2.6: Taylor-Made Management
- Understand how Frederick Winslow Taylor influenced management theory and how efficiency in management affects current management theory.
The economic upheaval of the Industrial Revolution also witnessed tremendous social upheavals. The U.S. professional classes (lawyers, administrators, doctors) had numerous concerns (McGerr, 2003). Because more and more people were now working in factories, there was the potential for creating a permanent underclass of poorly educated workers struggling to make a living. Many reformers felt that workers could be radicalized and actively try to better their working conditions, pay, and so on, thus disrupting the status quo of the labor markets, leading to strikes, riots, and violence. There were also concerns that money, influence, and pressure from big business were corrupting politics and overriding the will of the people.
The working class had many concerns about their work life. As mentioned earlier, there was a deep fear that work would disappear because of overproduction. There were also concerns over wages, job tenure, and workplace justice. And there was little in the way of standardization regarding how tasks were to be accomplished (Wiebe, 1967). When Frank Gilbreth, a pioneer in scientific management, was apprenticed as a bricklayer in 1885, he noted that he was taught three ways to lay bricks even though there was no need for more than one method.
In the factories, there was little concern for the workers’ physical or mental health, and there were no breaks (Kanigel, 1997). Management and the workforce were in vicious contention with each other. Management would set the rate of work expected for the day, and in response, workers would band together to limit production. This action, called “soldiering,” was a deliberate reduction of productivity on the part of the worker. Those workers who either over- or under-produced could expect that their equipment would be destroyed or that they themselves would be physically harmed. There were very few, if any, incentives provided by management. When managers sought to motivate workers, they did so through physical beatings and other punishments (Kanigel, 1997). Neither side had a reason to trust or cooperate with the other.
Compounding management problems, there was now a demand for managers, but there were few to fill this demand, as little training was provided. Before the Industrial Revolution, companies were largely in the hands of a family or a single owner/manager. As companies were getting larger and more complex and the exchange of goods was taking place across more and more regions, most business owners no longer had the expertise to run such vast geographic and financial enterprises (Wren & Bedeian, 2009). Yet, there was little in the way of management training or education. There were no established scholarly journals, such as the Academy of Management Journal , or practitioner journals, such as the Harvard Business Review . Nor were there business schools until 1881, when the Wharton School of Business at the University of Pennsylvania was established. Business education at this time consisted mostly of classes that taught secretarial work. Allied fields, such as psychology and sociology, were in their infancy. Any existing management education was mostly learned from lessons of history and literature. Although there were numerous examples of both excellent and terrible management, this education was anecdotal and not systematic.
The second phase of the Industrial Revolution commenced with establishing management as a distinct discipline of knowledge. Management’s birth was not in Great Britain but in the United States (Wren & Bedeian, 2009). According to management consultant and educator Peter Drucker, the development of management was one of the United States’ primary contributions to the world, along with the Declaration of Independence (Drucker, 1954). At the same time, management was established, sociology and psychology were developing, and the studies of history and economics were becoming more scientific and formal. Management also became formalized as a field of study using the scientific method. Drucker (1954) stated that the development of management was one of the factors that held off the development of radicalism in the United States because it increased productivity, lowered prices, and increased wages for workers. The success of scientific management lifted workers into the middle class. This crucial development has been attributed to one person in particular: Frederick Winslow Taylor .
Frederick Winslow Taylor (1856–1915) is known as the father of scientific management. Born to a prominent Quaker family in Pennsylvania, he initially planned to go to Harvard and become a lawyer or an executive until he suffered an eye injury that prevented him from reading (Kakar, 1970). With Harvard no longer an option, Taylor went to work at a family friend’s factory, the Midvale Steel Company. Taylor took to the work and was promoted quickly from pattern maker to foreman and then to chief engineer. During this time, he witnessed many acts aimed at limiting or reducing production—including having his tools destroyed—and it was he who coined the term soldiering to describe this deliberate act (Spencer, 1979). Rather than stand by and see such senseless acts affect the business he worked for, Taylor decided to take action. First, he went to the Stevens Institute of Technology to gain a background in engineering. Then, he took this knowledge and applied it to his work.
It is important to note that Taylor was not an original thinker. Many of his ideas came from other thinkers, especially the Englishman Charles Babbage (1791–1871) (Wrege & Greenwood, 1991). Taylor’s contribution was that he advanced a total system of management by uniting the ideas and philosophies of many others. Although he may not have invented the scientific study of management, Taylor contributed to the use and synthesis of management by pioneering the use of time studies, division of labor based on function, cost-control systems, written instruction for workers, planning, and standardized equipment. Taylorism is still the basis of modern management, including the use of incentives. For example, Taylor stressed piecework production, meaning that workers were paid for how much they produced. Taylor also stressed the idea of differential piecework, meaning that if workers produced more than a certain amount, they would be paid more. Some compensation systems, such as sales commissions (i.e., being paid for how much you sell), have their bases in Taylor’s work.
Taylor’s major contribution was his prizing knowledge and science over tradition and rules of thumb. He broke down each act of production into its smallest parts and watched the best workers perform their jobs. Using a stopwatch to time the workers’ actions, Taylor determined the most effective and efficient way to accomplish a given task. After breaking down each job into its components, Taylor then reconstructed them as they should be done. Taylor also developed time management studies to break down a person’s workday into a series of activities. He then timed the execution of each activity to see which way was the quickest. He would rebuild the job using only the most efficient ways possible and then train workers to perform the task. By allowing workers to have rest periods throughout the day, he got workers to work faster and better without making them tired (Taylor, 1919).
Another of Taylor’s significant contributions to the practice and profession of management was the concept of first-class work. When Taylor developed the notion of first-class work, he did so with the idea that workers should do as much work as they are physically and mentally capable of doing. Those who were not physically or mentally capable of keeping up with production and job demands were sent to different areas in the plant where they could work most effectively. First-class work was based not on physical strain or bursts of activity but on what a worker could realistically be expected to do.
Taylor also developed a task management system that allowed work to occur more efficiently and allowed for breaking up a supervisor’s work so that he could function within a discrete area of activities. This focus allowed supervisors to better plan and control the activities for which their workers were responsible. Taylor believed that managers would become better at and more suited to analyzing their specific area of expertise, with authority that came from knowledge and skill and not simply from position or power. He also developed a cost-accounting method that became an integral part of daily planning and control, not something that was applied only to long-term analysis.
Taylorism was based on four principles of management illustrated in Table 2.2.
- Principle 1: A manager should develop a rule of science for each aspect of a job. Following this principle ensures that work is based on objective data gathered through research rather than rules of thumb. For example, many people believed that allowing workers to take breaks would limit how much work could be done. After all, how could a worker produce if he was not working? Taylor changed this attitude through research demonstrating the benefits of breaks during the workday. Due to Taylor’s research, we now enjoy coffee breaks.
- Principle 2. Scientifically select and train each worker. When you get to the chapter on human resource management, you will see that Taylor’s ideas still hold. Before Taylor’s work, workers were selected based on favoritism, nepotism, or random choice. Taylor got his job at Midvale because the owner was his father’s friend.  Taylor changed this viewpoint by using research to find the best worker for the job.
- Principle 3. Management and the workforce should work together to ensure that work is performed according to management principles. Taylor’s observation went against the long-established principles of both management and the worker, who believed that each was the other’s enemy. Rather than enmity, Taylor stressed cooperation and the need for a mutually beneficial working relationship.
- Principle 4. Work and responsibility should be equally divided between management and workers. Previously, management set the directives, and workers obeyed or blocked them. Taylor believed that management and workers had joint responsibilities to each other. Management’s responsibility was to scientifically select the quantity of output for the day and provide a fair wage. In return, workers were to provide a fair day’s work.
| Principles of Scientific Management |
|---|
| First, managers develop a science for each element of a man’s work, which replaces the old rule-of-thumb method. |
| Second, managers scientifically select and then train, teach, and develop the workman, whereas in the past, he chose his own work and trained himself as best he could. |
| Third, managers cooperate heartily with the men to ensure all of the work is being done following the principles of the science that has been developed. |
| Fourth, there is an almost equal division of the work and the responsibility between the management and the workmen. The management takes over all work for which they are better fitted than the workmen, while in the past, almost all of the work and the greater part of the responsibility were thrown upon the men. |
Table 2.2 (Attribution: Copyright Rice University, OpenStax, under CC-BY 4.0 license)
Taylor’s Acolytes
In addition to his groundbreaking work on scientific management, Taylor attracted a wide variety of talented individuals who aided him in his research. The first important individual was the mathematician Carl G. Barth (1860–1939). Barth made two notable contributions. The first was his work on employee fatigue. He attempted to find what aspects made a worker tired. The second was using the slide rule to calculate how much steel to cut. A slide rule is a ruler with a sliding central strip. It makes it possible to perform calculations rapidly and accurately. Barth developed one for cutting steel. Before Barth’s work, workers were required to make difficult calculations to determine how much steel to cut. Usually, they guessed, leading to many errors and waste. With the slide rule, however, the number of errors decreased, as did the associated costs.
Another notable contributor to Taylor’s methods was Henry Gantt (1861–1919), who developed the Gantt chart, which allowed for greater and more precise control over the production process. The Gantt chart, illustrated in Exhibit 2.4, tracked what was supposed to be done versus what was actually done. Gantt gives two principles for his charts: First, measure the time needed to complete an activity. Second, use the space on the chart to visually represent how much of an activity should have been completed in that given time. Today, the closest thing to a Gantt chart is a scheduling system. These charts allowed management to see how projects were progressing, take steps to see if they were on schedule, and monitor budget concerns (Wren & Bedeian, 2009). Gantt also pioneered the employee bonus system, in which employees were given a bonus if they completed their assigned tasks.
