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Received: 26 November 2019 Revised: 10 January 2020 Accepted: 19 January 2020 DOI: 10.1111/obr.13005 PEDIATRICS/PHYSIOLOGY Adipokines: A gear shift in puberty DesirĂŠe Nieuwenhuis | NatĂ lia Pujol-Gualdo Amanda J. Kiliaan Department of Anatomy, Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, The Netherlands Correspondence Amanda J. Kiliaan, PhD, Associate Professor, Department of Anatomy, Donders Institute for Brain, Cognition, and Behaviour, Preclinical Imaging Center PRIME, Radboud university medical center, 6500 HB Nijmegen, Geert Grooteplein 21N 6525 EZ Nijmegen, The Netherlands. Email: amanda.kiliaan@radboudumc.nl Funding information Europees Fonds voor Regionale Ontwikkeling (EFRO), Grant/Award Number: BriteN 2016 1 | INTRODUCTION The prevalence of obesity in adolescents and children is increasing in | Ilse A.C. Arnoldussen | Summary In this review, we discuss the role of adipokines in the onset of puberty in children with obesity during adrenarche and gonadarche and provide a clear and detailed overview of the biological processes of two major players, leptin and adiponectin. Adipokines, especially leptin and adiponectin, seem to induce an early onset of puberty in girls and boys with obesity by affecting the hypothalamic-pituitary- gonadal (HPG) axis. Moreover, adipokines and their receptors are expressed in the gonads, suggesting a role in sexual maturation and reproduction. All in all, adipokines may be a clue in understanding mechanisms underlying the onset of puberty in child- hood obesity and puberty onset variability. KEYWORDS adipokines, obesity, puberty 1,2 the age of 5 years were overweight or were with obesity in 2016, and 3 Obesity is defined by an excessive accumulation of white adipose tissue (WAT), and it is often indicated by a body mass index (BMI) 4 above 30. Two main types of adipose tissue were described: WAT and brown adipose tissue (BAT), which differ in morphology and func- 5-7 Ilse A.C. Arnoldussen and Amanda J. Kiliaan contributed equally to this work. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Š 2020 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation Obesity Reviews. 2020;21:e13005. wileyonlinelibrary.com/journal/obr 1 of 10 https://doi.org/10.1111/obr.13005 alarming rates. Specifically, worldwide, 41 million children below this number is expected to increase to 70 million in 2025. obesity is associated with various severe health complications, includ- ing increased risk of diabetes mellitus type 2, hypertension, heart dis- eases, and disturbances in sex hormone levels. 5,6 and mitochondria and plays a role in thermogenesis. Adipocytes in tion. BAT consists of adipocytes containing multiple lipid droplets WAT contain only a few mitochondria and a single lipid droplet. Adipose tissue has several functions including the storage of energy, thermogenesis, and the production and secretion of adipokines Generally, two physiological processes, adrenarche and gonadarche, 11,24 Childhood 5,7,8 a key role in puberty onset. Puberty is known as a period through which the body changes physically, being a physiological process resulting in the maturation of children, i.e. they develop sexual characteristics and obtain reproduc- 9,11 Adipokines are involved in a number of physiological processes including blood pressure, metabo- lism, glucose, and vascular homeostasis and may play amongst others 8-10 (hormones, cytokines, and peptides). tive functions. between obesity and puberty,2,12-23 the biological mechanisms under- lying obesity and puberty onset remain unclear. Hereafter, we review in detail the role of adipokines in the onset of puberty in childhood obesity. Although many studies have shown associations 2 | INITIATION OF PUBERTY PHYSIOLOGICAL PROCESSES IN THE interact to regulate the onset of puberty. During adrenarche, the adrenal cortex secretes steroid hormones (including 2 of 10 NIEUWENHUIS ET AL. androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate (DHEAS), androstenedione, and cortisol), insulin-like growth factor, and growth hormone, which contribute to the pubertal insights on new genetic loci (e.g. melanocortin-4 receptor, mitochon- drial carrier 2, and mitogen-activated protein kinase 13) and on sev- eral pathways that regulate the timing