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Certainly, let's expand on each section in detail so you can learn more from the provided text: # Summary This text aims to explain various aspects related to technology, particularly focusing on a concept known as "Tech Disruption." It explores how technology affects different sectors, outlines the conditions for tech disruption, discusses the industrial revolutions, introduces the laws of disruption, and mentions factors influencing technology choices. ## Concept of Technology **Technology** encompasses a range of elements within organizations. It includes **expertise, equipment, and procedures** used to convert inputs, such as resources or raw materials, into outputs, which can be products or services. This involves various aspects, such as **product design, production techniques, quality assurance measures, human resource development, and management systems**. In essence, technology represents the tools and knowledge used to create and deliver goods or services effectively. ## What is Tech Disruption **Tech Disruption** refers to a phenomenon where smaller companies with limited resources successfully challenge well-established incumbent businesses. This disruption is primarily driven by **technology**, which acts as the catalyst, enabler, or even the sole reason behind the change. The significance of this concept lies in the fact that entrepreneurs must make careful and thoughtful decisions when it comes to adopting and investing in technology. **Why it's Important?** These decisions are crucial because they involve significant investments and will have a substantial impact on a company's ability to create, innovate, and operate its services in a sustainable and cost-effective manner. ## Four Main Impact **Tech Disruption** has four main impacts on businesses and industries: 1. **Shifting Customer Expectations**: As technology evolves, customer expectations change. Companies must adapt to meet these evolving demands to remain competitive. 2. **Enhanced Products Through Data**: Data-driven insights improve the productivity and efficiency of assets, leading to better products and services. 3. **New Partnerships and Collaboration**: Tech disruption encourages companies to form new partnerships and collaborations, recognizing the importance of working together to stay relevant. 4. **Transformation of Operating Models**: Traditional operating models are being transformed into digital models, where technology plays a central role in how businesses operate and deliver value. ## The 11 Macro Sources of Distribution The **11 Macro Sources of Distribution** represent various factors that influence the distribution of resources and opportunities in society. These factors include: 1. **Wealth Distribution**: How wealth is distributed among individuals and entities. 2. **Education**: The availability and quality of education opportunities. 3. **Infrastructure**: The state of infrastructure, such as transportation and communication networks. 4. **Government**: Government policies and regulations that impact resource distribution. 5. **Geopolitics**: Geopolitical factors, such as international relations and conflicts. 6. **Economy**: Economic conditions and trends, including markets and financial systems. 7. **Public Health**: The state of healthcare and public health systems. 8. **Demographics**: Characteristics of the population, such as age and gender. 9. **Environment**: Environmental factors and sustainability concerns. 10. **Media and Telecommunications**: The role of media and communication technologies. 11. **Technology**: Technological advancements and their impact on society. ## When Does Tech Disruption Happen? **Tech Disruption** occurs when specific conditions are met: ### Technology Is Mature Enough - **Technology Accessibility**: Technology must be accessible to a wide range of people and organizations. - **Critical Mass**: It should have reached a critical mass where it can create significant impact. - **Affordability**: Technology must be affordable for businesses to adopt. ### Sector Is Ready For Change - **Tech Infrastructure**: The sector should have the necessary technological infrastructure in place. - **Policy Framework**: A conducive policy framework is essential to support and regulate the use of technology. - **Lack of Disruption**: If the sector is stagnant or facing issues, it becomes ripe for tech disruption. ### Sector + Technology + Timing + Product - **Mature Technology with an Unready Sector**: If technology is mature but the sector is not ready, it can lead to building the wrong product based on incorrect assumptions. - **Unmatured Technology with a Ready Sector**: Conversely, if technology is not matured but the sector is ready, it may take longer to develop the product. ## Ready for Industri 5.0? This section briefly outlines the five industrial revolutions: 1. **Industri 1.0 (1784)**: Marked by mass production assembly lines using electrical power. 2. **Industri 2.0 (1870)**: Introduced mechanization, steam, and water power. 3. **Industri 3.0 (1969)**: Characterized by automated production, computers, IT systems, and robotics. 4. **Industri 4.0 (Present)**: Involves smart factories, autonomous systems, IoT (Internet of Things), and machine learning. 5. **Industri 5.0 (Future)**: Envisions mass customization and cyber-physical cognitive systems. ## Three Laws of Disruption These laws explain the nature of disruption: 1. **Disruption Comes to All**: Disruption is a universal phenomenon; it affects all industries and businesses sooner or later. 2. **Product-Market Fit**: Disruption occurs due to changes in Product-Market Fit, which means aligning a product with its target market effectively. 3. **Methods to Change Product-Market Fit**: To address disruption, a company can change the product, the target market, or influence people's preferences regarding the product. ## The 40% Rule This rule provides a framework for evaluating the fit between a product and its market: - **Value Proposition**: The product should solve customers' problems effectively. - **Channels**: The product should be able to reach customers cost-effectively. - **Monetization**: Customers should be willing to pay for the product. ## PMF Framework: 5 Steps to Product/Market Fit The **PMF (Product/Market Fit) Framework** consists of five steps: 1. **Business Modeling**: Developing a business model that aligns with the market. 2. **Market Validation**: Confirming that there is demand for the product in the market. 3. **Customer Interviews**: Gaining insights from potential customers. 4. **Product Development and Customer Acquisition**: Creating the product and acquiring customers. 5. **Product Analytics**: Using data to determine if the product has achieved Product/Market Fit. ## Factors Determining the Choice of Technology Several factors influence the choice of technology: 1. **Government Policy**: Government regulations and policies can encourage or restrict the adoption of specific technologies. 2. **Available Resources**: The resources, both financial and human, impact the adoption of technology. 3. **Technological Capability**: The organization's technological capabilities influence the choice of technology. 4. **Existing Technological Level**: The current technological state of the industry or organization plays a role. 5. **Institutional Arrangement**: Organizational structures and arrangements affect technology choices. ## Conclusion In conclusion, the text emphasizes the critical role of technology in driving change and disruption in various industries. It highlights the need for informed decision-making when it comes to technology investments, as well as the conditions necessary for tech disruption to occur. Understanding the historical context of industrial revolutions, the laws of disruption, and the factors influencing technology choices is essential in today's fast-paced and tech-driven business environment. Embracing technology disruption is crucial for transforming business models and adapting to evolving market dynamics.
