confirmed in separate studies and are consistent with minor exceptions at most.

5.What items are required at a handwashing station?

Handwashing sinks should have hot andcold running water, liquid soap, single-use paper towels or hand dryers, a garbage container and a sign indicating that all employees must washtheir hands

Relationship behavior

How excited is the employee about the task? How willing are they to engage in the task? How much motivation will the leader need to provide?You can think of relationship behavior as the degree of supportive behaviorrequired by the leader.When "relationship behavior" or "supportive behavior"is LOW, the employee is self-motivated and does not require a large amount of support from the leader. When "relationship behavior" or "supportive behavior" is HIGH,the employee requires a large amount of support fromthe leader as they may not be confident or excited about the task

In contrast, potassium (K+) and phosphate (PO43-)reside in the ECF or ICF in the resting state?

ICF

Pareto Chart

In the FOCUS model section, the diagram mentions Pareto Charts and cause and effect Charts in "F" for "Find the problem". Pareto charts have 2 components: a bar graph that representsthe descending frequency of occurrence (or cost), and a line graph representing the cumulative percentage of total occurrences(or cost). Why do we use Pareto charts? By ordering the occurrence of a complaint in descending order, we can identify the complaintthat has the largest effect on satisfaction.14We can also determinethe number of factors we need to address in order to reduce complaint frequency by a certain percent. If the chart represents cost rather than occurrence, thenyou can imagine that addressing the most expensive problem, or knowing how many problems you need to address to cut costs to meet your budget, would be helpful

Patients with liver disease or decreased liver function need to avoid what herbal supps/ supps in general ?

Kava, valerian root

Temperature Style warewashers-LOW

Low temperature warewashers use sanitizing chemicals and cleaning agents to clean and sanitize dishes. Compared to high temperature models, these models create less steam and heat. You can imagine that less steam and less ambient heat might make the dish roommore pleasant for employees ormay be preferred for an under-bar glass washer

edema stage 1+

Mild pitting edema 2mm depression disappears rapidly

Acid-Base BalanceNormal blood gas values can be reported for arterial blood (ABGs) or mixed venous blood

Normal ABG valuep H 7.35 -7.45 PCO2 35 -45 HCO3- 22 -26

The top five bacteria that cause illnesses from food eaten in the United States are:

Norovirus Salmonella Clostridium perfringens Campylobacter Staphylococcus aureus (Staph)

Cold TCS food: fish

Receive at 41 degrees F or colderIntact, clean packaging (if packed in ice, should be surrounded by crushed, self-draining ice)Bright red gills, firm flesh, mild ocean/seaweed smell, bright/clear/full eyes

static menu

Same menu items are offered every day; that is, a restaurant-type menu. does not change daily or seasonally; typically grouped by appetizers, entrees, salads, soups, desserts, etc.Example: Red Lobster, TGIF, Olive Garden, fast food chains

define Management Functions staffing

Staffing-recruiting and screening potentialemployees; hiring, orienting, and training newemployees; supervising and evaluating employees

In addition to hazards from the environment, people can make food unsafe through 4 practices: Time-temperature

Time-temperature abuserefers to improper food handling practices regarding temperature control. Food is allowed to stay too long at unsafe temperatures where pathogens can grow. You'll learn more about time-temperature control in the Food Safety Management section.

When the tube terminates beyond the stomach -beyond the pylorus -we call it post-pyloric access. Why might we do this?

To avoid stimulatingthe pancreas •Due to recent esophageal or gastric surgery •Due to severe gastroparesis

The final group of employees is responsible for patient meal service. The meal prep line involves assembling thawed items onto trays, loading them onto meal delivery cartsand delivering the trays to patients. This is an example of ________________.

Tray service

Two compartment sink

Two compartment sinks are often used to thaw and prep meats or frozen bagged sides, or to use as a vegetable sanitizing and prep station.

stainless steal work table 430

Type 430 is lower grade than Type 304, and includes iron so it is less resistant to corrosion. It'susedfor produce prep, mixing ingredients,and plating. It's slightly magnetic

Chemical foam extinguisher:

Used for Class A and Class B-flammable liquids (not gas). The foam blankets the fire, preventing oxygen from reaching it

Accumulated depreciation:

a fixed asset;the total depreciationof an asset up to a given date subtracted from the original cost attimeof purchase

Systems Thinking

a way of monitoring the entire system by viewing multiple inputs being processed or transformed to produce outputs while continuously gathering feedback on each part

Net profit:

also called final profit;subtracts expenses from gross profit

manufacturer's representative

an agent sells manufacturer products to wholesale and retail customers. The wholesaler or retailerpays the manufacturer's representative a commission on the sale.

limiting amino acid

an essential amino acid that is present in dietary protein in an insufficient amount, thereby limiting the body's ability to build protein

Service Style-Machine vending

an outside company is contracted to keep items stocked. Items may include drinks, snacks, sandwiches, microwave items, or frozen foods. Machine vending is often used in supplement to other types of foodservice, like handling off-hours

popularity index

analyze sales and then predict future sales of that item # of servings of an item / total number of servings of all items in that category that day calculated by dividing the sales of an item by total sales. X-axis is profitability (profit contribution) and the Y-axis is popularity (popularity index).

Hydrazines

are formed from toxins found in certain mushrooms (i.e. button mushrooms, portobello mushrooms, cremini mushrooms) and are destroyed upon cooking.10Some mushrooms are considered poisonous due to high concentrations of compounds that are converted into hydrazines in the body. For example, the Gyomitramushroom contains gyromitrin which is converted to monomethylhydrazine in the body and interferes withthe nervous system and liver. Even in small amounts, monomethylhydrazine is considered carcinogenic.

Lectins

are glycoproteins found in legumes and grains. Lectins are also called hemagglutinins and are often used in blood typing, however their ability toagglutinate red blood cells is also what makes them so dangerous. Lectins have effects throughout the body, in addition to red blood cell agglutination.They can bind to GI mucosal cells, inhibiting nutrient absorption, and facilitate bacterial overgrowthin the intestines.11Kidney beans, green beans, and fava beans contain a significant quantity of phytohemagglutininwhich can lead to acute toxicity within 3 hours after consuming.The FDA recommends cooking legumes in moist heat (steaming or boiling) to reduce the concentration of lectins, like phytohemagglutinin.

Flat bottomfryers

are heated from below by gas and are best for items that will float in oil at the top, such as donuts and battered foods. There is no sediment zone,which is why you only use lighter foods with minimum sediment.These are also called shallow fryers or donut fryers. They may have a tray that hinges into the oil and easily comes out.

queuing theory

balancing the cost of waiting in lines against the cost of expanding facilities to prevent them. For example, balancing the number of cashiers working in the hospital cafeteria with the number of customers waiting in line

Par Stock Ordering

brings stock numbers up to par level each time an order isplaced, regardless of how much is on hand. This system means that stock is allowed to dip below par level.

Some plant proteinsare actually complete proteins, including buckwheat, quinoa, hemp seed, chia seed,soy,and spirulina. Some animal protein sources, including

buckwheat, quinoa, hemp seed, chia seed,soy,and spirulina. gelatin, are incomplete proteins.

Profitability

can be calculated several ways, and the formula you use will depend on what you're given in the question. You can calculate profit for a single unit of an item sold(also called the unit price profit),or you can multiply that unit price profitby total items sold and then divide it by its contributionto total profits (percent profit contribution). To calculate "profit", you'll see either of these: 𝑈𝑛𝑖𝑡𝑃𝑟𝑖𝑐𝑒𝑃𝑟𝑜𝑓𝑖𝑡=𝑆𝑒𝑙𝑙𝑖𝑛𝑔𝑃𝑟𝑖𝑐𝑒−𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡 𝑃𝑟𝑜𝑓𝑖𝑡=𝑖𝑡𝑒𝑚 𝑝𝑟𝑜𝑓𝑖𝑡×𝑢𝑛𝑖𝑡𝑠 𝑠𝑜𝑙𝑑

Metabolic acidosis can be

"high anion gap" or "normal anion gap". High anion gap metabolic acidosis can occur due to lactic acidosis (e.g.metformin use, liver failure, infection, ischemia), ketoacidosis, salicylate use, renal insufficiency, excess iron intake, accumulation of exogenous organic acids (e.g. methanol or paraldehyde poisoning), uremia (e.g. rhabdomyolysis). Normal anion gap metabolic acidosis can occur due to renal tubular acidosis, GI loss of HCO3-from diarrhea, fistulas or intestinal stomas, hyperchloremia (e.g. from excess salineor PN), Addison's disease(e.g. aldosterone deficiency), or from use of some drugs like spironolactone. In both cases of metabolic acidosis, we will see low pH and low HCO3-levels. The body compensates by lowering PCO2 production. © 2021 V1MAY2021Kidney Function, Electrolytes, and Dehydration10Anion gap is calculated from the differencebetween the major positive and negative ions in the blood (sodium, potassium, chloride, and bicarbonate). You don't need toknow how to calculate anion gap.

How many fl oz are in a single case of #10 cans?

#10𝑐𝑎𝑛=3𝑞𝑡=32𝑓𝑙𝑜𝑧∗3=96𝑓𝑙𝑜𝑧 (6𝑐𝑎𝑛𝑠)/(𝑐𝑎𝑠𝑒) 𝑥 (96𝑓𝑙𝑜𝑧)/(1𝑐𝑎𝑛) =6∗96 𝑓𝑙𝑜𝑧= 576 𝑓𝑙𝑜𝑧 =18𝑞𝑢𝑎𝑟𝑡𝑠

What if labor cost wasn't given to you in a dollar amount but in terms of how many minutes it took at anhourly rate? For example, if you were told that the labor cost was 5 minutes at $12/hour,you can calculate the labor cost per minute and multiply that by the minutes taken to make the item

$12/ℎ𝑜𝑢𝑟 ×1ℎ𝑟 (60𝑚𝑖𝑛)= $12 /(60𝑚𝑖𝑛)=$0.20𝑝𝑒𝑟𝑚𝑖𝑛 $0.20𝑝𝑒𝑟min𝑥5min=$1.00

exaust air

Air from the workspace is filtered into exhaust Exhaust exits the building

1.Thermometers used in receiving should be accurate to ____. a.± 1-degreeF b.± 2 degrees F c.± 3 degrees F d.± 4 degrees F

Answer: B. Thermometers used to check food temperatures should be accurate to ± 2 degrees F. Air temperature thermometers in walk-in coolers and hot-hold areas should be accurate to ± 3 degrees F

12.After cooking, hot TCS food that will not be consumed immediately should be cooled to ____ degrees F within 2 hours and then to ____ degrees F in the following 4 hours. a.90, 40 b.70, 41 c.135, 41 d.70, 32

Answer: B.Bacteria grows rapidly between 70 and 125-degrees F, so it is important to get food through that temperature range quickly (within 2 hours). The food should be cooled to 41 degrees or lower within a total of 6 hours.

10.What is NOT an acceptable way to freeze fish? a.frozen at -4 degrees F for at least 7 days b.frozen at -4 degrees F until solid and stored for 24 hours c.frozen at -31 degrees F until solid and stored at least 15 hours d.frozen at -31 degrees F until solid and stored at -4 degrees for 24 hours

Answer: B.Choices A, C, and D are acceptable ways to freeze fish. Proper freezing of raw fish is required to prevent anisakiasis. Reputable and approved sushi-grade fish suppliers follow these freezing procedures

22.Whichagency is responsible for inspecting poultry? a.CDC b.HHS c.FDA d.FSIS

Answer: D. The Food Safety and inspection Service of the USDA is responsible for inspecting meat, poultry and eggs. The FDA is responsible for all otherfood items.

how do the kidneys regulatem pH balence?

Both the kidneys and the lungs play a role in maintaining blood acid-base balance.Therespiratory system compensates for short term disruption of acid-base balance by changing ventilation patterns.The kidneys are slower to respond to acid-base imbalance but have a larger effect by excreting excess acid (H+) in the urine or reabsorbing bicarbonate (HCO3-) to keep in the blood.Bicarbonate does not have a transporter so reabsorption and excretion occur © 2021 V1MAY2021Kidney Function, Electrolytes, and Dehydration9via reactions controlled by renal epithelial cells.Buffers, like NH3, absorb the excess H+ and OH-to maintain pH

Break-Even Point

Break-even point is when expenses and revenue are equal (total costs = total revenue). It's used to determinethe number of sales or overall profits that will cover total costs.

Charrette

Charrette: collaborative planning process harnessing the talents of all interested parties.31Results in a master plan that represents transformative community change.

Class D Fire

Combustible metals -Metal "sawdust" can combust and burn in contact with air or water -dry powder extinguisher

define Management Functions controlling

Controlling -establishing standards forperformance; evaluating actual performance; implementing corrective action

Operating costs:

company expenses

Respiratory alkalosis can occur

due to pain, anxiety, panic attacks, pregnancy, hypoxemia, drug toxicity, hyperventilation, or pulmonary disease. The pH will be high and PCO2 will be low. As the body compensates, we see decreased HCO3-and H2CO3 because the body is increasing the respiratory rate (hyperventilation) to wash out excess CO2.

Bottom-up budget

each unit prepares a budget that is then sent up to upper management

Parenteral Nutrition Complications Hyperglycemia

elevated blood glucose can occur when the body is unable to transport glucose into its cells fast enough, whether due to insulin resistance or diabetes, steroid medications, body stress,or excess dextrose infusion.

If fixed costs are $85,000, variable costs are $21,000, and total sales are $420,000,calculate the break-even point

fixed cost devided by (1 - varible cost divided by sales) $85,000 1−($21,000) ($420,000) = First, calculate the denominator 𝑉𝑎𝑟𝑖𝑎𝑏𝑙𝑒 𝑐𝑜𝑠𝑡𝑠 divided by 𝑆𝑎𝑙𝑒𝑠= ($21,000)/($420,000)=0.05 Variable costs comprise about 5% of all sales 1−0.05=0.95 then we divide fixed costs by 1 -proportion of variable costs relative tosales, which we just calculated ($85,000)/ (0.95)=$89,473.68

Transactional Leadership

focus is on supervision, organization, performance•Goalis to maintain the status quo•Obtains employee followers through rewards and punishments, which typically only lasts for the short term•Effective in a crisis; effective when projects have very specific parameters

"Gluten-free" is defined asa

food inherently gluten free or does not contain an ingredient that is a gluten-containing grain, derived from a gluten-containing grain not processed to remove gluten, or derived from a gluten-containing grain processed to remove gluten but still has ≥ 20 ppm gluten in the food. Any 'unavoidable presence of gluten' must be < 20 ppm.47

Cycle menu:

for each day of a cycle, the menu is different. The cycle then repeats on a regular basis (usually weekly or monthly), covers variety with some control overpurchasing, production, and cost. Cycle menus savetimeandcontrol food costs while still offering varietythatcan incorporate seasonality, holidays, and USDA commodity foods. Using cycle menus is a more efficient approach to plan menus, develop specifications, standardize purchasing procedures and gives the ability to buy in bulk, as well as accountingfor increased or decreased needs based on the last cycle iteration (it reduces food waste, reduces storage cost, and keeps appropriate stock). Staff familiarity with recipes also leadsto efficient production.

Respiratoryacidosiscan occur

from pulmonaryissues, such as COPD exacerbation, asthma, pneumonia, pulmonary edema, respiratory muscle weakness (e.g. ALS), or from CNS depression (e.g. head trauma, drug toxicity, post-ictal state). The pH will be low and PCO2 will be high. As the body compensates, we will see elevated HCO3-and H2CO3 levels because the lungs are hypoventilatingin order to retain CO2

blind check receiving method

give clerk blind invoice or purchase order listing incoming merchandise but omitting quantities, weights. That information needs to be filled in and is used to check the delivery against the invoice. takes longer and costs more in labor

du jour menu

has specials for the day. Offersflexibility,especially for small and busy restaurants; customizable each dayand/or throughout the dayand may apply to a single,special item (soup du jour) in conjunction with a static menu

1 foot-candle =

illuminancecast on a 1 x 1 foot surface 1 foot away by a 1-candela light source

Per the 2017 Food Code, the 5 major risk factors for foodborne illness outbreaks relate to employee behaviors and food preparation practices in retail and foodservice establishments.3Most foodservice inspections are based on these 5 risk factors and theirassociated public health interventions.

improper holding temperatures •Inadequate cooking •Contaminatedequipment •Food from unsafe sources •Poor personal hygiene

Biological hazards

include bacteria, viruses, parasites, and fungi, and any toxins they produce. While some are harmless, some bacteria, viruses and parasites cause foodborne illness and are called pathogens.A foodborne illness is a disease transmitted to people through food.

Physical hazards

include bones (like in a fish filet) and fruit pits,as well as items that can fall into food like jewelry, glass, plastics, ceramics, nail polish, artificial nails and bandages. Workplace protocols typically specify if jewelry, nail polish and artificial nails can be worn. Bandages used in foodservice are brightly colored (rather than beige or brown) so they stand out from food and when wearing a bandage on the hands or fingers, usually an additional finger cot must be worn to keep the bandage in place. Other hazards like glass, plastic and ceramics can fall into food if equipment breaks and shards fall into food.

Conjugate proteins include both amino acids and other compounds, either organic or inorganic.

include both amino acids and other compounds, either organic or inorganic. Examples include lipoproteins like low density lipoprotein (LDL), glycoproteins like immunoglobulinG, phosphoproteins like casein, hemoproteins like hemoglobin, metalloproteins like ferritin, and nucleoproteins like ribosomes

Chemical hazards

include cleaners, sanitizers and pesticides. Proper use of cleaners and sanitizers is important to maintain food safety from pathogens. Improper use of cleaners, with residue remaining on equipment or dishwarecan be a hazard in itself. To mitigate hazards from pesticides, proper produce handling is important.

Polysaccharides are

include starch (i.e. amyloseandamylopectin), glycogen, and various fibers. They are made up of long chains of glucosewith different shapes,depending on the type and number of glycosidic bonds. The different shapes of polysaccharides determine their properties, including whether humans can digest them or not.Polysaccharides are important,both as foods we eat and as energy we store. Cellulose(a fiber)and starch are from plant sources.Glycogen and amylopectin are highly branched (via α1-6 bonds), rather than a single long line of glucose (like amylose via α1-4 bonds). The main chains of glucose in glycogen and amylopectin are joined via α1-4 bondsand branches form at the α1-6 locations. Branching has an advantage because enzymes can work on the free end of the strand, either to release glucose for energy or to add glucose on. Glycogen has branching about every 10 monomers, while amylopectin has branching about every 20 monomers. Due to this,glycogen is much more branched than amylopectin

Retained earnings:

income set aside by the company instead of being distributed to shareholders

When the blood is too acidic (low pH) the kidneys will:

increase bicarbonate reabsorption •increase hydrogen ion secretion from renal epithelial cells •increase ammonia secretion to increase the NH3buffer

The dominant force in how a patient views healthcare is ________________.21__________________ are secondary drivers

individual experience, (Social hierarchy, race, and ethnicity)

As purchased cost

is the amount paid for the as purchased amount.

what happen in the body and kidneys When extracellular fluid (ECF) volume is low?

plasma solute concentration decreases,which decreases osmolarity.In responseto decreased solute concentration, the kidney excretes excess water,which reduces ECF volume, restores solute concentration and osmolarity to normal, and results in dilutedurine as water is excreted into the collecting duct.

Wait service- American

plates are individually prepared for customers and deliveredby server with all guests at one table served before moving on to the next table

In addition to hazards from the environment, people can make food unsafe through 4 practices:

poor personal hygiene, time-temperature abuse, cross-contamination, and poor cleaning and sanitizing

cohort studies

record exposures throughout time and then assess the rate of a certain outcome the exposure is measured before the outcome develops. Cohort studies can be prospective, where you recruit participants and follow them over time, or retrospective, using existing data where the exposure was still measured prior to the outcome

snowball sampling

recruitment of participants based on word of mouth or referrals from other participants

Fixed costs are the same over atime period and aren't relevant to output decisions- examples are

rent, equipment, insurance, interests, property taxes, salaries, and depreciation

Investigators want to study the predictors of ICU readmission during a single hospital stay following cardiac surgery. They identify patientswho underwent cardiac surgery from January to December of 2010 and were admitted to the ICU at least once. Cases are those that were readmitted to the ICUfollowing the initial ICU stay. Controls were those not readmitted to the ICU (one ICU stay during the cardiac surgery-related hospitalization). what type of study is this?

retrospective

edema stage 4+

severe pitting edema 8mm depression that last more than 2 min

Observer effect:

the researcher or interviewer'sbody language or intonation affects the way participants respond. This can occur during a nutrition counseling session, too. •In research, you may be reading out questions to a participant in contrast to a participant doing a paper-and-pen or computer survey. The tone of your voice, sighing, or remarking on an answer, instead of just saying "Ok" can influence the interview.The fact that another person is "witnessing" their responses can also influence the interview.•In counseling, we can generally avoid leading questions via open ended questions, however it can still persist. For example, asking "What do you dislike about your current situation?" is a leading question because you automatically assign "dislike" instead of asking "How do you feel about your current situation

paired comparison test

two samples are presented side by side to compare specific qualities laid in in seqenses (AB) or (BA)

Meal delivery carts

will keep foods at the right temperature during transport and may be used to hold patientmeal trays

Food quality should be negotiated with suppliers as part of contracts. Any food item that arrives with poorfood quality may have been time/temperature abused and should be rejected.Regarding sensory characteristicssuch as odor, texture and appearance, you should reject items forthe following reasons

•Appearance:moldy, abnormal color or moist when supposed to be dry •Texture: meat, fish or poultry that is slimy, sticky or dry,or has soft flesh that leaves an imprint when touched •Odor: abnormal or unpleasant odor

Minimum Internal Temperatures after Cooking for TCS Foods 155°Ffor 17 seconds

•Ground meat•Injected meat •Mechanically tenderized meat •Ground seafood •Eggs& egg productshot-held for service

Minimum Internal Temperatures after Cooking for TCS Foods 165°Ffor <1 second

•Previously cooked foods (i.e. leftovers) •Poultry (whole and ground) •Stuffed foods: meat, seafood, poultry, pasta •Stuffing containing TCS foods

essential amino acids

histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine

Scoop numbers (found on a scoop handle) refer to the number of scoops per

quart

Economic Order Quantity (EOQ)

the optimal order size to minimize the sum of ordering, carrying, and stockout costs

A company produces infant formula and has offices across the United States. They would likely benefit from a (decentralized / centralized) organizational structure because

(decentralized) because it is a geographically dispersed company

Top 15 Most Costly Foodborne Pathogens in the United States, 2015

1Salmonella 2Toxoplasma gondii 3Listeria monocytogenes 4Norovirus 5Campylobacterspp. 6Clostridium perfringens 11Shigellaspp. 7Vibrio vulnificus 8Yersinia enterocolitica 9E. coli O157 10Vibrio (non-cholera) 12Cryptosporidium 13Vibrio parahaemolyticus 14E. coli non-O157 15Cyclospora

Maslow's Hierarchy of Needs 2nd need

2. Safety needs - once an individual's physiological needs are satisfied, the needs for security and safety become salient. People want to experience order, predictability and control in their lives. These needs can be fulfilled by the family and society (e.g. police, schools, business and medical care). For example, emotional security, financial security (e.g. employment, social welfare), law and order, freedom from fear, social stability, property, health and wellbeing (e.g. safety against accidents and injury).