of puberty; however, it partly 34 9,24,25 Both adrenarche and gonadarche are involved in the development growth spurt, body odor, skin oiliness, and skeletal maturation. explains puberty timing variation. Thereby, defining the role of 25 adipokines is of importance in elucidating the variability in puberty as the expression of adipokines is sex-specific and is altered with body composition, adiposity, and during growth spurts. Moreover, adipokines and their receptors are expressed in gonads and several brain regions suggesting involvement in the onset of puberty and sex- ual maturation. Lastly, adipokines interfere in processes regulating timing and duration of puberty, for instance in the HPA and HPG axes which are both key players during adrenarche and gonadarche. Involvement of adipokines in the onset of puberty and specifically in individuals with obesity will be further reviewed in the next 2,24 3 | Puberty onset in girls is assessed using different markers, such as thelarche (breast development), menarche (the start of of pubic hair. pituitary-gonadal (HPG) axis is activated,2,26 and several hormones have been identified to participate in the activation of the HPG axis During gonadarche (Figure 1), the hypothalamic- 2,27 Kisspeptin, neurokinin B, and dynorphin are released by specialized including kisspeptin, neurokinin B, dynorphin, leptin, and ghrelin. 28 key regulator of the pulsatile secretion of gonadotropin releasing neurons, the KNDy neurons in the hypothalamus. Kisspeptin is a 29,30 B stimulates, and dynorphin inhibits the release of kisspeptin, which hormone (GnRH) from the hypothalamus. In addition, neurokinin implies that both coordinate a pulsatile release of kisspeptin. 31 Sub- sections. sequently, the activated HPG axis induces the pituitary gland to secrete luteinising hormone (LH) and follicle stimulating hormone (FSH). As a result, gametogenesis occurs, and the gonads will release sex hormones. Consequently, secondary sex characteristics develop including breast development in girls and an increased testicular vol- 2,26,32 is possibly due to differences in levels of body fat, hypothalamic-pitui- THE ONSET OF PUBERTY IN GIRLS ume in boys. The age at puberty onset varies greatly among individuals, which 19 35 menstruation), and pubic hair development. 33 genome-wide association studies have provided important new tary-adrenal (HPA) axis activity, and genetic background. Recent The average age of However, this age differs between cultures and ethnicities, and since 1980, age at menarche is girls at start of menarche is 12.4 years. 36 significantly decreasing. 36-39 F I G U R E 1 Hormonal regulation in the initiation of puberty in boys and girls. The secretion of kisspeptin, neurokinin B, and dynorphin from KNDy neurons initiate the release of gonadotropin releasing hormone (GnRH) from the hypothalamus. This activates the pituitary gland to produce and secrete luteinising hormone (LH) and follicle stimulating hormone (FSH), which in turn stimulate the gonads to produce estrogen and testosterone in girls and boys, respectively 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 3 of 10 T A B L E 1 Summary of included studies Authors Year Country Study Design Primary Outcome Sex Sample Size (n) Age (y) Data Collection Lian et al21 2019 China Cross-sectional Puberty starts earlier in Chinese Han girls with obesity compared with Chinese Han girls with normal weight. Girls 2996 9-19 2012 and 2013 Biro et al12 Lazzeri et al20 2018 USA 2018 Italy Longitudinal Cross-sectional Body mass index had a greater effect on age at menarche than did race and ethnicity. Girls 946 6-16 2004-2014 Li et al23 2018 China Longitudinal For both, boys and girls, a higher BMI (ie, overweight and obese) is associated with earlier onset of puberty Girls Girls Boys Girls 542 Deng et al22 Flom et al15 2017 China Cross-sectional Increased BMI is associated with early timing spermarche and menarche. Boys Girls Girls 1278258 9-15 2005-2012 He et al24 Holmgren et al17 2017 China 2017 Sweden Cross-sectional Longitudinal Onset of puberty is not related to obesity in boys. Boys Boys Girls Girls 782 7-17 972 929 5839 Kelly et al19 2017 UK 2016 Brazil 2016 USA Longitudinal prospective cohort Higher BMI in girls is associated with the onset of menstruation at an earlier age. 11 