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 Desirée Nieuwenhuis | Natàlia 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. © 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-α 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- α 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-α 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-α, 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-α 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-α, 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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BMC Womens Health. 2018;18(1):168-174. thereby an early onset of obesity. leptin can inhibit the production of testosterone in boys and subse- quently inhibit the development of secondary sex characteristics affecting spermatogenesis. for other adipokines, like resistin and omentin, are present in the testes and ovaries suggesting a role in puberty or reproduction; 58, 71 however, their plausible function is still unknown. that adipokines may be key regulators in an early onset of puberty in both girls and boys with obesity, specifically by affecting the HPG axis during gonadarche. Future research should focus on assessing puberty onset by measuring consistent puberty markers and determine the percentage of body fat and its distribution and adipokines and hormone serum levels particularly involved in the HPG axis. CONFLICTS OF INTEREST The authors declare no conflict of interest. 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 ‘onset of puberty and adiposity/obesity’, ‘onset of puberty’, ‘children with obesity’, ‘adipose tissue’, ‘childhood obesity’, ‘adiposity’, ‘obesity’, ‘adipokine(s)’, ‘HPG axis’, ‘adipokines ovary/ova- ries’, or ‘adipokines testes’, 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 gover
HEALTH EDUCATION 3. SPECIFIC OBJECTIVES: Students should able to know about_______ 1. definition of health education 2. aims of health education 3. objectives of health education 4. principles of health education 5. scope of health education 6. planning of health education 7. steps in planning health education 8. levels of health education 9. doctors s responsibility 4. INTRODUCTION: Health education is a term frequently used by health care professional. its aims at individual and community health. Health education is the translation of what is known about health into desirable individual and community behaviour pattern by means of an education process. Definition: “A process aimed at encouraging people to want to be healthy , to know how to stay healthy, to do what they can individually and collectively to maintain health And seek help when needed”. OBJECTIVES - To inform people or disseminate scientific knowledge about prevention of disease and promotion of health - To motivate people to change their habits and lifestyle that are harmful to their health also motivate people to adopt habits and ways of living conducive to healthy living. - To guide the people who need help to adapt and maintain healthy practices and lifestyle by showing proper community resources. --- PRINCIPLES OF HEALTH EDUCATION - Credibility Of Message: It is the degree to which the message to be communicated is perceived as trustworthy by the receiver. - Creating interest among participants: It is a psychological principle that people are unlikely to listen to things that are not of their interest. If a health programme is based on the felt needs, people will participate in the programme willingly. - Motivating the participants: Motivation is like a petrol engine that drives the mental engine. It is the fundamental desire in every person to learn. Motivation is contagious; one motivated person may spread motivation throughout the group. 13. - Enhance comprehension of content: It means health education should be based on the level of understanding, education and literacy of people at whom the teaching is directed. Teaching should be within the mental capacity of the audience. - Ensure reinforcement: Repetition at intervals is necessary to promote learning. Without reinforcement and feedback, students can go back to the pre-awareness stage. - Encourage active participation: Health education should aim at encouraging people to work actively with health workers and others in identifying their own health problems and also in developing solutions. 14. - Learning by doing: Teaching is effective when individuals actively participate in health education. Learning becomes active and quicker if the individuals are made active physically as well as psychologically. - Known to unknown: The people in a community know something and the health educator enlarges this knowledge. If the health educator links new knowledge with the old knowledge, it can enhance learning. - Maintaining good human relations: Sharing of information, ideas and feelings happens most easily between people who have a good relationship. 15. - Setting an example: The health educators should set a good example in the topic they are dealing with as it fosters better understanding. - Regular feedback: Feedback is one of the key concepts of the system approach. The health educator can modify the elements of the system in light of the feedback from his audience. For effective communication, feedback is of paramount importance - Efficient leadership: Leaders are agents of change and they can be made use of in health education work. Psychologists have shown and established that we learn best from people we respect and regard. 16. The essential attributes of a leader are as follows - Understands the needs of the community. - Provides proper guidance. - Takes initiative. - Is receptive to the views and suggestions of people. - Identifies himself with the community. Is selfless, honest, impartial, considerate and sincere. - Is easily accessible to people. 17. SCOPE OF HEALTH EDUCATION 1. Nutrition 2. Hygiene 3. Family health 4. Disease prevention and cantrol 5. Psychological health 6. Prevention of accident 7. Use of health services 8. Human biology 19. - Nutrition: The aim of nutrition education is to guide people to choose optimum and balanced diets, remove prejudices and promote good dietary habits. nutrition education is a major intervention for the prevention of malnutrition, promotion of health and improving the quality of life. 20. - Hygiene: This has two aspects: personal and environmental. Personal: The aim of personal hygiene is to promote standards of personal cleanliness . Environmental: Has two aspects: Domestic and community. All environmental sanitation programmes should include health education 21. - Family health: The family is the first defence as well as the chief reliance for the well-being of its members. One of the main tasks of health education is to promote family self-reliance, especially regarding the family's responsibilities in child bearing, child rearing, self-care and in influencing their children to adopt a healthy lifestyle. 