Correct handwashing should take

20 secs

You need 2 lbs of cooked eggplant for a dish. The yield from raw to cooked eggplant is 81%. How much raw eggplant do you need to purchase?Identify what you're given and what you're calculating.Use your triangle to solve for AP

2lb cooked /.81 percent yield =2.47

you will need to knowone #10 can =

3 quartsand there are 6 cans per case.

How many grams of amino acids would be in 500 mL of a 3% AA solution? 7% AA solution?

3% AA solution has 3 g per 100ml 500ml X (3𝑔𝐴𝐴)/(100𝑚𝐿) =15𝑔𝐴𝐴 7% AA solution has 7 g per 100lmL 500𝑚𝐿𝑥 (7𝑔𝐴𝐴)/(100𝑚𝐿)=35𝑔𝐴𝐴

To estimate fluid needs

30-35 ml/kg 100 mL/kg for the first 10 kg body weight, 50 mL/kg for the next 10 kg, and 20 mL/kg for the remaining body weight 1ml/kcal

A patient weighs 70 kg and is given 1500 mL of parenteral nutrition containing 300 g dextrose, 110 grams amino acids, and 50 grams fat. Calculate the calories from dextrose and the GIR What if the infusion is given over 12 hours?Calculate GIR using 12 hours instead of 24 hours 300 g dextrose

300 g dextrose / 70 kg / 12 hours = 0.36 g/kg/hr300,000 mg dextrose / 70 kg / 720 mins = 5.95 mg/kg/min

a #4 scoop has how many scoops per quart

4

Maslow's Hierarchy of Needs 5th need

5. Self-actualization needs are the highest level in Maslow's hierarchy, and refer to the realization of a person's potential, self-fulfillment, seeking personal growth and peak experiences. Maslow (1943) describes this level as the desire to accomplish everything that one can, to become the most that one can be.

Ex 3.8: You purchase 5 lb 2 oz of strip steak with a 50% yieldfor $5.99/lb. What is the total EP cost? In Ex 3.3 you calculated EP quantity of 41 oz from the AP quantity of 82 oz. Now, calculate total EP cost

5.99/16oz =.374 cent per oz .374 x 82oz= 30.67 𝐸𝑃𝑐𝑜𝑠𝑡= (𝐴𝑃𝑐𝑜𝑠𝑡)/(𝑌𝑖𝑒𝑙𝑑) 30.67/.50=61.34

you have 2 positionsto fill, each for 7 days per week working 6:30am to 3pm with a 30-minute lunch. How many productive FTEs do you need for these positions?

6:30𝑎𝑚 𝑡𝑜 3𝑝𝑚=8.5 ℎ𝑜𝑢𝑟𝑠−0.5 ℎ𝑜𝑢𝑟 𝑙𝑢𝑛𝑐ℎ= 8ℎ𝑜𝑢𝑟𝑠 8ℎ𝑜𝑢𝑟𝑠 ×7𝑑𝑎𝑦𝑠 ×2𝑤𝑜𝑟𝑘𝑒𝑟𝑠 =112ℎ𝑜𝑢𝑟𝑠 112ℎ𝑜𝑢𝑟𝑠/𝑤𝑒𝑒𝑘 40ℎ𝑜𝑢𝑟𝑠/𝑤𝑒𝑒𝑘=2.8𝐹𝑇𝐸𝑠

Lipid Volume and Concentration

A 10% emulsion is 1.1 kcal/mL and a 20% emulsion is 2 kcal/mL.

perpetual inventory system

A detailed inventory system in which a company maintains the cost of each inventory item, and the records continuously show the inventory that should be on hand. Records for each product are maintained, with the datethatitemswerereceived,the dateitems were removed, the reorder point, the purchase unit size, and par stock all in one place.

invoice

A form describing the goods or services sold, the quantity, and the price provided by supplier to buyer in order to request payment for items received

One compartment sink

A handwashing sink is a one compartment sink. However, there may be additional one compartment sinks around the kitchen to prep produce, soak pots and pans, or ina bar area

Steam oven

A steam oven cooks with water vapor, and can maintain flavor and nutrients of the fooditems. Cooking time is very fast, consistent, and even. It is a healthy alternative to frying but cannot brown or crisp food and shouldn't be used for delicate foods.

False Negatives (FN)

A test result that is negative in a person who has the disease.

8.Thermometers used in a foodservice operation should register temperatures below ____ degrees F and above ____ degrees F. a.0, 200 b.32, 200 c.32, 212 d.41, 135

Answer: C.Thermometers should register below 32 degrees F for incoming frozen foods and above 212 degrees for hot-held foods

How much of the total calorie needs should be from PN lipids?

At least 4% of calories should come from lipids to avoid essential fatty acid deficiency

maslows hierarchy of needs states that Motivation increases as ______________ needs are met and motivation decreases as _______________ needs are me

B-needs are met , D-needs

Costs of goods sold:

COGS, the cost of producing the goods that are sold

For the following solutions, calculate calories, NPC, NPC:N ratio, percent NPC from fat, and osmolarity. b.0.5 L D20W, 1 L 3.5% AA, 200 mL 20% lipid

Calories 500 mL x 20 g/100 mL = 100 g dextrose x 3.4 kcal/g = 340 kcal 1000 mL x 3.5 g/100 mL = 35 g AA x 4 kcal/g = 140 kcal 200 mL x 2 cal/mL = 400 kcal 340 + 140 + 400 = 880 kca NPC and NPC:N ratio 340 + 400 = 740 NPC 35 g AA / 6.25 = 5.6 g N 740 NPC / 5.6 g N = 132:1 ratio % NPC from Fat400 kcal from lipid / 740 NPC = 54% Osmolarity500 mL x 20 g/100 mL = 100 g dextrose1000 mL x 3.5 g/100 mL = 35 g AA(100 g dextrose x 5) + (350 g AA x 10) = 500 + 350 + 300 to 400 = 1150 to 1250 mOsm/L

Hypertonic enteral formulas can lead to GI symptoms and distress. Describe these symptoms and why they occur.

Hypertonic enteral formulas can cause water to enter the intestinal lumen because the higher concentration of solutes results in water diffusing in. This leads to watery diarrhea, cramping, and other abdominal symptoms

Duration of access for nasel/oral/g-tube/J-tube/PEG/PEG-j/PEJtube

Nasal and oral tube feeding access is for short term only. If the patient needs longterm enteral nutrition support, we would switch to G-tube, J-tube, PEG, PEG-J, or PEJtube.

Pizzas are offered on the Joe's Diner menu but so are a lot of other Italian-American favorites. When a group comes in looking for pizza, he sells a lot of pies, but they don't make up a large portion of his sales overall. He's thinking about making Wednesday evenings "Pizza Pie Night", offering a special discount for college kids. what type menu item is this clasified as?

Not popular, but profitable. Pizzas are a 'puzzle' item -when Joe does sell pizza he makes a profit, but he doesn't sell many overall (that is, pizza doesn't make up a large percentage of total sales).

Why don't we provide lipid emulsions continuously?

We want to give the body a chance to clear lipids from the blood. Continuous administration of lipids can lead to hyperlipidemia so we usually provide it 1 to 2 days per week, and at 4 to 24 hours per bag.

supply air

air coming to the workspace from the HVAC system (from outside)

Countertop warmers

are used in display cases and for soups and side dishes

14 gauge prep table/work area

butcher use most durables withstanding chopping, pounding etc.

edema stage 0+

no pitting edema

Baseline budget:

startswith previous budget and adjustsfor current conditions

embezzling

steal or misappropriate (money placed in one's trust or belonging to the organization for which one works).

pilfering

stealing minor items in small amounts, petty theft

Glutamine requirements are increasedduring _________________

stress (trauma, burns, sepsis, surgery, catabolic state)

parstock (par)

the amount of stock necessary to cover operating needs between deliveries

Ifthe power goes out, keep refrigerator and freezer doors shut to maintain cold temperatures.Know these facts for the exam: Refrigerators

will keep food safe for ~ 4 hours (with the door shut)

Health Risk Appraisal

A health risk appraisal, or health risk assessments, are the first step in multi-step health promotion programs.They are individual-level assessments often used by wellness companies and health insurance companies. There is no standard way to conduct a health risk appraisal but it may include the following:1.Participant provides self-reported health-related information, including•Behaviors: eating patterns, average sleep duration, employment status, smokingfrequency, alcohol consumption•Risk factors or diagnoses: Have you ever been diagnosed with...diabetes, heart disease, heart failure? Has a doctor ever told you that you have hypertension? Have you ever had a stroke or heart attack?2.Participantreceives individualized feedback based on self-reported health information•You mentioned being diagnosed withdiabetes. Because you have diabetes, you are at a higher risk of developing heart disease, including stroke, heart attack, or heart failure.3.Informationisused to provide at least onerecommendation or intervention towards promoting health, sustaining function, or preventing disease•You can reduce your risk of heart disease by eating more colorful foods and reducing your intake of processed foods.•If you quit smoking, after 6 months your risk of heart disease will besimilar to someone who hasnever smoked.•As you age, it's important to maintain your balance and strength. You can do this by walking regularly, doing weight-bearingexercises, or participating in yoga or tai chiexercises.

ABC inventory classification system

A items vital, high value only make up 15-20% of storage -butmake up 60-80% of the total value of purchases. C items, trivial, low value only make up 60-65% of storage- but with only 5-10% of the total purchases B items somewhere inbetween

True Negative (TN)

A negative result for patients who do not have the disease

physical inventory

A periodic inventory conducted by counting, weighing, or measuring items of merchandise on hand.

Prime vendor agreement

A prime vendor agreement is a pricing contract that a supplier offers to businesses on products they frequently buy. It is also used when a single vendor provides a customer with a majority of purchases. Prime vendor agreements fit well with wholesale distribution and should benefit both buyer and seller.

Standard oven

Also called a conventional oven, a standard oven has 2 heating elements that heat the air inside the oven. Dishes closest to the activeheating element(at top or bottom) will cook faster.Standard ovens are inexpensive, can be used to cook nearly anything, and are easy to repair. Disadvantagesinclude the inconsistentheating, uneven cooking, and slow cook times

2.What factors contribute to the economic burden of a foodborne illness? What were the top 5 costly pathogens in 2015? The costliest virus? The costliest parasite?

Economic burden, or overall cost, is a function of how common the illness is and how serious it is. Costs associated with severity include costs related to death, medical costs and productivity loss. The top 5 costly pathogens in 2015 were Salmonella, Toxoplasma gondii, Listeria, Norovirus and Campylobacter. The costliest virus was Norovirus, and the costliest parasite was Toxoplasma gondii

management 4 E's

Efficient: getting the most output from the least amount of input1 •Effective: doing things well, producing intended results1 •Economical: havinggood value with respect to the money/time/effort spent1-aka your total inputs for the "budget"; an economical approach -aka a "thrifty"approach •Expedient: suitable for a purpose,given the circumstanc

Epoxy flooring

Epoxy flooring is a protective coating on concrete flooring and is incredibly strong -strong enough to be used in manufacturing facilities and airplane hangars,while sanitary enough to be used in labs. A slip-resistant coating can be used to improve slip resistance or rubber mats can be added. It's easy to maintain with standard cleaners and resistant to abrasion, physical impact, and chemicals. Concrete floor is hard so it's important that measures are taken for comfort and worker fatigue.

outputs may be achieved in a variety of ways, such as producing quality meals (outputs) from both raw ingredients in-house and/or quality pre-prepared products (inputs

Equifinality:

EAR

Estimated Average Requirement-nutrient intake level estimated to meet the needs of 50% of people ofa certain age and sex group. Used to determine the RDA

Simple proteinscontain only amino acids, so when they are hydrolyzed, they yield only aminoacids.

Examplesinclude albumin, globulin, and glutelin

Accounts receivable:

Money owed to the company that will be fulfilled promptly, such as pending credit card payments or pending payments from a large catering order

Accounts payable:

Money the company owes, such as to vendors or wholesalers. These mightbe transactions that aren't completed each time an order comes in but rather on a monthly or quarterly basis

psychological needs(also D- needs)

Next are belonginess and love needs (intimate relationships, friends),and esteem needs(prestige, feeling of accomplishment)-the psychological needs,referenced above, are the human needsfor interpersonal relationships that motivate behavior at this level. Esteem includes esteem for yourself (dignity, independence), desire for reputation (status, prestige) and desire for respect from others. Esteem needs are higher among children and adolescents than certain adults.

Parenteral Nutrition Complications

Pneumothorax, hemothorax, arterial laceration, air emboli, catheter thrombosis, sepsis, hyperglycemia, HHNK * Patients receiving TPN should have a BMP daily

intact feeding Formulas

Polymeric formula −Protein, carbohydrate, and fat in thesame form as dietary intake −Standard, first-line EN formula (1 cal/mL) −Also available in high-calorie and high-protein options (1.5 -2 cal/mL

In addition to hazards from the environment, people can make food unsafe through 4 practices: Poor cleaning and sanitizing

Poor cleaning and sanitizing referto the transfer of pathogens or allergens from incorrectly cleaned surfacesto food

dissadvantages of group purchasing power

Requires accurate menu forecasting Requires membership agreement Requires delivery and storage capacity Requires minimum case orders

Identify mothers whose baby died from Sudden Infant Death Syndrome (SIDS). Identify mothers with babies born the same day who are still alive. Send questionnaires to the mothers asking about sleeping and feeding patterns Is the study design describedis prospective (P) or retrospective (R) and explain why. Then identify the independent and dependent variables.

Retrospective -exposure measured after outcome (case control study). Independent = sleeping and feeding patterns, dependent = SIDS.Note that this is a classic example for case-control studies, illustrating the possibility of recall bias, as mothers whose baby died likely think and worry about the events leading up to it much more than mothers whose baby did not die

Identify lung cancer cases among factory workers and determine if they were exposed to asbestos in the 5 years before diagnosis. Is asbestos associated with lung cancer? Is the study design describedis prospective (P) or retrospective (R) and explain why. Then identify the independent and dependent variables.

Retrospective -exposure measured after outcome. Independent = asbestos, dependent = lung cancer

Identify trauma surgery patients in the medical record database over the past year and classify them as having received enteral nutrition, parenteral nutrition, oral intake, or no food (NPO). Examine the relationship between feeding method and length of hospital stay. Is the study design describedis prospective (P) or retrospective (R) and explain why. Then identify the independent and dependent variables.

Retrospective -exposure measured after outcome. Independentt= feeding method, dependent = length of hospital stay

Patients undergoingradiationtherapy need to avoid what herbal supps/ supps in general ?

Rhodiola, vitamin A

PEG-J

See above for post-pyloric access notes.Difference between PEG-J and PEJ tube is that with a PEJ tube the port is inserted directly into the jejunum, rather than through the stomach and threading the tube through to the jejunum Need to use hydrolyzed formula because we are bypassing the duodenum where key digestion occurs. May still experience diarrhea and dumping syndrome with hydrolyzed formulas, particularly after bolus feeds

A patient weighs43 kg and is receiving 200 mL, 20% fat emulsionover 12 hours. Calculatelipid infusion rate

200𝑚𝐿𝑥 (2𝑘𝑐𝑎𝑙)/(1𝑚𝐿)=400𝑘𝑐𝑎𝑙 400𝑘𝑐𝑎𝑙 𝑥 (𝑔rams 𝑙𝑖𝑝𝑖𝑑)/(10𝑘𝑐𝑎𝑙 per gram)=40𝑔 𝑙𝑖𝑝𝑖𝑑 40𝑔𝑙𝑖𝑝𝑖𝑑/43𝑘𝑔/12ℎ𝑜𝑢𝑟𝑠=0.08𝑔/𝑘𝑔/ℎ𝑟

𝐴𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦−𝐸𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦=𝑤𝑎𝑠𝑡𝑒

25𝑙𝑏𝑠−21.25𝑙𝑏𝑠=3.75𝑙𝑏𝑠𝑤𝑎𝑠𝑡𝑒

if you are preparing a recipe that needs 29 number 10 cans of tomato paste, how many cases do you need to purchase?

29 𝑐𝑎𝑛𝑠 × (1𝑐𝑎𝑠𝑒)/(6𝑐𝑎𝑛𝑠) =4.83𝑐𝑎𝑠𝑒𝑠→𝑟𝑜𝑢𝑛𝑑𝑈𝑃𝑎𝑙𝑤𝑎𝑦𝑠→5𝑐𝑎𝑠𝑒𝑠

Maslow's Hierarchy of Needs 3rd need

3. Love and belongingness needs - after physiological and safety needs have been fulfilled, the third level of human needs is social and involves feelings of belongingness. Belongingness, refers to a human emotional need for interpersonal relationships, affiliating, connectedness, and being part of a group. Examples of belongingness needs include friendship, intimacy, trust, and acceptance, receiving and giving affection, and love.

A patient weighs 70 kg and is given 1500 mL of parenteral nutrition containing 300 g dextrose, 110 grams amino acids, and 50 grams fat. Calculate the calories from dextrose and the GIR Convert 300 dextrose grams to milligrams

300 g dextrose x 1000 mg/g = 300,000 mg

A patient weighs 70 kg and is given 1500 mL of parenteral nutrition containing 300 g dextrose, 110 grams amino acids, and 50 grams fat. Calculate the calories from dextrose and the GIR Calculate the calories from 300 g dextrose (PN)

300 g dextrose x 3.4 kcal/g = 1,020 kcal

A patient weighs 70 kg and is given 1500 mL of parenteral nutrition containing 300 g dextrose, 110 grams amino acids, and 50 grams fat. Calculate the calories from dextrose and the GIR Calculate 300g dextrose rate per minute

300,000 mg dextrose / 70 kg / 1440 minutes per day = 2.98 mg/kg/min

A patient weighs 70 kg and is given 1500 mL of parenteral nutritioncontaining 300 g dextrose, 110 grams amino acids, and 50 grams fat. Calculate the lipid dose and lipid infusion

50 g lipid / 70 kg = 0.71g/kg/day In order to calculate hourly lipid infusion rate(g/kg/hour), convert milliliters to grams lipid, divide by body weight, and divide by infusion time in hours.To convert mL to grams lipid, determine the numberof calories in the emulsion and divide by 10 kcal/g.50 g lipid / 70 kg / 12 hrs= 0.06 g/kg/hr

Carbon dioxide extinguisher:

Used for Class B and Cfires, the carbon dioxideblankets the fuel and displaces oxygenand can also remove heat by cold discharge.

dumping syndrome occurs after

We see dumping syndrome after bariatric surgery, gastric resection, esophageal pull-up surgery, and sometimes with post-pyloric EN access

Ex 3.5: You need to figure out how many cans of sliced peaches in syrup to purchase for this week's peach cobbler. The recipe calls for 8 quarts of peaches after draining and rinsing. Yield from canned to drained is 90%. How many Number 10 cans do you need to purchase, knowing that each can of peaches from your vendor weighs 6 lb 10 oz

What are we solving for? AP quantity -the quantity of peaches we need to buy to get to our EP of 8 quarts. Do we need to do any conversions? Yes! We need to get 8 quarts and 6 lb 10 oz on the same page. Let's start by converting the Number 10 can of peaches to oz, and the 8 quarts to oz. 6lb x16oz =96oz +10 oz = 106oz in #10 can 8qts x 32oz = 256 oz (4 qts in a gallon!) Now we need to calculate AP using the yield factor of 0.90. 256/.9(the yeild )=284.4 (285oz) 285 oz /106(#10 can) =2.68 cans (always round up!) =3 cans

McGregor's Theory Y

Yassumes that most people not only accept but seek responsibilityand that exerting physical and mental effort at work is as natural as play or rest.14Managers believing in Theory Y believe that most people will exercise self-control to achieve an organizational objective. Theory Y builds on the esteem and self-actualization needsfrom Maslow's Hierarchyof Needs.Note that managing via Theory Y does not mean a manager must use a "soft approach". Key tools for managers using Theory Y include: decentralization and delegation, broadening the scope of an employee's job description, consulting employees in decision making (participative management), and having employees set goals and conduct self-evaluations

Acidemia and alkalemia refer to abnormal pH while

acidosis and alkalosis refer to the metabolic or respiratory process whose compensatory response led to the abnormalpH values.

return air

air returning to the HVAC system from the workspace

non-essential amino acids

alanine, arginine, asparagine, aspartic acid, cysteine, glutamic acid, glutamine, glycine, proline, serine, tyrosine

The InterstateTravel Sanitation Program

allows Food and Drug Administration (FDA)agents to inspect foodservice systems on interstate carriers such as boats, planes and trains. Note that the FDA has jurisdiction to set standards, monitor and inspect foodservice activities on all interstate carriers.

Specialtyformulas with glutamine can improve _________________ metabolism and prevent ________________ atrophy

glucose and protein GI atrophy

SHIGELLA SPP

infection results in shigellosis. Shigellais shed in the feces of infected persons (or recently recovered persons) and so it is important to exclude employees with a shigellosis diagnosis(also called bacterial dysentery)or who currently have diarrhea from food handling. Flies can also transfer the bacteria from feces to foodso controlling flies around the operation is important. •Prevention measures include excluding infected employees or those with diarrhea, washing hands, controlling flies, and practicing personal hygiene. •Symptoms include bloody diarrhea, fever and stomach cramps. •Time to onset is 1 to 2 days and symptoms last about one week. •Commonly associated foods include poultry (raw or undercooked),contaminated water, unpasteurized dairy, meats, and stews or gravies.

key to an efficient and effective system. Allows for continual relationships and interaction between the subunitswithin an organization

interdependency

Requisition form

internal form used bythefoodservice manager or chef to request items from the purchasing manager or purchasing department

Dry chemical extinguishers

interrupt the chemical reaction between the 3 elements in the fire triangle. Regulardry chemical extinguishers only work with Class B and C, and can exacerbateClass A fires. There aremultipurpose,dry chemicalfire extinguishersthat can be used in Class A, B, and C fires -these are theredfire extinguishers you commonly seeand may be labeled as ABC extinguishers

Game theory:

introduces a competitive componentinto decision making by bringing the actions of an opponent into the situation. The goal is to obtain the highest gains with smallest amount of losses,regardless of what a competitor does

D5W

is 5% dextrose in water, or 5 g dextrose per 100 mL water

Per the CDC, the TOP FIVE foodborne pathogens are

norovirus, Salmonella, Clostridium perfringens, Campylobacterjejuni andStaphylococcus aureus.4These 5 pathogens cause the most foodborne illnessesper year(Table 2).The top 5 pathogens may change over time, so check the CDC website at https://bit.ly/2Ti9ad9as part of studying for your exam.

