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Birth of the Universe
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Here's how scientists figured out the age of the universe It took some cosmic detective work. by Passant Rabie Oct. 20, 2021 You never ask a cosmic being its age. But if that cosmic being encompasses all of space, time, and matter, you could get a little curious. Scientists have long been curious about the age of the universe and how much time has elapsed since the Big Bang. Today, scientists estimated the age of the universe to be approximately 13.8 billion years old. But how did scientists estimate how old the universe is, and are they sure of that number? It all comes down to ancient stars and the ever-expanding cosmos. How do astronomers calculate the age of the universe? To estimate the age of the universe, scientists rely on two main methods. Calculating the expansion rate of the universe Determining the ages of the oldest stars The Hubble Constant: Since its conception, the universe has been expanding at an accelerating rate. The universeâs expansion rate is known as the Hubble Constant, which is estimated at 46,200 mph per million light-years. The Hubble Constant was first calculated in the 1920s by American astronomer Edwin Hubble after discovering that several galaxies were moving away from Earth. Scientists looked to distant galaxies to measure how fast the universe was expanding. Hubble also noted that the further a galaxy was, the faster it was moving away. Based on Hubbleâs observations, the astronomer came up with Hubbleâs law which showed a correlation between how far an object is and the speed at which itâs receding. Using Hubble law, scientists were able to estimate the expansion rate of the universe. Scientists were then able to use the Hubble Constant to estimate the age of the universe by working backward, all the way back to the Big Bang. This extrapolation depends on the current density and composition of the universe, which shows the history of its expansion. In 2012 NASAâs Wilkinson Microwave Anisotropy Probe used that data to estimate the universe's age to be 13.772 billion years old, give or take 59 million years. A year later, The European Space Agencyâs Planck spacecraft estimated the universe's age to be 13.82 billion years. Ancestral stars: Another way to determine the age of the universe is to look to the oldest stars. The universe canât be younger than its oldest stars. Therefore, to narrow down the age of the universe, scientists measure the ages of the very first stars that formed in the cosmos. The lifecycle of a star depends on its mass, with high mass stars burning fuel at a faster rate and therefore dying out faster while low mass stars can live up to 20 billion years. Globular clusters are a dense stellar collection of around a million stars which all formed roughly around the same time. These clusters can then serve as timekeepers for the universe. By determining the masses of their stars, scientists can estimate when the globular cluster formed. The oldest globular clusters contain stars that are 0.7 times less massive than the Sun, which suggests that they are between 11 to 18 billion years old. What came before the Big Bang? Scientists can trace the universe back to its explosive birth, the Big Bang. But what happened before this theoretical birth of the cosmos? The universe may have been a singularity, all compact within a form that is smaller than a subatomic particle. Itâs difficult to imagine what caused this matter to exist, but one theory even suggests that our universe was born from another universe while another imagines a series of universes being born out of one another like a formation of bubbles. Meanwhile, another theory suggests that the universe goes through an endless cycle of death and rebirth, born from its own demise. How old is the universe in seconds? If the universe is indeed cyclical, then time becomes irrelevant. But just in case youâre still attached to the modern way in which we measure the progression of life, then the age of the universe comes up to about 436,117,076,900,000,000 seconds.THE SOAR SYSTEM A solar system is a group of planets and other celestial bodies that revolve around a star. A solar nebula- a vast cloud of gas and dust, mostly hydrogen and helium. How the Solar System Form ⢠COLLAPSE AND SPINNING DISK FORMATION - Gravity pulls material inward. The cloud flattens into a spinning disk due to conservation of angular momentum. ⢠PROTOSTAR FORMATION- (BIRTH OF THE SUN). Material collects at the center, and begun to heat up. When it reaches to 10 million KELVIN, nuclear fusion begins. thus, SUN is born. ⢠PLANETESIMALS AND PROTOPLANETS. Dust and gas in the disk stick together via static and gravitational forces. These form planetesimals, which grow into protoplanets collision and accretion. ⢠PLANET FORMATION. Inner disk: too hot for gas rocky planets form Mercury, Venus, Earth, Mars. ⢠PLANET FORMATION. Outer disk: gas and ice giants. Jupiter, Saturn, Uranus, Neptune ⢠LEFTOVER DEBRIS. Remaining materials forms moon, asteroids, comets and dwarf planets. DIFFERENT HYPOTHESIS IN THE FORMATION OF SOLAR SYSTEM. 1. NEBULAR HYPOTHESIS- The Solar system formed from a rotating cloud of Gas and Dust (solar nebula). As it rotates conservation of angular momentum caused the cloud to flatten into a disk. the Sun formed at the center (DISK) while planets formed from the surrounding materials through acceleration. thus, it explains the coplanar and nearly circular orbit of the planets all planets orbits around the sun on the same flat, disk shaped plane. Proposed by Immanuel Kant in 1755 and Modified by Pierre Simon Laplace in 1756. PROTOPLANET HYPOTHESIS. The Solar system formed from a rotating cloud of Gas and Dust (solar nebula). As it rotates conservation of angular momentum caused the cloud to flatten into a disk. 2. Protoplanet hypothesis. Builds on the nebular model but focuses more on the role of planetesimals which then form into full planets. PROCESS: - Small solid particles stick together through collisions. As collisions takes place, it grows into kilometer-sized planetesimals. Gravitational interactions lead to the formation of planets. Lead to formation of steroids belts and varying planet sizes 3. Encounter hypothesis. States that the sun encountered a rogue star. The encounter led to the removal of hot gas from both stars due to their gravitational interaction. The hot gas then accumulated and formed the planets. The materials from the less dense rogue star formed the other planets, while that from the sun formed the inner planets. 4. TIDAL HYPOTHESIS. (also called the Tidal Theory) is an early scientific idea about how the solar system might have formed. Proposed by James Jeans and Harold Jeffreys. A massive star passed very close to the early Sun. The hot gas then accumulated and formed the planets. The materials from the less dense rogue star formed the other planets, while that from the sun formed the inner planets. Streams of hot gas were drawn out from the Sun in elongated shape. These streams eventually condensed and cooled, forming planets, moons, and other bodies in the solar system. 5. Not accepted theory. Later studies showed the streams of hot gas would disperse too quickly into space instead of condensing into planets. The theory also couldnât explain the specific orbital patterns and compositions we see today. Modern science favors the Nebular Hypothesis, which explains solar system formation through the collapse of a rotating gas cloud. Earth as the only habitable planet 1. Right Distance from the Sun (The Goldilocks Zone). Not too hot, not too cold â just right for liquid water to exist. 