22. - Disease prevention and control: Drugs alone will not solve health problems. Without health education, a person may fall sick again and again from the same disease. Educating the people about the prevention and control of locally endemic diseases is the first of the eight essential activities in primary health care. 23. - Psychological health: Psychological health problem can occur everywhere. There is a tendency to an increase in the prevalence of psychological diseases when there is a change in society from agriculture to an industrial economy and when people move from the warm intimacy of a village. 24. - Prevention of accidents: Accidents are a feature of the complexity of modern life. Accidents can occur in home, road and place of work. The predominant factor in accidents is carelessness that can be tackled by health education. 25. - Use of health services: Many people, particularly in rural areas, do not know what health services are available and many more do not know. There is a communication gap between the public and state health administration in the form of feedback for further improvement of health services. One of the declared aims of health education is to inform people about the health services available in their community. 26. PLANNING FOR HEALTH EDUCATION planning: is the process of making thoughtful and systemic decision about what needs to be done , how it has to be done, by whom And with what sources. 27. Principles of planning health education 1) Focus on actual current needs and context of community: It is important that plans are made with the needs and context of the community in mind. Health education should try to understand what is currently happening in the community one works in. 2) Plan for basic needs and interest of the community: Consider the basic needs and interests of the community. If the local needs and interests are not kept under consideration, the plans may not be effective. 28. 3) Planning with actual beneficiaries of health education: Plan with the people involved in the implementation of an activity. If people are included in planning, they will be more likely to participate and the plan will be more likely to succeed. 4) Identify and use all relevant community resources: It is essential that the health educator identify all the relevant resources that are locally available which could be used for benefit of people receiving the health education. 29. 5) Follow principle of flexibility: Planning should be flexible, not rigid. One should be able to modify the plans when necessary. For example, you would have to change your priorities if a new problem needing an urgent response arose. 6) A realistic plan not hypothetical: The planned activity should be achievable and take into consideration the financial, personal resources available and time constraints. Planning must be realistic; do not plan unachievable activities. 30. Steps in planning health education Planning is a continuous process. It does not just happen at the start of project . Health education must be well planned to actually improve and promote individual, family and community health 31. - Needs assessment: Conducting needs assessment is the first and probably the most important step in any successful planning process. assessment is the process of identifying and understanding the health problems of the community and their possible causes. - Identify priorities: After identifying the needs and resources of the community, the next is to identify their priorities because each community may have several problems but the urgent have to be given top priority in health education. For example: goitre 32. - Set the goals and objectives: In planning the process of health education, setting goals and objectives is the third and most essential step because these goals and objectives serve as consciously thought baseline parameters to be achieved during health education. - Develop strategies: Prior to the implementation of the health education intervention one must plan, develop and evaluate the several alternative strategies to achieve the set goals and objectives of health education because each problem and target community is quite unique. 33. - Implementation: This is the core phase of the health education process which includes carrying out the planned strategies so that the set goals and objectives of health education may be achieved. - Monitor and evaluation: This is the final step of the planning process of health education where continuous monitoring as well as end evaluation is carried out to ensure the degree to which stated goals and objectives have been achieved. 34. LEVELS/APPROACH OF HEALTH EDUCATION 35. INDIVIDUAL LEVEL - Individual Approach: The health education must first create an atmosphere of friendship and allow the individual to talk as much as possible. In this individual teaching we can discuss, argue and persuade the individual to change his behaviour. But by this we can reach to a small population and who come in contact with us. Methods of individual health education 1) Home visit 2) Personal contact/ counselling 3) Personnel letters 36. 1) Home visit: A home visit is one of the best approaches for individual health education because it can become one of the best opportunities for health education with individuals and their families. Home visits are important to understand the real background of families, their living conditions and the environment in which they live. 37. 2) Personal contact/counseling : Personal contacts or counselling (one-to-one communication) is a helping process where one person explicitly and purposefully gives his or her time to assist people explore their situations and act on a solution. After this the counsellor needs to work together with the person to find solutions that are appropriate to their situation. 38. 3) personal letters: Personal letters may also be used for individual health education, where health educators may get an opportunity to dispatch letters or printed education material to the people in a target community. 39. GROUP LEVEL Group health education may be useful way to deliver health education massages in efficient manner. A well organized group permits sharing of experiences and skills so that people are able to learn from each other. 