The next key contributors to Taylor’s system of scientific management were Frank (1868–1924) and Lillian Gilbreth (1878–1972), a couple that sometimes competed with and sometimes worked with Taylor (Krenn, 2011). Frank Gilbreth was a bricklayer who, before he heard of Taylor, had begun to find ways to limit his fatigue and lay down more bricks more efficiently. Unlike Taylor, Gilbreth was concerned with motion studies , in which he would film various motions while someone worked on the job. To determine the most efficient way to perform a task, for example, Gilbreth reduced all hand motions into some combination of 17 basic motions. Gilbreth would then calculate the most efficient way of carrying out a job. Gilbreth filmed workers performing various jobs, including bricklaying, secretarial duties, and even a baseball game.
When working in construction, Gilbreth developed a management system that included rules about no smoking on the job, a ten-dollar prize for the best suggestion on how to improve labor, and a new training system to teach workers only the best way to perform a task. He developed a rule that all accident sites be photographed for use in future lawsuits. Gilbreth also prepared employees for their present and future positions by introducing a plan for promotion, training, and development. This system required charting promotion paths and record keeping for performance appraisals. He wanted to impress upon both workers and managers an understanding of fatigue and of how to improve pay. In his research, Gilbreth realized that monotony came not from the job itself, but from a worker’s lack of interest in the job.
Lillian Gilbreth may not have originated the industrial psychology movement, but she brought a human element into the study and practice of management with her training and insight. She stated that to understand how to work better, we must understand the worker. Under scientific management, for example, understanding the worker became a fundamental principle in selecting workers for particular tasks and providing workers with incentives. The object was to develop each person to their fullest potential by strengthening their personal traits, special abilities, and skills. After Frank Gilbreth died, Lillian Gilbreth shifted her focus to increasing domestic efficiency and, in the process, designed the modern kitchen.
Taylor’s Shortcomings
Taylor was a monomaniac on a mission to convert as many people to scientific management as possible. Yet despite his conviction and zealousness, Taylor’s ideas were poorly understood, and he attracted more enemies than followers (Wrege & Greenwood, 1991). Taylor attracted enmity from unions because he was against them; he believed that unions separated workers from management. Taylor attracted enmity from the workers because he compared them to apes and other beasts of burden. And Taylor gained the distrust and enmity of management because he criticized them for their previous management failures. Taylor had a difficult personality and angered just about everyone.
Additionally, Taylor made several mistakes. Taylorism, despite its claims, was not an overall theory of management but a management system designed for frontline managers, those immediately supervising. He generally ignored strategy and implementation and thought of workers as machine tools to be manipulated rather than as human beings. Although he was aware of group pressures, he believed that monetary incentives could overcome group pressures. This oversight caused him to ignore the human aspects of handling workers—those that involved emotions, personality, and attitudes.
Although Taylor was certainly a flawed individual, these criticisms do not diminish his great contributions. Taylor dramatically changed management practices and created the modern management world. Future researchers did not replace Taylor but complemented him. What is remarkable about Taylor was not that he was right in his time and place but that his vision continues to have meaning and consequence even today (Locke, 1982). Management was truly Taylor-made.
- List the contributions from Taylor and his associates.
- How did Taylor change management?


13.9: Chapter Review - Review Questions
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Review Questions
1 .
Data must be ___________ to be useful for digital transformation.
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unorganized
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inaccessible
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actionable
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live
2 .
The most common type of database used to power transactional systems is __________.
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NoSQL
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RDBMS
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SQL
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analytical database
3 .
________ link objects together.
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Relationships
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Flat files
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Joins
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Queries
4 .
Which database system should be used for testing and experimentation?
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production database
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development database
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transactional database
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relational database
5 .
Which object in Access stores data for use?
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report
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query
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table
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form
6 .
When would you use Access instead of Excel?
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to store data in multiple tables
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to perform complex numerical analysis
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to create visualizations
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to create a pivot table
7 .
How many databases can be open in Access at one time?
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one
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two
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three
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four
8 .
Queries are used in databases to __________.
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access and prepare records
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raise questions in business discussions
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manage simple datasets
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write questions for presentations
9 .
In a(n) ______ join, the common fields and data between the two tables are looked at and only displays the matches.
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QBE
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outer
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foreign key field
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inner
10 .
The parts of an Access query include __________.
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field names and criteria only
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table names, field names, and other detail
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table names, field names, and sort order
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criteria and sort questions only
11 .
When would you navigate through a database using the navigation buttons on the datasheet?
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when you have many records to look at
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when you want to see thousands of records at a glance
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when you do not want to take the time to create a query
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when you are looking at a small set of records (e.g., from a query)
12 .
Which statement best explains the process of manually adding a record to a database?
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You never add a record manually to a database because this is not a function in Access.
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You are unlikely to add a record manually but can do so when necessary.
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You are likely to add records to ensure that the database matches the production database.
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You will scan records but will not manually input them to update the production database.
13 .
What is the keyboard shortcut to save a record manually?
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Ctrl+Enter
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Shift+Enter
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Ctrl+S
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There is no shortcut, you have to use the Home tab.
14 .
Why should you use reports when working with a database?
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because data is confusing
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because data is ugly
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because reports are attractive
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because reports provide data in a more usable form
15 .
If you want an image to show up at the top of each page of the report, where do you put it?
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detail section
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in the page header
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in the footer
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in the report header
16 .
Reports in Access are best used to summarize what type of information?
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record detail
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header code
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total code
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summary header
17 .
Which tab may not be available unless you select multiple items in the form?
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Form Design
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Format
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Arrange
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Create
18 .
What tool provides an efficient way to create a form?
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Form Wizard
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Form Code
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Form Grid
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Form SQL
19 .
Forms can be created based on __________.
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reports or other forms
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tables or queries
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tables or reports
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queries or other forms


7.13: Customer Retention Techniques
- Identify some customer retention techniques based on collected data
Based on the CRM data of their customers, retail businesses use multiple techniques to encourage customer retention. We are all willing or unwilling participants in these activities on an everyday basis. Your morning email inbox is stuffed with news or offers regarding some sale or incentive from your favorite retailer. Your trip to the gas station may involve a reduced gasoline price based on your prior food shopping trip. When you pick up gardening supplies on your way home from work, you are asked for your rewards number and personalized discount coupons are then generated for future purchases.
Customer retention techniques can start simply with soliciting customer feedback after each interaction with the company to learn ways to improve the customer experience. Often, a customer purchase from a retailer is rewarded with an incentive to purchase again. As the retailer learns more about their customers’ preferences, more communication can be initiated in the form of notifications of upcoming sales events, additional discount offers, cross-marketing campaigns involving related products, etc. This series of actions and responses is sometimes referred to as “High Touch” marketing.
Grocery retailer Kroger retains customers through a “preferred customer club.” To join, customers must provide their contact information and in turn receive a membership card. With every purchase, customers swipe their card enabling Kroger to record and categorize every transaction. This allows the retailer to offer coupons and promotions for their favorite frequent purchases.
Contributors and Attributions
- Customer Retention Techniques. Authored by : Bob Danielson. Provided by : Lumen Learning. License : CC BY: Attribution


14.5: Alexander Technique
By the end of this section, you will be able to:
- Discuss the history of the Alexander Technique for childbirth, including how to find an instructor
- Summarize the benefits to the birthing person during labor and birth when using the Alexander Technique
- Evaluate the education provided to the birthing person regarding self-awareness and releasing muscle tension
- Discuss how the Alexander Technique is taught to the birthing person
- Summarize the positions the birthing person is taught to utilize for comfort using the Alexander Technique
The Alexander Technique is a form of muscle relaxation and positioning to use during pregnancy, labor, and birth. The technique teaches common causes of pain in pregnancy and body mechanics that can help prevent pain and injury to the body during pregnancy. The goal for use in pregnancy is progressive muscle relaxation for the improvement of mindful movement to optimize the body position and health for childbirth.
History of Alexander Technique
F. Matthias Alexander , born in 1869, was an actor who experienced complications from overuse of his voice that impacted his performance. He stumbled upon the solution to his voice problems by learning to release excess tension in his neck and body, which greatly improved his ability to speak, act, and move his body. Over time, he further developed the technique and began training other people to be teachers of the Alexander Technique ( Who was F. Matthias Alexander? , n.d.).
Research Supporting Alexander Technique
Evidence of the efficacy of the Alexander Technique is readily available for all types of chronic pain, health conditions, and discomforts. This method is taught to athletes, dancers, and musicians to improve speed, breathing, and vocal production. There is less evidence specific to pregnancy, but some research can be generalized to overall health and well-being that is relevant to pregnancy as well. Some studies support the Alexander Technique’s use in pregnancy and the postpartum period for improved satisfaction during these formative times of a person’s life (Banoofatemeh et al., 2017; Hanefeld et al., 2021). The technique uses freedom of movement, flexibility, balance, and coordination to allow the pregnant body to birth as it was designed to do.
Benefits of Alexander Technique
Benefits of the Alexander Technique include greater comfort during pregnancy, labor, and birth, as well as improved general well-being leading directly to psychologic well-being due to mind-body integration (Kinsey et al., 2021). These benefits continue for the lifespan as long as the person continues to practice the learned techniques. This technique is especially useful in the early postpartum period, the breast-feeding period, and the first year postpartum when people are most at risk for postpartum mood disorders. The technique teaches that if a person supports their body with these techniques, they can “get out of their own way” and allow the body to birth (Likar & Clare-Newman, n.d., p.1). The technique also discusses breast-feeding and caring for the newborn using proper body technique to avoid strain or injury. Other benefits include improved posture, improved balance and mobility, better stress management, better breathing, and pain relief (Likar & Clare-Newman, n.d.).
Shortcomings of Alexander Technique
The Alexander Technique works best when started early and practiced often with the support of a well-trained instructor. To find an instructor, the birthing person can visit the Alexander Technique website and select their location to find the nearest local practitioner. The drawback to this method is that it can be hard to find an instructor. Some articles and videos are available online for the pregnant person to begin working through techniques to see if this method is helpful for them.