10-18 11-17 Barcellos Gemelli et al25 Cross-sectional Longitudinal Excess weight is associated with early age of menarche. Girls 727 2014 2003-2009 Glass et al16 Lee et al26 In girls, but not in boys, greater adiposity is associated with the earlier onset of puberty. Boys Girls 135 Cabrera et al27 Leonibus et al14 2014 USA 2013 Italy Cross-sectional Longitudinal Thelarche occurred earlier than recently reported, while age of menarche remained unchanged. Girls 610 3-17.9 2007 2005-2012 Currie et al13 2012 Europe, USA, Canada Cross-sectional Overweight/obesity during childhood predicts the early onset of puberty in girls. Girls 20410 11, 13, 15 2005-2006 2017 USA Prospective birth cohort Overweight/obese status at the age of 7 ye was associated with increased risk of early menarche 788 From birth to menarche occurred Pregnancies 1959-1966 2016 USA Cross-sectional Boys with overweight enter puberty earlier compared with boys with normal weight or obesity, while puberty starts later in boys with obesity compared with boys with normal weight and overweight. Boys 3872 6-16 2005-2010 Overweight during childhood shows a relation with the early onset of puberty in girls. 6535 4259 695 11 15 5.8-12.2 2009/2010 2013/2014 2014-2017 Higher BMI during childhood is associated with early puberty. 2008 and 2009 2000-2002 Obesity during childhood is related to the earlier onset of puberty. Boys Girls 84 123 71 (Continues) 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 4 of 10 NIEUWENHUIS ET AL. 3.1 | Fat storage For the initiation of puberty, the timing of stimulation and/or inhibi- tion of different hormones is important, and additionally, a certain amount and distribution of body fat is needed in order to start menar- che, which emphasizes the importance of body fat. From an evolution- ary point of view, body fat increases in mammalian females during puberty onset, and it highlights the need to guarantee a healthy preg- 40 women with anorexia nervosa. particularly body fat localized predominantly on the gluteofemoral fat depots, is profoundly associated with start of menarche, more than nancy, offspring, and maternal survival. fat, sex-hormones, and neuroendocrine alterations can evolve in men- strual dysfunction, for instance, in women with severe obesity or in 41-43 44-46 to gluteofemoral fat depots suggesting that leptin may convey infor- amount of total body fat. mation on body fat distribution to the hypothalamus during puberty. An improper level of body Importantly, body fat distribution, Blood leptin levels are strongly related 45 3.2 | HPG axis The HPG axis is activated by the release of kisspeptin resulting in the release of GnRH from the hypothalamus, and LH and FSH from the pituitary gland. In girls, FSH is involved in the development of the folli- cles in the ovaries, and it promotes the secretion of estrogen. LH stim- ulates the production of androgen hormones and induces ovulation 48 9,47 the release of kisspeptin and neurokinin B, and kisspeptin thereby (Figure 1). The secretion of estrogen has an inhibitory effect on inhibits the GnRH release from the hypothalamus. pattern of GnRH is important for the regulation of the menstrual cycle. This roughly 28-day-cycle comprises several phases, including the follicular phase and luteal phase. During the follicular phase, increasing levels of FSH stimulate the maturation of follicles and the production of estrogen from the ovaries. This in turn inhibits the release of FSH from the pituitary gland. A high level of estrogen will induce the production of LH by the pituitary gland, resulting in ovula- tion. The matured follicle secretes progesterone thereby inhibiting the release of GnRH. When the corpus luteum is demolished, there is less 48 3.3 | Adipokines According to results from studies reported in Table 1, girls with obe- sity enter puberty earlier compared with girls with normal higher leptin concentrations inhibit the intake of food and increases inhibition of GnRH. As a consequence, the cycle will start again. whole process, starting from the activated HPG axis, results in the development of the secondary sex characteristics in girls including 9,47 thelarche and menarche. 13,14,16-23,49-51 weight. these girls might be found in the secretion of adipokines. For instance, leptin is positively associated with the amount of body fat. Generally, energy expenditure. 