40. Methods of group discussion 1)Lecture method: (Chalk & Talk ) A lecture may be defined as carefully prepared oral presentation of facts organized thoughts and ideas by a qualified person. The group should not be more than 30 and talk should not exceed 15-20 minutes. By using suitable audiovisual aids. 2) Group discussion: A group is an aggregation of people interacting in a face to face situation. It is a very effective method of health communication. 41. 3) Demonstration: A demonstration is a carefully prepared presentation to show how to perform a skill. This procedure is carried out step by step before an audience. 4) Panel discussion: In a panel discussion 4-8 qualified persons talk about the topic. Sit and discuss a given topic in front of a large group/audience. The chairman opens the meeting. Panel comprises of a chair person and 4-8 speakers. After the main aspect of the subject are explored, the audience is invited to take part. 42. 5) Symposium: It is a series of speeches on a selected subject. Each expert person present it briefly and at the end of session the chair person make a comprehensive summary. Audience are allowed to raise question. 6) Workshops : It consists of series of meetings usually 4 or more with emphasis on an individual work, within the group and with the help of consultants and response personnel. 7) Role play: This is a brief acting out of an actual situation for the benefit of the audience for better understanding. 43. 8) Conference and seminars: This programmes are usually held on a regional, state/national level. Where several experts from different disciplines meet to deliberate on a particular theme, to appraise others of latest knowledge and research in a particular field. 9) Open forum: It refers to the public meeting which are held for various purposes in the community, for example: gram sabha 44. COMMUNITY LEVEL It is meant for a defined community and is not only to create awareness but also to help people understand their health problems and needs, find alternatives solutions to their problems and needs , implement them, evaluate and get feedback and accordingly do the needful. For health education at the community level, it is better to approach local leaders who are influential and who have the people’s confidence. These may include local officers such as gramsevak, panchayat sarpanch ,police officer or block development officer etc . 45. HOSPITAL LEVEL 1) Health Education in OPD/Outdoor: The patient and his attendants have to spend a lot of time in the outpatient department for health check-up, treatment, registration, diagnosis, admission procedure etc. This period can be utilised for health education. For this, the following means/devices can be used: - Exhibiting pictures, posters, charts, bulletin board and models in the waiting hall. - Arranging group discussion, slide show, or documentary film in a proper place and on a proper topic. - Giving health education on a personal level in the consulting room. This mainly includes nutrition clinic, family planning clinic, psychiatric clinic etc. 46. - Distributing pamphlets. - Arranging street plays or nukkad naatak in the outpatient department or its neighbourhood. 47. 2) Health Education in wards/ IPD: While taking care of the patients the indoor patients, doctors s have the opportunities to educate them. This period can be fully utilised to give health education to the patients. For this the following methods can be effective: - Conversation with the patient and motivating him for change in his behaviour. - Imparting health education by arranging live demonstration for nutrition, treatment, diagnosis etc. - Providing clinical or bedside teaching. - Providing incidental teaching to patient and his attendants. 48. - Presenting examples. To describe the gains of health education in an individual suffering from the same health education in an individual suffering from the same disease and arranging a meeting between the patient and the cured old patients.
Multiple Choice Questions A6. You’ve hired a third-party to gather information about your company’s servers and data. The third-party will not have direct access to your internal network but can gather information from any other source. Which of the following would BEST describe this approach? ❍ A. Backdoor testing ❍ B. Passive footprinting ❍ C. OS fingerprinting ❍ D. Partially known environment A7. Which of these protocols use TLS to provide secure communication? (Select TWO) ❍ A. HTTPS ❍ B. SSH ❍ C. FTPS ❍ D. SNMPv2 ❍ E. DNSSEC ❍ F. SRTP A8. Which of these threat actors would be MOST likely to attack systems for direct financial gain? ❍ A. Organized crime ❍ B. Hacktivist ❍ C. Nation state ❍ D. Competitor A9. A security incident has occurred on a file server. Which of the following data sources should be gathered to address file storage volatility? (Select TWO) ❍ A. Partition data ❍ B. Kernel statistics ❍ C. ROM data ❍ D. Temporary file systems ❍ E. Process table Quick Answer: 33 The Details: 43 Quick Answer: 33 The Details: 44 Quick Answer: 33 The Details: 45 Quick Answer: 33 The Details: 46 6 Practice Exam A - Questions A10. An IPS at your company has found a sharp increase in traffic from all-in-one printers. After researching, your security team has found a vulnerability associated with these devices that allows the device to be remotely controlled by a third-party. Which category would BEST describe these devices? ❍ A. IoT ❍ B. RTOS ❍ C. MFD ❍ D. SoC A11. Which of the following standards provides information on privacy and managing PII? ❍ A. ISO 31000 ❍ B. ISO 27002 ❍ C. ISO 27701 ❍ D. ISO 27001 A12. Elizabeth, a security administrator, is concerned about the potential for data exfiltration using external storage drives. Which of the following would be the BEST way to prevent this method of data exfiltration? ❍ A. Create an operating system security policy to prevent the use of removable media ❍ B. Monitor removable media usage in host-based firewall logs ❍ C. Only allow applications that do not use removable media ❍ D. Define a removable media block rule in the UTM Quick Answer: 33 The Details: 47 Quick Answer: 33 The Details: 48 Quick Answer: 33 The Details: 49 Practice Exam A - Questions 7 A13. A CISO (Chief Information Security Officer) would like to decrease the response time when addressing security incidents. Unfortunately, the company does not have the budget to hire additional security engineers. Which of the following would assist the CISO with this requirement? ❍ A. ISO 27701 ❍ B. PKI ❍ C. IaaS ❍ D. SOAR A14. An insurance company has created a set of policies to handle data breaches. The security team has been given this set of requirements based on these policies: • Access records from all devices must be saved and archived • Any data access outside of