Alexander Technique: Self Awareness and Releasing Muscle Tension
The Alexander Technique for pregnancy includes the concepts of inhibiting and directing. The conscious act of preventing oneself from rushing into an action without thoughtful consideration of the body is inhibiting . Consciously organizing one’s body prior to and during an action so that the head leads the body’s movement is directing . People who practice the Alexander method make measured adjustments to the balance of the head in relation to the rest of the body to reduce tension and resistance within the body to maintain healthy postures (Hanefeld et al., 2021).
Awareness of Posture
Students of this modality learn to undo the tension in their muscles so that their body movements are freer and more relaxed, as in Figure 14.6. Avoidance of compressing the head down to the chest is one of the postural recommendations. Encouraging body awareness and adjusting alignment help practitioners to feel loose, open, and free for movement (Hanefeld et al., 2021).
Deep Breathing
Deep breath work is one component recommended to prepare for pregnancy and birth due to changes in the chest wall and lung function during pregnancy. The Alexander Technique teaches practiced breathing called “ whispered ah ” (Duffee, 2021). This technique states there is a connection between jaw tension and the cervix; therefore, a low breath sound allows the person to relax the mouth and throat muscles, thereby allowing the cervix to relax (Duffee, 2021).
Alexander Technique: Learning the Technique
A few books and online resources exist, but most Alexander Technique educators recommend private classes to customize the teaching to the specific person. The private lessons usually last between 30 and 60 minutes, with the instructor introducing practices that will open awareness of how the nervous, muscular, and skeletal systems function (American Society for the Alexander Technique, n.d.-b). The instructor uses verbal and manual guidance to assist the person in moving with more ease and flexibility. As the student sits, stands, walks, and so forth, the instructor guides the movement to help maintain ease of movement (American Society for the Alexander Technique, n.d.-b).
The American Society for the Alexander Technique has collected a list of research studies on the Alexander Technique that are all peer reviewed.
Thorough History
The teacher assesses the student’s body by addressing any discomforts that may be linked to tension. These can include low back pain, hip pain, sciatic pain, symphysis pubis pain, gastrointestinal complaints, neck pain or tension headaches, and stress. Obtaining a thorough history allows the instructor to personalize the techniques taught.
“Hands-On” Examination
Alexander Technique instructors provide hands-on assessments to help identify muscle tension and enhance postural adjustments for the most benefit during body movements. The instructor will assess all muscles and posture, as shown in Figure 14.7. In-person courses are most effective because of this hands-on evaluation. Teachers of the Alexander Technique are required to be certified in the method. They complete an approved teacher training course and must have 1,600 hours of training over a 3-year period (American Society for the Alexander Technique, n.d.-a). They must also maintain continuing education.
Online Courses
Online courses can successfully teach the Alexander Technique because much of the work is done through self-awareness of one’s own body movements. The person can practice the movements while watching the courses. This also allows students to replay techniques while practicing.
Alexander Technique: Positions for Pregnancy
Typical posture in pregnancy includes an arched back, which causes low back pain. This should be adjusted to a relaxed head and neck in neutral positions with the head leading the spine. This posture is employed in body movements such as sitting in a chair or standing up from a seated position. Suggested movements in pregnancy include squatting, breath work with the whispered “ah,” and release of tension when sitting, standing, and walking (The Alexander Technique, 2023).
Using Alexander Technique in the First Stage of Labor
During the first stage of labor, progress can be assisted by maintaining a relaxed body with continued release of tension before, during, and after contractions. Restful positions like side lying can be alternated with vertical movements and squats to encourage regular progression. The whispered “ah” or a reminder to the self to smile can release the jaw and throat, which may also release the chest and abdomen (The Alexander Technique, 2023).
Using Alexander Technique in the Second Stage of Labor
Similar to the first stage, squats and the whispered “ah” can help create a relaxed pelvic floor that the fetus is able to move through with ease. Pushing with expulsive efforts while directing the movement down without tension in the head and neck can be helpful. Pushing in different positions can also be helpful (The Alexander Technique, 2023).
Breast-Feeding and Alexander Technique
Breast-feeding can be associated with significant neck, shoulder, and back pain. Back pain is one of the most documented conditions that improve with use of the Alexander Technique. Movements to consider would be neutral head position with supported sitting for upright or forward-leaning spine. The breast-feeding person will release tension and support the newborn in a way that prevents hunched shoulders (The Alexander Technique, 2023).
Postpartum Year and Alexander Technique
Reminders to the birthing person to continue to utilize this resource throughout postpartum recovery can encourage wellness and relieve many aches and pains. Positions to consider are the release of upper body strain with a neutral head. Proper sit-to-stand and stand-to-sit techniques with alignment will help prevent pain and injury. As the child grows, they will notice and mimic parental movements of a relaxed posture with free movement (The Alexander Technique, 2023).


15.7: Review Questions
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1.
A home health nurse has several clients who live in the same apartment building. In the last week, the nurse has noticed that both elevators in the four-story building are out of order. Two of the clients live on the second floor and use a wheelchair. The nurse leaves a message for the building manager describing their concern for the clients. This action describes the role of the nurse as
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advocate
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care provider
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consultant
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educator
2.
Routine bloodwork results indicate that a client has type 2 diabetes. The client does not have any of the symptoms the nurse describes that are common with diabetes. The nurse assesses that this client is in which stage of disease?
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Clinical
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Susceptible
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Subclinical
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Underlying
3.
An older individual attends an exercise class in the community’s parks and recreation facility at the recommendation of their primary provider. At a follow-up appointment, the client tells the nurse in the primary care office that they are unable to perform several of the exercises due to problems with vertigo and have stopped attending the classes. The nurse determines that the client is experiencing which type of negative enabling factor?
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Accessibility of services
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Availability of resources
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Community and/or government laws/policies
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Issue-related skills
4.
An individual who is trying to lose weight is dining out with friends. While looking at the menu, they notice that the restaurant includes calorie content with all menu items. How is this information likely to impact the individual’s menu choices?
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It is a barrier.
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It is a cue to action.
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It is an innovation.
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It is perceived susceptibility.
5.
An elementary school nurse has proposed the delivery of a healthy message through the school’s audio system every day. The principal thinks this is a new idea that hasn’t been tried before, the intercom system is easy to use and readily available, and students tend to listen to the announcements provided. The principal is likely applying which theory or model in making their decision?
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The socio-ecological model
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The health belief model
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The transtheoretical model
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The diffusion of innovations theory
6.
A public health nurse is working with community members to develop a walking trail to encourage residents to be outdoors and engage in exercise. Which level of prevention is this nurse practicing?
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Primordial
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Primary
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Secondary
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Tertiary
7.
A community health nurse is developing a community-wide health promotion program to reduce high blood pressure in community members. Which sectors will the nurse need to work with to develop this program?
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The health sector only
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The combined roles of multiple sectors
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The health sector and the food and agriculture sector
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Different sectors for each individual
8.
A public health nurse is working in a rural community. Community members have expressed concerns about the distance necessary to travel and the time it takes to receive medical care. The nurse collaborates with a hospital in the closest city to establish a mobile clinic that visits the community once a week. What enabling factor did the nurse target to improve population health?
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Availability of health care services
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Individual behaviors and lifestyle choices
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Genetic predisposition to disease
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Social and cultural norms
9.
A densely populated urban area has a high prevalence of obesity among the residents. The local government is partnering with the health department to build parks and recreation centers to promote physical activity. Which of the following is the most likely system-related barrier the program faces?
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Genetic predisposition to obesity
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Lack of community engagement
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Individual client attitudes and beliefs
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Limited financial resources
10.
During the COVID-19 pandemic, a public health department wanted to introduce a smartphone application (app) that could track and notify individuals who came into close contact with a confirmed case. However, the department encountered challenges in gaining widespread acceptance and adoption of the new technology. Which concept from the diffusion of innovations theory likely influenced the implementation of the app?
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Trialability
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Observability
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Relative advantage
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Compatibility


6.1: California’s Agricultual Past
In recent years, California has accounted for over one-tenth of the value of the entire U.S. agricultural output. Perhaps more impressive than the value of farm output is the great diversity of crops, the capital intensity, the high yields, and the special nature of the state’s agricultural institutions. California's agriculture evolved differently from what was found in the home states and countries of the immigrants who settled and farmed its soils. These differences were not just an outcome of the state’s distinct geoclimatic features; they were molded by the farmers, laborers, researchers, railroad barons, and policy- makers who interacted to create one of the most productive and dynamic agricultural-industrial complexes in the world.
Want to learn more? Either scan the QR code or visit this link to watch a lecture that introduces the history and future of California’s agriculture. (Video length: 27 min).
The Beginning - 1850
There's been a long-standing debate about whether pre-contact California societies practiced agriculture. Europeans typically defined agriculture by plowing fields, planting crops in rows, and raising domesticated animals. While California's Indigenous peoples didn't follow this model, relying more on hunting and gathering, the argument is that their practices still constituted a form of agriculture.
This perspective hinges on the idea that Indigenous Californians actively managed the ecosystem to maximize resource output. They used fire management techniques to manipulate the land and focused on cultivating specific native plants. In this sense, their approach can be seen as a form of resource management, even if it differed vastly from the European model of intensive agriculture.
Some California hunter-gatherer tribes, including the Owens Valley Paiute, developed irrigation. Native Californians were skilled at gathering resources from plants at all times of the year, allowing the consistent plethora of materials in all seasons. Depending on when the succulents, flowers, and trees bloomed or became ripe, different aspects of the plant could be accessed or harvested by Native California peoples.
Native Californians also developed strategies when it came to competing with animals for resources. The Kashaya Pomo, for example, timed their harvest of dogwood to be before insects and worms would be able to access the inner parts of the plant. Indigenous Californians also developed strategies for acquiring black oak acorns directly from tree branches using a long pole, increasing harvest yields that would otherwise have been disturbed by animals.