2. Atmosphere with Oxygen. Earth has a mix of gases, especially oxygen, which most living things need to survive. 3. Liquid Water. Earth has oceans, rivers, and rain â water is essential for all life. 4. Magnetic Field. Earthâs magnetic field protects us from harmful solar radiation. 5. Stable Climate. The atmosphere and natural cycles keep temperatures and weather mostly stable over time. 6. Rich Resources. Earth has soil for growing food, minerals, and energy sources that support life and technology. Solar explorations 1. AUGUST 6, 2014. First space craft to orbit a comet (ROSETTA PROBE). Captures the comet photograph. -Comets have coma and tail as it approaches to the sun. 2. JULY 14, 2015. NASAâs New Horizons spacecraft made history by becoming the first spacecraft to fly by Pluto, giving us our first close-up look at the dwarf planet. First time visiting Pluto. Before this, Pluto was just a blurry dot in telescope images. Revealed a surprising world New Horizons showed mountains of ice, smooth plains, and a heart-shaped region called Tombaugh Regio. Changed what we knew. Scientists thought Pluto would be dull and frozen â instead, it turned out to be geologically active and incredibly complex. 3. SEPTEMBER 8, 2016. NASA launched OSIRIS-REx, the first U.S. mission to collect a sample from an asteroid and return it to Earth. Changed what we knew. Scientists thought Pluto would be dull and frozen â instead, it turned out to be geologically active and incredibly complex. OSIRIS-REx stands for: Origins, Spectral Interpretation, Resource Identification, SecurityâRegolith Explorer It was sent to study the asteroid Bennu, a near-Earth asteroid about 500 meters wide. Mission Goals: Collect a sample of surface material from Bennu Study the asteroidâs omposition, structure, and history. Mission Goals: Help scientists understand the origins of the solar system. Learn more about asteroids that could impact Earth. 4. August 12, 2018: Launch of NASAâs Parker Solar Probe, the first spacecraft to "touch" the Sun by flying through its outer atmosphere, called the corona. Mission Goal: To study the Sun up close and help scientists understand: How the solar wind (a stream of charged particles) is formed. Why the Sunâs corona is hotter than its surface. What causes solar storms that can affect Earthâs satellites and power grids. 5. November 26, 2018: NASAâs Insight Lander Touches Down on Mars. Its mission was focused on studying the interior of the Red Planet (crust, mantle, and core of the planet). Why the Sunâs corona is hotter than its surface. What causes solar storms that can affect Earthâs satellites and power grids 6. November 26, 2018: NASAâs Insight Lander Touches Down on Mars. Its mission was focused on studying the interior of the Red Planet (crust, mantle, and core of the planet) 7. JULY 30, 2020 PERSEVERANCE PROBE. Perseverance rover as part of the Mars 2020 mission aboard an Atlas V-541 rocket This marked a major step in Mars exploration. 8. DECEMBER 25, 2021-JAMES WEBB SPACE TELESCOPE. Investigate exoplanetsâ atmospheres for signs of habitability. Observe the first galaxies formed after the Big Bang. Study the formation of stars and planetary systems. Look deeper into the infrared universe than ever before. RESULTS OF EXPLORATION ⢠Evidence of Ancient Life-friendly Environment. ⢠Sedimentary rocks formed in water-rich environments. ⢠Signs of clay and carbonate minerals, which can preserve biosignatures (traces of past life). ⢠Evidence of Ancient Life-friendly Environment. ⢠Sedimentary rocks formed in water-rich environments. ⢠Signs of clay and carbonate minerals, which can preserve biosignatures (traces of past life). ⢠Evidence of Ancient Life-friendly Environment. ⢠Sedimentary rocks formed in water-rich environments. ⢠Signs of clay and carbonate minerals, which can preserve biosignatures (traces of past life).In a single domesticated grain seed, one might see the bud of great civilizations. The birth of agriculture was a turning point in humans' social development, as stable food supplies enabled people to transcend the constraints of food gained by hunting and gathering. After that, people were able to settle down and experience population booms. As one of the major areas around the globe where agriculture originated, China has contributed to the world's domesticated rice, millet, buckwheat and soybeans. Archaeological studies have unveiled that the planting of rice originated around 10,000 years ago in the lower reaches of the Yangtze River, leading to the eventual replacement there of hunting and gathering practices dating back 5,000 to 6,000 years. "It marked the formation of a rice-based agricultural society in the area," said Zhao Zhijun, an archaeologist at the Chinese Academy of Social Sciences. Archaeological studies of the origins of rice-based agriculture are an important part of a national project tracing the origins of Chinese civilization itself. President Xi Jinping has greatly valued the project. At a group study session of the Political Bureau of the Communist Party of China Central Committee on May 27, 2022, Xi, who is also general secretary of the CPC Central Committee, emphasized the significance of the project and the role that archaeological studies play in better understanding Chinese civilization. The project to trace the origins of Chinese civilization, in addition to finding signs of human activity more than 1 million years ago, has also proved that China's history includes 10,000 years of culture and more than 5,000 years of civilization. The project has provided clear knowledge of the origins and formation of Chinese civilization, the history of its development, the process of the formation and development of its pluralistic and integrated pattern, and the characteristics of the civilization and why it was formed in such a way, he added. This was not the first time that Xi emphasized the importance of the origin-tracing project. Since the 18th National Congress of the CPC in 2012, Xi has toured more than 100 historical and cultural locations and issued many instructions related to archaeology and the origin-tracing project. During the 23rd group study session of the Political Bureau of the CPC Central Committee in 2020, Xi called for giving more attention to archaeological research and letting historical facts speak for themselves. "This will provide strong support for our efforts to carry forward the best of traditional Chinese culture and increase our cultural confidence," said Xi. The origin-tracing project has been carried out since 2002. Its ongoing fifth phase, which started in 2020, involves the participation of more than 500 researchers from 29 institutes across the country. It primarily centers on several ancient capital sites, including the Liangzhu site in Hangzhou, Zhejiang province, the Taosi site in Xiangfen county, Shanxi province, the Shimao site in Shenmu, Shaanxi province, and the Erlitou site in Luoyang, Henan province, from 3,500 to 5,500 years ago, as well as other settlements mainly along the basins of the Yellow, Yangtze and Liaohe rivers. The project has also expanded to a wider geographic and chronological framework to decode how Chinese civilization emerged and how its diverse elements formed a unity. Excavation of the Liangzhu site, which is over 5,000 years old and is one of the major sites covered in the origin-tracing project, has yielded an inner city covering 3 million square meters and an outer city of 6.3 million sq m, making it the