normal working hours must be immediately reported • Data access must only occur inside of the country • Access logs and audit reports must be created from a single database Which of the following should be implemented by the security team to meet these requirements? (Select THREE) ❍ A. Restrict login access by IP address and GPS location ❍ B. Require government-issued identification during the onboarding process ❍ C. Add additional password complexity for accounts that access data ❍ D. Conduct monthly permission auditing ❍ E. Consolidate all logs on a SIEM ❍ F. Archive the encryption keys of all disabled accounts ❍ G. Enable time-of-day restrictions on the authentication server Quick Answer: 33 The Details: 50 Quick Answer: 33 The Details: 51 8 Practice Exam A - Questions A15. Rodney, a security engineer, is viewing this record from the firewall logs: UTC 04/05/2018 03:09:15809 AV Gateway Alert 136.127.92.171 80 -> 10.16.10.14 60818 Gateway Anti-Virus Alert: XPACK.A_7854 (Trojan) blocked. Which of the following can be observed from this log information? ❍ A. The victim's IP address is 136.127.92.171 ❍ B. A download was blocked from a web server ❍ C. A botnet DDoS attack was blocked ❍ D. The Trojan was blocked, but the file was not A16. A user connects to a third-party website and receives this message: Your connection is not private. NET::ERR_CERT_INVALID Which of the following attacks would be the MOST likely reason for this message? ❍ A. Brute force ❍ B. DoS ❍ C. On-path ❍ D. Disassociation A17. Which of the following would be the BEST way to provide a website login using existing credentials from a third-party site? ❍ A. Federation ❍ B. 802.1X ❍ C. PEAP ❍ D. EAP-FAST Quick Answer: 33 The Details: 53 Quick Answer: 33 The Details: 54 Quick Answer: 33 The Details: 55 Practice Exam A - Questions 9 A18. A system administrator, Daniel, is working on a contract that will specify a minimum required uptime for a set of Internet-facing firewalls. Daniel needs to know how often the firewall hardware is expected to fail between repairs. Which of the following would BEST describe this information? ❍ A. MTBF ❍ B. RTO ❍ C. MTTR ❍ D. MTTF A19. An attacker calls into a company’s help desk and pretends to be the director of the company’s manufacturing department. The attacker states that they have forgotten their password and they need to have the password reset quickly for an important meeting. What kind of attack would BEST describe this phone call? ❍ A. Social engineering ❍ B. Tailgating ❍ C. Watering hole ❍ D. On-path A20. A security administrator has been using EAP-FAST wireless authentication since the migration from WEP to WPA2. The company’s network team now needs to support additional authentication protocols inside of an encrypted tunnel. Which of the following would meet the network team’s requirements? ❍ A. EAP-TLS ❍ B. PEAP ❍ C. EAP-TTLS ❍ D. EAP-MSCHAPv2 Quick Answer: 33 The Details: 56 Quick Answer: 33 The Details: 57 Quick Answer: 33 The Details: 58 10 Practice Exam A - Questions A21. Which of the following would be commonly provided by a CASB? (Select TWO) ❍ A. List of all internal Windows devices that have not installed the latest security patches ❍ B. List of applications in use ❍ C. Centralized log storage facility ❍ D. List of network outages for the previous month ❍ E. Verification of encrypted data transfers ❍ F. VPN connectivity for remote users A22. The embedded OS in a company’s time clock appliance is configured to reset the file system and reboot when a file system error occurs. On one of the time clocks, this file system error occurs during the startup process and causes the system to constantly reboot. Which of the following BEST describes this issue? ❍ A. DLL injection ❍ B. Resource exhaustion ❍ C. Race condition ❍ D. Weak configuration A23. A recent audit has found that existing password policies do not include any restrictions on password attempts, and users are not required to periodically change their passwords. Which of the following would correct these policy issues? (Select TWO) ❍ A. Password complexity ❍ B. Password expiration ❍ C. Password history ❍ D. Password lockout ❍ E. Password recovery Quick Answer: 33 The Details: 59 Quick Answer: 33 The Details: 60 Quick Answer: 33 The Details: 61 Practice Exam A - Questions 11 A24. What kind of security control is associated with a login banner? ❍ A. Preventive ❍ B. Deterrent ❍ C. Corrective ❍ D. Detective ❍ E. Compensating ❍ F. Physical A25. A security team has been provided with a noncredentialed vulnerability scan report created by a thirdparty. Which of the following would they expect to see on this report? ❍ A. A summary of all files with invalid group assignments ❍ B. A list of all unpatched operating system files ❍ C. The version of web server software in use ❍ D. A list of local user accounts A26. A business manager is documenting a set of steps for processing orders if the primary Internet connection fails. Which of these would BEST describe these steps? ❍ A. Communication plan ❍ B. Continuity of operations ❍ C. Stakeholder management ❍ D. Tabletop exercise A27. A security administrator is concerned about data exfiltration resulting from the use of malicious phone charging stations. Which of the following would be the BEST way to protect against this threat? ❍ A. USB data blocker ❍ B. Personal firewall ❍ C. MFA ❍ D. FDE Quick Answer: 33 The Details: 62 Quick Answer: 33 The Details: 63 Quick Answer: 33 The Details: 64 Quick Answer: 33 The Details: 65 12 Practice Exam A - Questions A28. A company would like to protect the data stored on laptops used in the field. Which of the following would be the BEST choice for this requirement? ❍ A. MAC ❍ B. SED ❍ C. CASB ❍ D. SOAR A29. A file server has a full backup performed each Monday at 1 AM. Incremental backups are performed at 1 AM on Tuesday, Wednesday, Thursday, and Friday. The system administrator needs to perform a full recovery of the file server on Thursday afternoon. How many backup sets would be required to complete the recovery? ❍ A. 2 ❍ B. 3 ❍ C. 4 ❍ D. 1
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 universe’s 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 Hubble’s observations, the astronomer came up with Hubble’s law which showed a correlation between how far an object is and the speed at which it’s 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 NASA’s 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 Agency’s 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 can’t 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. It’s 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 you’re 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.