Black oak acorn harvests were further increased by cultural burning, which stimulated acorn growth and increased biodiversity in the area. Cultural burning was commonly practiced by throughout California to maintain a healthy landscape that produced quality resources. The Karuk, Yurok, Hupa peoples all regularly burned areas of bear grass and California hazelnut and to encourage the growth of stronger stems that could be used for basketry.
In the late 1700s, Franciscan missionaries established Spanish missions in California. Like earlier Spanish missions established in Baja California, these missions were surrounded by agricultural land, growing crops from Europe and the Americas, and raising animals originating from Europe. Indigenous workers from Baja California made up a large part of the initial labor force on California missions. In the early 1800s, this flow of laborers from Baja California had largely stopped, and the missions relied on converts from local tribes. By 1806, over 20,000 Mission Indians were "attached" to the California missions. As missions were expected to become largely self-sufficient, farming was a critically important Mission industry. George Vancouver visited Mission San Buenaventura in 1793 and noted the wide variety of crops grown: apples, pears, plums, figs, oranges, grapes, peaches, pomegranates, plantain, banana, coconut, sugar cane, indigo, various herbs, and prickly pear. Livestock was raised for meat, wool, leather, and tallow, and for cultivating the land. In 1832, at the height of their prosperity, the missions collectively owned over 150,000 cattle and over 120,000 sheep. They also raised horses, goats, and pigs.
While the Spanish were the most successful farmers active in California in the early 1800s, they were not the only ones. In 1812, the Russians established Fort Ross in what is now Sonoma County, California, and intended the fort in part as an agricultural supply point for other Russian activity on the west coast, such as collecting otter pelts. Despite Russian plans for the colony, agriculture at Fort Ross had low yields, significantly lower than the California missions. Inefficient farming methods, labor shortages, coastal fog, and rodents all contributed to limit agriculture at the fort.
The Spanish (1784–1810) and Mexican (1819–1846) governments gifted many land grants to private individuals from 1785 to 1846. These ranchos included land taken from the missions following government-imposed secularization in 1833, after which the missions' productivity declined significantly. The ranchos were focused on cattle, and hides and tallow were their main products. There was no market for large quantities of beef (before refrigeration and railroads) until the California Gold Rush.
1850–1900
In 1848, before the Gold Rush, the population of CA was approximately 15,000, not counting Native Americans. By 1852, there were over 250,000 people in the state, and by 1870, 560,000 people. This rapid population growth drove an increase in importation of agricultural products, and, within a few years, a massive growth in in-state agriculture. These early settlers found an ideal environment for raising wheat: great expanses of fertile soil and flat terrain combined with rainy winters and hot, dry summers. By the mid-1850s, the state’s wheat output exceeded local consumption, and California’s grain operations began to evolve quite differently from the family farms of the American North. The image is vast tracts of grain grown on huge bonanza ranches in a countryside virtually uninhabited except at harvest and plowing times. California grain farms were very large for the day and used labor-saving and scale-intensive technologies, pioneering the adoption of labor-saving gang plows, large headers, and combines. Californians vigorously pursued the development of technologies and production practices suited to early California’s economic and environmental conditions. This search for large-scale, labor-saving technologies culminated in the perfection of the world’s first commercially successful combined grain harvesters by the Holt Manufacturing Company and other local manufacturers in the early 1880s. Combines became common in the California grain fields by 1890), when California was the second largest wheat-producing state, following only Minnesota.
Some bonanza farms planted thousands of acres and were far larger than Midwestern operations. They would establish many precedents. Most of the wheat and barley was shipped to European markets, setting a pattern of integration into world markets that has characterized California agriculture to the present. Their size, the extent of mechanization, and a reliance on hired labor would also become hallmarks of the state’s farm sector.
In the first years of the gold rush, the state relied on agricultural imports arriving by ship, from Australia, Chile, and Hawaii. During these years, there was rapid growth in vegetable farming for local markets. This was followed by an expansion of grain farming. A shift in the economic dominance of grain farming over cattle raising was marked by the passage of the California "No-Fence Law" of 1874. This repealed the Trespass Act of 1850, which had required farmers to protect their planted fields from free-ranging cattle. The repeal of the Trespass Act required that ranchers fence livestock in, rather than farmers fencing cattle out. The ranchers were faced with either the high expense of fencing large grazing tracts or selling their cattle at ruinous prices. By the 1890s, California was second in US wheat production, producing over one million tons of wheat per year, but monocrop wheat farming had depleted the soil in some areas resulting in reduced crops.
Irrigation was almost nonexistent in California in 1850, but by 1899, 12 percent of the state's improved farmland was irrigated.
1900–1950
The 1902 Newlands Reclamation Act funded irrigation projects on arid lands in 20 states including California.
In 1905, the California legislature passed the University Farm Bill, which called for the establishment of a farm school for the University of California (at the time, Berkeley was the sole campus of the university). The commission took a year to select a site for the campus, a tiny town then known as Davisville. UC Davis opened its doors as the "University Farm" to 40- students (all male) from UC Berkeley in January 1909.
In 1919, the California Department of Food and Agriculture was established. The department covers state food safety, state protection from invasive species, and promoting the state's agricultural industry.
In 1933, the state saw several agricultural labor strikes, with the largest actions against cotton growers. Cherry, grape, peach, pear, sugar beet, and tomato workers were also involved.
The Dust Bowl of the 1930s drove many people from the American prairie, and a significant number of these economic migrants relocated to California. Poor migrants from Oklahoma and nearby states were sometimes referred to as Okies, generally a pejorative term. Another turning point in California’s agriculture came during World War I when high prices of cotton, coupled with government research and promotional campaigns, encouraged farmers in the Imperial, Coachella, and San Joaquin Valleys to adopt cotton as a primary crop. The tremendous absolute increase in California’s cotton acreage from the 1920s to 1980 contrasts with the absolute decline nationally. California’s acreage in cotton ranked 14th out of 15 cotton-producing states in 1919; by 1959 it ranked only behind Texas.
In 1942, the United States began the Bracero program. Lasting until 1964, this agreement established decent living conditions and a minimum wage for Mexican workers in the United States.
Also in 1942, the Incarcerated Japanese Americans in California during World War II played a crucial role in growing food for the internment camps. Forced to abandon their farms upon being placed in camps, many internees possessed valuable agricultural skills. The camps, aiming for some level of self-sufficiency, turned to farming to provide food for the internees themselves. Despite the challenging conditions and limited resources, the internees adapted by cultivating vegetables suited to the local climate. Their success in producing a significant portion of the camps' vegetables, with some even having surpluses sent elsewhere, highlights both the resilience of Japanese Americans and the disruption they faced during this period (Figure 6.2)
1950–2000
In 1965, the Williamson Act became law, providing property tax relief to owners of California farmland and open-space land in exchange for agreement that the land will not be developed.
The 1960s and 1970s saw major farm worker strikes including the 1965 Delano grape strike and the 1970 Salad Bowl strike. In 1975, the California Agricultural Labor Relations Act of 1975 was enacted, establishing the right to collective bargaining for farmworkers in California, a first in U.S. history. Individuals with prominent roles in farm worker organizing in this period include Cesar Chavez, Dolores Huerta, Larry Itliong, and Philip Vera Cruz.
In the late 1980s the Ives flower ranch was the site of a notorious employment case. This ranch was in Ventura and involved Mixtec farm workers (from the Oaxaca state of southern Mexico) and illegal employment conditions. The ranch paid $1.5 million in unpaid wages and fines.
Through 1995 there were 50,000 Mixtec’s every year in California agriculture. They were about 70% of the 10,000 agricultural laborers in San Diego County and had been spreading northwards to also work in Oxnard, Santa Maria, and Madera County, and even into Oregon and Washington. They were usually not the only indigenous Mexican ethnic groups – Zapotecs and Mayans were also usually working the same jobs. In the 1990s it was common to arrive in Arizona first, work on an Arizonan farm, and then move here.
Dairy and poultry operations represent exceptions to the general pattern of slow growth of livestock farming in the first decades of the twentieth century. These activities steadily expanded, primarily to serve the state’s rapidly growing urban markets. In 1993, California replaced Wisconsin as the nation’s number one milk producer
2001–Present
In the 2000s and 2010s, Californians voted for propositions which established new protections for farm animals. 2008 California Proposition 2 and 2018 California Proposition 12 both established minimum requirements for farming egg-laying hens, breeding pigs, and calves raised for veal. Few veal and pig factory farm operations exist in California, so these propositions mostly affect farmers who raise California's 15 million egg-laying hens.


  Since June 26, 2015, same-sex marriage has been legal in all 50 States and American territories except American Samoa and Native American land.[1] [2] Though heterosexuality is viewed as the social "norm" in the United States, many other cultures maintain a very diverse perspective on sexuality and sexual orientation. Various types of sexual orientation are defined below and can be found in many different cultures across the globe.
- Heterosexuality: refers to the emotional and sexual attraction between men and women.
- Homosexuality: refers to the emotionally and sexually attracted to those of the same sex.  It is completely interchangeable with the word "homosexual" but is generally used more casually.
- Bisexuality: Being attracted to two or more genders. It is a common misconception that bisexual people are attracted to their own and the "opposite" gender, specific preferences
vary from person to person and are not limited to cisgendered "men" and "women".[2]
- Pansexuality: Is the sexual, romantic or emotional attraction towards people regardless of their sex or gender identity. Pansexuality is defined differently from other sexual orientations by explicitly including people who are intersex or outside the gender binary.
