Ethel is a 38-year-old woman with a normal BMI who is pregnant with her first child. She is in her second trimester, yet has only gained 2 pounds. She complains of being so tired, she can “barely get out of bed” in the mornings and suffers from “morning sickness” at least 4 times per week. She is referred to you for your sound nutritional advice.
My first piece of advice would be for Ethel to not only take prenatal vitamins but to also take a vitamin D3 supplement no more than 5,000IU. This will help her regain her energy, as vitamin D3 deficiency is already common in non-pregnant women. Also, because she has just started her second trimester, she can start adding an extra 300 calories to her diet. This can be in the form of an snack like a PB&J. At this point it's important for her to gain about a pound a week. Something else to note is that Ethel needs to keep up with being active. Now that she's out of the first trimester, she has less of a chance of miscarriage and her activity levels should increase in a short time. This means healthy, low impact exercise is a great idea to get into the habit of doing. Swimming, dancing, and walking are all good options. If she successfully follows this advice then transitioning to the third trimester will be easier and she'll most likely have a complication free and shorter labor. If this is a first time pregnancy, it may be difficult to understand how to go about a healthy diet, but with a little help, Ethel will learn everything she needs to know about proper nutrition and exercise for this exciting time in her life. Ethel's Diet Plan 1. Breakfast: ½ cup of oatmeal or barley, one slice of whole grain toast with three tablespoons of peanut butter, one banana, one glass of milk. (Starting off the morning with something bland like the oatmeal and dry like the toast will help keep the morning sickness at bay. The protein from the peanut butter will give her the energy she needs to perk up and also the potassium in the banana is known to help with morning sickness.) 2. Snack #1: Popcorn. (This is yet another food that can help with the sickness while it's also a serving of grain.) 3. Lunch: Small chicken breast with spinach salad containing carrot shreds, grape tomatoes, one hard boiled egg, cucumber and light Italian salad dressing, one medium sized apple. (Since the average pregnant woman needs up to 70 grams of protein a day, the chicken and the egg provide a combined 44 grams. This is more than half of what Ethel needs. The spinach [also rich with iron], grape tomatoes, cucumber, and carrot shreds serve as a great source of the necessary 2 ½ to 3 cups of vegetables she needs daily.) 4. Snack #2: One medium sized orange, six low sodium crackers. (If morning sickness is still a problem midday, crackers will help calm the feeling of throwing up. The vitamin C from the orange will be a great 2:30 pick me up as well.) 5. Dinner: Ground turkey burger, one slice of low-fat cheese, tomato slices, and kale in a whole wheat pita, four asparagus spears, ½ of a sweet potato. (This last full sized meal contains the appropriate amount of protein, calcium and vegetables that will help supply Ethel and her unborn child with the right nutrients.) 6. Snack #3: One container [5.3 ounces] of Greek yogurt, 16 grapes. (This finishes up Ethel's food intake for the day. She's ending it with her final servings of calcium, protein and fruit.)
What is the subject-by-subject method? What is the point-by-point method? How do they differ?
The subject-by-subject method is an outline format that is generally used for shorter papers. Whether writing a compare and contrast or an argumentative essay, you first discuss one side of the subjects/oppositions completely in the first body paragraph. You then use the second body paragraph to discuss the other side's points. It's important that you address the same points in both paragraphs or there is no comparison/contrast or argument. The point-by-point method is more frequently used in writing long papers. In this method, the writer establishes one point of comparison/contrast or argument in each body paragraph and then applies those points to each side of the subject.
John and Sarah are a young couple who have just received the news their son suffers from a debilitating and severe genetic disorder. They want to continue having children, but they want to know the chances of their next child having the same condition. John and Sarah opt for genetic testing to find out the probability of this. The results from the child reveal that there's a 25% chance of their next child being diagnosed with this disease. However, John's DNA shows that his offspring only has a 1 out of 1000 chance. It turns out John is not the father of this child. As their doctor, what is the protocol in this situation? In such a case, there are so many avenues to go down, but which one is the most respectful, confidential, and of course ethical?
There are a lot of factors to consider. First, you have to ask yourself if it's necessary to disclose. Considering that John has a significantly lower chance of passing this disease onto their next child, telling them wouldn't really be out of medical necessity. Second, you have to wonder who to address about the situation. Telling Sarah and not John would be a great deal of disregard for him. Telling John and not Sarah would disturb the patient-doctor confidentiality rule. Women hold a higher level of bodily autonomy than men do. As much as I disagree with the morality of it, and as sympathetic as I am for John, I would only disclose to Sarah about it since she is the only biological parent. Even though John is under the assumption he's the father, he isn't. Therefore, his medical history has nothing to do with what they came to the geneticist for in the first place.