Acidemiais when blood pH is

less than 7.35

Percutaneous endoscopic gastrostomy(PEG),percutaneous endoscopic jejunostomy (PEJ)or PEG-J tube:

lightedendoscope fed through the mouth down into the stomach(or jejunum) to guide where the abdominal incision is made and to guide placement of the G-tube or J-tubeonce inserted in the incision.PEG/PEJtubes can last months or years. Complications include gastric content leakage and skin irritation, aspiration (PEG), and bleeding or bowel perforation (PEJ). A PEG-J tube is one where the tube enters the stomach and is fed through to the jejunum, rather than entering the body directly at the level of the jejunum. Enteral and Parenteral Nutrition5G-tubes are prone to leakage, skin irritation, nausea, vomiting, and bloating. J-tubes do not have those downsidesbut haveanincreased chance of diarrhea.

Current assets:

liquid assets, or those easily converted to cash(ex: accounts receivable)

Since gross profit is the difference in revenue and COGS, a higher COGS will lead to_________ profit, and alower COGS will lead to ________ profit.

lower/greater

A la carte menus:

prices each food item separately. Instead of entrée items like steak accompanied by a side salad and mashed potatoes, customers will order each item separately

Informational roles

process information and includethe roles of amonitor, disseminator, and spokesperson.4Monitorsseek informationrelated to their industry, look for changes in the industry environment, and monitorthe team on productivity and well-being. Disseminators communicate useful information to teamsand colleagues.Spokespersonsrepresent and speak for their organization,andtransmit information about their organization and goals to people outside of it

in a large cohort study constructed in 1980, a group of 20,000 adults aged 30 -80 were recruited and attended regular clinic visits every 5 years. Between clinic visits, study staff contacted participantsvia telephone. At every 5-year clinic visit, participantscompleted a food frequency questionnaire. Using this data, study investigators studied the association betweentheHealthy Eating Indexfrom the dietary data and the risk of hospitalization from ischemic stroke,beginning with a baseline in1980 andfollowing participantsthrough 2010. what kind of study is this

prospective

Interpersonal Roles

provide information and includethe roles of afigurehead, leader, and liaison.4Figureheads have social, ceremonial, and legal responsibilities; they serve as an authority figureand a source ofinspiration.Leaders serve as a leader, and manage performance and responsibilities. Liaisonscommunicate with internal and external contacts and network effectively

Service Style-Buffet

provides many options and items but must optimize eye appeal and choose items that hold up under long presentation time

Foodservice systems-Commissary

n a commissary foodservice system, the food is prepared in a large,central kitchen and then delivered in bulk for final production and service. The commissary system is ideal for serving large volumes of food. Food may be transported frozen, chilled, or hot. Examples include school systemsand airline foods. Raw food is purchased,prepared, and then held frozen, chilled, or hot during transport until service. Advantages include cost savings (low food cost, lack of equipment duplication, low labor cost), limited workload variability, uniform products across service locations, and no cooking during mealtime. Disadvantages include food safety concernsand quality concerns during holding and transporting. This method requires reliable transportationand a large production kitchen where the cost of that large kitchen is only offset by the large quantityof food it's able to produce. Since food is transported to the satellite locations, meals can be prepared any time of day in contrast to conventional foodservice systems where employees have higher workload prior to mealtimes.Cost savings from avoiding equipment duplication refers to the fact that all of the food production is done at one location, rather than at several satellite kitchens.

Glutamine is a key transporter of nitrogen, carbon, or ATP?

nitrogen

The costliest virus is norovirus

norovirus

D50W

s 50% dextrose in water, or 50 g dextrose per 100 mL water

18 gauge prep table/work area

salad, sandwhich and gereral assembly susceptible to dents and scrathes

In addition to hazards from the environment, people can make food unsafe through 4 practices: Cross-contamination

Cross-contamination refers to the transfer of pathogens from one food to another food. Cross-contact is when an allergen from one food transfers to another food item meant to be allergen-free. Even after proper time-temperature handling, food remains dangerous after cross-contact.

benefits of group purchasing power

Increased purchasing power Increased menu variety and quality Labor savings Cost savings

Activity ratio:

ability to transfer non-cash assets to cashassets

Solvency ratio:

abilityto meet long-term debts

Value-Added Research

"Value-added" is when a business adds something extra to a generic product that gives a greater perception of value. Thus, value-added researchis the process of assessing if value should be added

𝑀𝑎𝑟𝑘𝑢𝑝𝐹𝑎𝑐𝑡𝑜𝑟=

(1)/(𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡)

𝑀𝑎𝑟𝑘𝑢𝑝𝐹𝑎𝑐𝑡𝑜𝑟=

(1)/(𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡+𝐿𝑎𝑏𝑜𝑟𝐶𝑜𝑠𝑡)

Calcitriol

(1,25-D3) circulates as a hormone regulating calcium and phosphate metabolism, and is the active form of vitamin D. Vitamin D can be generated from cholecalciferol (sun) which goes to the liver and then travels to the kidney as calcidiol (25-hydroxy D3). Vitamin D can also be generated from cholecalciferol (D3;from food) or ergocalciferol (D2;from supplements) which then go to the liver and the kidney.

Your foodservice operation requires thirteen 8-hour positions, four 4-hour positions, and one 3-hour position. How many FTEs does your foodservice operation needfor daily demands?

(13𝑥8ℎ𝑜𝑢𝑟𝑠)+(4𝑥4ℎ𝑜𝑢𝑟𝑠)+(1𝑥3ℎ𝑜𝑢𝑟𝑠)=104+16+3ℎ𝑜𝑢𝑟𝑠=123ℎ𝑜𝑢𝑟𝑠 (123ℎ𝑜𝑢𝑟𝑠) (8ℎ𝑜𝑢𝑟𝑠𝑝𝑒𝑟𝑑𝑎𝑦)=15.37𝐹𝑇𝐸𝑠

Calculate the maximum daily lipids and dextrose for a 72 g patient.

(2.5𝑔)/(𝑘𝑔) 𝑥72𝑘𝑔 =180𝑔𝑙𝑖𝑝𝑖𝑑/𝑑𝑎𝑦 0.36𝑔/𝑑𝑎𝑦𝑥72𝑘𝑔𝑥24ℎ𝑟=622𝑔𝑑𝑒𝑥𝑡𝑟𝑜𝑠𝑒/𝑑𝑎𝑦

If you're given a scoop size, you can calculate volume of that scoop by dividing 32 fl oz by the scoop size. If you're given scoop volume, you can calculate which scoop number that corresponds toby dividing 32 by the scoop volume.

(32)/(#4𝑠𝑐𝑜𝑜𝑝) =8𝑓𝑙 𝑜𝑧 𝑝𝑒𝑟 𝑠𝑐𝑜𝑜𝑝 (32)/(8𝑓𝑙 𝑜𝑧) =#4𝑠𝑐𝑜𝑜𝑝

Food Allergen and Labeling Consumer Protection Act

(FALCPA) was enacted in 2004 and applies to all foods regulated by the FDA. Under FALCPA, the Big Eightallergens must be listed within the ingredients list using their common name(i.e. whey)and theingredient they arederived from(i.e. milk)(see Example 1) or listedimmediately after or adjacent to the ingredient list with the word 'Contains' (see Example 2).46The specific type of tree nut, fish and crustacean shellfish must also be identified, if applicable.However, if an ingredients name already specifies its allergen source, such as soymilk, buttermilk or eggs, these labeling criteria are not necessary

CIF origin

(cost insurance and freight) is the oppositeas responsibility transfers to the buyer only when the goods arrive at the destination

𝑌𝑒𝑎𝑟𝑙𝑦𝑑𝑒𝑝𝑟𝑒𝑐𝑖𝑎𝑡𝑖𝑜𝑛=

(𝐶𝑜𝑠𝑡𝑜𝑓𝐸𝑞𝑢𝑖𝑝𝑚𝑒𝑛𝑡−𝑆𝑎𝑙𝑣𝑎𝑔𝑒𝑣𝑎𝑙𝑢𝑒)/ 𝑌𝑒𝑎𝑟𝑠𝑜𝑓𝑈𝑠𝑎𝑏𝑙𝑒𝐿𝑖𝑓𝑒

weightedaverage purchase pricing.

(𝑈𝑛𝑖𝑡𝑠𝑖𝑛𝑂𝑝𝑒𝑛𝑖𝑛𝑔𝐼𝑛𝑣𝑒𝑛𝑡𝑜𝑟𝑦𝑥𝑃𝑢𝑟𝑐ℎ𝑎𝑠𝑒𝑃𝑟𝑖𝑐𝑒)+(𝑈𝑛𝑖𝑡𝑠𝑃𝑢𝑟𝑐ℎ𝑎𝑠𝑒𝑑𝐷𝑢𝑟𝑖𝑛𝑔𝑀𝑜𝑛𝑡ℎ𝑥𝑃𝑢𝑟𝑐ℎ𝑎𝑠𝑒𝑃𝑟𝑖𝑐𝑒)/𝑇𝑜𝑡𝑎𝑙#𝑈𝑛𝑖𝑡𝑠

Delbecq Nominal group technique

.Delbecq's nominal group technique: using structured,small-group discussion to reach a consensus.30The moderator presents the question of interest. Each group member writes down their ideas separately. Then each person shares their idea and the moderator writes them on a group board. The group then discusses each idea, revising them, and then voteson the best one.

Infusion rate is important to control because a rate in excessof?

0.36 g dextrose per kg body weight per hourcan lead to hyperglycemia, fatty liver, and respiratory issues9becauseglucose is oxidized at a maximum rateof 0.36 g/kg/hourin our body.The maximum oxidation rate is the same as the maximum infusion rate for dextrose.We can calculatethe maximum grams of dextrose to give a patient as 0.36 g x body weight x 24 hours.

if your patient weighs 85 kg, what would their maximum dextrose tolerance be (in grams)? TIP: Use the maximum infusion rate for dextrose.A patient weighs 70 kg and is given 1500 mL of parenteral nutrition containing 300 g dextrose, 110 grams amino acids, and 50 grams fat. Calculate the calories from dextrose and the GIR.Thencalculate the GIR using g/kg/hr.What if the infusion is given over 12 hours?

0.36 g/kg/hrx 85 kg x 24 hours = 734.4 g dextrose per day

the receiving process is:

1)Comparepurchase order to invoice 2)Inspect items against invoice 3)Accept or reject items-fresh produce and frozen foods should be examined before accepting the item 4)Complete receiving recordsand sign the invoice 5)Place products in appropriate storage

What are the4steps in controlling?

1)Establish standards (targets to achieve) 2)Measureperformance 3)Compareactual and standard performance -identify causes and extent of deviation 4)Takeremedial actions -takecorrective measures for deviations and possibly revising targets. A manager can only exercise control by taking corrective measures

Maslow's Hierarchy of Needs 1st need

1. Physiological needs - these are biological requirements for human survival, e.g. air, food, drink, shelter, clothing, warmth, sex, sleep. If these needs are not satisfied the human body cannot function optimally. Maslow considered physiological needs the most important as all the other needs become secondary until these needs are met.

three compartment sink

1. Sink One: detergent with 110 degree water 2. Second sink: clean water 3. Third sink: water and sanitizer

Hot TCS food must be received at

135F or higher

The Management ProcessThe management process begins with establishing objectives and then identifies functions required to achieve the objectives. Then,the manager determines responsibilities -describes them and assigns them as appropriate. Finally, the manager delegates by assessing whichemployees have the skills and/or resources to achieve the tasks

1. establish objectives- managment objectives begins with establishing objectives 2. identify fucntions- the function to be included to acheive objective 3. determine responsibilities- task or responsibilites must be described and assigned as appropriate 4. delegate- assess what employees have the skills/resources to acheive task

How many grams of amino acids would be in 1.5 L of 3.5% AA solution? 0.75 L of 8.5%?

1.5 L is the same as 1500 mL and 3.5% AA solution has 3.5 g per 100 mL 1500𝑚𝐿𝑥 (3.5𝑔𝐴𝐴)/(100𝑚𝐿) =52.5𝑔𝐴𝐴 0.75 L is the same as 750 mL and 8.5% AA solution has 8.5 g per 100 mL 750𝑚𝐿𝑥 (8.5𝑔𝐴𝐴)/(100𝑚𝐿) =64𝑔𝐴𝐴

Calculate labor cost for the following scenarios: 10 minutes at $10/hour 2 minutes at $12/hour 8 minutes at $11.75/hour

1.66 .4 1.56

there are 7 HACCP Principles

1.Conduct a hazard analysis. 2.Determine the critical control points (CCPs). 3.Establish critical limits. 4.Establish monitoring procedures. 5.Establish corrective actions. 6.Establish verification procedures. 7.Establish record-keeping and documentation procedures

Informal ProcurementProcess

1.Develop specifications in writing 2.Identify sources eligible, able, and willing to provide products 3.Contact sources 4.Evaluate bidders'response 5.Determine most responsive and responsible bidder at the lowest price

The 5 indications for parenteral nutrition answer the "why" question -why a patient can't use oral or enteral nutrition, and why we can't use the gut.

1.Inability to achieve or maintain enteral access 2.Impairedabsorption or loss of nutrients 3.Mechanical bowel obstruction 4.Need for bowel rest 5.Motility disorders

Contraindications (things that preclude or prevent from happening) to Enteral Nutrition

1.Intestinal obstruction, ileus, or hypomotility 2.Severe diarrheaor vomiting 3.Severe hemodynamic instability 4.Major upper GI bleeding 5.Prognosis doesn't warrant aggressive nutrition support 6.High output enterocutaneous fistula

Allergens are proteins that cause allergic reactions. While many food proteins can cause allergic reactions, there are 8 that cause the majority of food allergy reactions: TheBig Eight. Know the list and be aware of products that contain them as an ingredients

1.Milk 2.Soy 3.Tree nuts (e.g. almonds, walnuts, pecans) 4.Crustacean shellfish (e.g. crab, lobster, shrimp) 5.Eggs 6.Fish (e.g.bass, flounder, cod) 7.Peanuts 8.Wheat The majority of fatal and near-fatal food allergyreactions in the US are caused by peanuts or tree nuts.

4 P's of Marketing

1.Price: pricing affects how a product is sold; linked to perceived value of product; must understand how a consumer sees the product because a price too high OR too low will hinder sales. 2.Promotion: marketing communication strategies and techniques,including advertising, sales promotions, special offers, and public relations. Must be suitable for product, price, and end user. Promotion is the communication part of the entire marketing function. 3.Place: how is the product provided to the customer? Placement strategy assessesthe most suitable channel and must complement the rest of the product strategy. 4.Product: atangible good or intangible service; developed to meet a specific consumer need and demand. Need to understand the problem the product is trying to solve and then convey the benefits tothe consumer.

Enteral nutrition (EN) is when nutrition is provided to the gut when a person cannot consume sufficient (or any) nutrition on their own. There are 5 main indications for enteral nutrition:

1.Protein-energy malnutrition andinadequate oral nutrient intake for ≥ 5 days 2.Meeting < 50% of nutrient needs for 5 -7 days 3.Severedysphagia 4.Coma 5.Low output enterocutaneous fistula

The 3skills you need to be a successful manager are

1.Technical-knowledge and capabilities to perform specific tasks 2.Human/Interpersonal-soft skills that should be nurtured, such as communication and attention to relationships (in contrast tohard skills that can be learned) 3.Conceptual-ability to integrate activities and interests of an organization →the most important skill to have at higher levels of managemen

If food cost is 23% and raw food cost is $0.25:Can you calculate markup factor? Yes, with food cost alone. Calculate selling price using the selling price formula that requires markup factor and raw food cost, but not labor cost or prime cos

1/.23=4.34 𝑆𝑒𝑙𝑙𝑖𝑛𝑔𝑃𝑟𝑖𝑐𝑒=𝑀𝑎𝑟𝑘𝑢𝑝𝐹𝑎𝑐𝑡𝑜𝑟×𝑅𝑎𝑤𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡=4.3478×$0.25=$1.09So, the cost of the food item was $0.25 and we are going to charge $1.09 for it.

Calculate markup factor for the following items. •Prime rib -Food cost 33%, labor cost 5% •Pizza -Food cost 12%, labor cost 26% •Steak entrée -Food cost 42%

1/.33+.05=2.63 1/.12+.26=2.63 1/.42=2.38

Calculate the caloriesand grams of lipidin the following emulsion-volume combinations 100 mL, 10% emulsion •250 mL, 10% emulsion •200 mL, 20% emulsion •500 mL, 20% emulsion

100 mL, 10% emulsion= 100𝑚𝐿𝑥 (1.1𝑘𝑐𝑎𝑙)/(1𝑚𝐿)=110𝑘𝑐𝑎𝑙 110𝑘𝑐𝑎𝑙𝑥 (𝑔ram 𝑙𝑖𝑝𝑖𝑑)/(10𝑘𝑐𝑎𝑙)=11𝑔𝑙𝑖𝑝𝑖𝑑 250 mL, 10% emulsion 250𝑚𝐿𝑥 (1.1𝑘𝑐𝑎𝑙)/(1𝑚𝐿) =275𝑘𝑐𝑎𝑙 275𝑘𝑐𝑎𝑙 𝑥 (𝑔rams 𝑙𝑖𝑝𝑖𝑑)/(10𝑘𝑐𝑎𝑙) =27.5𝑔𝑙𝑖𝑝𝑖𝑑 200 mL, 20% emulsion 200𝑚𝐿𝑥 (2𝑘𝑐𝑎𝑙)/(1𝑚𝐿) =400𝑘𝑐𝑎𝑙 400𝑘𝑐𝑎𝑙 𝑥 (𝑔rams 𝑙𝑖𝑝𝑖𝑑)/(10𝑘𝑐𝑎𝑙) =40𝑔𝑙𝑖𝑝𝑖𝑑 500 mL, 20% emulsion 500𝑚𝐿 𝑥 (2𝑘𝑐𝑎𝑙)/(1𝑚𝐿) =1,000𝑘𝑐𝑎𝑙 1,000𝑘𝑐𝑎𝑙 𝑥 (𝑔rams 𝑙𝑖𝑝𝑖𝑑)/(10𝑘𝑐𝑎𝑙) =100𝑔𝑙𝑖𝑝𝑖𝑑

#3 can

12 cans/case, 46 oz(some say 51)., 5 3/4 cups, 12-15 servings

Given that full-time employees work 236 of 365 days per year (given vacation and benefit days), how many FTEare neededfor dailycoverage?

365𝑑𝑎𝑦𝑠/𝑦𝑒𝑎𝑟 236𝑤𝑜𝑟𝑘𝑑𝑎𝑦𝑠/𝑦𝑒𝑎𝑟 =1.55𝐹𝑇𝐸𝑠

Maslow's Hierarchy of Needs 4th need

4. Esteem needs are the fourth level in Maslow's hierarchy and include self-worth, accomplishement and respect. Maslow classified esteem needs into two categories: (i) esteem for oneself (dignity, achievement, mastery, independence) and (ii) the desire for reputation or respect from others (e.g., status, prestige). Maslow indicated that the need for respect or reputation is most important for children and adolescents and precedes real self-esteem or dignity.

Our goal is for the amino acids in the PN to be used for protein synthesis, not calorie requirements. We want to provide sufficient calories from other sources so thatthe body can use amino acids for protein synthesis.9Amino acids are hypertonic.Common non-protein calorie:nitrogen ratios are:

80:1 for critically ill patients •100:1 for patientswith difficulty maintaining muscle mass •150:1 for unstressed and stable patients

if you purchase a countertop fryer for $990, estimate the useful life of 5 years, and salvage value at $100, you can calculate the yearly depreciation.Yearly depreciation can also be called annual depreciation.

990Cost-100salvage/ 5 years useable =178 a year

Parenteral Nutrition Complications Hypertriglyceridemia

: high blood triglyceridescan occur with hyperglycemia, particularly with renal insufficiency, steroid medications, and large IV fat emulsions

Current liabilities:

:include accounts payable and accrued expenses that must be paid within 12 months

Rotary Oven

A rotary oven allows for bulk production of fooditems, particularly flour-based foods like bread. Anythingthat cooks at the same temperature can go in -rolls, bread, cookies, and cake. Furthermore, rotary ovens provide acompact solution in contrast to several ovens, or even stacked ovens.Rotary ovens offer uniform baking and even cooking to all items compared to standard ovens where items closest to the heating elements will cook faster and brown more.Rotary ovens use an air distribution system to distribute warm air to achieve the consistent cooking. Rotary ovens look like a large walk-in chamber and have a special perforated tray. To understand better, look up a video of rotary ovens online

Request for Proposal (RFP)

A type of procurement document used to request proposals from prospective sellers of products or services. In some application areas, it may have a narrower or more specific meaning.

You purchase 8 lbsof apples to make apple cider. Is this your AP quantity or EP quantity? Why? After peeling and coring, you end up with 6 lbsof apples. Is this your AP quantity or EP quantity? Why? Calculate the percent yield

AP quantity EP quantity 𝑃𝑒𝑟𝑐𝑒𝑛𝑡𝑌𝑖𝑒𝑙𝑑= 𝐸𝑃 𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦/𝐴𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦 𝑥100% 6/8=.75

AMDR

Acceptable Macronutrient Distribution Range-used to report macronutrient recommendations,such as 45 -65% of daily calories from carbohydrates

AI

Adequate Intake-when evidence is insufficient to developan RDA, the AI is set at a level assumed to ensure "nutritional adequacy"

Foodservice systems-Conventional

Also known as "cook-to-serve", conventional foodservice systems have kitchensthat produce items for immediate service. Food is purchased, transformed into the final product toserve, and then held at serving temperature until actually served An example includes restaurantsand cafeterias. Food is prepared in the same place it is servedand mostly raw food is purchased,though some convenience items may be purchased. Foods are held at serving temperature until served. Labor requirements are heavy and equipment for holding food,like chafers and other equipment we'll discuss,are necessary. Advantages of conventional foodservice systems include high food quality and flexibility in the foods that can be produced. Any food that can be held for up to 2 hours can be produced in this type of foodservice system, and food quality is maintained if held within thistime limit.However, disadvantages of the conventional foodservice system include less time flexibility and more labor because food is produced so close to service. Workload is unevenly distributedandlimited to the length of time that hot food can be held

Foodservice systems-Ready Prepared

Also known as "cook/chill" and "cook/freeze", ready prepared foodservice systems have kitchens that produce and chill menu items and then heat items back up for service. This system type is often used in combination with other systems. Food is prepared on location and then chilled or frozen to be used later on (in the same location or transported). Large refrigerators and freezers are required for this method,as well as reheating equipment to warm chilled or frozen food for service time. Advantages of this method include the ability to prepare food in bulk or in individual portions which evens out the workload. The menu also supports an increased variety of chilled and frozen items. If food is transported, this method has the advantage of transporting foodschilled orfrozen, which is easier to do than transporting hot food. Think about this aspect of ready prepared foodservice when we talk about commissary.Disadvantagesof this method includelarge equipmentrequirements -large refrigerators,freezers and the budget for the high energy costs associated with that equipment. If the power goes out, a large amount of food can be lost and food safety can be an issue. Also, not all foods freeze or chill well, so while there is the possibility of variety because of the ready prepared method, some foods aren't compatiblebecause they cannot be frozen or chilled well. Freezer burn, textural changes, and emulsion separation are all food quality concerns with the readypreparedmethod, and hot food undergoes 2 heating periods -when it's first cooked (before chilling or freezing) and when it's reheated for preparation.

true positives, TPand incorrectly miss some (falsenegatives, FN)

Among those who truly have the disease, the screening test will correctly identify said disease.