- Asexual: One that does not experience sexual attraction. Asexuality exists on a spectrum that varies person-to-person, from individuals who are disgusted by the idea of having sex (called Sex Repulsed ) to individuals that can and do feel sexual attraction, but only under specific circumstances (called Demisexuality or Gray-Asexual ) and every option in between. [3]
 There is an embedded stigma within American culture that erases the validity and existence of the transgender community. Oftentimes, transgender people are either highly-sexualized or demonized. Starting in the early 1990s, political activists began challenging the opprobrium associated with being transgender and started to put pressure on the government to recognize the rights of gender variants.  However, according to American Anthropologist David Valentine, many individuals resist the label "transgender" because it is overly inclusive.  Additionally, these activists are primarily white and middle-class, which contributes to the erasure of racial minority transgenders. While the meaning of "transgender" is still in formation, it is still very clear that American culture still resists accepting people who identify as neither male nor female, instead, they prefer to just be a person. This may be due in part to the idea that Americans view transgenderism as an expression of perverse sexuality, but, regardless, it is imperative that we acknowledge the rights and legitimacy of the transgender community.
Romantic Orientation
Romantic Orientation, also known as Affectional Orientation, indicates the sex or gender with which a person is most likely to have a romantic relationship or fall in love. It is used both alternatively and side-by-side with the term sexual orientation . It is based on the perspective that sexual attraction is but a single component of a larger dynamic. For example, although a pansexual person may feel sexually attracted to people regardless of sex or gender identity, they may be predisposed to romantic intimacy with females. For polyromantic people, they are attracted to many but not all genders, also known as asexual. For asexual people, romantic orientation is often considered a more useful measure of attraction than sexual orientation.[3]
People may or may not engage in purely emotional romantic relationships. The main identities relating to this are:
- Aromantic: Lack of romantic attraction towards anyone (aromanticism)
- Heteroromantic: Romantic attraction towards person(s) of one gender other than their own (heteroromanticism).
- Homoromantic: Romantic attraction towards person(s) of the same gender (homoromanticism).
- Biromantic: Romantic attraction towards person(s) of two genders (biromanticism).
- Panromantic: Romantic attraction towards person(s) of any and all genders (pan romanticism).
- Polyromantic: Romantic attraction toward multiple people, but not all genders.
- Gray-romantic: Individuals who do not often experience romantic attraction.
- Demiromantic: Romantic attraction towards any of the above but only after forming a deep emotional bond with the person(s) (demiromanticism).[4]
Cultural Examples of LGBTQ Relationships
Two-Spirit
In many North American indigenous tribes, a person could be two-spirit. These people were generally viewed as having two spirits within them; both masculine and feminine. They dressed using both male and female garments and filled an essential and respected role in society. They generally took on this role around puberty. Male-bodied two-spirit's could be gravediggers, conductors of rituals, nurses during the war, craftspeople, storytellers, etc. Female-bodied two-spirit's could be traders, warriors, chiefs, hunters, guides, etc. Both could be diviners or medicine people. It was generally accepted that two-spirit's had a special power; they could have relationships with people of any sex, and the relationship was viewed more as "hetero-gender" than specifically homosexual or heterosexual. In today's world, the role is being reclaimed by Native Americans who identify as such.
Lesbianism in Mombasa
Anthropologist Gill Shepherd[5] explored female sexual relationships among Swahili Muslims in Mombasa, Kenya, and found that relationships between females were perfectly acceptable, as were relationships between men. Women are allowed to choose other women as sexual partners after they are married. Many such women also have a husband at home, are widowed, or divorced.   Having a woman for a lover is less important than a woman's rank, and her being a good Muslim. A relationship may be set up in a number of ways. A young woman can go around to wealthy lesbian circles in order to find a lover. A wealthy woman may not want her autonomy diminished by a husband and so establishes a relationship with another woman so that she may continue in her independence. A wealthy woman may set up a marriage of convenience with a man for a poorer woman so that when they are divorced soon after the poorer woman will live with her lesbian benefactress. The relationships are not stigmatized and having a lesbian relationship, while less respectable than being married to a man, is nonetheless better than not being married at all. The relationships can or cannot include a sexual relationship, but a sexual relationship is more likely when one woman pays a bride-price, the exchange of a bride for money, land, or other property from the fiance's family, and constructs her own compound.
Sexuality in Ancient Greece
In Ancient Greece, same-sex relationships between men were considered the highest form of love; they were just as common and accepted as heterosexual relationships of today. This male-male relationship was based on love and reciprocity and typically called for the older man to initiate the relationship. He would give gifts to the younger man as a promise of love.[6] These relationships were thought to be the highest form of love because they showed that the men regarded furthering themselves in knowledge and intelligence rather than just a physical connection. Some who did not attempt to make this connection were seen as "shallow." The older man would become the mentor and lover to the younger man, and the two would form a close emotional bond. The youth would be taught his duties as a citizen, and skills to further his place in society by the older man, and once the youth reached adulthood, the sexual relationship between the two men evolved into a very strong friendship. As an adult, the youth would then marry a woman, and initiate a relationship with another adolescent.
An exclusively homosexual relationship was discouraged, however, and not considered a substitute for male-female marriage. Marriage and the children that would be produced within it was required to maintain both the family and society. The wives were viewed by their husbands as domestics and child bearers.[4]. While the men were away with their young lovers, women raised children and took care of the household. Women were discouraged from taking lovers outside of the marriage to bed.
Ritual Homosexuality of the Sambia
In 1981, the American anthropologist, Gilbert Herdt described the pseudonymous "Sambia" people, a tribe located in Papua New Guinea. They are remarkable for their beliefs about human fertility cycles and the rites of passage they constructed, as a result.[5] Rites of passage being rituals that are carried out inorder for an individual to transition from one state in life to another. In this case the Sambia people of Papua New Guinea have a rite of passage that allow young boys to become men, and viable husbands in the future. The Sambia place the onus of reproductive vitality on the male, believing that the baby is formed in the mother's womb by the father's life-giving semen. The child then gets all nourishment from the mother's milk, which causes them to grow and develop in the early stage of life. At the onset of puberty, however, it is believed that to develop any further the child must be reintroduced to the life-giving semen—the male's analog to milk. However, since they view semen as a highly scarce, albeit necessary resource for development, it must be carefully distributed among their people.  It's thought that by doing this they will develop into strong and reproductively viable human beings. Around the age of 14, the boys switch places and become the fellated, providing the necessary sustenance for the next generation to develop. Interestingly, the cultural practices of secret initiations diminished across the 1980s and by 1990 the secret initiation rituals were no longer practiced.[7]
Rights of Sexuality
Family Rights of LGBQT Couples
In March 2016, U.S. District Judge, Daniel Jordan, ruled that Mississippi's long-held ban on same-sex parents adoption was unconstitutional. He cited the Supreme Court's decision in the Obergefell vs. Hodges court case that made same-sex marriage legal in all 50 states in 2015. Mississippi was the last state with such a ban, meaning that it is now legal for gay parents to adopt children in all 50 states. The ban, which simply states "adoption by couples of the same gender is prohibited" had been in place since 2000. Overturning this law was a long, overdue change that even the man who signed it into being, Former Mississippi Governor, Ronnie Musgrove, believed should be overturned. He has said that "this decision that all of us made together has made it harder for an untold number of children to grow up healthy and happy in Mississippi -- and that breaks my heart."[8]
Obergefell vs. Hodges
Obergefell vs. Hodges is the supreme court case that made same-sex marriage legal in all 50 states on June 26, 2015. It was decided by a 5-4 vote between Judges, Stephen G. Breyer, Ruth Bader Ginsburg, Elena Kagan, Anthony Kennedy, and Sonia Sotomayer voting in favor of same-sex marriage, and judges Samuel Alito, John Roberts, Antonin Scalia, and Clarence Thomas dissenting.[9] LGBTQ+ American's throughout the country celebrated, many buildings including the White House, the Empire State Building, and the Space Needle were lit up in rainbow colors. It was a huge victory for all of the people throughout history who have fought for equal marriage rights and for the millions of LGBT people in the United States.
Sexual Harassment
The definition of sexual harassment is, "harassment in a workplace or other professional or social situation, involving the making of unwanted sexual advances or obscene remarks" [6] . An example of sexual harassment in schooling could be teasing someone about their body parts, snapping a girl's bra strap, catcalling, touching or slapping private areas, or asking unwanted questions repeatedly.
Although in the U.S laws do not prohibit simple teasing, offhand comments or isolated incidents, harassment is illegal when it is frequent enough to create a hostile or offensive work environment. The are several consequences for individuals who harass in the workplace such as losing their job or having a restraining order.The International Labor Organization is a specialized United Nations agency that has addressed sexual harassment as a prohibited form of sex discrimination under the discrimination convention [7] . When looking at sexual harassment in culture, it is typical in most cultures that women are the most vulnerable to the abuse. However, in the Kung culture, both men and women are seen as aggressive. Women especially are abusive verbally and tend to tease and provoke others. In Saudi Arabia, in specific the culture and Islam religion (which construct the country's laws) are against sexual harassment and display this in many ways. If an individual harasses a woman then the woman has the right to report it and the punishment for the man is jail time.
Heteronormativity : The idea that relationships between men and women are the norm, often resulting in harassment from believers of the idea. This also infers that men and women will follow the social guidelines presented by their gender.
Homophobia , [8] is the hatred, prejudice, and fear of someone who is sexually interested in someone of the same-sex. Often this has to do with direct aggression, violence, and discrimination of homosexuals so that their daily lives are directly affected. If someone is a homophobe they tend to treat homosexuals differently, typically looking down on them in society, this causes them to be isolated from society. Homophobia usually leads to homosexuals not receiving the same benefits as heterosexual couples, in many countries homosexuality is illegal. Homophobia can be psychologically as well as physically harmful to those who identify as homosexual.