world's largest capital at the time. It also had a giant water control system, which contributed to the formation of a rice-based agricultural society. By calculating the earthwork volume, archaeologists found that building the entire ancient city, the water control system and Mojiaoshan â a 10-meter-tall man-made terrace in the center of the city â required 10,000 people working daily for seven-and-a-half years. The discoveries show that Liangzhu had a kingship able to organize people for large-scale public construction, and its social differentiation, emergence of the city concept and existence of a kingship prove that it became a civilized society, said Wang Wei, a veteran archaeologist at the Chinese Academy of Social Sciences. Significant topic Wang said that tracing the origins of a civilization is a significant topic in the research of human history. Over the years, the Chinese project has provided China's answer to how to define civilizations. In 2022, Xi commended the efforts and stressed that the project has made creative contributions to the research on tracing the origins of the world's civilizations. Wang said: "International academia has proposed three indispensable elements for a civilized society based on features of Mesopotamian and Egyptian civilizations: written characters, metallurgy and the city concept. But we can find that some of the three elements were absent in many ancient civilizations. For example, the Mayan civilization had no metallurgy, while the Incan civilization didn't have written characters." Western scholars believe that Chinese civilization began with the Yinxu Ruins in Anyang, Henan province, a capital of the late Shang Dynasty (c.16th century-11th century BC), based on the discovery of inscribed oracle bones from that time. However, Chinese archaeologists don't agree. With continued archaeological research, international academia now believes that places around the world can propose criteria for civilization based on their own ancient social development. China's archaeological studies have shaped the nation's criteria in defining a civilization: the development of productivity, an increase in population, the appearance of cities, social differentiation and the emergence of kingship and state. "These criteria are suitable for identifying other civilizations as well," said Wang. "Civilizations have in common the appearance of kingship and state. They are only different in the ways of imposing kingship and the forms of state." In China, kingship and state "were shown by exquisite jade and bronze ritual artifacts, grand palaces and magnificent mausoleums imitating aboveground palaces", he added. "In Mesopotamia and ancient Egypt, they were demonstrated through superb stone temples, pyramids and large-scale tombs." Multidisciplinary subject President Xi said in 2020 that archaeologists should work closely with researchers from other fields to make an interpretive analysis of material remains. Zhang Chi, a professor of archaeology at Peking University, said that since material remains are often the research focus of archaeological studies, these should not only be observed with the eyes, but also studied using scientific and technological tools. Therefore, from the perspective of research methods, archaeology is by nature a multidisciplinary subject, Zhang added.Write simple RCQ for 2nd graders: Success Story Guess Who? He was born in the southeastern part of China. He failed the college entrance exam twice. He was rejected by 30 companies for a job, including KFC. He was once an English teacher. Resume Name: Ma Yun (Jack Ma) Birth Date: Sep. 10th, 1964 Family: Married Education: 2013, Hong Kong University of Science & Technology, PhD. 1988, Hangzhou Normal University, Bachelor's Degree in English. Experience: Founder and Executive chairman of Alibaba Group. How successful he is! Ma Yun founded Alibaba Group, China's biggest E-commerce company. He is worth an estimated $29,000,000,000, one of the richest men in the world. Do you want to be successful? Advice from Jack Ma: Get used to rejection. Keep your dream alive. Ignore the 'dirty dogâ. Get inspired. Stay focused. Don't complain. Received: 26 November 2019 Revised: 10 January 2020 Accepted: 19 January 2020 DOI: 10.1111/obr.13005 PEDIATRICS/PHYSIOLOGY Adipokines: A gear shift in puberty DesirĂŠe Nieuwenhuis | NatĂ lia Pujol-Gualdo Amanda J. Kiliaan Department of Anatomy, Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, The Netherlands Correspondence Amanda J. Kiliaan, PhD, Associate Professor, Department of Anatomy, Donders Institute for Brain, Cognition, and Behaviour, Preclinical Imaging Center PRIME, Radboud university medical center, 6500 HB Nijmegen, Geert Grooteplein 21N 6525 EZ Nijmegen, The Netherlands. Email: amanda.kiliaan@radboudumc.nl Funding information Europees Fonds voor Regionale Ontwikkeling (EFRO), Grant/Award Number: BriteN 2016 1 | INTRODUCTION The prevalence of obesity in adolescents and children is increasing in | Ilse A.C. Arnoldussen | Summary In this review, we discuss the role of adipokines in the onset of puberty in children with obesity during adrenarche and gonadarche and provide a clear and detailed overview of the biological processes of two major players, leptin and adiponectin. Adipokines, especially leptin and adiponectin, seem to induce an early onset of puberty in girls and boys with obesity by affecting the hypothalamic-pituitary- gonadal (HPG) axis. Moreover, adipokines and their receptors are expressed in the gonads, suggesting a role in sexual maturation and reproduction. All in all, adipokines may be a clue in understanding mechanisms underlying the onset of puberty in child- hood obesity and puberty onset variability. KEYWORDS adipokines, obesity, puberty 1,2 the age of 5 years were overweight or were with obesity in 2016, and 3 Obesity is defined by an excessive accumulation of white adipose tissue (WAT), and it is often indicated by a body mass index (BMI) 4 above 30. Two main types of adipose tissue were described: WAT and brown adipose tissue (BAT), which differ in morphology and func- 5-7 Ilse A.C. Arnoldussen and Amanda J. Kiliaan contributed equally to this work. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Š 2020 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation Obesity Reviews. 2020;21:e13005. wileyonlinelibrary.com/journal/obr 1 of 10 https://doi.org/10.1111/obr.13005 alarming rates. Specifically, worldwide, 41 million children below this number is expected to increase to 70 million in 2025. obesity is associated with various severe health complications, includ- ing increased risk of diabetes mellitus type 2, hypertension, heart dis- eases, and disturbances in sex hormone levels. 