To understand melody in music, think about some music you’re familiar with. If you were asked to hum it, what would that sound like? The part of the music that you’d hum is the melody. It’s the main thread of sound that your brain tracks and holds onto when you’re listening to music. In vocal music, the melody is sung by the lead singer. Other vocalists can provide harmony and instruments can add accompaniment, but the melody is the star of the show.What are the characteristics of melody in music? How do you describe a melody in music? A melody needs to have two things. The first is a sequence of notes, or pitches, which range from high to low. The second is rhythm, which is the timing and duration of each note. These two simple elements can create an incredible variety of combinations. Even though a melody only consists of one note at a time, it can convey so much energy and emotion. Melodies can be fast and sparkly, like “The Flight of the Bumblebee.” They can be slow and majestic, like “Finlandia.” They might be sweeping and graceful, like a Strauss waltz. Or they can be fun and exciting, like your favorite pop tunes that you love to sing along with. Melodies often tell you a lot about where a piece of music comes from. It’s easy to recognize and identify melodies from different folk traditions such as the Japanese folk song “Sakura” or the Irish tune “Star of the County Down.” Learn how to play your favorite melodies on piano, and more! Sign up now. What is melody in music? Here are some examples. Here is the famous melody for the song “Lean on Me” written out on a staff. Notice the way that the notes move up, down, and then repeat. What is melody in music? Example of Lean On Me notes on treble staff. A melody all by itself is great, but music can be even more fun when there’s an accompaniment. Here are a few bars of “Lean on Me” with the accompaniment written out. As you listen to this song, notice how the accompaniment has a very similar rhythm and movement to the melody. Then there’s that one note in the bass line that comes along every measure with its own rhythm, which adds some extra energy and movement to the song. What makes a good melody? When you create a melody, there are four types of movement you can use: Repeat (same note) Step (up or down) Skip (up or down) Leap (up or down) Stepping and repeating are the most common types of melodic motion, and this makes a melody easier to sing. Most “hummable” tunes use steps and repeats almost exclusively. This kind of melody is called conjunct. Beethoven’s “Ode to Joy,” one of the most famous melodies of all time.Skips and leaps are generally more sparing in melodies, but when thoughtfully placed they can have a powerful emotional impact. Tunes with a lot of leaps are called disjunct. Listen to Sarah Brightman sing All I Ask of You from The Phantom of the Opera starting at 0:39. This is a very disjunct melody, and challenging to sing. Great melodies also incorporate patterns that blend unity, repetition, and contrast. Our ears love patterns, but they also love novelty and growth. A good melody incorporates all of these elements. For example, listen to John William’s “Princess Leia Theme.” Can you hear the repeated pattern in the melody that gradually moves higher as the theme progresses? Now listen to the way it changes and develops into something that fits with what came before but sounds new at the same time. This is some great melodic writing! Can melody exist without rhythm? There is no way for a melody to exist without rhythm. Even if your melody only has one note, that note has a duration, and that’s the rhythm. If your melody has two notes, how long those notes last and how much time passes between hearing them is also a rhythm. A melody in music can often be recognized even when it’s performed with different rhythms. This frequently happens in live performances of pop, rock, and jazz, in which singers typically improvise slight rhythmic differences with each performance. No two renditions are exactly the same, and this constant reinterpretation keeps the music fresh. How to make a melody for a song on piano Creating your own melodies on the piano is easy and fun! There are so many ways you can discover a melody all your own. Here are a few ideas. Get some inspiration from the world around you. What can you hear right now? A clock ticking? A bird song? A car passing by your house? See if you can find some notes on the piano that imitate the sounds you hear. Think of a feeling you’d like to put into a melody. What are some ways you could make a string of notes sound happy, sad, angry, or maybe just thoughtful. Choose a line from a poem you like, or write your own. Read it out loud and put some feeling into it. Did your voice rise and fall in pitch as you were reading? Now go to the piano, start on any note you like, and try to imitate what happened when you read. Go up when your voice naturally went up, go down when your voice naturally went down. How did that sound? Now you have the perfect melody to go with those words. Too many keys on the piano? The truth is, most melodies use only a limited number of different notes. Try creating a melody using only the black keys. These form what’s called a pentatonic scale. It’s used in a lot of folk music traditions around the world and can be a great place to start if you want to create your own melodies. Remember, when you create your melody, keep it simple. Use repeated notes and steps, but add a few skips to keep things interesting. One tip about leaps: when you do put in a big leap, try doubling back and filling in the empty space you leaped over. This keeps the melody self-contained and easier to sing. Also, see if you can use the same patterns of notes and rhythms to give the melody unity, but also change those patterns to give it variety. There is no right or wrong way to create your own music. Keep trying combinations of notes and rhythms until you find something that you like. How many bars and notes are in a melody? Many types of music tend to have a prescribed number of bars, or measures. This will vary widely between different genres, and creates an overall sense of musical structure. If you’re writing a pop song, a verse will usually have between eight and sixteen bars. The prechorus that follows often has just four bars, and this “foreshortening” creates a sense of acceleration, driving the listener toward the chorus. The number of notes can also vary widely. A melody in music needs at least two notes, and a long and complex one can have hundreds or even thousands of notes. What is a countermelody in music? How many melodies should a song have? A counter melody is a melodic line that interacts with the primary melody as an independent but supportive voice. A great example of this is the song “We Don’t Talk about Bruno.” Each character sings their own melody during the piece, but these melodies all combine at the end as countermelodies. This produces a musical texture known as counterpoint. The same thing happens in “One Day More” from Les Miserables. The different melodies are first sung separately, but end up being combined in a splendid, complex texture that leads the music to its thrilling conclusion. The difference between a countermelody and regular harmony is that harmony usually supports the rhythms of the melody. A countermelody will move more independently, with different rhythms from those of the melody, and will often sound “melodic” when sung or played all by itself. A melodic song should have one main