9,52-54 An explanation for the early onset of puberty in The expression This TABLE 1 (Continued) Authors Year Country Study Design Primary Outcome Sample Sex Size (n) Age (y) Data Collection Herman-Giddens et al28 2012 USA Cross-sectional Observed mean ages of beginning genital and pubic hair growth and early testicular volumes were earlier than in past studies, depending on the characteristic and race/ethnicity. Boys 4131 6-16 2005-2010 Sorensen et al29 Aksglaede et al30 2010 2009 Denmark Denmark Cross-sectional/longitudinal Longitudinal Puberty onset at earlier ages was associated with an increased BMI in boys. Boys 1528 5.8-19.9 1991-1993/2006-2008 1930-1969 Juul et al31 Ribeiro et al32 2007 2006 Denmark Portugal Retrospective cohort Cross-sectional Higher BMI is associated with early voice break. 11-15 10-15 1990-1999 Kaplowitz et al18 Abbreviation: BMI, body mass USA Cross-sectional The early onset of puberty in Caucasian girls is likely related to an increased BMI. 5-12 1992-1993 2001 index. The higher BMI in boys and girls at 7 y of age, the earlier they enter puberty. Boys 21 612 Girls 135 223 Boys 463 Boys 382 Girls 437 Girls 10 750 Early sexual maturation in boys and girls is associated with overweight. 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 5 of 10 Leptin may possibly play a role in adrenarche as its plasma level increases with higher levels of body fat and as it can modulate both girls. 33 ing adrenarche. In coherence, in children with obesity, the androgen These findings suggested that lower reproductive status was associated with higher total adiponectin concentrations and that a higher reproductive status was related to higher HMW adiponectin the HPA and HPG axes. These axes are functionally integrated dur- DHEAS was positively associated with leptin levels. Nevertheless, concentrations in girls. In addition, individuals with obesity often another study showed that enhanced adrenal androgen secretion in girls with premature adrenarche was not explained by leptin or BMI 55 ated with androgen levels in girls ; however, it was not related to levels. and IL-6. TNF-Îą alters, and IL-6 inhibits the expression of 56 8 In addition, the adipokine adiponectin was negatively associ- 57 differences of adiponectin seem to develop during the progression of 56 adiponectin (Figure 2). Thereby, a low level of total adiponectin and/or high levels of inflammatory cytokines in individuals with obe- sity can promote the onset of puberty. Many more adipokines are secreted by WAT including omentin, 52,65-67 9,36,62,68 adrenarche in girls with Prader-Willi syndrome. Interestingly, sex puberty. adrenarche; however, both are not required factors. Thus, leptin and adiponectin might be able to influence In gonadarche, leptin can stimulate the secretion of kisspeptin, and subsequently activation of the HPG axis, which eventually increases the expression of estrogen and androstenedione in the ova- 58 2,60 65-67 The expression of these ries (Figure 2). Ob gene in WAT, resulting in the synthesis and secretion of leptin. Thus, high levels of leptin promote onset of puberty in girls via secre- tion of kisspeptin, and estrogen stimulates leptin secretion addition- ally. Moreover, adiponectin can affect the HPG axis due to the expression of adiponectin receptors in the hypothalamus, pituitary In return, estrogen stimulates the expression of the 59 gland, and gonads. onset as it inhibits the secretion of kisspeptin and GnRH in the hypo- thalamus and the release of GH and LH in the pituitary gland, and 2,60-62 52,60 63 girls with central precocious puberty (CPP). Moreover, total adiponectin had negative correlations with progression of puberty in girls (defined by Tanner stages), whereas HMW adiponectin had FIGURE 2 Adipokinesaffectingthe initiation of puberty in girls. Leptin stimulates the release of kisspeptin in KNDy neurons, which activates the hypothalamus to produce gonadotropin releasing hormone (GnRH). In response to the release of GnRH, the pituitary gland secretes follicle stimulating hormone (FSH) and luteinising hormone (LH), which stimulates the ovaries to release estrogen resulting in the formation of secondary sex characteristics in girls. Estrogen stimulates the production of leptin. Adiponectin