Controlling has 5 characteristics.

An end function-comes into play when performances are made with plans •Pervasive-includes all managers, all levels, all types of concerns •Forwardlooking-look to the past for effective control in the future •Dynamic-continuous review, making changes wherever possible •Related to planning-without planning, controlling is meaningless and without controlling, planning is useless

Group Purchasing Organization (GPO)

An entity consisting of two or more hospitals or other healthcare entities that is formed to offer its members access to purchasing contracts for health supplies at a lower cost

decentralized organization

An organization in which lower-level managers make important decisions Good for: •Adaptability and innovation •Quick decision-making •Good training experience for future promotions to higher level management •Diverse businesses•Geographically dispersed companies

time/temperature control for safety" (TCS)foods are:

Animal Products: Meat and poultry EggsFish, shellfish, crustaceans Milk and cheese (especially unpasteurized) Plant Products: Cooked: rice, beans, baked potato Raw: seed sprouts, cut melon, cut tomatoes, cut leafy greens, garlic-in-oil mixtures High-water, Low-acid Foods: a food that because of its water activity level and pH may promote the growth of pathogens or toxins

Which type of foodservice system may be particularly prone to food safety concerns? a.Commissary b.Assembly-serve c.Conventional d.Ready prepared

Answer: A, commissary.Because all items are prepared at a single central kitchen, transported and then held onsite, food safety is of particular concern with this type of foodservice system.

What advantages does a ready prepared foodservice system haveover a conventional foodservice system? a.More even workload b.More labor required c.Lower energy costs d.One heating period

Answer: A, more even workload.Conventional foodservice systems have uneven workloads in the schedule because the majority of food preparation is done just prior to service so that food is held only for the maximum of 2 hours. For this same reason, conventional systems require more labor than ready prepared. Ready prepared foodservice systems prepare food in advance and then chill or freeze items, and reheat prior to service. Thus, food production can occur at any time and is not tethered to meal time. However, conventional systems may have lower energy costs compared to ready prepared because of the high energy requirement of large refrigerators and freezers required to hold chilled and frozen food. Additionally, in a ready prepared foodservice system, the food undergoes two heating periods, which may reduce food quality

7.Ham packed in a USDA-inspected facility should be cooked to an internal minimum temperature of: a.140°F for 4 minutes b.145°F for 4 minutes c.155°F for 17 seconds. d.165°F for <1 second

Answer: A. Ham packed in an USDA-inspected facility can be cooked to 140 degrees F. Ham from other sources should be cooked to 145 degrees for 4 minutes.

16.What parasite is commonly associated with cod, halibut, mackerel and pacific salmon? a.Anisakis simplex b.Norovirus c.Cryptosporidium parvum d.Ciguatoxin

Answer: A.Anisakis simplex is a parasite commonly associated with the listed fish. Norovirus is associated with shellfish harvested from contaminated waters and is a virus. Cryptosporidium parvum is a parasite and associated with contaminated water and improper hygiene. Ciguatoxin is a toxin associated with barracuda, grouper, jacks, snapper and sturgeon

20.Category A agents are considered the highest priority because they require special action for adequate public health preparedness, result in high mortality rates, and: a.result in high mortality rates b.are moderately easy to disseminate c.can be monitored with existing surveillance systems d.All of the above

Answer: A.Category A agents include anthrax, botulism, plague, smallpox, tularemia and viral hemorrhagic fevers. They post a risk to national security because they are easily disseminated or transmitted, have high mortality rates, may cause public panic and requirespecial action for adequate public health preparedness. Category B agents are moderately easy to disseminate (with less person-to-person contagion risk compared to Category A), have high morbidity but low mortality rates and require enhanced surveillance but not specific public health preparedness actions

13.Which of the pathogens below is associated with unpasteurized dairy and deli meats? a.Listeria monocytogenes b.Giardia duodenalis c.Salmonella spp. d.Shigella spp.

Answer: A.Listeria monocytogenes can grow at refrigeration temperatures and is commonly associated with unpasteurized dairy, including soft cheeses, deli meats, hot dogs and raw meat. Listeria has serious consequences for pregnant women and fetuses and so these foods should be avoided.

4.A foodborne illness outbreak can have negative effects on a business, including: a.loss of reputation, lawsuits, staff retraining b.loss of sales, increased productivity, increased insurance premiums c.higher staff morale, lost productivity, legal fees d.staff retraining, positive media exposure, lost productivity

Answer: A.The costs of a foodborne illness include loss of reputation, legal fees and lawsuits and staff retraining. Other costs include loss of customers and sales, negative media exposure, poor staff morale, lost productivity and increased insurance premiums.

The head of the foodservice department informs you that a new specialty diet will be added to the patient menu by the end of the year. They want you to draft up the advantages and disadvantages of a ready prepared versus assembly serve system. Which of following aspects differ between the two foodservice systems? a.Menu variety is limited to what can be chilled or frozen b.Less food waste with assembly serve system c.Less labor required for ready prepared system d.Lower food cost with assembly serve system

Answer: B, less foodwaste with assembly serve system.Both assembly serve and ready prepared are limited to what can be chilled or frozen, however because items are purchased pre-portioned in an assembly serve system, there is less food waste. Ready prepared systems require more labor than assembly serve systems (though conventional systems require the most labor), but food cost is higher with assembly serve because prepared foods are more expensive than raw foods

5.When preparing and cooking, fish should reach an internal temperature of: a.135°F for 15 seconds. b.145°F for 15 seconds. c.155°F for 17 seconds. d.165°F for <1 second

Answer: B. Fish, shellfish and crustaceansshould be cooked to a minimum internal temperature of 145 degrees F for 15 seconds

21.Coving is important in food preparation areas and walk-in coolers because a.it prevents corrosion of flooring material b.it eliminates corners and gaps that are difficult to clean c.it makes it easier to move equipment d.All of the above

Answer: B.Coving is a sealed curved edge between the wall and floor that eliminates corners and gaps which are difficult to clean,as well as eliminating hiding spots for pests and protecting the walls from water damage.

19.Which of the following foods should be accepted at receiving? a.Vacuum-packed fish with a broken seal b.Shelled eggs received at 44 degrees F c.Flour with intact packaging showingwater stains d.Frozen shrimp with ice crystals

Answer: B.Reject the frozen shrimp because there is evidence of thawing and refreezing (ice crystals). Shelled eggs can be received at 45 degrees F or lower. Vacuum-packed foods should have an intact seal. Dry packaged goods should have intact packaging, no discoloration (such as watermarks), undesirable odors, mold, or signs of pest damage. Frozen foods should be frozen solid at the time received with intact packaging, no undesirable odors and no fluid stains on packaging or ice crystals.

14.Which of the following patients would be considered part of a vulnerable population? a.woman of reproductive age b.patient receiving chemotherapy c.adolescent d.patient with obesity

Answer: B.Vulnerable populations include pregnant women, infants and children under 5, persons with compromised immune systems (including those receiving chemotherapy or radiation therapy) and older adults (over age 65).

6.When cooking a roast, it should reach a minimum internal temperature of: a.135°F for 15 seconds. b.140°F for 15 seconds. c.145°F for 4 minutes. d.165°F for <1 second

Answer: C. A roast should reach 145 degrees and rest for 3 minutes, then register 145 degrees (or reach 145 degrees for 4 minutes)

You want to make sure the tool you are using to collect data about dietary supplements in your community has validity. To ensure the tool is valid, you need to select a tool that: a.has been used repeatedly in the literature b.contains words and phrases familiar to participants c.measures accurately what it is intended to measure d.yields primarily quantitative data

Answer: C. Many researchers use instruments that have been used previously in literature because repeated use is often confused with validity. It's important to note that an instrument that has been validated in a certain population is not necessarily valid in another population. You would want to make sure you use an instrument validated in a population like yours, not one developed for another culture or another country. Answer choice B speaks to face validity, which is only one aspect of validity. Quantitative data does not have anything to do with validity, they are 2 separate concepts. Answer choice C is the verbatim definition of validity.

The results of a 3-day food record were obtained in June and again a month later. What is this called? a.Validity b.Sensitivity c.Reliability d.Specificity

Answer: C. This isn't a great question, but is reflective of what you might see on the exam. Why isn't it a great question? Because it's plausible that someone would change how they eat within a month, and the question doesn't specify that the 3-day food record is being done with the same person. But the idea of repeating the same procedure in the same way,with the same person,is getting at reliability. Don't just be able to recognize that it's referring to reliability, be able to write out the definitions of the other answers, too

15.Which foodborne pathogen is not associated with seafood? a.Vibrio vulnificus b.Histamine c.E. coli d.Brevetoxin

Answer: C.E. coli is associated with raw and undercooked meat, contaminated produce and unpasteurized milk and juices. Vibrio vulnificus is a bacterium associated with oysters from contaminated water. Histamine causes scombroid poisoning and is associated with tuna, bonito, mackerel, mahi mahi, herring, yellowtail, skipjack and marlin. Brevetoxin is associated with clams, mussels and oysters found in warm waters and causes neurotoxic shellfish poisoning

18.The process of collecting and evaluating information on hazards associated with foods under consideration is: a.part of monitoring b.part of validation c.hazard analysis d.part of prerequisite programs

Answer: C.Hazard analysis is the first principle of HACCP and is the process of collecting and evaluating information on hazards associated with the food under consideration to decide which hazards are significant and must be addressed in the HACCP plan. Monitoring procedures are planned sequencesof observations or measurements to assess if a CCP is under control. Validation is partof verification and focuseson determining if the HACCP plan will effectively control hazards. Prerequisite programs are the foundation of a successful HACCP system and provide the basic conditions necessary for the production of safe and wholesome foods.

23.Which of the following is an example of a nutrient-content claim? a.Diets low in sodium may reduce the risk of high blood pressure. b.Calcium builds strong bones c.Reduced fat d.None of the above

Answer: C.Nutrient content claims provide informationon the nutrient content of a food or they compare the amount of a nutrient or dietary substance in similar foods, such as fat-freemilk compared to 2%or low sugaroatmeal compared to regular oatmeal. Choice A is a qualified health claimandchoice B is astructure/function claim.

3.When making peanut butter and jelly sandwiches for a school class, a teacher notes that two of the students have peanut allergies and should only receive jelly sandwiches. However, the teacher uses the same utensil for the peanut butter jar and the jelly jar. This is an example of: a.cross-contamination b.hypersensitivity c.cross-contact d.All of the above

Answer: C.The peanut allergen coming into contact with the jelly is cross-contact. Cross-contamination is the transfer of pathogens from one food to another. Hypersensitivity can occur when foods are contaminated with biological or chemical hazards. Remember that not all biological hazards are pathogens.

2.The five major risk factors for foodborne illness include improper holding temperatures, poor personal hygiene, food from unsafe sources, inadequate cooking and: a.excessive cooking b.improper storage c.bioterrorism d.contaminated equipment

Answer: D.Per the 2017 Food Code, the 5 major risk factors for foodborne illness include improper holding temperatures, poor personal hygiene, food from unsafe sources, inadequate cooking and contaminated equipment.

9.Stuffed pasta shells should be cooked to a minimum internal temperature of: a.135°F for 15 seconds. b.145°F for 15 seconds. c.155°F for 17 seconds. d.165°F for <1 second.

Answer: D.Stuffed foods (stuffed meat, stuffed seafood, stuffed poultry and stuffed pasta) should be cooked to 165 degrees for <1 second.

Whichof the following containcommon food allergens? a.Potatoes b.Mushrooms c.Citrus fruit d.Red peppers e.Ice cream f.Yogurt g.Soymilk h.Omelets i.Rice j.Cod k.Tea l.Peanut butter m.Melon n.Crab legs o.Shrimp tacos p.Pecan pie q.Whole-wheat flour r.Tilapia s.Wheat bread t.Cheese pizza

Answers: e, f, g, h, j, l, n, o, p, q, r, s, t

Foodservice systems-Assembly/Serve

Assembly/servefoodservice systemsare also called "convenience food" or "minimal cooking concept". Prepared food that requires minimal assembly or cooking prior to service is purchased. Examples include convenience stores, kiosks, fast food, and special diet menus in hospitals. Food is held chilled orfrozen before being assembledorheated forserving.The only labor and equipment required is enough to assemble the foodand transport it. Advantages of the assembly/serve foodservice system is the reduced labor and skill required,compared to other foodservices systems,as food is purchased already prepared. It also requires minimal equipment. Pre-portioned items are helpful for a la carte menus and better portion control means less waste. An important note is that the advantages of this method areonly conferred to a small foodservice operation. Why? The higher food cost from purchasing prepared food items versus equipment investment isn't offset with a large foodservice operation -larger foodserviceoperationswill save money by lowering food cost.Disadvantages of this system include a limited menu because the variety of the menu is subject to market availability of prepared foods. Food is also purchased at a higher cost compared to raw food,and the quality of the pre-prepared foods is not the same as fresh. While minimal equipment for cooking and other preparation is required (an advantage), refrigerator and freezer space are required

false negative

Assessment error in which no pathology is noted (that is, test results are negative) when one is actually present.

Why do we taper up PN infusion rates?

By starting infusion rates slowly, we allow the body to adjust to the glucose load, the hyperosmolarity of the solution, and reduce the risk of fluid overload.We often start with1 L of the solution for 24 hours, and increase by 1 L a day until we get to goal volume. It's important to monitor blood glucose and electrolytes. If the pump is turned off, don't try to "catch-up".

A patient weighs 70 kg and is given 1500 mL of parenteral nutrition containing 300 g dextrose, 110 grams amino acids, and 50 grams fat. Calculate the calories from dextrose and the GIR Now, calculate the GIR of dextrose grams using g/kg/hr.

Calculate GIR per hour300 g dextrose / 70 kg / 24 hours = 0.18 g/kg/hr

For the following solutions, calculate calories, NPC, NPC:N ratio, percent NPC from fat, and osmolarity. a.1.5 L D50W, 1.5 L 8% AA, 500 mL 10% lipid

Calories 1500 mL x 50 g/100 mL = 750 g dextrose x 3.4 cal/g = 2550 kcal 1550 mL x 8 g/100 mL = 120 g AA x 4 cal/g = 480 kcal 500 mL x 1.1 kcal/mL = 550 kcal2550 + 480 + 550 = 3,580 kcal NPC and NPC:N ratio 2550 + 500 = 3100 NPC 120 g AA / 6.25 = 19.2 g N3100 NPC / 19.2 g N = 161:1 ratio % NPC from Fat550 kcal from lipid / 3100 NPC = 17.7% Osmolarity1500 mL x 50 g/100 mL = 750g dextrose1500 mL x 8 g/100 mL = 120 g AA(750 g dextrose x 5) + (120 g AA x 10) = 3750 + 1200 + 300 to 400 = 5250 to 5350 mOsm/L

If raw food cost is $1.75, labor cost is $1.00, percent food cost is 30% and percent labor cost is 52%, what will the selling price be? Can you calculate markup factor? Can you calculate prime cost? How will you calculate selling price?

Can you calculate markup factor? Yes, with food cost and labor cost. 𝑀𝑎𝑟𝑘𝑢𝑝𝐹𝑎𝑐𝑡𝑜𝑟=(1)/𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡+𝐿𝑎𝑏𝑜𝑟𝐶𝑜𝑠𝑡= (1)/(0.30+0.52)=1/(0.82)=1.2195 Can you calculate prime cost? Yes, with raw food cost and labor cost. 𝑃𝑟𝑖𝑚𝑒𝐶𝑜𝑠𝑡= 𝑅𝑎𝑤𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡+𝐿𝑎𝑏𝑜𝑟𝐶𝑜𝑠𝑡=$1.75+$1.00=$2.75 How will you calculate selling price? With prime cost and markup factor 𝑆𝑒𝑙𝑙𝑖𝑛𝑔𝑃𝑟𝑖𝑐𝑒=𝑀𝑎𝑟𝑘𝑢𝑝𝐹𝑎𝑐𝑡𝑜𝑟×𝑃𝑟𝑖𝑚𝑒𝐶𝑜𝑠𝑡=1.2195×$2.75=$3.35 Note that if you're given labor costin dollar amounts, you should use the selling price formula that includes both markup factor and prime cost, rather than calculating markupfactor with both food cost and labor cost, and multiplying it by the raw food cost.

Central Access pn is

Central access is venous access delivered to the superior vena cava or right atrium.Central access is achieved by a catheter (tunneled or not) into the chest, or a PICC line, which is peripherally inserted (arm) and threaded up to the chest. Look up images online of a tunneled catheter, PICC line, and central access catheter.Hypertonicsolutionscan be provided via central access becausethe large vena cava dilutes parenteral nutrition via its large blood volume and high blood flow rate

Contingency / Situational leadership

Changes leadership approach depending on the situation•Used when tasks and environment vary, and/or when organizations are open systems requiring careful management

PERT chart

ChartPERTchartstands for "Program Evaluation Review Technique" and is a project management evaluation toolused for effective planning at the management level. We use it to schedule, organize, and coordinate tasks within a project. To construct a PERT chart: 1)Each task necessary to complete a project is written in nodes (blank boxes in this example) .2)Directional arrows represent sequential tasks -one must be completed before another. Not all tasks are sequential;some can be performed at the same time. 3)The amount of time needed to complete each activity is written along each line -it could be days, weeks, hours, or months. 4)Critical path analysis is a bolded line that shows the longest path by duration to completethe project as described in the chart.

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. Corrosive

Chlorine

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. Works against spores

Chlorine

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. not affected by water hardness

Chlorine

Combination oven

Combination ovens combine convection (circulatedwarm air) and steam (water vapor). Advantages include fastercooking times andconsistent heating. However,combination ovens are very expensive.

Class A fire

Common Combustible material such as paper, wood, furniture, clothing - Water Extingiusiher, Foam Extingiusiher chemical supression

What reduces a manager's span of control?

Complicated work, geographical or departmental dispersion of workers, and vague policies.

Transformational Leadership

Connects with employees' sense of identity and dedication to the mission and organization. In doing so,enhances motivation, morale,and performance •Aligns followers with appropriate tasks in order to improve performance•Goalis to change the future•Acts as a positive role model•Effectivein smaller businesses due to hands-on outreach to employees, rather than in complex or large organizations

Hydrolyzed Formulas

Contain products of digestion of proteins, carbohydrates, and fats; also called elemental formulas; used for clients who have difficulty digesting food −Monomeric formula −Pre-digested protein and carbohydrate −Fat in form of MCTs or oiloMCTs don't require emulsificationandcan be absorbed without transforming back into triglycerides −Used with jejunal access, short bowl syndrome, patients with impaired ability to digest nutrients −Tend to be hypertonic, which can lead to excess fluid in the GI tractcausing cramping, nausea, vomiting, and diarrhea

Convenience Sampling

Convenience sampling means you sample participants in a way that is convenient. For example, you need college students to fill out your survey. You sit in the student union and ask each person that walks by to fill out your survey. You might approach it systematically by askingevery 5thperson who walks in to fill out your survey.

conveyor oven

Conveyor ovens force hot air up through a perforated sheetwhich quickens the cooking time(called "impingement"). Cooking time is very fast, heating is consistent, and cooking is even. The structure allows for high output and less attention by workers. Models can also be stacked to save floor space. However, conveyor ovens aren't ideal for small items or delicate foods, havelow clearance limits, and theirhigh heat and fast speed of cooking can deteriorate flavor and texture in some foods. Have you ever been to a build your own pizza restaurant? Did they have a conveyor oven to cook pizza?

Which one has a heavy workload close to meal time?

Cook-to-serve group for cafeteria

Campinha-Bacote Model

Cultural awareness- involves challenging assumptions and asking client questions about their values, beliefs, and practices, resulting in acquisition of cultural knowledge Cultural knowledge-the provider familiarizes themselves with variations in cultural impact and expands their Cultural skills- to collect key information in order to conduct effective assessments and decide on an intervention that takes into account preferred language, foods consumed or avoided (especially when feeling ill), and foods consumed or avoided for religious reasons Cultural encounters Cultural desire- where the practitioners want to engage in cross-cultural care.

marketing is concerned with

Customerwants-focus on producingthegoods customers want•Profit-maximize net profit rather than focusing on total sales•Futuregrowth-forecasting future growth

Deck oven

Deck ovens have a heavy stone shelf (deck) that heats up. The food is placed on the deck, allowing for fine control of heating (coolerat the top, hotterat the bottom). Some deck oven models can be stacked (i.e. a double deck, pictured on the right below) or are for pizzas (i.e. a pizza deck oven,pictured on theleft below). Deck ovens are great for baking but have long preheating times and the deck shelf must be reheated between items.

Delphi Method

Delphi method: a group of experts are contacted individually and anonymously with questionnaires.29Their responses are statistically tallied and summarized in a report which is sent back to the experts with another questionnaire. The goal of the Delphi method is to reduce the range of responses from experts and arrive at what might be called a consensus.

DRI

Dietary Reference Intake -refers to all of the reference values listed below that areused to guide nutrient intake in healthy people,sortedbyfactors such asage, sex, pregnancy, and breastfeeding status

triangle test

Difference test in which three samples (two of which are the same) are presented, and the odd sample is to be identified There are 6 possiblesequences: ABB, BAA, AAB, BBA, ABA, BAB that are randomized across all judges. All 6 sequences must be presented the same number of times. If you have 30 judges, each sequence would be presented to 5 judges each.

A nonprofit health organization interacts with government officials, healthcare professionals, and education representatives. Their market span is (diverse / not diverse) and would likely benefit from a (decentralized / centralized) organizational structure.