Acephobia is the discrimination and hatred or mistreatment of asexual people. This is very similar to homophobia, and is often expressed through microaggressions , which are everyday actions or words that are common throughout society and reaffirm the privilege of the aggressor, [9] or identity erasure . These microaggressions can be extremely harmful and oppressive over time. For instance, if an asexual person's relative continually nags them about getting a boyfriend or girlfriend, this will over time wear on the person and cause them to emotional harm and distress. Microaggressions like this are so common because society in the modern United States is highly sexualized; whether talking about branding, advertisement, or popular culture, there's a huge emphasis on sex and sexuality.[10] Acephobia is a direct result of this societal norm. Non-asexual people are not only the statistical majority, they're also the only culturally represented group which leads to a common belief (often proclaimed as "truth") that everyone experiences sex and sexual feelings in the same way. Though the development of that mindset is somewhat explainable, the negative effects it has on asexual people are devastating. Commonly, asexual people are told their identity is "just a phase" that they will "grow out of", or that "plenty of people chose not to have sex". The most major problems with these phrases is that they both erase and invalidate the perfectly valid identity of the asexual individual by implying that asexuality is both a choice and/or a "phase" when in fact it is neither.[11] These types of acephobia are harmful not just to the individual they are addressing but also to young and future asexuals who will grow up with those prejudices taught as truth and will probably believe they are somehow "broken" as most asexuals do before discovering the asexual community.


23.6: Motional Emf
Learning Objectives
By the end of this section, you will be able to:
- Calculate emf, force, magnetic field, and work due to the motion of an object in a magnetic field.
As we have seen, any change in magnetic flux induces an emf opposing that change—a process known as induction. Motion is one of the major causes of induction. For example, a magnet moved toward a coil induces an emf, and a coil moved toward a magnet produces a similar emf. In this section, we concentrate on motion in a magnetic field that is stationary relative to the Earth, producing what is loosely called motional emf.
One situation where motional emf occurs is known as the Hall effect and has already been examined. Charges moving in a magnetic field experience the magnetic force \(F = qvB\sin{\theta}\), which moves opposite charges in opposite directions and produces an \(emf = Blv\). We saw that the Hall effect has applications, including measurements of \(B\) and \(v\). We will now see that the Hall effect is one aspect of the broader phenomenon of induction, and we will find that motional emf can be used as a power source.
Consider the situation shown in Figure \(\PageIndex{1}\). A rod is moved at a speed \(v\) along a pair of conducting rails separated by a distance \(l\) in a uniform magnetic field \(B\). The rails are stationary relative to \(B\) and are connected to a stationary resistor \(R\). The resistor could be anything from a light bulb to a voltmeter. Consider the area enclosed by the moving rod, rails, and resistor. \(B\) is perpendicular to this area, and the area is increasing as the rod moves. Thus the magnetic flux enclosed by the rails, rod, and resistor is increasing. When flux changes, an emf is induced according to Faraday’s law of induction.
To find the magnitude of emf induced along the moving rod, we use Faraday’s law of induction without the sign:
\[emf = N\frac{\Delta \Phi}{\Delta t}.\label{23.4.1}\]
Here and below, “emf” implies the magnitude of the emf. In this equation, \(N = 1\) and the flux \(\Phi = BA\cos{\theta}\). We have \(\theta = 0^{\circ}\) and \(\cos{\theta} = 1\), since \(B\) is perpendicular to \(A\). Now \(\Delta \Phi = \Delta \left(BA\right) = B \Delta A\), since \(B\) is uniform. Note that the area swept out by the rod is \(\Delta A = l\Delta x\). Entering these quantities into the expression for emf yields
\[emf = \frac{B\Delta A}{\Delta t} = B\frac{l\Delta x}{\Delta t}.\label{23.4.2}\]
Finally, note that \(\Delta x/ \Delta t = v\), the velocity of the rod. Entering this into the last expression shows that
\[emf = Blv \left(B, l, and \quad v \quad perpendicular\right)\label{23.4.3}\]
is the motional emf. This is the same expression given for the Hall effect previously..
MAKING CONNECTIONS: UNIFICATION OF FORCES:
There are many connections between the electric force and the magnetic force. The fact that a moving electric field produces a magnetic field and, conversely, a moving magnetic field produces an electric field is part of why electric and magnetic forces are now considered to be different manifestations of the same force. This classic unification of electric and magnetic forces into what is called the electromagnetic force is the inspiration for contemporary efforts to unify other basic forces.
To find the direction of the induced field, the direction of the current, and the polarity of the induced emf, we apply Lenz’s law as explained in "Faraday's Law of Induction: Lenz's Law" (Figure \(\PageIndex{1b}\)).
Flux is increasing, since the area enclosed is increasing. Thus the induced field must oppose the existing one and be out of the page. And so the RHR-2 requires that I be counterclockwise, which in turn means the top of the rod is positive as shown.
Motional emf also occurs if the magnetic field moves and the rod (or other object) is stationary relative to the Earth (or some observer). We have seen an example of this in the situation where a moving magnet induces an emf in a stationary coil. It is the relative motion that is important. What is emerging in these observations is a connection between magnetic and electric fields. A moving magnetic field produces an electric field through its induced emf. We already have seen that a moving electric field produces a magnetic field—moving charge implies moving electric field and moving charge produces a magnetic field.
Motional emfs in the Earth’s weak magnetic field are not ordinarily very large, or we would notice voltage along metal rods, such as a screwdriver, during ordinary motions. For example, a simple calculation of the motional emf of a 1 m rod moving at 3.0 m/s perpendicular to the Earth’s field gives \(emf = Blv = \left(5.0 \times 10^{-5} T\right)\left(1.0 m\right)\left(3.0 m/s\right) = 150 \mu V\). This small value is consistent with experience. There is a spectacular exception, however. In 1992 and 1996, attempts were made with the space shuttle to create large motional emfs. The Tethered Satellite was to be let out on a 20 km length of wire as shown in Figure 2, to create a 5 kV emf by moving at orbital speed through the Earth’s field. This emf could be used to convert some of the shuttle’s kinetic and potential energy into electrical energy if a complete circuit could be made. To complete the circuit, the stationary ionosphere was to supply a return path for the current to flow. (The ionosphere is the rarefied and partially ionized atmosphere at orbital altitudes. It conducts because of the ionization. The ionosphere serves the same function as the stationary rails and connecting resistor in Figure 1, without which there would not be a complete circuit.) Drag on the current in the cable due to the magnetic force \(F = IlB\sin{\theta}\) does the work that reduces the shuttle’s kinetic and potential energy and allows it to be converted to electrical energy. The tests were both unsuccessful. In the first, the cable hung up and could only be extended a couple of hundred meters; in the second, the cable broke when almost fully extended. The example below indicates feasibility in principle.
Example \(\PageIndex{1}\): Calculating the Large Motional Emf of an Object in Orbit
Calculate the motional emf induced along a 20.0 km long conductor moving at an orbital speed of 7.80 km/s perpendicular to the Earth’s \(5.00 \times 10^{-5} T\) magnetic field.
Strategy:
This is a straightforward application of the expression for motional emf--\(emf = Blv\).
Solution:
Entering the given values into \(emf = Blv\) gives \[emf = Blv\] \[= \left(5.00 \times 10^{-5} T\right)\left(2.0 \times 10^{4} m\right)\left(7.80 \times 10^{3} m/s\right)\] \[= 7.80 \times 10^{3} V.\]
Discussion:
The value obtained is greater than the 5 kV measured voltage for the shuttle experiment, since the actual orbital motion of the tether is not perpendicular to the Earth’s field. The 7.80 kV value is the maximum emf obtained when \(\theta = 90^{\circ}\) and \(\sin{\theta} = 1\).
Summary
- An emf induced by motion relative to a magnetic field \(B\) is called a motional emf and is given by \[emf = Blv \left(B,l, and \quad v \quad perpendicular\right),\] where \(l\) is the length of the object moving at speed \(v\) relative to the field.


6.2: Nutrition and Fluid Needs
Nursing assistants (NAs) help clients meet their nutritional and fluid needs as they assist them with their activities of daily living. Let’s begin by reviewing the anatomy and physiology of the gastrointestinal system.
Anatomy and Physiology of the Gastrointestinal System
The gastrointestinal system (also referred to as the digestive system) is responsible for several functions, including digestion, absorption, and immune response. Digestion begins at the mouth, where chewing of food occurs. This is called mechanical digestion. If food is not broken down mechanically by the teeth, it is very difficult to digest, and it also increases the risk of choking. If there are any concerns with missing or broken teeth, dentures that don’t fit well, or any pain or open areas in the mouth, the NA should report these concerns to the nurse immediately.
After food is chewed and swallowed, it goes into the stomach via the esophagus. Involuntary movement, called peristalsis, allows the food to enter the stomach to mix with acidic gastric juices. The breaking down of food with these acids is called chemical digestion. From the stomach, the liquid food (called chyme) passes through the small and large intestine where nutrients and water are absorbed into the bloodstream. Waste products are condensed into feces and excreted through the anus. [1] , [2] More information on the structure and function of the digestive system will be covered in Chapter 11 .
Appropriate food and fluid intake are essential to good health, so anything that potentially decreases a client’s appetite must be addressed. For example, all five senses decline in functioning to some extent in older adults. It is important for the NA to provide accommodations that address these declines in sensory function that can impact food intake and overall health. Enhancing food intake in older adults with altered sensory function includes the following accommodations:
- Vision
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- If the resident is known to wear glasses, ensure they are wearing them, and the lenses are clean. Seeing food often stimulates the desire to eat.
- Explain what is on the meal tray if the client has significant visual impairment. It is helpful to use the “clock method,” such as, “On your plate, your peas are at 3 o’clock, your roast beef is at 6 o’clock, and your mashed potatoes are at 9 o’clock.”
- If a resident has a pureed diet order, review their menu so you can describe each type of food in an appealing manner.
- Make meals look as attractive as possible. Take food off trays and avoid using plastic utensils and disposable cups whenever possible so the resident feels as if they are having a meal at home.