5,6 and mitochondria and plays a role in thermogenesis. Adipocytes in tion. BAT consists of adipocytes containing multiple lipid droplets WAT contain only a few mitochondria and a single lipid droplet. Adipose tissue has several functions including the storage of energy, thermogenesis, and the production and secretion of adipokines Generally, two physiological processes, adrenarche and gonadarche, 11,24 Childhood 5,7,8 a key role in puberty onset. Puberty is known as a period through which the body changes physically, being a physiological process resulting in the maturation of children, i.e. they develop sexual characteristics and obtain reproduc- 9,11 Adipokines are involved in a number of physiological processes including blood pressure, metabo- lism, glucose, and vascular homeostasis and may play amongst others 8-10 (hormones, cytokines, and peptides). tive functions. between obesity and puberty,2,12-23 the biological mechanisms under- lying obesity and puberty onset remain unclear. Hereafter, we review in detail the role of adipokines in the onset of puberty in childhood obesity. Although many studies have shown associations 2 | INITIATION OF PUBERTY PHYSIOLOGICAL PROCESSES IN THE interact to regulate the onset of puberty. During adrenarche, the adrenal cortex secretes steroid hormones (including 2 of 10 NIEUWENHUIS ET AL. androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate (DHEAS), androstenedione, and cortisol), insulin-like growth factor, and growth hormone, which contribute to the pubertal insights on new genetic loci (e.g. melanocortin-4 receptor, mitochon- drial carrier 2, and mitogen-activated protein kinase 13) and on sev- eral pathways that regulate the timing of puberty; however, it partly 34 9,24,25 Both adrenarche and gonadarche are involved in the development growth spurt, body odor, skin oiliness, and skeletal maturation. explains puberty timing variation. Thereby, defining the role of 25 adipokines is of importance in elucidating the variability in puberty as the expression of adipokines is sex-specific and is altered with body composition, adiposity, and during growth spurts. Moreover, adipokines and their receptors are expressed in gonads and several brain regions suggesting involvement in the onset of puberty and sex- ual maturation. Lastly, adipokines interfere in processes regulating timing and duration of puberty, for instance in the HPA and HPG axes which are both key players during adrenarche and gonadarche. Involvement of adipokines in the onset of puberty and specifically in individuals with obesity will be further reviewed in the next 2,24 3 | Puberty onset in girls is assessed using different markers, such as thelarche (breast development), menarche (the start of of pubic hair. pituitary-gonadal (HPG) axis is activated,2,26 and several hormones have been identified to participate in the activation of the HPG axis During gonadarche (Figure 1), the hypothalamic- 2,27 Kisspeptin, neurokinin B, and dynorphin are released by specialized including kisspeptin, neurokinin B, dynorphin, leptin, and ghrelin. 28 key regulator of the pulsatile secretion of gonadotropin releasing neurons, the KNDy neurons in the hypothalamus. Kisspeptin is a 29,30 B stimulates, and dynorphin inhibits the release of kisspeptin, which hormone (GnRH) from the hypothalamus. In addition, neurokinin implies that both coordinate a pulsatile release of kisspeptin. 31 Sub- sections. sequently, the activated HPG axis induces the pituitary gland to secrete luteinising hormone (LH) and follicle stimulating hormone (FSH). As a result, gametogenesis occurs, and the gonads will release sex hormones. Consequently, secondary sex characteristics develop including breast development in girls and an increased testicular vol- 2,26,32 is possibly due to differences in levels of body fat, hypothalamic-pitui- THE ONSET OF PUBERTY IN GIRLS ume in boys. The age at puberty onset varies greatly among individuals, which 19 35 menstruation), and pubic hair development. 33 genome-wide association studies have provided important new tary-adrenal (HPA) axis activity, and genetic background. Recent The average age of However, this age differs between cultures and ethnicities, and since 1980, age at menarche is girls at start of menarche is 12.4 years. 36 significantly decreasing. 36-39 F I G U R E 1 Hormonal regulation in the initiation of puberty in boys and girls. The secretion of kisspeptin, neurokinin B, and dynorphin from KNDy neurons initiate the release of gonadotropin releasing hormone (GnRH) from the hypothalamus. This activates the pituitary gland to produce and secrete luteinising hormone (LH) and follicle stimulating hormone (FSH), which in turn stimulate the gonads to produce estrogen and testosterone in girls and boys, respectively 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 3 of 10 T A B L E 1 Summary of included studies Authors Year Country Study Design Primary Outcome Sex Sample Size (n) Age (y) Data Collection Lian et al21 2019 China Cross-sectional Puberty starts earlier in Chinese Han girls with obesity compared with Chinese Han girls with normal weight. Girls 2996 9-19 2012 and 2013 Biro et al12 Lazzeri et al20 2018 USA 2018 Italy Longitudinal Cross-sectional Body mass index had a greater effect on age at menarche than did race and ethnicity. Girls 946 6-16 2004-2014 Li et al23 2018 China Longitudinal For both, boys and girls, a higher BMI (ie, overweight and obese) is associated with earlier onset of puberty Girls Girls Boys Girls 542 Deng et al22 Flom et al15 2017 China Cross-sectional Increased BMI is associated with early timing spermarche and menarche. Boys Girls Girls 1278258 9-15 2005-2012 He et al24 Holmgren et al17 2017 China 2017 Sweden Cross-sectional Longitudinal Onset of puberty is not related to obesity in boys. Boys Boys Girls Girls 782 7-17 972 929 5839 Kelly et al19 2017 UK 2016 Brazil 2016 USA Longitudinal prospective cohort Higher BMI in girls is associated with the onset of menstruation at an earlier age. 11 10-18 11-17 Barcellos Gemelli et al25 Cross-sectional Longitudinal Excess weight is associated with early age of menarche. Girls 727 2014 2003-2009 Glass et al16 Lee et al26 In girls, but not in boys, greater adiposity is associated with the earlier onset of puberty. Boys Girls 135 Cabrera et al27 Leonibus et al14 2014 USA 2013 Italy Cross-sectional Longitudinal Thelarche occurred earlier than recently reported, while age of menarche remained unchanged. Girls 610 3-17.9 2007 2005-2012 Currie et al13 2012 Europe, USA, Canada Cross-sectional Overweight/obesity during childhood predicts the early onset of puberty in girls. Girls 20410 11, 13, 15 2005-2006 2017 USA Prospective birth cohort Overweight/obese status at the age of 7 ye was associated with increased risk of early menarche 788 From birth to menarche occurred Pregnancies 1959-1966 2016 USA Cross-sectional Boys with overweight enter puberty earlier compared with boys with normal weight or obesity, while puberty starts later in boys with obesity compared with boys with normal weight and overweight. Boys 3872 6-16 2005-2010 Overweight during childhood shows a relation with the early onset of puberty in girls. 6535 4259 695 11 15 5.8-12.2 2009/2010 2013/2014 2014-2017 Higher BMI during childhood is associated with early puberty. 2008 and 2009 2000-2002 Obesity during childhood is related to the earlier onset of puberty. Boys Girls 84 123 71 (Continues) 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 4 of 10 NIEUWENHUIS ET AL. 3.1 | Fat storage For the initiation of puberty, the timing of stimulation and/or inhibi- tion of different hormones is important, and additionally, a certain amount and distribution of body fat is needed in order to start menar- che, which emphasizes the importance of body fat. From an evolution- ary point of view, body fat increases in mammalian females during puberty onset, and it highlights the need to guarantee a healthy preg- 40 women with anorexia nervosa. particularly body fat localized predominantly on the gluteofemoral fat depots, is profoundly associated with start of menarche, more than nancy, offspring, and maternal survival. fat, sex-hormones, and neuroendocrine alterations can evolve in men- strual dysfunction, for instance, in women with severe obesity or in 41-43 44-46 to gluteofemoral fat depots suggesting that leptin may convey infor- amount of total body fat. mation on body fat distribution to the hypothalamus during puberty. An