Diverse, decentralized

Classifying menu items- Dog

Dog-low profitandlow sales Dog -not popular or profitableThesearedishes with low profit and low sales numbers. Relative to what you can charge, "dog items" cost a lot of money to make and you don't sell enough units to offset that extra food cost. However, insome cases,you keep them on your menu because these might be unique items that bring people into your restaurant whether or not they will order the item. You can increase the price because those who do want to buy it won't change their mind based on price. To improve popularity or profitability: •Assess if this item is customer specific -items on the children's menu (chicken fingers, mac and cheese, PB&J).Relegate to a "hidden" spot on the menu -children's menus are often on the back page in the bottom corner •If not customer-specific, try increasing the selling price

Dry storage requirements

Dry storage items include canned goods, baking supplies like flour and sugar, other grains, and cereals Foods should be stored off the floor and away from the walls to maintain ventilation, and away from heat sources, like hot vents,and light. Heat and lightwill decrease shelf life. Dry storage shelving has minimum height requirements to prevent food from being too close to the floor while also beingaway from the wall for pest control

In the resting state,sodium (Na+), calcium (Ca2+), and chloride (Cl-)reside primarily in the ECF or ICF?

ECF

For the RD exam, be able to recognize examples of cost-benefit analysis or situationswhere it should be used in contrast to methods like value analysis and value-added research. For example -Should we remodel the foodservice kitchen?The cost of remodeling is $3.4 million and the expected revenue generated after the remodeling is $2.7 million. Is the value of the remodeling greater than the cost of the project?

Expected revenue followingremodeling(value) -cost of the project $2.7 million -$3.4 million = negative (net loss)$2.7 million / $3.4 million = < 1

Investigators randomize patients to a rapid extubation protocol in the ICU or to standard procedure decide if the study design described is observational or experimental (O or E). Then identify the independent and dependent variablesand the specific study type.

Experimental -randomized control trial, independent -rapid extubation protocol, dependent -not given.

What is FATTOM?

F-Food-bacteria need nutrients to survive and TCS foods are the perfect source of food A-Acidity-bacteria grow best in low-no acid foods (pH 7 to 14) T-Time-more time in the temperature danger zone provides more time for bacteria to grow T-Temperature-bacteria grow best in the temperature danger zone and particularly between 70-and 125-degreesF O-Oxygen-some bacterianeed oxygen, while others thrive in low-no oxygen environments M-Moisture-bacteria grow faster at higher levels of water activity (aw)Source: ServSafe, 7thed.1

Class B Fire

Flammable and combustible liquids and gases, alcohol, gasoline, fuel oil; things that cannot be cooled by water to effect extinguishment. The best way to extinguish a fuel fire is to shut off the source. Extinguishing agents which may be used are dry chemical, carbon dioxide and foam. Water stream not used because it will scatter the fuel and spread flamesDry chemical extinguisher, carbon dioxide extinguisherFoam extinguisher for flammable liquids only

EAL; Evidence Analysis Library evidence grade 3

Grade III: Limited / Weak -"The evidence consists of results from a limited number of studies of weak design for answering the questions addressed. Evidence from studies of strong design is either unavailable because no studies of strong design have been done or because the studies that have been done are inconclusive due to lack of generalizability, bias, design flaws, or inadequate sample sizes.

EAL; Evidence Analysis Library evidence grade 4

Grade IV: Expert opinion only / Consensus -"The support of the conclusion consists solely of the statement of informed medical commentators based on their clinical experience, unsubstantiated by the results of any research studies."

EAL; Evidence Analysis Library evidence grade 5

Grade V:Insufficient Evidence / Grade Not Assignable-"There is no evidence available that directly supports or refutes the conclusion."

HACCP

Hazard Analysis Critical Control Point (HACCP) is a management system addressing food safety by analyzing and controlling hazards from raw material production, procurement and handling, manufacturing, distribution, and consumption of food products

Temperature Style warewashers-HIGH

High temperature warewashers use super-heated water to clean dishes, reaching a rinsing temperature of 180 degrees F and don't require a chemical sanitizing solution. While aflash dry feature reduces the energy needed to dry with these models, the hot water requirement uses more energy compared to low temperature models.

task behavior

How knowledgeable is the employee? Do they have the necessary skills?How much help will they need from the leader?You can think of task behavior as the degree of directive behaviorrequired by the leader.When "task behavior"or "directive behavior"is HIGH, the employeeneeds to be instructed on every aspectof the task they are being asked to do. When "task behavior" or "directive behavior" is LOW, the employee is knowledgeableabout the task at hand and have the necessary skills to get it done

Higher calorie enteral formulas are hypertonic. What does hypertonic mean in this situation?

Hypertonic enteral formulas have osmolarity higher than plasma (> 300 mOsm/L)

Diarrhea after tube feeding is more often due to infection (gastroenteritis), antibiotics, medications with sorbitol, malabsorption,and formula intolerance.4It can also be due to a rapid infusion of solution or bolus feeds (instead of continuous) but will manifest later than dumping syndrome.

If a question asks about the cause of diarrhea following enteral feeds, think about the timing of onset

Decentralized Delivery-Service System

In a decentralized service system, there is amain kitchen and satellite locations. The satellite locations might be a serving or assembly galley, a ward kitchen, or satellite kitchens. Bulk quantities of food are prepared and transported to the satellite locations -they may be transported hot or cold. Staff at the satellite locations reheat, portion, and assemble the meals as necessary. After meal service, dishes are returned to the central kitchen. Decentralized systems are used whenthere is a large distance between kitchen and consumer, and/or the menu items travel better in bulk than plated. This type of system might be used in large hospitals, medical centers, school districts, and hotels

convection oven

In contrast to a standard oven, convection ovens circulate warm air inside the oven for faster, even cooking and consistent heating. These ovens can also cook at a lower temperature than standard ovens, are affordable, and very versatile. However, convection ovens cannot be used for all types of cuisine. There are also specific convection ovens for breaditems called bakery convection ovens.

Chlorine. In foodservice

In foodservice, chlorine must be "food grade" and not contain any fragrances, thickeners, or additives. Chlorineis corrosive to metal surfaces and has human safety concerns due to skin irritation and mucous membrane damage. Chlorine'seffectiveness is affected by pH, temperature, and soilload but not by water hardness. Chlorine is effective against fungi and bacterial spores

Example: Cold Food and Feedback-The dietetic technicians and dietitians hear from the patients andcafeteria customers that the food is cold. The DTRs and RDNs relay this information to the food service manager, who discusses recipe changes with the chef,trickling down to the line cooks. Using a systems approach,evaluating theeffectiveness of a new policy should consider both the internal and the external environments via feedback(See next page for a diagram). are these feed backs internal or external?

In thisexample, internalfeedbackcomes from the patients and customers about food temperature to the diet tech or the dietitian. Internal feedback occurs within a department, so the communication between the DTR/RDNs, foodservice manager, chef, and line cooks is also internal feedback. Externalfeedback, such as thatfrom The Joint Commissionor the health inspector,is external feedback. In this example, there is no external feedback. Don't be fooled by thinking the feedback from the patients and customers isexternal feedback.

Qualitative Data

Information about qualities, often expressed in themes or quotes •Attempt to understand human behavior from the interviewee'sperspective •Collect information via observation and interviews •Data analyzed by themes and descriptions•Data reported in quotes from interviewees •Non-statistical analyses used,includingcontent analysis, grounded theory, and thematic analysis •Smaller sample sizes useddue tothe burden of interviewing participants •Context-rich data of words and texts, photographs, videos, and sound recordings •Difficult to apply reliability and validity standards due to subjectivity

Quantitative Data

Information that can be measured and written in numbers •Discover facts and associations;test theories and hypotheses •Data collected through measurement, including controlled observation, experiments, and surveys,with a rating scale or yes/no answers •Data analyzed by numerical comparison and statisticalanalysis (descriptive statistics and inferential statistics) •Data reported through statistical analyses, includingmeans, standard deviations, medians, ranges, percentages, odds ratios, and hazard ratios •Large sample sizes to conduct meaningful and accurate statistical analyses •May include random sampling or survey sampling to improve robustness of conclusion

Glucose Infusion Rate (GIR)

Infusion rate is how quickly the parenteral nutrition formula enters the blood stream and is something we need to calculate. We often start with a GIR ≤ 3 mg/kg/min andcan advance to a maximum of about 5 mg/kg/minin adults, with some sources using 4 mg/kg/min.

When should parenteral nutrition be used? Well-nourished stable patients who is unable to meet at least 50% of nutritional needs PO or via enteral nutrition

Initiate PN after 7 days

When should parenteral nutrition be used? Moderately or severely malnourished patient in whichoral intake or EN is not possible

Initiate PN as soon as possible

When should parenteral nutrition be used? Nutritionally-at-risk patient unlikely to achieve sufficient oral or EN intake

Initiate PN within 3-5 days

HBL leadership style telling

Instruction, direction, autocratic Leader gives precise and firm instructions and deadlines while closely monitoring progress

HBL leadership style participating

Involvement, consultation, teamwork Leader works with followers, involving the group, seeking input, and encouraging efforts

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. Works against protozoans

Iodine

iodine.

Iodine compounds, called "iodophors" are active against bacteria, mold, fungi, viruses, yeasts, and protozoans. Theyevaporate at 120°F and thus,can't be used with high temperature water. Iodophors shouldn't be used with basicpHwater and may stain plastics yellow/brown

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. affected by pH

Iodine, chlorine

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. affected by water temperature

Iodine, chlorine

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. Works against bacteria

Iodine, quats

cause and effect diagram (fishbone diagram)

Ishikawa" diagrams, named after their developer, Kaoru Ishikawa, These diagrams can be used to identify problems for continuous quality improvement programs, like the F step of the FOCUSmodel.28It can also be used in less formal processes to discover bottlenecks and root causes of problems. To construct a cause and effect diagram: 1)Write down the problem to one side as the fish head 2)Brainstorm major factors that might affect the situation by drawing lines off the center spine 3)Write down causes (horizontal lines) that contribute to each major factor 4)Add further sub-causes with more branches off of the cause lines(vertical) and their factors (horizontal)5)Analyze the diagram

macro digestion/absorption in large intestine

Large intestine.In the large intestine, mechanical digestion occurs via segmentation (peristaltic waves) and chemical digestion is performed only by bacteria, not digestive enzymes. Ions, water, vitamins, minerals, and some organic molecules are absorbed in the colon.By the time chyme reaches the large intestine, much of the water has already been reabsorbed by the jejunum. The remaining fluids, nutrients, and other organic matter is going to be absorbed by the colon but the colon will be working against the osmotic gradient to do so. Ion absorption aids in water absorption by creating an electrolyte gradient.

Line Authority

Line Authority: when multiple employees report to a single administrator, such as 20 clinical RDs reporting to one nutrition manager. There is still a chain of commandbut it is via line authority (multiple employees to one supervisor) versus the one-to-one in Unity of Command

used by managers to unify a system. Include communication and decision making

Linkingprocesses:

Why?•Why would we take advantage of IV lipids in PN?

Lipid emulsions don't contribute to tonicity

Isotonic / Isonatremic / Hypovolemic Dehydration

Loss of water and electrolytes in proportion to plasma levels •Excessive sweating •Repeated vomiting •Diarrhea •Severe bleedingMost common type of dehydration Sodium: WNL 130-150 mmol/LBUN: WNL 7-20 mg/dL

HBL maturity levels M1:

M1 are the least experienced workers and are described by some texts as "unable and unwilling", corresponding to R1 in the diagram following.The employee may be inexperienced or simply lack the skillsnecessary for the task. The employee will require a high level of direction from the leader at every step and because the leader is guiding them in the tasks themselves, there is a low amount of supportive behavior required. M1 maturity corresponds to R1 readiness and S1 -telling

HBL maturity levels M2:

M2 are inexperiencedlike M1, but are interested in learning. The leader should adapt their style to provide more supportivebehavior to match the employee's excitementabout increasing their skill set. The leader needs to provide both direction and support.M2 maturity corresponds to R2 readiness and S2 -selling

HBL maturity levels M3:

M3 are employees who have most of the skills and knowledge necessary to get the job done correctly, thus requiring little guidance on the task from the leader. They benefit from supportive behavior to enhance their confidence and build the employee-leader relationship.M3 maturity corresponds to R3 readiness and S3 -participating

HBL maturity levels M4:

M4 are employees who are confidentin their ability to complete at ask and can do so independently, without direction or support from the leader. M4 maturity corresponds to R4 r4e3adiness and S4 -delegating

Nasojejunal (NJ)

Main difference between NJ and PEG-J or PEJ tube is durationof EN access required Post-pyloric access used to avoid stimulating the pancreas, in cases of severe gastroparesis, gastric intolerance, or after esophageal or gastric surgery Need to use hydrolyzed formula or intact formula + enzymes because we are bypassing the duodenum where key digestion occurs

Carbohydrates

Major source of energy Calories/gram4 cal/g DRI45 -65% cal/day [AMDRfor adults] Fiber: 14 g per 1,000 kcal[DGA]or 25+ gram/day for adults [AI] Added sugar: <10% cal/day[DGA] Food SourcesWhole grains, legumes, starchy vegetables (peas, beans, lentils, potatoes, yams), dairy, fruitsDifferent FormsMonosaccharides (glucose, fructose, galactose)Disaccharides* (maltose, sucrose, lactose)Polysaccharides** (amylose, glycogen, amylopectin, cellulose)Digested into...by...*Poly → di → mono by amylase, maltase, sucrase, lactaseAbsorbed asMonosaccharides Notes•The brain prefers to use glucose for energy and can convert amino acids or glycerol to glucose for energy •The body stores glucose as glycogen in the liver and skeletal muscle; glycogen in the muscle can't be used to provide glucose for the rest of the body (lacks G6P enzyme)

To avoid essential fatty acid deficiency, 2-4% of the total estimatedcalorie needs should come from lipidsthat include linoleic acid.9Lipids should not exceed60% of non-protein caloriesor1 -2.5 g/kg/day.Critically ill patients should not receive more than 1 g/kg/day.9Why?

Maximumlipid dose: 2.5 g/kg/day −Maximum hourly lipid infusion rate: 0.11 g/kg/hr−Typical rate of 4-6 hours for 10% lipid emulsions and 12-24 hours for 20% lipid emulsions

macros digested in mouth

Mouth. In the mouth,there is mechanical digestion via chewing and swallowing, as well assome chemical digestion ofamylose via α-amylase in the saliva. There isno chemical digestion of protein and very little chemical digestionof fatvia lingual lipase.Intact protein and fat droplets enter the stomach, while polysaccharides have been degraded into oligosaccharidesand disaccharides

Frozen food TCS foods

Must be frozen solid when receivedReceive at 0 degrees F or lower(6 to 10 degrees F for ice-cream)Intact, clean packaging with use-by dateNo undesirable odorsReject if evidence of thawing and refreezing: •Fluid or water stains at bottom of case or on packaging •Ice crystals or frozen liquids on the food or packaging

hypotonic (hyponatremic) dehydration

Na<130 sodium losses exceed water losses seen when -patient consumes diluted fluids or free water during dehydration -adrenal insufficiency can be rehydrated over 24 hours -too rapid correction -> central pontine myelinosis Primarily loss of electrolytes, especially sodium •Intravascular water shifts to ECF •Results in hypotonic plasma, water shifts from ECF to ICF leading to swelling Treating dehydration with electrolyte-poor fluids •Diarrhea •GI obstruction, fistula, or ileus •Heat exhaustion•Pancreatitis •Burns •Trauma •Ketonuria •Chronic malnutrition •Cystic fibrosis with excessive salt loss in sweat •Renal tubular acidosis •Diuretics (thiazides, furosemide, mannitol)

hypertonic (hypernatremic) dehydration

Na>150 BUN> 20mg/dl water losses exceed sodium losses associated with highest mortality causes -breastfeeding failure -inappropriate use of rehydration solutions (boiled milk) -diabetes insipidus -DKA can be rehydrated over 48 hours -too rapid correction -> cerebral edema Water deprivation•Diarrhea (esp. in peds) •Excessive sweating •Hyperventilation •Unmanaged diabetes with ketoacidosis and polyuria •Heat stroke •End-stage renal failure •Infusion of hypertonic solutions •Some diuretics

Natural stone and tile

Natural stone tile and brick is another option, often used in cafes, delis, and restaurants where the kitchen area is visible to customers. Slate and granite are easier to maintain than other natural stone in terms of cleaning. Brick is porous and must be sealed twice a year. Importantly, polished tile can be incredibly slippery when wet

One of the first items on the menu back in the 1950's was liver and onions. Miss Martha hosts a bridge club at Joe's Diner every week and orders liver and onions every time. Joe doesn't make much money off the item relative to the cost of buying the liver and only Miss Martha and her friends order the item what type menu item is this clasified as?

Not popular or profitable. Liver and onions is a dog item -Joe keeps it on the menu for nostalgia and his customer base.

Investigators identify cases of sleep apnea and survey patients about their eating habits before bed decide if the study design described is observational or experimental (O or E). Then identify the independent and dependent variablesand the specific study type.

Observational -= case-control study. Independent -eating habits before bed, dependent = sleep apnea.

Investigators measure coronary artery calcium and follow participants for 20 years for risk of heart attack decide if the study design described is observational or experimental (O or E). Then identify the independent and dependent variablesand the specific study type.

Observational-prospective cohort. Independent-coronary artery calcium, dependent = heart attack

Given the following expenses, calculate the COGS for the month of March.Inventory value on March 1 $25,730 Total purchases during March$44,757 Inventory value on April 1$23,850 Labor expenses during March$15,309

Opening InventoryPurchases + LaborClosing Inventory=61,946

define Management Functions organization

Organization -assigning duties; delegating authority; creating responsibility

the movement of water from a lower tonicity solution to a higher tonicity solution through a semipermeable or permeable membrane.Osmosis maintains homeostasis,or equilibrium,because it evens out the ratio of fluid and solute between the intracellular and extracellular compartments.

Osmosis

Fire triangle - 3 parts

Oxygen, Fuel, Heat

CLOSTRIDIUM PERFRINGENS

PERFRINGENSisspore-forming bacteriafound in the intestines of animals and humans. It does not grow at refrigeration temperatures, is anaerobic, and unlike many other foodborne pathogens, symptoms of the associated illness do not include nausea, fever, or vomiting.Some strains produce a toxin once the bacteria reachthe intestines, and the toxin causes illness. Outbreaks most commonly occur in hospitals, cafeterias, prisons, nursing homes, or catered events, where large quantitiesof food are prepared and then kept warm for too long before serving •Prevention measures includecooling, holding,and reheating food correctly.•Symptoms include diarrhea and severe abdominal pain. •Time to onset is typically 8 to 12 hours with sudden onset and lasting less than 24 hours. Persons in vulnerable populations may have more severe symptomsthat last up to 2weeks. •Commonly associated foods include meat, poultry, and dishes made with meat and poultry like stews and gravies.

Patient was admitted to the ICU after bowel surgery. She is 80% of her ideal body weight and will remain NPO for 7 days. Would you consider starting her on PN, and if so, when?

Patient is nutritionally at risk and unlikely to achieve desired oral intake or EN within 3-5 days -initiate PN immediately.

Peripheral Access PN is

Peripheralaccess is achieved via a short IV cannula in the hand or arm and shouldn't be used for more than 10 -14 days.6,9Peripheral PN (PPN)is used when central access is contraindicated or for short term PN. Look up reasons online why central access might be contraindicated

PICC line

Peripherally Inserted Central Catheter (PICC)

HBL leadership style selling

Persuasion, encouragement, incentive Leader explains goals, tasks, methods and reasons, and remains available to followers to provide support

define Management Functions planning

Planning -usingproblem solving and decision making to ensure proper utilization of all resources

Minimum Internal Temperatures after Cooking for TCS Foods 135°Ffor 15 seconds

Plant foods hot-held for service Examples: mashed potatoes, cooked greens, baked beans

Classifying menu items- Plow horse

Plow horse -very popular but doesn'tbring in a lot of money Plow horse -popular but not profitable Items that are very popular but don't bring in a lot of money -and they are price sensitive.Customers are often aware of a typical price and increasing the price to increaseprofit can reduce sales. An example is pepperoni pizza at a pizza parlor -the waitstaff doesn't have to promote them to get sales, but they don't bring in as much profit as other items. You might try changing the portion size to decrease the food cost. Similar to dogs, plow horse items might bring in customers and then you hope they order additional items. One example is steak - a whole family comes in because someone in the familywants steak, or people see steak on a restaurant menu and feel it is a classy place.To create more profitable versions of these popular staples, you can: •Improve appearance •Decrease portion size(easiest to do) •Decrease food cost

In addition to hazards from the environment, people can make food unsafe through 4 practices: Poor personal hygiene

Poor personal hygiene, where pathogens are transferred from a person into food, is a major preventablecause of foodborne illness outbreaks.

Joe's Diner is popular on the weekends with local college kids who come in for brunch. The majority of his weekend sales are omelets which are cheap and easy for Joe to make what type menu item is this clasified as?

Popular and profitable -Omelet's are a start. They have a low food cost percentage, meaning Joe can sell them for more than it costs to make and they are popular on his busiest days.

The Signature Italiano Sandwich is a lunch favorite at Joe's Diner but not the most profitable. Joe is trying to decide between swapping expensive Italian soppressota for pepperoni to reduce food cost or serving a half-hoagie instead of a full-size sub what type menu item is this clasified as?

Popular, but not profitable. This item is a plow horse -Joe sells a lot ofthese sandwiches but wants to increase his profit margin by reducing food cost

Centralized delivery-service system

Prepared foods are portioned and assembled at a central area and then the completed orders are transported and delivered to the consumer. You'll see this system in fast food, restaurants, banquet services, hospitals, and long-term care facilities. Like with conventional foodservice systems, workload can be uneven and excessively long. Importantthings for a manager to consider with centralized systems is the need for close supervision, food quality control, and portion size control.

Prime Cost

Prime cost is the combination of raw food cost and labor cost, that is, the cost of goods purchased and the cost to make the final product. In contrast to markup factor, prime cost uses food cost and labor cost in dollar values. In the earlier selling price formulas, there was a value for "cost to make". When we have the necessary information to calculate prime cost, prime cost replaces "cost to make". 𝑃𝑟𝑖𝑚𝑒𝐶𝑜𝑠𝑡=𝑅𝑎𝑤𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡($)+𝐿𝑎𝑏𝑜𝑟𝐶𝑜𝑠𝑡($)

Patientswith low blood cell count need to avoid what herbal supps/ supps in general ?

Probiotics

Identify patients with diabetes at hospital admission and record key aspects of their hospital stay. Examine the relationship between hospital admission characteristics and mechanical ventilation as an event Is the study design describedis prospective (P) or retrospective (R) and explain why. Then identify the independent and dependent variables.