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Hearing
- If the resident has hearing aids, ensure they are in place, charged, and functioning so they can hear you describe the food.
- Ask if music is preferred during mealtime.
- When seating residents in a public eating area, ensure they are seated with others with similar cognitive status so they may enjoy conversation while eating.
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Touch
- Encourage the resident to eat as independently as possible by using adaptive silverware or other meal aids. Occupational therapists can assess the needs of the resident and provide adaptive equipment.
- If utensils can’t be held by the resident, try using finger foods such as fruit, bread, or crackers.
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Smell
- If possible, dietary staff should prepare meals near resident rooms because the aroma of cooking food may increase hunger.
- If a client is eating a meal in their room, clear the room of unpleasant odors or sights. For example, empty the trash can if it has soiled incontinence products, and empty urinals that may be sitting on side tables.
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Taste
- Check the diet order. If the order permits, ask residents if they prefer seasoning or condiments.
- Ensure hot foods are served hot and cold foods are served cold. Judge the temperature of the food by placing your hand above the food to sense heat, but do not touch the food directly with your hand. Rewarm hot foods that have cooled.
- If the resident does not like the meal choice, find an alternative food that appeals to them.
Refer to the “ Assisting With Nutrition and Fluid Needs ” section and the checklist “ Preparing Clients for Meals and Assisting With Feeding ” in Chapter 5 for specific steps and additional insight on feeding a dependent client.
Macronutrients
In hospitals and long-term care facilities, the dietician assesses clients periodically to ensure that their nutritional and fluid needs are met. However, when providing care in a group home, assisted living, or home health, NAs are often responsible for creating meals. It is important to understand basic nutritional concepts so you can address your clients’ nutritional needs.
Macronutrients make up most of a person’s diet and provide energy, as well as essential nutrient intake. Macronutrients include carbohydrates, proteins, and fats. However, too many macronutrients without associated physical activity cause excess nutrition that can lead to obesity, cardiovascular disease, diabetes mellitus, kidney disease, and other chronic diseases. Conversely, too few macronutrients contribute to nutrient deficiencies and malnourishment. [3]
Carbohydrates are sugars and starches and are an important energy source. Each gram of carbohydrates provides four calories. Carbohydrates break down into glucose and raise blood sugar levels. Diabetics should limit carbohydrate intake to maintain blood sugar levels in a healthy range.
Proteins are peptides and amino acids that provide four calories per gram. Proteins are necessary for tissue repair and function, growth, energy, fluid balance, clotting, and the production of white blood cells.
Fats consist of fatty acids and glycerol and are essential for tissue growth, insulation, energy, energy storage, and hormone production. Each gram of fat provides nine calories.  Due to its high-calorie content, a little fat goes a long way. [4]
Fats are classified as saturated, unsaturated, and trans fatty acids. Saturated fats come from animal products, such as butter and red meat (e.g., steak). Saturated fats are solid at room temperature. Recommended intake of saturated fats is less than 10% of daily calories because saturated fat raises cholesterol and contributes to heart disease. [5]
Unsaturated fats come from oils and plants, although chicken and fish also contain some unsaturated fats. Unsaturated fats are healthier than saturated fats. Examples of unsaturated fats include olive oil, canola oil, avocados, almonds, and pumpkin seeds. Fats containing omega-3 fatty acids are considered polyunsaturated fats and help lower cholesterol levels. Fish and other seafood are excellent sources of omega-3 fatty acids. [6]
Trans fats are fats that have been altered through a hydrogenation process, so they are not in their natural state.  Trans fats are found in processed foods, such as chips, crackers, and cookies, as well as in some margarines and salad dressings. Minimal trans-fat intake is recommended because it increases cholesterol and contributes to heart disease. [7]
Choosing Food Groups to Meet Macronutrient Needs
Good resources for healthy nutritional choices are the USDA’s “My Plate” guidelines. [8] By using a plate as a visual, sections on the plate illustrate general amounts of the different types of food groups that should be eaten every meal, including fruits and vegetables, grains, protein, and dairy. See Figure 6.1 [9] for an image of the USDA’s “My Plate” guidelines.
About half the plate should be fruits and vegetables that provide many nutrients, as well as fiber for healthy bowel elimination.  Fresh fruits and vegetables are the best choice, but frozen options have similar nutritional value. Frozen produce can also be more cost-effective because it doesn’t spoil and can save time as the food is already cleaned and chopped. A variety of colors of fruits and vegetables not only makes the plate visually appealing, but also provides the greatest array of nutrients.
About 25% of the plate should be grains. Pasta, cereal, and bread are sources of grains. Types of grains include wheat, corn, rice, oats, barley, and quinoa. Grains are low in fat and cholesterol but have high carbohydrate and fiber content. The fiber content in grains can be helpful in preventing constipation and lowering cholesterol. Due to the high carbohydrate content of grains, they may need to be limited for clients with diabetes.
The remaining 25% of the plate should contain protein sources. Common proteins include soy, quinoa, eggs, fish, meat, nuts and seeds, legumes (beans), and dairy products. Just as with the other food groups, a variety of protein selections provides the most nutrients. Red meat can contain a lot of fat and cholesterol, so lean cuts are preferred for heart health. Fish, especially salmon, has healthy fat and should be consumed twice weekly. Nuts, seeds, and legumes are low in saturated fat and high in fiber, which also make them a good choice for protein.
Dairy choices are important for calcium intake that aids in bone health. Calcium intake is important for older adults because they naturally retain less calcium and are at higher risk for bone fractures. Dairy products include milk, lactose-free milk, soy milk, buttermilk, cheese, yogurt, and kefir. Sour cream and cream cheese are not considered dairy items in terms of nutritional benefits. Adults should consume about three cups of dairy per day.
Choosing whole foods that are unprocessed, or as close to their original form as possible, is important to feeling full and stabilizing blood sugar because it takes longer to digest unprocessed foods. Think about eating an apple as compared to drinking apple juice. The whole apple will take a long time to chew and chemically break down to chyme, whereas the juice is ready to move through the digestive tract immediately. Eating whole foods can also reduce salt, fat, and sugar intake because they have no additives and can keep blood pressure, blood sugar, and cholesterol levels lower.
Read additional information about My Plate guidelines at https://www.myplate.gov/.
Fluid Intake
Fluid intake comes from both liquids and foods. For example, most fruits and vegetables contain a lot of water, so they contribute to fluid intake. See Table 6.2 [10] for water content in various foods.
Table 6.2 Water Content in Foods
| Percentage | Food Items |
|---|---|
| 90-99 | Nonfat milk, cantaloupe, strawberries, watermelon, lettuce, cabbage, celery, spinach, squash |
| 80-89 | Fruit juice, yogurt, apples, grapes, oranges, carrots, broccoli, pears, pineapple |
| 70-79 | Bananas, avocados, cottage cheese, ricotta cheese, baked potato, shrimp |
| 60-69 | Pasta, legumes, salmon, chicken breast |
| 50-59 | Ground beef, hot dogs, steak, feta cheese |
| 40-49 | Pizza |
| 30-39 | Cheddar cheese, bagels, bread |
| 20-29 | Pepperoni, cake, biscuits |
| 10-19 | Butter, margarine, raisins |
| 1-9 | Walnuts, dry-roasted peanuts, crackers, cereals, pretzels, peanut butter |
| 0 | Oils, sugars |
The average fluid intake in adults per day is 1.5 liters of fluids with additional 700 milliliters (mL) of water gained from solid foods. About 2.5 liters of fluid are excreted daily in adults in urine, feces, respiration, and other body fluids like sweat and saliva. [11]
There is some debate over the amount of water required to maintain health. There is no consistent scientific evidence proving that drinking a particular amount of water improves health or reduces the risk of disease. Additionally, the amount of fluids a person consumes daily is variable and based on their climate, age, physical activity level, and kidney function. [12]
Our bodies are constantly trying to balance our fluid volume using the physiological mechanisms of thirst and urine output.  As people age, their thirst mechanism becomes less responsive, causing a higher risk of dehydration. See Figure 6.2 [13] for an illustration of the thirst response. Thirst occurs in the following sequence of physiological events:
- Receptors in the kidney, heart, and hypothalamus detect decreased fluid volume or increased sodium concentration in the blood.
- Hormonal and neural messages are relayed to the brain’s thirst center in the hypothalamus.
- The hypothalamus sends neural signals stimulating the conscious thought to drink.
- Fluids are consumed.
- Receptors in the mouth and stomach detect mechanical movements involved with fluid ingestion.
Thirst is a subconscious physiological mechanism to stimulate water intake. However, actual fluid intake is controlled by conscious eating and drinking habits that are influenced by cognitive, social, and cultural factors. For example, some individuals have a habit of drinking a glass of orange juice, coffee, or milk every morning before going to school or work. Conversely, older adults often have decreased fluid intake due to physical or cognitive challenges in obtaining or drinking fluids. For this reason, older adults often require assistance to maintain a healthy intake of fluids.
Due to the decreased thirst response in older adults, it is important to prevent dehydration by encouraging fluid intake even when they don’t feel thirsty. Dehydration can lead to confusion, falls, and bladder infections. Signs of dehydration include the following [15] :
- Dry mouth or other mucous membranes
- Dry skin or skin that does not return to normal shape when gently pinched
- Dark urine or urine amounts smaller than 200-300 mL
- Headache
- Dizziness
- Rapid heart rate
- Low blood pressure
If signs or symptoms of dehydration are noted, these concerns should be reported to the supervising nurse, and fluid intake should be encouraged as tolerated.
In hospitals and long-term care facilities, dieticians often determine the amount of daily fluid intake for clients. Fluid restrictions may be prescribed by the health care provider based on the client’s medical condition. Fluid restrictions are further discussed in the following “Modified Diets” subsection.