improper level of body Importantly, body fat distribution, Blood leptin levels are strongly related 45 3.2 | HPG axis The HPG axis is activated by the release of kisspeptin resulting in the release of GnRH from the hypothalamus, and LH and FSH from the pituitary gland. In girls, FSH is involved in the development of the folli- cles in the ovaries, and it promotes the secretion of estrogen. LH stim- ulates the production of androgen hormones and induces ovulation 48 9,47 the release of kisspeptin and neurokinin B, and kisspeptin thereby (Figure 1). The secretion of estrogen has an inhibitory effect on inhibits the GnRH release from the hypothalamus. pattern of GnRH is important for the regulation of the menstrual cycle. This roughly 28-day-cycle comprises several phases, including the follicular phase and luteal phase. During the follicular phase, increasing levels of FSH stimulate the maturation of follicles and the production of estrogen from the ovaries. This in turn inhibits the release of FSH from the pituitary gland. A high level of estrogen will induce the production of LH by the pituitary gland, resulting in ovula- tion. The matured follicle secretes progesterone thereby inhibiting the release of GnRH. When the corpus luteum is demolished, there is less 48 3.3 | Adipokines According to results from studies reported in Table 1, girls with obe- sity enter puberty earlier compared with girls with normal higher leptin concentrations inhibit the intake of food and increases inhibition of GnRH. As a consequence, the cycle will start again. whole process, starting from the activated HPG axis, results in the development of the secondary sex characteristics in girls including 9,47 thelarche and menarche. 13,14,16-23,49-51 weight. these girls might be found in the secretion of adipokines. For instance, leptin is positively associated with the amount of body fat. Generally, energy expenditure. 9,52-54 An explanation for the early onset of puberty in The expression This TABLE 1 (Continued) Authors Year Country Study Design Primary Outcome Sample Sex Size (n) Age (y) Data Collection Herman-Giddens et al28 2012 USA Cross-sectional Observed mean ages of beginning genital and pubic hair growth and early testicular volumes were earlier than in past studies, depending on the characteristic and race/ethnicity. Boys 4131 6-16 2005-2010 Sorensen et al29 Aksglaede et al30 2010 2009 Denmark Denmark Cross-sectional/longitudinal Longitudinal Puberty onset at earlier ages was associated with an increased BMI in boys. Boys 1528 5.8-19.9 1991-1993/2006-2008 1930-1969 Juul et al31 Ribeiro et al32 2007 2006 Denmark Portugal Retrospective cohort Cross-sectional Higher BMI is associated with early voice break. 11-15 10-15 1990-1999 Kaplowitz et al18 Abbreviation: BMI, body mass USA Cross-sectional The early onset of puberty in Caucasian girls is likely related to an increased BMI. 5-12 1992-1993 2001 index. The higher BMI in boys and girls at 7 y of age, the earlier they enter puberty. Boys 21 612 Girls 135 223 Boys 463 Boys 382 Girls 437 Girls 10 750 Early sexual maturation in boys and girls is associated with overweight. 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 5 of 10 Leptin may possibly play a role in adrenarche as its plasma level increases with higher levels of body fat and as it can modulate both girls. 33 ing adrenarche. In coherence, in children with obesity, the androgen These findings suggested that lower reproductive status was associated with higher total adiponectin concentrations and that a higher reproductive status was related to higher HMW adiponectin the HPA and HPG axes. These axes are functionally integrated dur- DHEAS was positively associated with leptin levels. Nevertheless, concentrations in girls. In addition, individuals with obesity often another study showed that enhanced adrenal androgen secretion in girls with premature adrenarche was not explained by leptin or BMI 55 ated with androgen levels in girls ; however, it was not related to levels. and IL-6. TNF-Îą alters, and IL-6 inhibits the expression of 56 8 In addition, the adipokine adiponectin was negatively associ- 57 differences of adiponectin seem to develop during the progression of 56 adiponectin (Figure 2). Thereby, a low level of total adiponectin and/or high levels of inflammatory cytokines in individuals with obe- sity can promote the onset of puberty. Many more adipokines are secreted by WAT including omentin, 52,65-67 9,36,62,68 adrenarche in girls with Prader-Willi syndrome. Interestingly, sex puberty. adrenarche; however, both are not required factors. Thus, leptin and adiponectin might be able to influence In gonadarche, leptin can stimulate the secretion of kisspeptin, and subsequently activation of the HPG axis, which eventually increases the expression of estrogen and androstenedione in the ova- 58 2,60 65-67 The expression of these ries (Figure 2). Ob gene in WAT, resulting in the synthesis and secretion of leptin. Thus, high levels of leptin promote onset of puberty in girls via secre- tion of kisspeptin, and estrogen stimulates leptin secretion addition- ally. Moreover, adiponectin can affect the HPG axis due to the expression of adiponectin receptors in the hypothalamus, pituitary In return, estrogen stimulates the expression of the 59 gland, and gonads. onset as it inhibits the secretion of kisspeptin and GnRH in the hypo- thalamus and the release of GH and LH in the pituitary gland, and 2,60-62 52,60 63 girls with central precocious puberty (CPP). Moreover, total adiponectin had negative correlations with progression of puberty in girls (defined by Tanner stages), whereas HMW adiponectin had FIGURE 2 Adipokinesaffectingthe initiation of puberty in girls. Leptin stimulates the release of kisspeptin in KNDy neurons, which activates the hypothalamus to produce gonadotropin releasing hormone (GnRH). In response to the release of GnRH, the pituitary gland secretes follicle stimulating hormone (FSH) and luteinising hormone (LH), which stimulates the ovaries to release estrogen resulting in the formation of secondary sex characteristics in girls. Estrogen stimulates the production of leptin. Adiponectin inhibits GnRH release resulting in reduced levels of GnRH and thereby a delayed onset of puberty. TNF- Îą and IL-6 inhibit the production of adiponectin and therefore stimulate the onset of puberty In detail, adiponectin is a regulator of puberty thereby inhibiting the onset of puberty (Figure 2). with obesity often have low levels of adiponectin. et al. showed that total adiponectin was significantly lower, whereas high molecular weight (HMW) adiponectin was significantly higher in ment. 55 63 develop a chronic low-grade inflammatory state, which can be indi- cated by a high level of circulating inflammatory cytokines like TNF-Îą 64 Individuals Sitticharoon positive associations with LH levels and the progression of puberty in 63 visfatin, resistin, and chemerin. and visfatin are expressed in the ovaries. adipokines in the ovaries suggests a role within the reproductive sys- tem; however, the exact biological processes have to be examined. Thus, specifically leptin, adiponectin, and inflammatory cytokines pro- duced by WAT could be permissive key players during an early onset of puberty in girls with obesity. As an exception, HMW adiponectin seems to have a stimulatory effect on peripheral repro- ductive function as HMW is not able to cross the blood brain 63 barrier. 