Prospective -exposure measured before outcome (at hospital admission). Independent = hospital admission characteristics, dependent = mechanical ventilation

Classifying menu items- Puzzle

Puzzle-don't sell muchbut profitable when it does Puzzle -not popular but profitableThese are dishes that you don't sell very many of but when you do,you make a lot of money (low popularity but high profitability).You try to increase the number of units sold by jazzing up the item description, adding a photo, highlighting it as a special, moving it to the first or last item of a category on the written menu, or adjusting the price. For example, it's typical for a fine dining restaurant to have steak on its menu. If their steak dish is a puzzle, they wouldn't just remove it but instead,try to increase the units sold. If it's nota staple item, you might consider removing it from the menu. Try to improve popularity by: •Reducing the selling price •Featuring it as a special •Giving it top priority on the menu •Offer a smaller portion size

Quarry tile

Quarry tile, also called non-porcelain ceramic tile,is common and an industry standard. It's natural material, cheaper than porcelain tile, and combined with epoxy grout. It's slip-resistant and often paired with rubber mats, especially for worker fatigue. Standard cleaners are okto use on quarry tile,but the grout lines need to be sealed every year to avoid bacterial growth.

Quaternary Ammonium. .

Quaternary ammonium compounds, or "quats", are commonly used in foodservice because they are effective againstbacteria, mold, yeast, and viruses, and are active and stable across a large temperature range. Quats shouldn't be used with hard wateror heavy soil. Rinsing after cleaning is important because if any detergent is left on a dish, quats will react and form dangerous gases.An advantage of quats are that they arenon-irritating, non-corrosive, and stable across arelatively wide pH range

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. Affected by water hardness

Quats

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. Tempurature stable

Quats

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. affected by soil load

Quats, chlorine

to prevent regurgitation with EN

Raising the patient's bed to at least 30 degrees can help prevent regurgitation If they have a PEG tube, formula can backflow into the tube which counts as regurgitation.

Which employee group has an even workload?

Ready-prepared for satellite sites

Cold TCS food: Crustacea(shrimp, crab, lobster)

Receive at 41 degrees F or colder (unless live)Intact, clean packaging and must have shellstock identification tags (which state when and where harvested)Hard and heavy shells (lobsters, crabs)

Cold TCS food:Reduced-oxygen packaged foods

Receive at 41 degrees F or colder, unless otherwise specified by manufacturerIntact, clean packaging with use-by dateNo undesirable odors or colors

Cold TCS food: poultry

Receive at 41 degrees F or colderIntact, clean packaging with USDA inspection stampNo discolorationFirm texture, no odor

Cold TCS food: refrigerated processed foods

Receive at 41 degrees F or colderIntact, clean packaging with use-by dateNo undesirable odors

Cold TCS food: meat

Receive at 41 degrees For colderIntact, clean packaging with USDA inspection stamp Beef -bright cherry red (purple if vacuum-packaged) Pork -light pink meatFirmtexture, no odor

Cold TCS food: Shucked shellfish(clams, oysters, mussels, scallops)

Receive at 45 degrees F or colderand cool to 41 degrees F within 4 hoursIntact, clean packaging Mild ocean/seaweed smell

Cold TCS food:Milkand milk products

Receive at 45 degrees For colder and cool to 41 degrees F within 4 hoursIntact, clean packaging with 'pasteurized' labelNoundesirable odor or curdling

Cold TCS food:Eggs and egg products

Receive at 45 degrees For colderIntact, clean packaging with USDA inspection stampNo odor;clean and unbroken shells

Dry foods (including shelf-stable dried foods, bakery foods, etc.)

Receive at room temperatureClean, intact packaging without sign of pest damageNo discoloration, undesirable odors, ormolding

Cold TCS food: Live shellfish(clams, oysters, mussels, scallops)

Receivingair temperature of 45 degrees For colder and internal temperature no greater than 50degrees F Cool to 41 degrees F within 4 hoursIntact, clean packaging and must have shellstock identification tags (which state when and where harvested)Mild ocean/seaweed smell;closed and unbroken shells

RDA

Recommended Dietary Allowance -average daily level of intake sufficient to meet the nutrient requirements for97-98%ofall healthy people. Vary by sex, age, and pregnancy/breastfeeding status

Refrigerated storage

Refrigeration slows bacterial growth and should be kept between 32°F and 40°F. Thermometers should be accurateandwithin3°F. Open,slotted shelving allows air circulation around shelvesand walls which helps maintain proper food temperatures. Doors should have a good seal to maintain efficiency. Refrigerator doors often have plastic flaps that help air stay inside.

Rotisserie oven

Rotisserie ovens are used to slowlycook meat, particularly large pieces of meat. You may have seen a rotisserie oven at a grocery store for rotisserie chickens. Theseovens prevent meat from drying out because the meat retains its natural juices and the rotation causes very even cooking. The downside,compared to other methods of cooking meat, is thatrotisserie ovens take a long time

In 2015, the 4 MOST COSTLYfoodborne bacteriapathogens were

Salmonella, Listeria, Campylobacter, and Clostridiumperfringens Overall costis a function of how common the foodborne illness is and how serious it is -most of the cost associated with foodborne pathogens is related to deaths, with the economic burden of nonfatal illnesses consisting of medical costs and productivity loss. The costliestvirus is norovirus and the costliestparasite is toxoplasmosa.

Factors Affecting Sanitizers

Sanitizer concentration (too much = toxic, too little = ineffective) •Ideal temperature •Contact time required •Water pH and water hardness •Adequate cleaning (to reduce soil) and rinsing (to reduce detergent residue) •Material being cleaned, if inanimate (plastic, metal, wood, glass) •Microbial load •Type of microorganism present

Scalar Principle

Scalar Principle:a management rule where each employee reports directly to their higher up and no one else. Authority and responsibility flow via delegation in a direct line, vertically from highest to lowest levels. This principle is alsoknown as the chain of command

Parenteral nutrition, or IV nutrition, is an alternative to oral or enteral nutrition when patients have intestinal failure. Intestinal failure can result from several different conditions

Short bowel syndrome(following extensive surgeries) •Inflammatory bowel disease (Crohn's Disease) •Small bowel tumors •Mesenteric root or retroperitoneum tumors •Congenital malformations of the gutoSmall bowel atresiaoGastroschisisoAganglionosis •Necrotizing enterocolitis(NEC) •Absorptive impairmentoIntestinal pseudo-obstructionoMicrovillus inclusion disease

digestion of macros in small intestine

Small intestine.In the small intestine,there is some mechanical digestionvia segmentationandperistalsisbut the small intestine is the main place in the digestive tract for chemical digestion and absorption.When the semi-liquid chyme enters the duodenum via the pyloric sphincter, it stimulates the release of pancreatic juice which contains bicarbonate and pancreatic enzymes, as well asthe production and release of bile. These actions are stimulated by the digestive hormones CCK, VIP, and secretin.

Controlled Carbohydrate tube feeding

Some institutions utilize controlled CHO formulas for patients with diabetes

Patients taking multiple medications need to avoid what herbal supps/ supps in general ?

St John'sWort, goldenseal

Classifying menu items- Star

Star -high in profit and high in sales Star -popular and profitableItems high in profit and high in sales -they are very popular and not price sensitive. In the bartending world, margaritas are a classic star. Customers will ask for the drink without checking the price, in contrast to bottled beer where they might ask to see the menu for pricing to decide. You can take advantage of stars by increasing the price because it won't translate into lost sales.•Don't mess with these items•Keep them consistent and continue promoting them, such aswith chef specials

digesting of macros in stomach

Stomach.In the stomach,there is mechanical digestion via the mixing and propulsion effects of peristalsisin addition tothe 3 layers of the stomach muscles.G cells in the stomach secrete gastrin which stimulates the release of gastric acidand intrinsic factorfrom parietal cells and the release of pepsinogenand gastric lipase from chief cells.Upon contact with gastric acid, the © 2021 V1JUNE2021Normal Nutrition, Digestion, and Absorption40proenzyme pepsinogen is activated to pepsin.The masticated food that enters the stomach is turned into semi-liquid chyme via gastric acid and some enzymatic action. Note that there is no digestion of carbohydrate in the stomach because pepsin acts on proteins and lipase acts on lipidsonly. Gastric acid denatures proteins, giving pepsin better access to the peptidebonds that results in polypeptides entering the small intestine rather than intact proteins. Gastric lipase helps break down fat droplets into smaller fat droplets, and the controlled gastric emptying through the pyloric sphincter also mechanically reduces the size of the fat droplets. The lipid droplets are still full of triglycerides when entering the small intestine.Some lipid-soluble substances can be absorbed into the blood stream fromthe stomach, such as alcohol and aspirin.Some medications are designed to be absorbed in the stomach. Medications that are meant to be absorbed in the small intestine must be able to survive the acidic conditions of the stomach

"the continuous and systematic management process to determine long-term goals, the best approach to accomplish them, and how success will be measured."1Itis used to inform policies and operational decisions. Itis notused in evaluation

Strategic Planning Strategic planning may also be called strategic management. It is a form of organizational and environmental analysis used to establish goals and success criteria by implementing strategies to move towards those goals.1A key part of strategic planningis evaluating progress towards the goal.

retrospective studies

Studies conducted using data that have already been collected about events that have already happened. Such secondary data were originally collected for a purpose other than the current research.

Synergy

Synergy: when the outcome of multiple employees working together is greater thanthe sum of themworking alone; you can replace the word "employees" with functional units; it's a practical approach for getting results.1Managers can foster synergy by creatingteams of people who complement each other, facilitate collaboration through open work spaces, and set common objectives that let team members overcome individual differences.

1.List the 3 types of foodborne hazards with examples of the hazards and how they can be prevented

The 3 types of hazards that make food unsafe include biological, physical and chemical hazards. Biological hazards include bacteria, viruses, parasites and fungi. Proper handwashing, controlling time and temperature, preventing cross-contamination, proper cleaning and sanitizing, andpurchasing foods from approved and reputable suppliers are important prevention steps for preventing foodborne illness outbreaks. Physical hazards include bones, fruit pits and items that can fall into food like jewelry, glass, nail polish, fake nails andbandages. Examples of preventive measures include workplace protocols that prohibit jewelry, nail polish and fake nails; brightly colored bandages that can be seen if they fall into food; lightbulb covers and shatterproof lightbulbs in foodservice areas. Chemical hazards include cleaners, sanitizers and pesticides. If cleaners or sanitizers are not applied or rinsed properly, residue can remain on food handling utensils. Proper washing of produce is important to reduce contamination from pesticides, as well as pathogens

FoodNet

The Centers for Disease Control and Prevention (CDC) created a foodborne illness active surveillance program called FoodNet. The program is used to estimate the number of foodborne illnesses, monitor trends in incidence of specificfoodborne illnessesover time (like E. coli), attribute illnesses tospecificfoods and settings, and to disseminate information. You can visit the FoodNet website here https://www.cdc.gov/foodnet.

The Food Code

The FDA and US Public Health Service publishes the Food Code at regular intervals. The Food Codeoutlines public health interventions to prevent foodborne illnesses and maintainthe safety of the public when consuming food and beverages at retailand foodservice establishments. The NationalRestaurantAssociation manages the ServSafe credential, whosematerialsand credential exam are based upon the most recent Food Code.The Food Code consists of federal recommendations and the FDA recommends that each state adopt these guidelines. State and local regulatory authorities write the food codes (or adopt the federal guidelines) to regulate retail and foodservice operations, and state and local inspectors conduct health inspections.

The LEARN Mode

The LEARN model was designed to overcome communication barriers in health care encounters. The model stands for: Listen, Explain, Acknowledge, Recommend treatment, Negotiate agreement

RUMBA

The RUMBA model stands for reasonable, understandable, measurable, believable, and achievable.27It's an individualized model that you can use as a manager to engage your team with change. An effective leader accepts change as a part of life and works with their team to embrace it.

Describe tonicity in 2 different ways.

The ability of a solution to attract water across a membrane. •The concentration of solutes on one side of a membrane relative to the other side

Food Cost

The actual wholesale cost of food, beverages, and ingredients. Standardized recipes will reduce food waste and thus,reduce cost.1Ingredient and portion control will also help reduce food cost. Having a system in place to control who takes items out ofthe storage room, such as a request system, will control who has access to what.Using proper measuring tools, such as scoop sizes to serve portions,will ensure that a recipe intended to serve100 patients actually does serve 100 patients. Using proper measuring tools while preparing food will also ensure that only the appropriate amount of ingredients isused.In summary, measures taken to decrease food cost, decrease labor/production cost, and optimizeinventory and food usage will all result in a better controlof totalcosts.

Why do wecalculate dextrose infusion rate?

The body can only oxidize glucose at a certain rate (0.36 g/kg/hr) and if we provide excessdextrose,we increase their risk of fatty liver.

independent variable

The experimental factor that is manipulated; the variable whose effect is being studied. I.e smoking is the independent varible to lung cancer

how do the kidneys regulate ion concentration?

The kidneys primarily regulate ion concentration by reabsorbing or excreting sodium, potassium, and calcium to maintain relatively constant levels of electrolytes. When electrolyte plasma levels are too high, the kidneys will remove them from circulation and excrete them in the urine. If electrolyte plasma levels are too low, the kidneys will retain them from the circulating blood instead of excreting them

dependent variable

The outcome factor; the variable that may change in response to manipulations of the independent variable. i.e lung cancer is the dependent varible to smoking

Causation vs. Correlation

The results of randomization give us the ability to infer causation of the independent variable on the dependent variable. In contrast, since there is no randomization inobservational studies(which is stronger than analytic control procedures,if done properly), we typically can only infer association or correlation. On the RD exam, youwill likely see questions about causation versus correlation and the key is to identify if the study was randomized. If it was randomized, you can infer causation. If not, you cannot.

Menu Cost

There are several ways to control menu costs in foodservice. These include making seasonal changes to the menuitems and also having the same menus across different avenues. For example, in a hospital with a commercial cafeteria and patient services, having the same menu for both will decrease costs by reducing food cost, labor and production cost, and optimizing inventory and food usage. Making seasonal changes to the menu will optimize the availability of items, while also reducing costs. Having the same menu items will reduce food cost partly by decreasing food waste,and it will reduce labor cost because it isquicker for a cook to prepare several of the same menu item rather than several different menu items. Additionally, having the same items on the menu means that less items need to be kept in inventory.

The BATHE Mode

This model helps create a culturally competent environment,focusing on the psychosocial context for the patient's visit rather than medical details. The model stands for: Background, Affect, Trouble, Handling, Empathy.

the purnell model

This model is derived from multiple theories and includes16 assumptions about culture. "A culturally competent health care provider develops an awareness of his or her existence, sensations, thoughts, and environment without letting these factors have an undue effect on those for whom care is provided."

The GREET Mode

This model is useful when working with immigrant populations and helps providers understand the context of the patient and how they understand information related to their illness. Generation, Reason, Extended family, Ethnic behavior, Time living in the United States

Service Style-cafeteria style

Traditional: customers follow each other in a line and are served by employees standing behind the counter•Hollow square/free-flow/scramble: separate counter areas provide different menu types; this format increase speed and flexibilitycompared to the traditional cafeteria style

HBL leadership style delegating

Trust, empowerment, responsibility Leader gives responsibility to followers to set goals, plan, and execute the plan.

stainless steal work table 304

Type 304 is highly resistant to corrosion and rust, andis durable, easy to sanitize, and toleratesmoisture. It has high chromium nickel and is not magnetic.

Unity of Command

Unity of Command: each employee is accountable to only one superior. Considered to be a traditional or classical management approach

PEG, G-tube

Used for long term EN needsPEG is placed endoscopically while G-tube is placed during a pre-planned surgery Main difference between nasal and PEG access is the length of time a patient will be receiving EN Check residuals before bolus feeds and every 3-5 hours for continuous feeds, and raise the head of the bed 30 degrees to reduce the risk of regurgitation

Variable costs vary with output and typically increase at a constant rate relative to labor costs and capital.

Variable costs may include labor costs (hourly wages), utilities, and production costs.

Vinyl/PVC flooring

Vinyl/PVC flooring can be vinyl sheet or tile. There are luxury options, called luxury vinyl tile (LVT) that provide flexible design options.Vinyl flooring is goodfor customer areas, even if highly trafficked. Commercialvinyl flooring is sometimes called "resilient" flooring. Vinyl flooring is waterproof and slip-resistant. It can be pretreated for microbial infection control. There are minimal seams and no grout which helps with cleaning, though it might require a special cleaner. Vinyl flooring can also include a silver ion core which is antimicrobial(useful alsoin operating rooms).Vinyl takes on the propertiesof the subfloor, so installingvinyl flooring over a soft layer can reduce dinnerware breakage and be better forreducingworker fatigue. Finally, for aestheticsand durability, the synthetic polymers in vinyl make it resilient with maximal durability. This flooring is resistant to abrasion, chemicals, grease, and physical impact.

Parenteral Nutrition Complications Respiratory issues:

When excess glucose is converted to fat, the process produces extra carbon dioxide that can be problematic for patients with respiratory issues.To avoid this, it's important to stay below the maximum dextrose rate

Parenteral Nutrition Complications PN-associated liver disease:

When excess glucose is convertedto fat, it can lead to steatosis (fatty liver). The lack of bile duct stimulation in patients receiving PN can lead to cholestasis and/or gallbladder stones. Continuousinfusion and high IV fat emulsion dosages are more likely to contribute to PN-associated liver disease than spaced out infusions

Preventing Cross-Contact what is cross contact

When food containing allergens comes into contact with other food, it is called 'cross-contact'. Cross-contact is distinct from cross-contamination because,even after cooking a food exposed to an allergen, the food is still unsafe for someone allergic to that allergen.

Freezer Storage

When frozen food is received, it should be stored frozen immediately. Freezer storage space should be kept at 0°F or below and thermometers should be accurate within3°F. Just like refrigeration, freezers should have open, slotted shelving for air circulation and doors should have a tight seal.

Menu planning principles:you want to have a variety of color, flavors, textures, and food shapes

You may have a question on the exam that gives you 4 different example meals and asks which reflects "proper menu planning principles". Visualize each option in terms of color, flavor, texture,and food shapes. •Flavors -you don't want all spicy, all savory, or all sour •Texture -you don't want all tough, all crunchy, or all mushy •Color -you don't want all white or all brown •Food shapes -you don't want all roundor all flat

Position paper

a critical analysis of current facts, data and research literature on a specific issue. A key feature isthe Position Statement, which presents the Academy's stance on a specific issue that impacts the public's nutritional status and is controversial, confusing, or requires professional clarification. As of 2017, all new and updated Academy position papers are generated from EAL systematic reviews.

purchase order

a form requesting that a vendor sell merchandise to a business lists items to be purchased from supplier and is completed by buyer

systematic review

a high-level process that collects and critically analyzes multiple research studies or papers on a clearly formulated question using explicit methods to identify, select, and critically appraise the primary research

explanatory model

a patient's views about health and illness and its treatment

FOB origin pricing

a price tactic that requires the buyer to absorb the freight costs from the shipping point ("free on board")

cross-sectional studies

a research method that compares participants in different groups at the same time you measure the exposure and outcome at the same time, like a snapshot in time. Surveys are often cross-sectional, such as NHANES and BRFSS

Misclassification error:

a type of measurement errorthat applies to variables that are categorical or binary. The result of misclassificationerror is that someone is shifted into another category.

A new research study reports a 12% mortality rate among infants in your state,but a 10% infant mortality rate in your neighboring state,over the past year. This means that: a.More infants died in your state than the other state b.More infants died in the other state than in your state c.12% of infants in your state have some sort of disease d.More infants in your state have disease than in the other state

a. More infants died in your state than the other state

Profitability ratios:

ability to generate excessincome relative tosales

Fill in the statements with the correct term: specific, negative predictive value, sensitivity, positive predictive value. Terms may repeat. a.If 100 patients with a disease are tested but only 80 test positive for the disease, that means the test has a _____________ of 80%. b.If 100 patients without a disease are tested and 90 test negative for the disease, that means the test has a ____________ of 90%. c.If 100 patients test positive on a screening test but only 20 truly have the disease, that means that the _______________ is 20%. d.If 100 patients test negative on a screening test but only 97% are truly disease-free, that means the _________ is 97%. e.The ability of a test to correctly identify all screenedindividualswho are positivefor a disease is the test's _____________. f.Theability of a test to correctly exclude all screened individuals without a disease is the test's ______________

a. sensitivity b. specificity c. PPV d. NPV e. sensitivity f. specificity

A community nutritionist wants to find out how many new cases of pediatric obesity there were in her county in the last year. What is she trying to estimate? a.Incidence b.Prevalence c.Specificity d.Sensitivity

a.Incidence

Your department is catering the hospital's board meeting lunch next week. There will be 30 people in attendance and the cost of food purchased for the event is $820. Your supervisor told you last week the budget for the event was $25 per meal, maximum. Are you over or under your supervisor's budget? By how much? a.Over, $2.33 b.Under, $2.33 c.Over, $70 d.Under, $70

a.Over, $2.33

Menu engineering:

allows the manager to examine a menu item's profitability and popularity so that proactive planning, recipe changes, and selling price decisions can be made. The menu can be re-engineered to encourage customers to buy certain items

Fixed budget:

also called static budgets;they do not change based on business variations. Even if business activity volume increases, the funding for thoseactivities remains static

Measurement error:

an error in the difference between a measured quantity and the true value. It is composedofbothrandom error as a result of imprecision,and systematic error as a result of inaccuracy

Aflatoxins

are created by fungi that live on corn and peanuts. They can be foundin the food supply when crops are harvested. Aflatoxins can also be concentrated in livestock that consume the infested plants. Large amounts of aflatoxins can lead to acute toxin poisoning, while smaller amounts,like those found in the food supply,can lead to liver cancer, liver failure, immunosuppression, and growth failure in children. Diets in developing countries are grain-dependent. Howgrain is harvested and stored is key in preventing aflatoxin infestation (molding). Do you think the harmful effects of aflatoxin may have a disproportionateeffect on developing countries compared to developed countries? Why?

VIBRIOVULNIFICUS andVIBRIO PARAHAEMOLYTICUS

are found in contaminated waters where shellfish, particularly oysters, are harvested. Vibrioproliferates rapidly in the temperature danger zonesoinfection is more common in the warmer summer months. Infection leads to Vibriogastroenteritis but can also lead to primary septicemia, particularly in persons with preexisting chronic illness. •Prevention measures include purchasing shellfish from reputable and approved suppliers, and cooking shellfish to minimum internal temperatures. •Symptoms include watery diarrhea, vomiting, stomach cramps, nausea, low-grade fever and chills. •Time to onset iswithin24 hours of exposure and the illness usually lasts around 3 days (except in severe cases where vibriosis progresses to septicemia). •Commonly associated foods include oysters harvested from contaminated waters

Cyclic feeds

are given at a faster rate over a shorter period of time, and thus a faster flowrate must be tolerated. It's often used overnight so the patient can freely move around during the day, or if a patient has a treatment schedule during the day (like chemotherapy) that precludes day time feedings

Heat lamps

are placed over prepared food or at a carving station to keepthemwarm.