Cultural and Religious Considerations With Nutritional Intake
Cultural and religious beliefs often influence a client’s food selection and food intake. Dieticians and nurses assess a client’s cultural and religious preferences on admission to a facility, but NAs should continually ask clients about their food and fluid preferences. A particular diet should never be assumed based on a client’s stated culture or religion.
Cultural beliefs may affect the types of food eaten, as well as when they are eaten. Some foods may be restricted due to cultural beliefs or religious rituals, whereas other foods may be viewed as part of the healing process. For example, some individuals choose not to eat pork because of cultural or religious beliefs that consider pork unclean. Other individuals choose to eat “kosher” food because its method of preparation fits with their religious guidelines. Additionally, some individuals avoid eating during certain times. For example, some clients’ religious beliefs encourage fasting on religious holidays from sunrise to sunset, whereas other individuals avoid eating meat during their religious season of Lent. [16]
Modified Diets
Some individuals require limitations of certain foods or fluids due to medical circumstances, illnesses, or chronic diseases. For these reasons, the provider may order a modified diet, also referred to as a “therapeutic diet,” based on recommendations from a dietician. A modified diet is any diet altered to include or exclude certain components. For example, a client may have a modified diet order due to an upcoming test or procedure, a specific medical condition like diabetes, an allergy like a gluten allergy, or to lose weight.
As previously discussed in Chapter 5, it is critical for the NA to verify the diet orders for every client and then verify the food and fluids on their meal trays are correct based on the diet order. Here are some of the most common diet orders:
- Low-Sodium: Salt intake is commonly restricted for individuals with high blood pressure, heart failure, and kidney disease. Salt substitutes may be offered and high sodium condiments, such as ketchup, soy, barbecue and steak sauces, are avoided. This diet is commonly abbreviated as Low NA (sodium) or NAS (No added salt/sodium).
- Low-Fat: A low-fat diet is commonly prescribed for individuals with high cholesterol, heart disease, or arterial circulation problems. High-fat dairy and meat products, fried foods, desserts, and baked goods are avoided. However, healthy fats can be consumed from plant-based sources such as olive oil, nuts, avocados, and salmon.
- Low-Residue or Low-Fiber: Low-residue or low-fiber diets are commonly prescribed for individuals with bowel disorders. Fiber is found in grains, seeds, fruits, and vegetables, so these food choices are typically avoided.
- Diabetic or Carb-Controlled: Carb-controlled diets are typically prescribed for individuals with diabetes to help keep their blood sugar in a healthy range. This diet includes reduced intake of carbohydrates, especially from processed sources such as juices, starches such as potatoes and bread, and cereal or pasta that is not whole grain. Good carbohydrate sources include whole fruits and vegetables. Fat intake may also be restricted because it can elevate blood sugar levels. This diet is commonly abbreviated as CHO or CCHO. Many clients with diabetes have orders for a bedside blood glucose test before eating; ensure this test is completed and/or reported to the nurse.
- Gluten-Free: The gluten-free diet is typically prescribed for people with gastrointestinal conditions such as celiac disease or irritable bowel syndrome because their symptoms are aggravated by gluten. Gluten is found in wheat, rye, and barley, so rice, oats, and quinoa are good substitutes. There are many gluten-free pasta, cereal, and bread products available.
- Lactose-Free: Lactose is removed from the diet for individuals who are lactose intolerant. Lactose is found in milk and dairy products. Soy, almond, or rice milk are good substitutes that provide calcium.
- Fluid Restriction: Fluid restriction orders may be temporary, such as several hours before surgery, or permanent, such as for clients with kidney failure or heart failure. The provider prescribes the amount of fluid a person should consume in one day. In a hospital or facility, this amount is typically split across shifts based on meal and snack times while also taking into consideration fluids consumed with medications. Clients on fluid restrictions will also have their fluid intake and output tracked and documented daily as previously discussed in Chapter 5.
- NPO : NPO is a common medical abbreviation referring to “nothing by mouth.” NPO may be a temporary order, such as 8-12 hours before surgery, or a permanent order, such as for an individual with a permanent feeding tube due to dysphagia. Dysphagia refers to difficulty swallowing that can cause aspiration of liquids and food into one’s lungs and lead to life-threatening pneumonia. Individuals with severe dysphagia may never be able to eat or drink anything without risking pneumonia. Their nutrition is typically given through a permanent tube placed directly into their stomach (i.e., a PEG tube), or if it is a temporary condition, a tube is inserted through their nose into the stomach (i.e., an NG tube). Residents who are NPO do not typically desire to go to the dining room during meals because they can’t eat a regular diet, but be sure to ask their preference.
Diet Texture
In addition to modified diet orders regarding the content of the food choices, the texture of the food may also be modified based on the chewing and swallowing ability of the resident. Common orders for diet textures for residents include regular, mechanical soft, or pureed:
Regular Diet: Regular diets include any texture of food.
Mechanical Soft: Mechanical soft diets include food that is soft or easily mashed with a utensil. Meat is ground to make chewing easier. Fruits and vegetables are boiled to soften any skin, and sometimes it is removed. See Figure 6.3 [17] for an image of a mechanical soft diet.
Pureed: Pureed diets include food that is blended to the consistency of a thick paste. See Figure 6.4 [18] for an image of a pureed diet.
Liquid Consistency
Clients may require a specific type of liquid consistency if they have dysphagia and increased risk for aspiration. The flap that covers the trachea and prevents liquids from entering the lungs when swallowing is called the epiglottis . If the epiglottis loses muscle tone, liquid can seep around it into the lungs and cause aspiration pneumonia. Signs of possible dysphagia are when a client continually coughs or clears their throat while eating or drinking. These signs should be reported immediately to the nurse because it can indicate early stages of dysphagia.
Clients with dysphagia typically have orders for thickened liquids. Thickened liquids are easier for the epiglottis to prevent from entering the lungs. Here are common types of liquid consistencies ordered:
Regular or Thin Liquids: No modifications for liquid consistency are required.
Nectar Thick (NT): Fluids are modified to have the consistency of thicker juices like a creamy soup.
Honey Thick (HT): Fluids are modified to have the consistency of honey or syrup that pour very slowly and may be consumed with a spoon.
Pudding Thick (PT): Fluids are modified to have semi-solid consistency like pudding. A spoon stands up in pudding-thick liquid.
See Figure 6.5 [19] for an illustration comparing liquid consistency.
Liquids can be thickened using thickening powder. Pre-thickened liquids from manufacturers typically have a smoother consistency than prepared liquids. See Figure 6.6 [20] for an image of a commercial thickening powder in use. Thickening liquid with powder requires exact attention to measurements to ensure the resident receives the correct liquid consistency and does not aspirate the fluid. Ice cubes should not be added to thickened liquids because as they melt, the liquid will become thinner. See Figure 6.7 [21] for an image of thickening water.
Read additional information on modified diets and liquid consistencies in the Virginia Department of Behavioral Health and Developmental Services PDF .
- This work is a derivative of Nursing Fundamentals by Chippewa Valley Technical College and is licensed under CC BY 4.0 ↵
- This work is a derivative of Anatomy and Physiology by Boundless and is licensed under CC BY-SA 4.0 ↵
- This work is a derivative of Nursing Fundamentals by Chippewa Valley Technical College and is licensed under CC BY 4.0 ↵
- This work is a derivative of Nursing Fundamentals by Chippewa Valley Technical College and is licensed under CC BY 4.0 ↵
- This work is a derivative of Nursing Fundamentals by Chippewa Valley Technical College and is licensed under CC BY 4.0 ↵
- This work is a derivative of Nursing Fundamentals by Chippewa Valley Technical College and is licensed under CC BY 4.0 ↵
- This work is a derivative of Nursing Fundamentals by Chippewa Valley Technical College and is licensed under CC BY 4.0 ↵
- MyPlate.gov. (n.d.). What is MyPlate? U.S. Department of Agriculture. https://www.myplate.gov/eat-healthy/what-is-myplate ↵
- “ MyPlate_blue.png ” by USDA is licensed under CC0 ↵
- This image is a derivative of “Table 3.1 Water Content in Foods” by University of Hawai‘i at Mānoa Food Science and Human Nutrition Program and is licensed under CC BY-NC-SA 4.0 ↵
- Human Nutrition by University of Hawai‘i at Mānoa Food Science and Human Nutrition Program is licensed under CC BY 4.0 ↵
- Human Nutrition by University of Hawai‘i at Mānoa Food Science and Human Nutrition Program is licensed under CC BY 4.0 ↵
- “Regulating-Water-intake-.jpg” by Allison Calabrese is licensed under CC BY 4.0 . Access for free at https://pressbooks.oer.hawaii.edu/humannutrition/chapter/regulation-of-water-balance/ ↵
- Human Nutrition by University of Hawai‘i at Mānoa Food Science and Human Nutrition Program is licensed under CC BY 4.0 ↵
- Human Nutrition by University of Hawai‘i at Mānoa Food Science and Human Nutrition Program is licensed under CC BY 4.0 ↵
- This work is a derivative of Nursing Fundamentals by Chippewa Valley Technical College and is licensed under CC BY 4.0 ↵
- “dysphagia-meat-and-potatoes-1w03r35.jpg” by Savannah Greiner is used with permission. Access for free at https://sites.udel.edu/chs-udfoodlab/2017/04/10/learning-about-dysphagia/ ↵
- “dysphagia-pureed-breakfast-1kl60uo.jpg” by Savannah Greiner is used with permission. Access for free at https://sites.udel.edu/chs-udfoodlab/2017/04/10/learning-about-dysphagia/ ↵
- “Honey Thick Liquid,” “Pudding Thick,” and “Thin Liquid” by Open RN Project are licensed under CC BY 4.0 ↵
- “ Powdered Thickener" and " Adding Thickener to Water" by Landon Cerny are licensed under CC BY 4.0 ↵
- “ Thickened Water ” by Landon Cerny is licensed under CC BY 4.0 ↵