4 | Markers that are used to assess puberty onset in boys are THE ONSET OF PUBERTY IN BOYS spermarche, voice break, testicular volume, and pubic hair develop- 35 spermarche develop in the early stages of puberty onset, voice In women, omentin, chemerin, While pubic hair development, larger testicular volume, and 69 testicular volume increases, which occurs at an average age of break usually appears in later stages of puberty. Generally, first 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 6 of 10 NIEUWENHUIS ET AL. 11.9 years, followed by the development of pubic hair at 12.2 years of average, and lastly, boys experience spermarche around an aver- 55 related with leptin levels. Thereby, leptin plausibly has a minor impact in adrenarche in boys. Since leptin receptors are found in the hypothalamus, pituitary gland, and testes, they might be involved in the onset of puberty by affecting the HPG axis during gonadarche. Leptin stimulates the release of kisspeptin and GnRH, and as a consequence, it accelerates the onset of puberty (Table 1, Figure 3). In contrast, adiponectin inhibits the secretion of GnRH, GH, LH, and FSH therewith delaying the onset of puberty. However, adiponectin levels are generally lower in men compared with women and even lower in men with obe- age age of 13.4 years. 70 4.1 | Fat storage Many aspects of the reproductive physiology are energetically demanding,71 and therefore, an adequate energy level is necessary. In boys, a dynamic change in body composition occurs around the age of 10 to 13 years, in which they gain approximately 40% of sity. culating inflammatory cytokines. levels can stimulate the HPG axis and therewith an early onset of puberty in boys. Nevertheless, leptin can inhibit the production of tes- 72 mostly consisting of lean mass, which causes exhaustion of most of fat. Subsequently, a growth spurt follows in which they gain tissue 72 in boys, an adequate amount of body fat is important in the onset of their body fat. These alterations in amount of body fat indicate that 4.2 | Puberty in boys is initiated by the release of kisspeptin. As mentioned before, this activates the HPG axis, resulting in the release of GnRH from the hypothalamus, and consequently the release of LH and FSH 9,74 puberty. tosterone from the testes, to estrogen (Figure 3). of the development of secondary sex characteristics in boys. Additionally, leptin can affect fertility in men as it can modulate the nutritional support of spermatogenesis, and moreover, dysfunction of spermatogenesis is associated with an increased leptin level and 73 58 2,60-62 HPG axis from the pituitary gland (Figure 1). and LH stimulates the secretion of testosterone from the testes, which inhibits the release of kisspeptin from the KNDy neurons and 9,48 in men, the release of kisspeptin is more consistent, causing a con- 29,48 subsequently GnRH from the hypothalamus. receptors expressed on KNDy neurons. In humans, KNDy neurons Contrarily to women, LH-induced testosterone levels lead to the stant release of LH. development of secondary sex characteristics in boys. differences between sexes in kisspeptin release are related to a sex- specific and sex steroid-dependent kisspeptin system as estrogen and progesterone modulate kisspeptin activity through the sex-steroid 48 in the infundibular nucleus are involved in negative and positive sex- 48 tal exposure to sex steroids and result in sex-specific differences in steroid feedbacks. kisspeptin release. These sexual dimorphisms are induced by perina- 75,76 4.3 | Adipokines The association between obesity and puberty onset in boys is rather controversial compared with findings in girls. Most studies reported an early onset of puberty in boys associated with increased ate adipose tissue from actual breast tissue. stages are more difficult to assess than female stages as boys lack a more determined marker such as menarche. Thirdly, puberty onset can be indicated by the activation of the HPG axis, and the presence of these secondary sex characteristics is the result of hormonal 2 14,17,22,23,50,51,77,78 BMI, 20,49 all while others reported no associations at Current markers used 79 16,80 or a delayed onset of puberty (Table 1). The presence of excessive adipose tissue can be involved in puberty onset in boys as the secretion of adipokines can modulate both adrenarche and gonadarche. Leptin can affect adrenarche by modulating both the HPG and HPA axes,33 and moreover, androgen levels were positively 55 nal androgen secretion in boys with premature adrenarche was not associated with plasma leptin levels. Nevertheless, enhanced adre- 9 In more detail, 61,62 adiponectin, and individuals with obesity often have high levels of cir- Moreover, inflammatory cytokines, TNF-Îą, and IL-6, inhibit expression of the leptin receptor in the testis. FSH induces spermatogenesis, too. function and role still have to be examined. 64 High leptin and low adiponectin and fat tissue can convert testosterone Both processes might result in the delay 29,61,79 81,82 In men, other adipokines like chemerin are found in the gonads 65 Thus, particularly high leptin and low adiponectin levels stimulate the HPG axis and thereby accelerate the onset of puberty in boys. Additionally, leptin can dysregulate the development of secondary sex characteristics and spermatogenesis by affecting testosterone levels and nutritional sup- port of spermatogenesis. 5 | LIMITATIONS AND FUTURE RESEARCH DIRECTIONS Even though multiple epidemiological studies have shown the link between puberty onset and obesity, there are some important limita- tions. Firstly, determining both the onset and stage of puberty is rather difficult. For instance, assessing the stage of breast develop- ment in girls with obesity is complicated as clinicians should differenti- 2 changes in response to the activated HPG axis. to determine the onset of puberty refer to secondary sex characteris- tics, such as testicular volume in boys and breast development in girls. A more accurate measurement of puberty onset would be to combine secondary sex characteristics with plasma or serum hormone level measurements such as LH, FSH, adipokines, e.g. leptin. Thereby, differences in puberty measurements could explain variations in the age of puberty onset between boys and girls within different Thereby, resistin is expressed in the testes of rats, but its exact 83 Secondly, male pubertal 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 7 of 10 FIGURE 3 Adipokines affecting the initiation of puberty in boys. Leptin activates kisspeptin secretion in KNDy neurons, this activates the production of gonadotropin releasing hormone (GnRH) from the hypothalamus. GnRH stimulates the pituitary gland to secrete follicle stimulating hormone (FSH) and luteinising hormone (LH), activating the production of testosterone from the testes allowing the development of secondary sex characteristics. Leptin also inhibits the production of testosterone, which may cause a delayed onset of puberty. Adiponectin inhibits GnRH release. Low levels of adiponectin, as a result of TNF-Îą and IL-6 expression, lead to a reduced inhibition of GnRH. In response to GnRH release, the pituitary gland will secrete FSH and LH, and the testes will produce testosterone resulting in the development of secondary sex characteristics in boys countries, and In addition, the inclusion of a of puberty. ferent time points is complicated, as subjects examined several decades ago presented pronounced differences concerning lifestyle patterns such as nutrition and exercise habits. Lastly, obesity or over- weight is often determined by BMI, a classification based on weight and height measurements. Additionally, it is important that all studies studies or across continents, ethnicities proper age range (8-16 years) is important when assessing the onset (Figure 4). 