Polycyclicaromatic hydrocarbons(PAH)

are the carcinogeniccompoundsthat form when meat is cooked at high temperatures and/or char forms and is ingested.8Nutritionrecommendations include removing charred portions of meat prior to consumption or not cooking meat over an open flame

Conveyor dishwashers

are the largest available commercial dishwasher. "Flight type continuous conveyor" is the most efficent and effective dishwasher for high volume foodservice, cleaning up to 1,000 dishracks ina single day. You can choose from low temperature and high temperature models, and installation requires specialty hard-wiring due to its size and its energy requirements.

Door type dishwashers

are the most common commercial dishwasher. You load dish racks with dirty dishes into the washer. Different models wash different numbersof racks (single rack versus double rack). If the door slides up, there is a safety switch feature to turn off the cycle. Door type dishwashers have a larger capacity than undercounter washers which make them a better alternative in large resturants, but they use more energy and more detergen

Undercounter dishwashers

are the most compact option and resemble residential dishwashers. They are versatile in that they can be freestanding or built in, like behind a bar. They can be low temperature to save energy. While they look similar to residential dishwashers,they clean at a much faster rate -20 racks in a single hour.

Tube style fryers

are used for frying onionrings, chicken, fish, or anything in a frying basket (i.e. Frenchfries, cheese sticks). The heating element is within the tubes and affixed to the fry pot. This style fryer is heated by gas and has a better sediment zone than the other models. The sediment zone keeps sediment separate from oil, which prolongs oil life and prevents poor flavor of food. This style is harderto clean than open pot fryers.

case-control studies

assess outcome status and then assess for exposure history ex: you measure the outcome at the start of the study and go backwards to measure the exposure. For example, if you are interested in looking at prenatal exposures in mothers with premature born children, you could identify all the mother-child dyads in the NICU at your hospital, and then interview the mothers about their behaviors during pregnancy

McGregor's Theory X

assumes that employees must be controlled, directed, and coerced.14Other assumptions are that employees have little ambition, they dislike work, are irresponsible, and will avoid work,if possible. Managers believing in Theory X think that the primary employee motivation is first monetary and then,security. Managers may use hard or soft management approaches. Hard management approaches includecoercion, implicit threats, micromanagement, and tight controls andmay result in hostility, employees producing poor work on purpose, and extreme demands from labor unions. Soft management approachesare permissive in the hopes employees will cooperate but may result in workers wanting greater reward if they can do less work.

A research article describes the number of new and existing cases of type 2 diabetes in the US in 2010. What does this number refer to? a.Incidence b.Prevalence c.Specificity d.Sensitivity

b. Prevalence

deficiency needsor D-needs

basic needs include physiological needs(food, warmth, water, rest) and safety needs(security and safety). These are also known as deficiency needsor D-needsalong with psychological needs. Motivations decrease as needs are met, and motivations increase as the duration of deficiency continue

With PPN, it's important to maintain formula osmolarity

below 900 -1,100 mOsm/L Note that we typically only use PPN for supplemental PN or as a bridge to other therapybecauselargeamounts of nutrients can't be provided through small peripheral veins, and small veins cannot tolerate hypertonic solution, because they result in a large fluid shift into vascular compartments leading to phlebitisor thrombosisAmino acids and dextrose contribute to hypertonicity of PN formula, but fat does not.As long as the patient does not have delayed blood lipid clearance, lipids can be given peripherallyeven when other PN is given centrally.

Q: Which statement best describes an incremental budget? a.Each unit prepares a budget that is then sent up to upper management b.Start with a previous budget and adjust for current conditions c.Use existing budgets and add increasing amounts relative to the current budget d.Prepared by upper management and given to operating units

c.Use existing budgets and add increasing amounts relative to the current budget

profit contribution

calculating profit (subtracting food cost fromselling price) and then dividing by the total profits. X-axis is profitability (profit contribution) and the Y-axis is popularity (popularity index).

Category A Bio terrorism Agents

can be easily disseminated or transmitted from person to person; result in high mortality rates and have the potential for major public health impact; might cause public panic and social disruption; and require special action for public health preparedness.

Banquet carts

can be heated or not. Non-heated banquet carts are often called "Queen Mary" carts and have open sides. Heated banquet carts have doors and will keep plated dishes at the correct temperature

Cronobacter sakazakii

can survive in dry foods (e.g. powdered infant formula, powdered milk, herbal tea, flour) and can be deadly forinfants. •Prevention measures include breastfeeding (rather than feeding powdered infant formula), properly cleaning, sanitizing, and storing baby bottles and breast pump parts, using formula within 2 hours of preparation, and washing hands properly and frequently. •Time to onset is not well established as infection is rare. •Symptomsin infants include fever, poor feeding, crying, and low energy. In persons of all ages, symptoms include diarrhea and urinary tract infections. The illness can progress to sepsis and meningitis. Vulnerable populations, including premature infants, are more susceptibleto Cronobacterinfection

Open pot fryers

can use gas or electricity. They are easy to clean and canbe used for nearly any type of food. These fryers have a shallow sediment zone that can get clogged easily so it is best to use for low-sediment foods.They can be used for basket fried foods like French fries, hashbrowns, and frozen foods.

Parenteral Nutrition Complications Catheter-related bloodstream infections:

central access is ideal to address osmolarityconcerns but there is an increasedrisk of bloodstream infection. This complicationis a major reason we don't globally prescribe parenteralnutrition.

A hospital's foodservice department has a Director, Nutrition Manager, Foodservice Manager, and HR Manager. The clinical RDs report to the Nutrition Manager; foodservice staff report to the Foodservice Manager; and support staff report to the HR Manager. Each week, all managers meet with the Director to get project approvals. All employees are required to follow the same policies and procedures. This department is an example of a (decentralized / centralized) organizational structure.

centralized

A hotel is hosting a gala for the regional dietetic association which includes a plated dinner service. The chef has the staff begin preparing the menu items a week in advance, chilling and freezing items to thaw the day before. On the day of the event, the kitchen staff cook the items that don't store well chilled or frozen. All of the food is prepared in the hotel kitchen and transported to the ballroom on banquetcarts for service. This is an example ofa________________delivery service system using ________________and ________________foodservice systems.

centralized, conventional, and ready-prepared

Flexible budget:

changeswith business activitybecause the budget is constructedwith a rate per unit of activity rather than a fixed amount. Flexible budgets are useful for measuring efficiency. So,if business activity increases, the amount of money needed to support that increase is available

Metabolicalkalosiscan be "

chloride-responsive" with normal urinary chloride levels or "chloride-resistant" with urinary chloride in excess of 40 mmol/L.They are also called saline-responsive and saline-resistant (saline contains chloride). Chloride-responsive metabolicalkalosis can occur from vomiting,excessive nasogastric suctioning, hypovolemia, or types of diuretics (loop, thiazide). Chloride-resistantmetabolic alkalosis can occur in several syndromesincluding hyperaldosteronism, Cushing's, Bartter(excess mineralocorticoids), very low serum potassium, or excess alkali intake. In both cases of metabolicalkalosis, HCO3-will be high and the body compensates byincreasingPCO2. For a straightforwardquestion on acid-base balance, evaluate first the pH (is it low or high), then look at PCO2 (high or low?), and then finally look at HCO3 (high or low?). For simple acid-base disorders, either PCO2 or HCO3 will be abnormal and can point you to respiratoryversus metabolic as the primary etiology of pH imbalance. In real life, acid-base disorders can be a mix,which is trickierto ascertain.

Glasswashers

come in several desigsn, including rotary, conveyor, and door-type under counter. The door-type is similar,if not identical,to the under counter dishwashers but is meant mainly for glasses. Why would we want a glass washer? Advantageousfor bars and cafes that need a steady supply of clean glasses without needing an employee dedicated to washing dishes. Glass washers use lowerwaterpressure than regular dish washers so that they safely clean glasses.

Cook and hold ovens

cook food and then keep it hot until serving time without drying it out

Class K Fire

cooking oils K for kitchen fire Class K fire extinguishers are wet chemical and will turn oil into a foam. Water stream notused because it willcause the fuel to scatter. Can also smother small kitchen fires with fire blankets

calculation for abc inventory classification

cost of item/total cost = value of purchase individual item units/total units=percent of units

Wet chemical extinguishers

createa soapy foam blanket that excludes air (removing oxygen) and cools the fuel below its ignition temperature. Wet chemicalextinguisherswere developed for Class K fires but some may be used on Class A fires in kitchens. They are silver.

Service Style-Self-service

customer carries food from display place to dining area

A large research organization has several highly qualified expert scientists and maintains several lab locations across the world, with an expert at each location. They advertise that the advantage of using their lab services is the high quality and standardized lab procedures. It would be best for them to use a (decentralized / centralized) organizational structure because

decentralized because of the geographically diverse location, despite having standardization and experts.

When the blood is too basic (high pH) the kidneys will:

decrease hydrogen ion secretion from renal epithelial cells •decrease rates of glutamine metabolism •decrease rates of ammonium excretion (NH4)

Zero-based budget:

determines cost, outlay, and inflowswithout a baseline budget. A manager has to justify every expensewith nothing automaticallyapproved. Zero-based budgets aim to eliminate any unnecessary expenditures. It can be very time consuming and works better for discretionary costs than with essential operating costs.

Parenteral Nutrition Complications Fluid and electrolyte imbalance:

dosing PN components per day is helpful,especially when the total volume of PN solution changes. We often need to adjust the additional fluid and electrolyte additions due to physiologic stress, wounddrainage, blood loss, GI fluid loss, organ malfunction, hormonal abnormalities, medications, IV fluids, and parenteral electrolyte shortages.

burglary

entering a building/residence with intention of theft.1Burglary does not require that property is actually stolen, and there may or may not be person-to-person interaction

For enteral feeds, gut integrity can be maintained

even with slow rates of feeds (like trophic feeds) or taperingup from slow rate to full rate feeds.9If parenteral nutrition is warranted, but the gut still works to the point of tolerating trophic enteral feeds, it's a good idea to use both

focus groups are

focus groups are a qualitative research technique that groups together a small number of people with a moderator to lead them through a discussion.

Bacteria need 6 things to grow

food, acidity, temperature, time, oxygen, and moisture. You can remember these 6 things with the acronym FATTOM(see Table 4). In ideal conditions, bacteria will replicate every 20 minutes.Some bacteria can survive under harsh conditions that are not ideal for growth (like refrigeration temperatures) and once theyare back in an ideal temperature (like the temperature danger zone during improper thawing procedures),they can replicate to dangerous levels quickly.

LISTERIA MONOCYTOGENES

grows in cool, moist environments(i.e. refrigerator temperatures)and typically doesn't cause illness in healthy persons. Listeria can cause listeriosis in vulnerable populations but is of particular concern for pregnant women because it can lead to miscarriage and in newborns,it can lead to sepsis, pneumonia, and meningitis. For these reasons, pregnant women are discouraged from consuming deli meat, hot dogs, and soft cheeses. •Prevention measures include throwingaway products pastuse-by/expiration dates, cooking raw meats to minimum temperatures, pasteurization, preventing cross-contamination between raw meats and ready-to-eat foods, avoiding unpasteurized dairy products, and maintaining time and temperature control. •Symptoms in pregnant women include fever, fatigue, and muscle aches. Symptomsin other persons (typically immunocompromised) include headache, stiff neck, confusion, loss of balance, convulsions, fever, and muscle aches. •Time to onset is heterogenous(anywhere from 24 hours to 70 days) but typically 1 to 4 weeks after consuming contaminated food. •Commonly associated foods include raw meat, unpasteurized dairy(soft cheeses), unpasteurized juices, and ready-to-eat foods like deli meatand hot dogs

Evidence-based nutrition practice guideline

guiding statements, developed from a systematic review, designed to assist practitioner and patients'decisions about appropriate nutrition care for specific disease states or conditions."

Electric steam tables

have food wells and can be used to display hot or cold foods.

If beginning inventory is inflated, COGs will be _________ . If ending inventory is inflated, COGS will be________ (because you're subtractingthat number)

higher/lower

#2 can

holds 2 1/2 cups; 1 lb 4 oz.; soup can

Refrigerated holding cabinet

holdsfood at the correct cold temperature prior to serving

Another group of employees is responsible for prepping food to serve at the main hospital cafeteria. General items are prepped and kept warm in holding carts and electric steam tables.Specialty items are prepped to be cooked at specialty counters, including a sushi counter and burger station. This is an example of a ________________cafeteria service style

hollow square / free-flow / scramble cafeteria service style.

Bimetallic stemmed thermometers should be regularly calibrated using the

ice point method. The thermometer stem should be immersed at least 2 inches into a crushed ice-water mixture and read 32 degrees F(0 degrees Celsius)after 30 seconds. Calibration can also be done using the boiling point method of boiling waterandreading 212 degrees F (100 degrees Celsius) after 30 seconds,but this method carries the risk of burns.Thermometers should be accurate to ± 2 degrees F

Non-response bias:

if you send out a survey to 1,000 people in your county and only 100 responds, you should be concerned about non-response bias. That is, the people who did not respond may be systematically different than those who did respond. Good quality studies report their response rate

Observational Studies

in observational studies, the researcher doesn't intervene or manipulate the conditions,they just gather information. Thus, the results are measures of association or correlation, not causation.

Theory Z (Ouchi)

is a "Japanese Management" style that boomed in the 1980's. Japanese employees were empowered and productive,leading to high quality products at low prices. Managerial assumptions about employees were that employees desired affiliation and expected support from their company, and that family culture and traditions are important,both at work and at home. Extensive training is a tool in Theory Z management to develop a sense of order and moral obligation to work hard and produce quality work. Managersbelieving in Theory Z focus on improving employee loyalty to the organization by improving their well-being,both in and outside of work. Benefits of this managerial style include stable employment (low turnover), high productivity, high morale, and high employee satisfaction.15Companies using this form of management typically have slow promotions, group decision-making, and life-time employment opportunities

value proposition budgeting

is a budget-building mindset. The manager asks, why is this amount included in the budget? does the item create value? does the value outweigh the cost? If not, is thereanother way to justify the cost? It is similar to zero-basedbudgetingin that it aims to tighten up the budget but not to the extent of a zero-basedbudget.

BACILLUS CEREUS

is a spore-forming bacteriumcommonly found in dirt. Itcan produce 2 toxins when allowed to proliferate. One toxin causes diarrhea illness and one causes vomiting illness. The diarrhealillness is caused by consuming bacteria or spores that then proliferate and produce toxins in the body. While heating destroys the bacteria, it does not destroy the heat-resistant spores. If food is allowed to cool over too long of a period, the spores cangerminate. The vomiting illness is caused by consuming preformed toxins present in food-this toxin is heat-resistantup to 250 degrees F Prevention measures include cookingto appropriate temperatures and cooling rapidly. Holding food at temperatures outside of the temperature zone is also important. Diarrheal illness •Symptoms include watery diarrhea, stomach pain, stomach cramping •Time to onset is 6 to 15 hoursand lasts around 24 hours. •Commonly associated foods include cooked plant foods, meat products, and milk. Vomiting illness •Symptoms include nausea and vomiting. •Time is 30 minutes to 6 hours and lasts around 24 hours. •Commonly associated foods include cooked rice dishes (e.g. fried rice, rice pudding).

Bain Marie

is an electric steam table hooked up to a food rethermalizer to heat the water keeping food wells hot. Bain Mariemight also be used to thaw large amounts of frozen food or for cooking

Broker

is an independent sales representativewhocontracts with certain manufacturers, processors, and prime source producers to arrange transactions between the two parties.Brokers don't keep inventory and thus,have no title to the goods sold but are paid a commission

YERSINIA ENTEROCOLITICA

is carriedprimarilyby pigs though other animalscan also carry it. Itcauses gastroenteritis in humans.Handwashing is important to prevent the spread of this pathogen -for example, someone who preparesa pork product andthen handles children'stoys, bottles, or pacifiers can spread the pathogen, as well as changing the diaper of a child with yersiniosisand not washing hands can lead to infection. •Prevention measures includecooking pork to proper temperature, avoiding unpasteurized dairy products, proper handwashing, and preventing cross-contamination between raw pork and ready-to-eat foods. •Symptoms may vary by age. Among children, the most common symptomsare bloody diarrhea, fever, and stomach pain. In older children and adults, right-sided abdominalpain and fever is more common andcan be confused with appendicitis. •Time to onset is typically 4 to 7 days but ranges from 24 hours to 2 weeksand may resolve within a few days or up to 3 weeks. Symptoms like reactive arthritisand rashes may take several months to resolve. •Commonly associated foods include raw or undercooked pork(including dishes made with pork intestines, like chitlins/chitterlings), other meats, unpasteurized milk, fish and shellfish,and foods contaminated by infected foodhandlers.

Sensitivity (epidemiology)

is the ability of a test to correctly identify those with a disease. That is, how often a positive test result corresponds to positive disease status Sensitivity = TP/TP+FN

Specificity (epidemiology)

is the ability of a test to correctly identify those without disease as disease-free. That is, how often a negative test result corresponds to negative disease status specificity= TN/FP+TN

Edible portion quantity

is the amount (weight, volume, or count) of the product after we have prepared it. This couldmean after we have cleaned, peeled, or trimmed the product, such as with the potatoes. With leafy vegetables, it could mean after cooking. With meat, it could mean after trimming fat, removing bones, and/or after cooking.In this hypothetical situation, we scrubbed and peeled the potatoes and were left with 21.25 pounds of our original 25 pounds that we purchased.

As purchased quantity

is the amount (weight, volume, or count) of the product as we purchased it or received from a vendor. For your recipe, you receiveda 25-poundbag of potatoesfrom your grocery vendor. This is your as-purchased quantity

Edible portion cost

is the cost to the department of the portion served. The EP cost takes into account the trim and waste that we calculated in the previous section with yield. (𝑇𝑜𝑡𝑎𝑙𝐴𝑃)/(𝐶𝑜𝑠𝑡𝑌𝑖𝑒𝑙𝑑)=𝐸𝑃𝑐𝑜𝑠𝑡 (𝐴𝑃𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡)/(𝑌𝑖𝑒𝑙𝑑)=𝐸𝑃𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡

CAMPYLOBACTER JEJUNI

is the most common bacterial diarrheal illness in the US.9Farm animals can be asymptomaticcarriers with Campylobacter jejuniin their intestines or otherorgansthatinfect otheranimals during slaughter. Milk can be contaminated if a cow has Campylobacterin her udder, thus pasteurizationis important. Produce can be contaminatedif exposed to feces-contaminated soil or water.Raw or undercooked poultry (or cross-contamination from raw or undercooked poultry) is one of the most common ways Campylobacter jejunicauses illness •Prevention measures include cooking food to minimum temperature, preventing cross-contamination between raw poultry and ready-to-eat food, and controlling time and temperature. •Symptoms include watery or bloody diarrhea, stomach cramping, fever, vomiting and headaches. •Time to onset is 2 to 5 days and symptoms last about one week. Complications include irritable bowel syndrome, Guillain-Barre syndrome and arthritis in some cases. •Commonly associated foods include poultry (raw or undercooked), contaminated water, unpasteurized dairy, meats, and stews or gravies.

Prevalence

is the number of existing disease cases during a period of time. Prevalence = Incidence x Duration For example, when we measure prevalence of heart disease in 2012, we don't distinguish between people who had heart disease in 2011 and those who were newly diagnosed with heart disease in2012.

Negative predictive value:

is the probability that a patient does not have the disease, given a negative screening test value.

Positive predictive value:

is the probability that a patient has the disease, given a positive screening test value

As purchased cost per unit

is the total AP cost divided by the quantity purchased (AP quantity). We often calculate AP cost per unit using the units from the recipe. (𝑇𝑜𝑡𝑎𝑙𝐴𝑃𝐶𝑜𝑠𝑡)/(𝐴𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦)=𝐴𝑃𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡

SALMONELLA TYPHI

is transmitted from human-to-human. Some people carry Salmonella typhi without ever developing symptoms,while others develop typhoid fever and,even aftertreatment,will continue to shed the bacteriain their bodily fluids •Prevention measures include excluding personsdiagnosed with Salmonella typhi from food handling, washing hands, cooking food to minimum temperatures and preventing cross-contamination. •Symptoms include high fever, weakness, stomach pain, headache, loss of appetite and rash. •Time to onset is 6 to 30 daysand symptoms canlast up to a month ifuntreated. •Commonly associated foods include ready-to-eat foods, beverages, contaminated waterand shellfish from contaminated water.Figure 2. Examples of how Salmonella spp. can infect produce and animal products

SALMONELLASPP.l

ivesin the intestines of humans and other animalsand can shed in the feces weeks after the illness has resolved •Prevention measures include preventing cross-contamination, cooking poultry and eggs to minimum internal temperatures, and excluding foodhandlers diagnosed with salmonellosis from foodhandlingactivities. •Symptoms include diarrhea,vomiting,fever and stomach cramping. •Time to onset is 6 hours to 6 days and can last 4 to 7 days. However, the illness can be heterogenous with some persons not developing symptoms for several weeks following exposure and some having illness last for several weeks. Some people also develop reactive arthritis after the gastrointestinal symptomsresolve. •Commonly associated foods include poultry, eggs, dairy and producecontaminated with salmonella-infected water or soil.

Dumping syndrome results from rapid gastricemptying or rapid infusion of formula intothe small intestine. Dumping syndrome symptoms can occur with

jejunal access when a hypertonic formula is directly infused into jejunum. It manifests as dizziness, sweating, tachycardia, and cramping with onset between 15 and 60 minutes after feeds

STAPHYLOCOCCUS AUREUS

may sound more familiar as a skin or systemic infection. However, when allowed to grow on food and produce toxins,this bacteriumcan lead to staphylococcal gastroenteritis. Staphylococcusaureus is commonly found in the hair, nose, and throat of humansand when food workerstouch their face or hair and then prepare food without washing their hands, they can contaminate food. Because the toxin is heat resistant, it is important to prevent contamination and proliferation •Prevention measures include washing hands, covering wounds, time/temperature control (holding, cooling, and reheating food correctly), and practicing personal hygiene. •Symptoms after ingesting the toxin include nausea, vomiting, and stomach cramping.Figure 4. C. perfringens is common in hot-held foods that aren't kept hot enough. Photo source: www.freepik.comFigure 5. Staphylococcus aureus under scanning electron microscope. Provider: CDC/Matthew JArduino, 2001. Public Domain, PHIL #11157. •Time to onset is usually 30 minutes to 8 hours after exposure to the toxin, and the illness lasts up to 24 hours.•Commonly associated foods include ready-to-eat foods containing TCS ingredients such as egg salad, tuna salad, chicken salad, and macaroni salad,as well as deli meat.