melody. This is the part that the lead voice sings. It’s usually in the spotlight, and will be the most memorable part of the music. Anything else is either harmony, countermelody, or accompaniment. Does all music have to have a melody? A piece of music doesn’t have to have a melody. There are many different kinds of music without melody. For example, a lot of music played on percussion instruments won’t have a melody. Listen to this example of Tahitian drumming. This is some great music, exciting and fun to listen to, but you’d have a hard time humming it. It’s music, but it doesn’t have a melody. Rap music is another style of music where there doesn’t have to be a melody. In rap, words are chanted rather than sung. The performer will raise and lower the pitch of their voice for emphasis, but it’s the rhythm of the words that creates most of the music. Music can even lack any melody, at least in some sections. Listen to the opening chords of “Duel of the Fates.” This choral passage is all about harmony, with little rhythmic variance or sense of melody. But it makes an effective contrast with the next section, which is bustling with rapid instrumental melodies. In some pieces, there are multiple melodic lines but there is no one main melody. When music is made up of equally important countermelodies, it creates a contrapuntal texture. Baroque composer J.S. Bach was one of the greatest masters of this style, such as in his Little Fugue in G minor. It starts with a single melodic line, the subject, but then a countermelody is added, and then more and more until several melodic lines are playing together. It’s fun to listen to, but once all the countermelodies are playing together it becomes hard to decide which part to hum along with! You’ll also hear a lot of counterpoint in jazz music, in which the different instruments are all playing together and improvising their own melodies that combine to create a rich, thick musical texture. Experience the wonder of melody in music! Whether you’re humming your favorite tune, or creating a new song all your own, melody is a memorable, shareable part of music. Enrich your music experience by being aware of, listening for, and enjoying the melodies all around you.
Positive/Negative/Neutral Objects - How are they different? Positive: has fewer electrons than protons Negative: Has more electrons than protons Neutral: has equal numbers of protons and electrons Laws of Electric Charges - What are they? How are they applied? Like charges repel, opposites charges attract, charged AND neutral objects attract Induced Charge Separation - Explain this process. A shift of the position of electrons when a charged object is brought near it. If the charged object is positive, the electrons will move toward it. If the charged object is negative, the electrons will move away from it. Charging by Friction (What is happening with the charges? - Know electrostatic series examples) Process in which objects made from different materials rub against each other, producing a net static charge on each object. When charged by friction, one material will have a stronger attraction to electrons and will pull the electrons off the other material Charging by Conduction (Be able to explain what the electrons are doing) Charging by contact with a charged object. An object that becomes charged by contact always gets the same type of charge that is on the object that charges it. Grounding (Be able to explain how it happens) A method of removing static charges from an object. Electrons from the ground move up to the charged object. If the object is negative, electrons leave the object. If the object is positive, electrons enter the object. The ground always remains neutral Conductors/Insulators/Semiconductors (Know examples for each and characteristics) Conductor: A material that allows electrons to flow through it easily. GOOD CONDUCTORS: Silver, copper, gold, aluminium, magnesium, iron, usually metals Insulator: A material that prevents electrons from flowing through it. Plastic, wood and glass are examples. To prevent electric shocks, conductive wires are wrapped in insulators. Semiconductors: Have special properties that make them fair conductors, they are the foundation of modern electronics, including radios, computers and telephones. Charging by Induction (How do we induce a PERMANENT charge?) You can permanently charge an object using induction by attaching a conducting wire to the neutral object that goes to the ground Electric Discharge - What causes it? Know everyday examples. How is lightning formed? When two objects that have a charge imbalance are brought close together or come in contact with each other, electrons are transferred rapidly. Electrons move from the object with a more negative charge to the object with the less negative charge. Lightning occurs through an imbalance of charge between clouds and the ground. Negative charge at the bottom of a cloud repels the electrons at the earth's surface which move away, causing the ground to become positively charged Current Electricity: Refers to the electrons that flow in a controlled way through a conductor Forms of Current Electricity - Alternating Current (AC) vs Direct Current (DC) - How do they differ? AC: Electrons move back and forth, alternating their direction. produced in generating stations and is then distributed over long distances ex. Something plugged into a wall outlet
How is personal data collected? There are several ways that an unauthorised person can try and collect your data. These include: •phishing •smishing •vishing •pharming. Phishing Phishing is when a person sends a legitimate looking email to a user. The email contains a link to a website that also looks legitimate. The user is encouraged to click the link and to input personal data into a form on the website. The email could also simply ask the user to reply to the email with their personal data. The user is tricked into giving their personal data to a source that they believe is legitimate. However, both the email and the linked website are from a fake unauthorised source. The personal data that is input is then collected by an unauthorised person. This person can then use this data for criminal acts, for example, to commit fraud or steal the person's identity. Intimidation has become a common feature of phishing emails, threatening the user that they must click the link and rectify a situation immediately, or there will be a further issue. The aim of a phishing attack is to steal the user's personal data. Figure 5.1: Phishing. A real-life example of phishing PayPal have been the subject of several different phishing emails. Users receive an email that looks as though it has been sent from PayPal, as it has the PayPal branding. The email normally warns of an issue such as unexpected activity on their account, or that some kind of verification of their account is required. The user is then asked to click a link to log into their account and resolve the issue. The link takes them to a webpage that looks like the PayPal login page. If the user inputs their login details into this page, they will not be taken to their account. It is often at this stage that the user may realise that the email and webpage are fake. However, they have already given the unauthorised person their PayPal login details. Figure 5.2: An example of a phishing email claiming to be from PayPal. How to recognise phishing There are several guidelines to be aware of regarding emails to avoid being subjected to phishing. These include: •Don't even open an email that is not from a sender that you recognise or a trusted source. •Legitimate companies will never ask you for your personal data using email. Be immediately suspicious of any email that requests your personal data. •Legitimate companies will normally address you by your name. Be suspicious of any email that addresses you as ‘Dear Member' or ‘Dear Customer'. •Legitimate companies will send an email that uses their domain name. If you hover your mouse over the sender's name, it will show the email address that the email is sent from. If this does not look legitimate, for example, does not contain the correct domain name, then it is probably fake. For example, if the sender's email is user@paypal1.com rather than user@paypal.com, this is from an incorrect domain name. •Legitimate companies are protective of their professional reputation and thoroughly check any communications. They will make sure that all information given is grammatically and correctly spelt. Be suspicious of any email that contains bad grammar or spelling mistakes. •A link in an email from a legitimate company will also normally contain the domain name of the company. You can sometimes hover over the link, or right click and inspect the link, to see the address of the URL that is attached. If the URL does not contain the domain name, or also contains typical errors such as spelling mistakes, then be suspicious of this. PRACTICAL ACTIVITY 5.02 Ask a friend or a member of your family if they have ever received an email that they believed was a phishing email. Ask them how they identified it was phishing. Ask them if they know all of the given guidelines for identifying phishing emails. Smishing Smishing (or SMS phishing) is a variant of phishing that uses SMS text messages to lure the user into providing their personal details. The user is sent an SMS text message that either contains a link to a website, in the same way that phishing does, or it will ask the user to call a telephone number to resolve an urgent issue. The same advice can be followed for smishing as given for phishing. The user must question at all times any links that are sent from an unknown or suspicious user. It is advisable that if a user believes the message may be legitimate, to type in the domain name for the legitimate company website into their web browser, rather than following the link in the message. Users should block any numbers that they believe are suspicious to prevent any further risk of smishing from that number. Figure 5.3: Smishing. Vishing Vishing (or voice phishing) has the same aim as phishing, to obtain a user's personal details. The user receives a telephone call that could either be an automated system or could be a real person. An automated voice could speak to the user and advise them that an issue has occurred, such as there has been suspicious activity regarding their bank account. The user may then be asked to call another number, or just to simply press a digit and be directed to another automated system. This system will ask them to provide their bank account details to resolve the issue. The bank account details have then been obtained by the unauthorised user and can be used to commit a crime against the user. The automated system could be replaced by a real person who will try to do the same thing. They will try to convince the user that there has been an issue with an account they have and to provide the log-in details or PIN for the account to verify who they are so the issue can be resolved. The precaution to take for vishing is that no company will ever call you and ask you to provide any log-in details or PIN details over the telephone. They may ask you to provide other personal information, and if you are in doubt that the person on the other end of the phone is legitimate, it is always advisable to put the phone down and call the company back on a legitimate number that you may already know or can obtain. Figure 5.4: Vishing. Pharming Pharming is when an unauthorised user installs malicious code on a person's hard drive or server. The malicious code is designed to redirect a user to a fake website when they type in the address of a legitimate one. The fake website is designed to look like the legitimate one, to trick the user and make sure they are not aware that their request has been redirected. The user will then enter their personal details into the fake website, believing it is the legitimate one, and the unauthorised person will now have their personal data. A common technique used in pharming is called domain name server (DNS) cache poisoning. This technique exploits vulnerabilities in the DNS and diverts the internet traffic intended for a legitimate server toward a fake one instead. The unauthorised user needs to find a way to install the malicious code on the computer. They often hide the malicious code in an email attachment or link. When the user opens the email attachment or clicks the link, the malicious code is downloaded also. Figure 5.5: Pharming. The aim of a pharming attack is also to steal a user's personal data. A real-life example of pharming In 2007 50 different companies all over the world were subject to a pharming attack, these included PayPal, eBay, Barclays bank and American Express. Over a three-day period, hackers managed to infect over 1000 PCs a day with a malicious pharming code. When users who had been infected visited the websites of the different companies, they were redirected to a legitimate-looking version of the site that was designed to steal their personal data. The original email, containing the malicious code, was set up to look like a shocking news story. Users were encouraged to click a link in the email to find out more information. The code was downloaded when the user clicked the link. This was quite a sophisticated attack that required legitimate looking websites to be set up for a large number of companies. It is not known how much money the hackers were able to retrieve as a result. How to prevent pharming All of the guidelines to avoid being subjected to phishing are also relevant for recognising pharming. There are also several other precautions that can be taken to check for pharming attacks. These include: •Have a firewall installed and operational. A firewall monitors incoming and outgoing traffic from your computer. It checks this traffic against set criteria and will flag and stop any traffic that does not meet the criteria. A firewall could detect and block suspicious traffic, such as a malicious code trying to enter your system. •Have an anti-virus program installed that is designed to detect malicious pharming code. You need to scan your computer on a regular basis to check for any malicious code. It is advisable to set up an automatic scan on a daily basis at a time when your computer will normally be switched on. •Be aware when using public Wi-Fi connections. A hacker could look to directly access your computer and install the malicious code if you are connected to a public Wi-Fi connection. It is often advisable to use a VPN when using public Wi-Fi. This will help shield your internet activity and personal details from a hacker, making it more difficult for them to access your computer. Smishing can also be used as a form of pharming. A user is sent a link, that when they click is designed to download malware onto their mobile device. Therefore, it is advisable to have security software installed on your mobile and also scan it regularly to detect any presence of malware.