12-15,17,20-23,49,77-79,84,85 30,47 Furthermore, comparison between studies from dif- 86 Specifically in children, BMI is often dependent on age and growth use the same anthropometric standards and sex-specific cut-offs. 13,14,16-23,49-51,77-80 fat and would represent a more accurate measurement in its regard. Based on this review, several suggestions can be made for further research. Firstly, the roles of adipokines like resistin, chemerin, visfatin, and omentin in puberty onset, fertility, and sexual maturation should be examined in detail. Secondly, future research examining the onset of puberty should combine indicators of puberty onset (e.g. breast development or testicular volume) with plasma or serum hor- mone measurements such as LH, FSH, sex-steroids, adipokines (e.g. spurts. ment in case of growth spurts. distribution of body fat should be taken into account in determining puberty and obesity in children. For instance, the body adiposity index (BAI), which was introduced in 2011 by Bergman et al.,87 uses hip cir- cumference and height in order to estimate the percentage of body 87 Thereby, BMI is a less accurate measure- F I G U R E 4 87,88 Therefore, both percentage and Average age of puberty onset in Europe, China, and the United States according to several studies from Table 1. Age of puberty onset ranges from 8.47 to 13.33 years in girls and from 8.63 leptin), and body fat distribution (e.g. BAI,87 waist-hip ratio's and/or dual-energy X-ray absorptiometry (DXA)2). Additionally, defining con- sistent and general measurements of puberty in both boys and girls, combined with a proper age range (8-16 years), would facilitate the comparisons between different studies and their results. 12-15, 17, 20-23, 25-29, 31 to 13.7 years in boys. included if average age of markers used to assess puberty was not reported. Pink: girls. Blue: boys Studies (Table 1) were not 39, 56 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 8 of 10 NIEUWENHUIS ET AL. 6 | CONCLUSION In conclusion, epidemiological data regarding obesity and puberty onset in girls show similar outcomes as adiposity results in the early onset of puberty in girls. The majority of the studies examining boys with obesity indicate an early onset of puberty, while not all reported an earlier onset of puberty. In detail, high leptin, TNF-Îą, and IL-6 levels combined with low adiponectin levels stimulate the activation of the HPG axis in girls and boys with obesity, and 5, 45, 50, 51 REFERENCES 1. Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. May- o Clin Proc. 2017;92(2):251-265. 2. Reinehr T, Roth CL. Is there a causal relationship between obesity and puberty? The Lancet Child & adolescent health. 2019;3(1):44-54. 3. WorldHealthOrganization. Facts and figures on childhood obesity. 2017. 4. Guglielmi V, Sbraccia P. Obesity phenotypes: depot-differences in adipose tissue and their clinical implications. Eat Weight Disord. 2018; 23(1):3-14. 5. Gomez-Hernandez A, Beneit N, Diaz-Castroverde S. Escribano O. 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FUNDING INFORMATION This research was funded by Europees Fonds voor Regionale Ontwikkeling (EFRO), project BriteN 2016. ORCID Ilse A.C. Arnoldussen Amanda J. Kiliaan https://orcid.org/0000-0002-7395-5284 https://orcid.org/0000-0002-2158-6210 13, 14, 16-26, 29-32 Furthermore, several receptors Nevertheless, We conclude Search strategy We searched PubMed for articles published before Novem- ber 15th, 2019 using relevant keywords, including âonset of puberty and adiposity/obesityâ, âonset of pubertyâ, âchildren with obesityâ, âadipose tissueâ, âchildhood obesityâ, âadiposityâ, âobesityâ, âadipokine(s)â, âHPG axisâ, âadipokines ovary/ova- riesâ, or âadipokines testesâ, either alone or in combination. 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Obesity Reviews. 2020;21:e13005. https://doi.org/ 10.1111/obr.13005 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are goverWH Ch 17.3 Birth of the American RepublicThe World after WWII: The birth of the UN and NATOHealth 11/12 Review for Final Exam Core Concepts - Mental and Emotional Health, Substance Abuse Prevention, Safety and Violence Prevention, Family Life and Human Sexuality, Disease Prevention and Control, Healthy Eating Health Education Skills - goal setting, decision making, accessing information/resources, analyzing influences, communication, self-management, advocacy DIMENSIONS of Wellness - social, spiritual, emotional/mental, environmental, financial, intellectual, multicultural, occupational, physical, sexual RISK factors - anything that increases the risk of disease, injury, or illness. PROTECTIVE factors - anything that decreases the risk of disease, injury, or illness. INTERNAL health factors - health factors that can be either hereditary and genetic or acquired elements -- include smoking and personal diet or eating habits. Example â a genetic predisposition to an illness. EXTERNAL health factors - health factors that are part of the direct outer environment, the geographical location, micro-organisms, socio-economic elements that could affect an individual's health. Example â being unable to afford mental health services. Unit 1- Managing Personal and Community Wellness Explain Maslowâs Hierarchy of Needs in your own words using the image provided. Explain how each Social Determinant of Health may impact a personâs health. Levels of Disease Prevention ⢠PRIMARY The goal is to avoid conditions altogether. ⢠SECONDARY The goal is early detection. ⢠TERTIARY The goal is to minimize the damage (manage). Define the following terms. Fads/Trends Sleep hygiene Driver safety Unit 2- Investigating Social Ecological Factors on Well-Being Socio-Ecological Model â The SEM examines how health behaviors form based on characteristics of individuals, communities, nations and levels in between. Each level overlaps with other levels signifying how the best public health strategies are those that encompass and target a wide range of perspectives. Interpersonal (personal) health vs. intrapersonal (relationship) health Health INEQUITY - systemic, ingrained and unjust barriers that prevent segments of the population from having the opportunity of health leading to health disparity. IMPLICIT BIAS - a form of bias that occurs automatically and unintentionally, that nevertheless affects judgments, decisions, and behaviors. Research has shown implicit bias can contribute to unequal access to quality healthcare, negative patient-provider relationships and interactions; and create mistrust in the healthcare system and practitioners among patients. This can contribute to health disparities. Health DISPARITY - represents a difference in health between populations. It is often used to describe disease burden and other negative health outcomes socially disadvantaged groups may face. Health EQUITY - The opposite of health inequity. It describes a system that supports a high standard of health and healthcare for all people. Racism - Beliefs, attitudes, institutional arrangements, and acts that tend to denigrate individuals or groups because of phenotypic characteristics or ethnic group affiliation. DISCRIMINATION - An unjust differential treatment of a person or a group. PRIVILEGE- The unearned access to resources and social power that are only available to some because of their membership within certain social groups. OPPRESSION is the act of taking away choices from others and can be defined as a system that maintains advantage and disadvantage based on social identities and that acts on multiple levels from interpersonal to institutional and societal. (internalized, interpersonal, institutional, structural) Systematic Oppression - Intentional disadvantage of groups of people based on their identity while advantaging members of dominant group (race, gender, sexual orientation, language, size, ability, etc.). Intersectionality - The complex, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism, and classism) combine, overlap, or intersect especially in the experiences of marginalized individuals or groups Unit 3- Accessing Resources and Communicating to Support Mental and Emotional Health What is anger? What is anxiety? What is stress? STRESSORS are the things that cause stress. Stressors can be internal and external. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time. INTERNAL Stressors - are made by your belief system and the way you evaluate yourself. Examples include pessimistic attitude, negative self-talk, deep need to be perfect, low self-esteem or body image, unhealthy standards for self. EXTERNAL Stressors - are stressful things that happen in your surroundings and/or in your environment. Examples include busy schedules, work problems, family issues, financial trouble, social problems, injury, unforeseen circumstances. Socio-economic issues are also a part of external stressors such as poverty, violence, and racism. Define the following mental health conditions. Depression Eating disorders NSSI Non-suicidal self-injury Grief/Loss Suicide prevention A.C.T. ⢠ACKNOWLEDGE- Tell them in a caring way that you recognize that they are having a problem ⢠CARE- You can show you care by actively listening - put away anything else you are doing, make eye contact, sit down, ask questions. ⢠TELL-(call 988 for additional help and support) - Tell them it is important that they speak with a trusted adult. Help them figure out who this may be and offer to go with your friend. A social norm is an unwritten, informal rule meant to guide behavior among the of society. It distinguishes between acceptable and unacceptable, good and bad, and so on. Social norms can influence a person with emotional or mental health disorders, access to care and stigmatize their situation. STIGMA- a mark of disgrace associated with a particular circumstance, quality, or person. ⢠Self-stigma - This describes the internalized stigma that people with mental health conditions feel about themselves. ⢠Public stigma - This refers to the negative attitudes around mental health from people in society. ⢠Institutional stigma - This is a type of systemic stigma that arises from corporations, governments, and other institutions. Unit 4- Evaluating Risks of Substance Use and Abuse Harm Reduction - a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Explain how each level of the Social Ecological Model is impacted by addiction. Individual Relationship Community Society SEM Level Contributing/Risk Factors to substance use Preventative/Protective Factors for substance use Individual Interpersonal/Relationship Community Society Unit 5- Analyzing Influences to Examine Ways to Increase Safety and Reduce Violence HATE CRIME - a crime, usually violent, motivated by prejudice or intolerance toward an individualâs national origin, ethnicity, color, religion, gender, gender identity, sexual orientation, or disability. Explain how the media influences violence in society. The Pyramid of Hate Explain the escalation of hate using the Pyramid of Hate visual. List several hate crime motivators. Example: age HEALTHY Relationship Signs - comfortable pace, trust, honesty, independence, respect, equality, kindness, taking responsibility, healthy conflict, fun UNHEALTHY Relationship Signs - intensity, possessiveness, manipulation, isolation, sabotage, belittling, guilting, volatility, deflecting responsibility, betrayal Sexual Assault is a sexual behavior WITHOUT consent. Human trafficking - the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, using force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery. Sex trafficking - commercial sex act induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age. Trafficking happens using⌠⢠Force - using violence to control someone. ⢠Fraud - using lies to control someone. ⢠Coercion - using threats to control someone. Unit 6- Family Life and Human Sexuality Agency - A belief about yourself and the extent to which you can act on that belief. ⢠The ability to choose freely oneâs own narrative. ⢠To embrace the idea that I am the cause (or agent) of my own thoughts and actions. ⢠Personal agency is a personal responsibility for who we are, what we experience, what we do about that experience, and how we shape our world to give us more of the experiences we want. SEXUAL Agency ⢠The ability to choose your own interests and desires vs. what we see in the media or othersâ perceptions ⢠The ability to identify, communicate, and negotiate oneâs sexual needs ⢠The ability to initiate behaviors that allow for the satisfaction of those needs Sexually Explicit Material - photographs, videos, films, magazines, and books whose primary themes, topics, or depictions involve sexuality that may cause sexual arousal. Sexual scripts - thoughts, patterns, or behavior that a person has about themselves in a romantic or sexual context. It is how people picture themselves or want to project themselves in front of others. Reproductive Rights of Teens - In Maryland, teens have the right to an abortion, keep their child, obtain and use birth control, paternity tests, adoption, give up custody of their child within 10 days of birth (Safe Haven Law). ⢠REPRODUCTIVE RIGHTS- legal rights and the freedom of the individual to control decisions regarding contraception, abortion, sterilization and childbirth. ⢠SAFE HAVEN LAW- a distressed parent who is unable or unwilling to care for their infant can safely give up custody of their baby, no questions asked. CONSENT is an agreement between participants to engage in sexual activity. ⢠It is clearly and freely communicated, verbal, and affirmative. Consent CANNOT be given if⌠⢠A person is underage, one or both partners is intoxicated or incapacitated by drugs or alcohol, one partner is asleep or unconscious, one partner feels pressured, threatened or intimidated, or one partner holds a position of power or authority over the other. Unit 7- Advocating for Enhanced Nutrition, Food Systems, and Health Outcomes Dietary Guidelines for Americans Guideline 1: Follow a Healthy Dietary Pattern at Every Life Stage Guideline 2: Customize and Enjoy Food and Beverage Choices to Reflect Personal Preferences, Cultural Traditions, and Budgetary Considerations Guideline 3: Focus on Meeting Food Group Needs with Nutrient-Dense Foods and Beverages, and Stay Within Calorie Limits Guideline 4: Limit Foods and Beverages Higher in Added Sugars, Saturated Fat, and Sodium, and Limit Alcoholic Beverages FOOD DESERT- a neighborhood where there is little or limited access to healthy and affordable food such as fruits, vegetables, whole grains, low-fat milk and other foods that make up the full range of a healthy diet. FOOD INSEQURITY lack of access to a sufficient amount of food because of limited funds. More than 49 million American households are considered food insecure and are vulnerable to poor health as a result. PROCCESED FOODS- any raw agricultural commodities that have been washed, cleaned, milled, cut, chopped, heated, pasteurized, blanched, cooked, canned, frozen, dried, dehydrated, mixed or packaged â anything done to them that alters their natural state.