Minimum-maximum stock method

means that we deplete stock to the safety level (parstock level) before an order is placed. When the quantity reaches par level, we re-order so that we're brough up to the maximum level (which is decided ahead of time). The number of units ordered each time will be the same -this would bethe difference between the maximumleveland par stocklevel.Orders for some itemswith this method may be standing ordersthat eliminate the cost associated with ordering daily or weekly orders (like paying an employee to do so

Prix Fixe Menu

menu which prices multi-course meals and allows a customer to order a predetermined, specific number and combination of items (a.k.a. fixed price): may present an entire meal, or several options within each meal category, for a single price

Owner's equity:

monetary value of property beyond debts, including retained earnings

here are 5 factors that affect quality and they include

money, materials, management, people, and market.

dumping syndrome is

occurs when hypertonic contents enter the small intestine, causing an influx of fluid into the lumen. This leads to epigastric fullness, weakness, dizziness, vertigo, diaphoresis, tachycardia, and/or abdominalcrampin The body reacts by sending water to the intestinal tract, thus reducing blood pressure. It may occur after surgery in which a portion or all of the stomach is removed.

Social desirability bias

occurs when the participant responds in a waythatthey think they should. We see this often when asking about societal taboos, such as illicit drug use orsmoking, particularly during pregnancy. •In research, we often ask about taboo topics via self-administered surveys. For example, NHANES now uses computerized surveys that participants fill out in a private booth with the aim that we will get more accurate measures of smoking prevalence and drug use.•In counseling, we can address this bias by developing a strong and neutral relationship with our patient. If they know that they will not be judged, they will be honest and progress can be made

Selection bias

occurs when the people you decide to include in your study are not representative of the population you are aiming to study. For example, if you want to study the health of children in your county, but you only enroll children from private school, you will likely encounter selection bias because children in private school do not adequately represent all children in your county.

You have 5 boxes(gray)in your inventory on April 1st. During April, you purchase two boxes during the month (white). At the end of the month (or at your next opening inventory) you have 3 boxes left. It doesn't matter which boxes are left over (gray or white, existing or new).You have 3 boxes left.

opening inventory purchase and closing inventory example

bolus feeds

or intermittent feedings are given several times throughout the day, often at meal times. Patients often transition from continuous drip in the hospital to bolus feeds when they leavein order to have more mobility during the day. However, bolus feeds may be difficult to tolerate,especially with post-pyloric access

what happen in the body and kidneys When extracellular fluid (ECF) volume is low?

plasma solute concentrationincreases,which increases osmolarity. In responsetoanincreased solute concentration, the kidneysreabsorb water in order toincrease the ECFvolume, which decreasesthe plasmasolute concentration and restores normal osmolarity. The resultof the kidneys reabsorbing water is concentrated urine.

Top-down budget:

prepared by upper management and given to operating units. Activity-based budgeting is a typeof top-down budget where the company sets targets or outputs,and then determines the activities necessary to meet the target and the cost of carrying out those activities.

just in time purchasing

purchase products as needed for production and immediate consumption by the customer without having to store and record products in inventory. This means that the receiving clerk will deliver items from the loading dock to the kitchen station where they willbe used, without logging them into inventory

For the following statements, write in chlorine, quaternary ammonium, or iodinewhere correct.Check your answerson the following pages. pH stable

quats

Gas commercial range

ranges have open burners and dials that allow for precise cooking temperature control. Immediateheat from open burners leadsto shorter cook times. Gas is typically more efficient than electric models with lower operational costs,unless gas prices in your area are high. Gas models require special hookups to the buildings gas line which may make installation more expensive than an electric range.British Thermal Units (BTUs)measure gas usage

Electric commercial ranges

ranges have protective tops above tubes with metal elements. Compared to gas ranges, electric ranges are easier and cheaper to install.With improvements in technology, electric ranges are more commoncommercially than they used to be

Proofing cabinets

re used for proofing bread products

A hospital kitchen provides meals for the entire health system. One group of employees is responsible for prepping food in bulk and transporting it to satellite sites, like the long-term rehabilitation center and the ambulatory care center, which has its own cafeteria. This is an example of a ________________foodservice system. The staff at the satellite centers complete the cooking and assembly process before meal time and serve it. This is an example of a ________________delivery service system.

ready prepred and decentralized

handwashing sinks are required in...

restrooms, food-prep areas, service areas, dishwashing areas The FDA issues the Model Food Code. This food code requires at least 1 hand-sink inside of, or at the entrance to, a food prep area. Hand-sinks should be easily accessible by employees that work in food prep, food serving, and warewashing

pancreatic insufficiency

results in reduced pancreatic enzyme release and consequent malabsorption. It may be due to cystic fibrosis, chronicpancreatitis, or pancreatic ductobstruction. In contrast, insufficient releaseof secretin and CCK may result in

Renin controls

salt and water balance, and thus blood pressure. In response to low mean arterial blood pressure (MAP), the kidneys release renin,which cleaves angiotensinogen (from the liver) to angiotensin I. Angiotensin converting enzyme (ACE) converts angiotensin I to angiotensin II, which constricts blood vessels and stimulates increased blood pressure via other mechanisms

Soluble fiber is converted to which is used by gut bacteria for food Helps maintain a healthy gut

short chain fatty acids

experimental studies

studies in which the independent variables are directly manipulated and the effects on the dependent variable are examined In experimental studies, the researchers manipulate the environment, like randomizing one group to receive standard diet instruction and another group to receive diet instructions plus a group exercise class.

prospective studies

studies planned by the researcher for collection of primary data for the specific study and implemented in the future (ex. all participants attend clinic visits in the same way, answer the same surveys, and have the same tests done. However,the researchers do not manipulate anything,they just collect dataand assess their observations.)

Service Style-Tray service

trays are delivered to floor pantry or to the patient. Tray service requirescooperation between different subsystems, suchas foodservice and nursing in a hospital. Food quality and food safety issues also need to be addressed with holding times pre-and post-delivery

Disaccharides are

sucrose, lactose, maltose include sucrose (fructose and glucose), maltose (glucose andglucose), and lactose (glucose and galactose). They are formed via dehydration reactions between 2 carbons on each monosaccharide. These glycosidic bonds are what digestive enzymes break. For example, sucrase breaks down the α1-2 linkage between glucose and fructose, maltase breaks down the α1-4 linkage between 2 glucose monomers, and lactase breaks the β 1-4 linkage between lactose and galactose

Gastrostomy and jejunostomy:

surgicallyplaced directly into stomach or jejunum. Bymaking an incision in the abdominalwall (stoma)and is usually done during another preplanned surgery.Used if EN needed for more than a few weeks, cannot have a tube through the mouth or throat, or vomit frequently (which would displace NG, ND, or NJ tubes)

checking feed residuals

t's important to check residuals before bolus feeds and every 3-5 hours with continuous feeds. A residual of 100 -150 mL may indicate an obstruction or poor motility

robbery

taking property that may involve forceandperson-to-person interaction

theft

taking property without force1-"taking" means removingwithout permission or right, and is often premeditated

We can take steps to prevent dumping syndrome with EN by

tapering up infusion rates, using continuous instead of bolus feeds, and using isotonic formula. Strategies for oral intake include avoiding fluids with meals, avoiding fatty foods, and avoiding high sugar foods.

Healthy volunteer bias:

the flip-side of non-response bias.Persons who volunteer for research trials, or who are most likely to respond to health surveys, tend to be healthier, moreaware of their health status, and even of a higher socioeconomic status than those who do not

span of control

the optimal number of subordinates a manager supervises or should supervise Span of control is at the individual manager level, not the organizational level.17A manager's span of control is their ability to efficiently and effectively supervise all work sites and workers.

Debt-to-equity ratio:

the percentage of assets funded by shareholder's equity and debt

A balance sheet is

the statement of an organizationscurrent and fixed assets, current and long-term liabilities, and owner's equity.Balance sheets are split in a "T"-shape with assets on the left side, and liabilities and owner's equity on the right side. Total assets must equal total liabilities +equity.

Systems Theory

theory that describes the interconnected elements of a system in which a change in one element affects all of the other elements

UL

tolerableUpper Intake Level-maximum daily intake that is unlikelyto cause adverse health effects

the ability of a solution on one side of the cell membrane to attract water from solution on the other side of the cell membrane. In clinical scenarios, tonicity refers to osmolality of a solution relative to human plasma. The tonicity of a fluid depends on the amount of osmotically activesolutesand tonicity of ECF is determined primarily by sodium levels

tonicity

Gross profit:

total sales minus the costs of goods sold(COGS)

the costliest parasite is

toxoplasmosa

the processes required to change inputs into outputs

transformation

continuous drip feeding

tube feedings are given at a steady flow rate for as many hours is required to administer the nutrientsfor the day. We often calculate the flow rate assuming a 24-hourduration.Continuous drip requires that the patient is tethered to an IV pole or pump.

𝑃𝑜𝑝𝑢𝑙𝑎𝑟𝑖𝑡𝑦𝑖𝑛𝑑𝑒𝑥=

units sold/ total units sold

Combination feeds

use bolus feeds during the day and continuous feeds at night

Decisional roles

use information and includethe roles ofentrepreneur, disturbance handler, resource allocator, and negotiator.4Entrepreneurscreate and control change (including problem solving), generate new ideas, and implement them. Disturbance handlers take charge when the team hits an unexpected roadblock and mediate disputes within the team. Resource allocators determine where organizational resources should be applied, allocate funding, and assign staff and other resources. Negotiators take part in and directimportant negotiationswithin the team, department, and even organization.

Single-use menu:

used once, such as thatfor a special event

formal procurement

uses the same process as informal procurement but scores bidders based on established scoring criteria, such as locally grown items receiving extra points. There are two methods of formal procurement: competitivesealed bidding and competitivenegotiation.

Incrementalbudget:

usesexisting budget numbers as a base and addsincremental amounts relative to the current budget.It is one of themost common budgeting methodsdue to simplicity but is more appropriate when primary cost drivers of a company do not change from year to year. This type of budget can be inefficientbecause if there is room for a 10% budget increase each year, and a manager claims that increase for their unit, it can "perpetuate inefficiencies", make a team look overly efficient, and typically ignores external drivers like high inflation and regular growth.

Low CHO/high fat formulas can facilitate _____________ weaning because excess CHO is converted to ________________, releasing CO2 (which is difficult to clear with impaired respiratory function)

ventilator fat

The kidneys have 4 key functions:

volume and osmolarity regulation, ion concentration and pH regulation, waste and toxin excretion, and hormone production.

Reporting bias

when the direction or statistical significance of results influences whether and how the research is reported. Some researchers conduct their experiments but only report what they find to be significant. This borders on unethical research practice because it is not transparent.

Protein complementation

when you combine two different plant proteins to make sure you consume all 9 essential amino acids. There are particular amino acids that are low in plant foods and these are called "limiting amino acids".They areoften the focus of protein complementation. Note that complementaryprotein sources don't need to be eaten in the same meal. Often,eatinga varied vegetarian dietthroughout the dayis sufficient to consume all 9 essentialamino acids.Note that protein complementation can be achieved by consuming a diverse diet Protein complementation, or protein pairing,is common in many cultures.2Asian culture often pairs rice and soy.Latin American culture often pairs beans and corn. Succotash (corn, beans, and other vegetables) was popularized during the Great Depression and is also an example of protein pairing.

functiona lpancreatic insufficiency

which can lead to villous atrophy and inactivation of pancreatic enzymes as the acidic gastric chyme is not neutralized. Functional pancreatic insufficiency is seen in celiac disease as a feedback loop of damaged enterocytesbeingunable to secret sufficient hormonesv

calculating yield

which is the difference between the as purchased quantity and the edible portion quantity. In this case, we may call it waste; with meat, we might call it trim. If we calculate the EP quantityafter cooking, we would also account for shrinkage.To calculate yield, we divided the EP quantity and AP quantity. With yield, you're asking the question -how much of the AP quantity am I left with after trimming and waste? EP quanity/AP quanity

Ifthe power goes out, keep refrigerator and freezer doors shut to maintain cold temperatures.Know these facts for the exam: Freezers

will hold temperature for ~ 48 hours (full) or ~24 hours (half full) with the door shut

Oven proofer combo

will proof and then bake dough in the same equipment using different controls

percent profit contribution

you can see how popularity (the number of items sold) plays into profitability, which makes sense given that the strategies earlier on involved increasing overall sales in order to increase profitability.

Temperature Danger Zone

zone from 41F° to 135F° in which foods should not be stored or kept for long periods of time due to risk of spoilage and bacteria growth

The key tenants of CQI are:

•Customer satisfaction •Data collection via the scientific method •Team involvement Customer satisfaction directs the CQI process towards what should be examined. Data collection, via the scientific method, provides high quality data to guide the improvement process. Team involvement encompasses the system level and includes people from all areas that the improved program or process might touch

7.An employee with what symptoms should be excluded from food handling?

•Diarrhea •Vomiting •Jaundice •Sore throat with fever

Describe the 3 types of dehydration. Connect the name with the loss of electrolytes versus the loss of water.

•Isotonic dehydration occurs with equal loss of fluid and electrolytes. Serum sodium and BUN will be WNL. •Hypotonic dehydration occurs with loss of electrolytes, leading to hypotonic plasma. Serum sodium will be low (<130 mmol/L). •Hypertonic dehydration occurs with loss of fluids, leading to hypertonic plasma. Serum sodium will be high (>150 mmol/L) and serum BUN will be high (>20 mmol/L

Minimum Internal Temperatures after Cooking for TCS Foods 145°F for 4 minutes

•Roasts-145 degrees and rest for 3 minutes Note: ham packed in USDA-inspected facilities can be cooked to 140°F

Minimum Internal Temperatures after Cooking for TCS Foods 145°F for 15 seconds

•Seafood (i.e. fish, shellfish, crustaceans) •Meat (i.e. pork, beef, veal, lamb) •Eggs& egg products to be served immediately

Why don't we recommend PN globally? Why do we go through steps for the what, why, and how?

−Because there are risks and complications −Without use for 2 or more weeks, the GI tract can atrophy, and gut bacteria can translocate into the circulatory system leading to infection −Peripheral access can lead to phlebitis and thrombosisoWhy? −Central access lines can lead to serious systemic infections

Specific things that should be monitored when a patient is on parenteral nutritioninclude

−Hypertriglyceridemia −Hyperglycemia −Fluid and electrolyte imbalance −Catheter-related blood stream infections −PN-associated liver disease −Respiratory issues

You purchase 40 qts of sliced canned peaches for $40.79. Yield for draining the peaches is 90%. What is the AP cost per unit?

𝐴𝑃𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡= $40.79/(40𝑞𝑡)=$1.02𝑝𝑒𝑟𝑞𝑡

f the question provided you with the 25 lbs as purchased quantity and 85% yield, you could calculate the EP quantity by multiplying the two values

𝐴𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦×𝑦𝑖𝑒𝑙𝑑=𝐸𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦 25𝑙𝑏𝑠×85%=21.25𝑙𝑏𝑠

Monthly food cost is calculated by summing the month's opening inventory +purchases made during the month, andthensubtracting the closing inventory. Note that the closing inventory is the beginning inventory for the next month

𝐶𝑜𝑠𝑡𝑜𝑓𝑓𝑜𝑜𝑑=𝑂𝑝𝑒𝑛𝑖𝑛𝑔𝐼𝑛𝑣𝑒𝑛𝑡𝑜𝑟𝑦+𝑃𝑢𝑟𝑐ℎ𝑎𝑠𝑒𝑠−𝐶𝑙𝑜𝑠𝑖𝑛𝑔𝐼𝑛𝑣𝑒𝑛𝑡𝑜𝑟𝑦

A patient weighs 70 kg and is receiving 2 L of D15 solution. Calculatethe glucose infusion rate

𝐷15= (15𝑔𝑑𝑒𝑥𝑡𝑟𝑜𝑠𝑒)/(100𝑚𝐿)=15%-> 2000𝑚𝐿 𝑥15%𝑑𝑒𝑥𝑡𝑟𝑜𝑠𝑒 =2000𝑚𝐿 𝑥0.15=300𝑔-> 300𝑔𝑥 (1000𝑚𝑔)/(𝑔)=300,000𝑚𝑔-> (300,000𝑚𝑔)/((1,440𝑚𝑖𝑛𝑑𝑎𝑦)𝑥70𝑘𝑔) =2.98𝑚𝑔/𝑘𝑔/𝑚𝑖𝑛

x 3.4:You need to purchase a turkey for holiday dinner that is large enough to feed a party of 45. Yield for a whole turkey after cooking is 90%, and you are assuming 8 oz portions per person. Your vendor has 15-pound turkeys available. How many do you need to buy?

𝐸𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦= 45𝑠𝑒𝑟𝑣𝑖𝑛𝑔𝑠 ×8𝑜𝑧 𝑠𝑒𝑟𝑣𝑖𝑛𝑔=360𝑜𝑧 𝐴𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦=(𝐸𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦)/ 𝑦𝑖𝑒𝑙𝑑= 360𝑜𝑧/(0.90)=400𝑜𝑧 divide 400 by 16oz = 25lbs or 2 turkeys 25/15 lb turkeys =1.67

break even point formula 1

𝐹𝑖𝑥𝑒𝑑 𝑐𝑜𝑠𝑡𝑠 (1−(𝑉𝑎𝑟𝑖𝑎𝑏𝑙𝑒 𝑐𝑜𝑠𝑡𝑠) ( 𝑆𝑎𝑙𝑒𝑠))

break-even point formula 2

𝐹𝑖𝑥𝑒𝑑𝐶𝑜𝑠𝑡𝑠 (𝑆𝑎𝑙𝑒𝑠𝑝𝑟𝑖𝑐𝑒𝑝𝑒𝑟𝑢𝑛𝑖𝑡)−(𝑉𝑎𝑟𝑖𝑎𝑏𝑙𝑒𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡)

𝑇𝑜𝑡𝑎𝑙 𝐶𝑜𝑠𝑡𝑠=

𝐹𝑖𝑥𝑒𝑑𝐶𝑜𝑠𝑡𝑠+𝑉𝑎𝑟𝑖𝑎𝑏𝑙𝑒𝐶𝑜𝑠𝑡𝑠

Given that fixed costs are $85,000, sales price per unit is $42, and variable cost per unit is $12, we'll use Formula 2 and calculate the denominator first(the contributionmargin)

𝐹𝑜𝑟𝑚𝑢𝑙𝑎2: 𝐹𝑖𝑥𝑒𝑑𝐶𝑜𝑠𝑡𝑠 (𝑆𝑎𝑙𝑒𝑠𝑝𝑟𝑖𝑐𝑒𝑝𝑒𝑟𝑢𝑛𝑖𝑡)−(𝑉𝑎𝑟𝑖𝑎𝑏𝑙𝑒𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡) 85,000 85,000 42-12 30 =2833 units

Raw food cost is $2.50,labor cost is 30 minutes at $14/hour. Calculate prime cost

𝑃𝑟𝑖𝑚𝑒𝐶𝑜𝑠𝑡=𝑅𝑎𝑤𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡+𝐿𝑎𝑏𝑜𝑟𝐶𝑜𝑠𝑡 14/hr/60min = .233 cents x 30 = 7 2.50+ 7 = 9.50

You make 25 plates for an awards dinner at $15 a plate.You paid 6 waitstaff $20/hour for 3 hours and 4 kitchen staff $15/hour for 6 hours. Calculate prime cost. Try it on your own before going through the calculations below

𝑃𝑟𝑖𝑚𝑒𝐶𝑜𝑠𝑡=𝑅𝑎𝑤𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡+𝐿𝑎𝑏𝑜𝑟𝐶𝑜𝑠𝑡 labor cost (20/hr x3 hours x 6 staff)= 360 + (15/hr x 6 hours x 4 staff) =360 food cost 15per plate x 25 plates = 375 360+360+375=1095

𝐶𝑜𝑛𝑡𝑟𝑖𝑏𝑢𝑡𝑖𝑜𝑛 𝑚𝑎𝑟𝑔𝑖𝑛=

𝑆𝑎𝑙𝑒𝑠𝑝𝑟𝑖𝑐𝑒𝑝𝑒𝑟𝑢𝑛𝑖𝑡−𝑉𝑎𝑟𝑖𝑎𝑏𝑙𝑒𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡

You spend $0.75 to create one portion of wings. You have a 30% food cost -what should the selling price be?

𝑆𝑒𝑙𝑙𝑖𝑛𝑔𝑃𝑟𝑖𝑐𝑒= (𝐶𝑜𝑠𝑡 𝑡𝑜 𝑚𝑎𝑘𝑒 𝑝𝑒𝑟 𝑢𝑛𝑖𝑡)/ (what you want 𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡 to be(𝑑𝑒𝑐𝑖𝑚𝑎𝑙))=($0.750)/(.30)=$2.50 𝐹𝑜𝑜𝑑𝐶𝑜𝑠𝑡= (𝐶𝑜𝑠𝑡𝑡𝑜𝑚𝑎𝑘𝑒𝑝𝑒𝑟𝑢𝑛𝑖𝑡)/(s𝑒𝑙𝑙𝑖𝑛𝑔𝑃𝑟𝑖𝑐𝑒)

You can also calculate selling price using markup factor and prime cost. 𝑆𝑒𝑙𝑙𝑖𝑛𝑔𝑃𝑟𝑖𝑐𝑒=𝑀𝑎𝑟𝑘𝑢𝑝𝐹𝑎𝑐𝑡𝑜𝑟×𝑃𝑟𝑖𝑚𝑒𝐶𝑜𝑠𝑡

𝑆𝑒𝑙𝑙𝑖𝑛𝑔𝑃𝑟𝑖𝑐𝑒=𝑀𝑎𝑟𝑘𝑢𝑝𝐹𝑎𝑐𝑡𝑜𝑟×𝑃𝑟𝑖𝑚𝑒𝐶𝑜𝑠𝑡

you purchase 8 lbs of apples at $2.99/lb. What is your total AP cost? After peeling and coring, you end up with 6 lbs of apples, giving you yield of 75%. What is your EP cost per lb?

𝑇𝑜𝑡𝑎𝑙𝐴𝑃𝑐𝑜𝑠𝑡=𝐴𝑃𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡×𝐴𝑃𝑞𝑢𝑎𝑛𝑡𝑖𝑡𝑦= $2.99𝑙𝑏×8𝑙𝑏=$23.9 𝐸𝑃𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑙𝑏= (𝐴𝑃 𝑐𝑜𝑠𝑡𝑝𝑒𝑟𝑢𝑛𝑖𝑡)/(𝑌𝑖𝑒𝑙𝑑)=$2.99/𝑙𝑏 (0.75)(the yield)=$3.99