inhibits GnRH release resulting in reduced levels of GnRH and thereby a delayed onset of puberty. TNF- Îą and IL-6 inhibit the production of adiponectin and therefore stimulate the onset of puberty In detail, adiponectin is a regulator of puberty thereby inhibiting the onset of puberty (Figure 2). with obesity often have low levels of adiponectin. et al. showed that total adiponectin was significantly lower, whereas high molecular weight (HMW) adiponectin was significantly higher in ment. 55 63 develop a chronic low-grade inflammatory state, which can be indi- cated by a high level of circulating inflammatory cytokines like TNF-Îą 64 Individuals Sitticharoon positive associations with LH levels and the progression of puberty in 63 visfatin, resistin, and chemerin. and visfatin are expressed in the ovaries. adipokines in the ovaries suggests a role within the reproductive sys- tem; however, the exact biological processes have to be examined. Thus, specifically leptin, adiponectin, and inflammatory cytokines pro- duced by WAT could be permissive key players during an early onset of puberty in girls with obesity. As an exception, HMW adiponectin seems to have a stimulatory effect on peripheral repro- ductive function as HMW is not able to cross the blood brain 63 barrier. 4 | Markers that are used to assess puberty onset in boys are THE ONSET OF PUBERTY IN BOYS spermarche, voice break, testicular volume, and pubic hair develop- 35 spermarche develop in the early stages of puberty onset, voice In women, omentin, chemerin, While pubic hair development, larger testicular volume, and 69 testicular volume increases, which occurs at an average age of break usually appears in later stages of puberty. Generally, first 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 6 of 10 NIEUWENHUIS ET AL. 11.9 years, followed by the development of pubic hair at 12.2 years of average, and lastly, boys experience spermarche around an aver- 55 related with leptin levels. Thereby, leptin plausibly has a minor impact in adrenarche in boys. Since leptin receptors are found in the hypothalamus, pituitary gland, and testes, they might be involved in the onset of puberty by affecting the HPG axis during gonadarche. Leptin stimulates the release of kisspeptin and GnRH, and as a consequence, it accelerates the onset of puberty (Table 1, Figure 3). In contrast, adiponectin inhibits the secretion of GnRH, GH, LH, and FSH therewith delaying the onset of puberty. However, adiponectin levels are generally lower in men compared with women and even lower in men with obe- age age of 13.4 years. 70 4.1 | Fat storage Many aspects of the reproductive physiology are energetically demanding,71 and therefore, an adequate energy level is necessary. In boys, a dynamic change in body composition occurs around the age of 10 to 13 years, in which they gain approximately 40% of sity. culating inflammatory cytokines. levels can stimulate the HPG axis and therewith an early onset of puberty in boys. Nevertheless, leptin can inhibit the production of tes- 72 mostly consisting of lean mass, which causes exhaustion of most of fat. Subsequently, a growth spurt follows in which they gain tissue 72 in boys, an adequate amount of body fat is important in the onset of their body fat. These alterations in amount of body fat indicate that 4.2 | Puberty in boys is initiated by the release of kisspeptin. As mentioned before, this activates the HPG axis, resulting in the release of GnRH from the hypothalamus, and consequently the release of LH and FSH 9,74 puberty. tosterone from the testes, to estrogen (Figure 3). of the development of secondary sex characteristics in boys. Additionally, leptin can affect fertility in men as it can modulate the nutritional support of spermatogenesis, and moreover, dysfunction of spermatogenesis is associated with an increased leptin level and 73 58 2,60-62 HPG axis from the pituitary gland (Figure 1). and LH stimulates the secretion of testosterone from the testes, which inhibits the release of kisspeptin from the KNDy neurons and 9,48 in men, the release of kisspeptin is more consistent, causing a con- 29,48 subsequently GnRH from the hypothalamus. receptors expressed on KNDy neurons. In humans, KNDy neurons Contrarily to women, LH-induced testosterone levels lead to the stant release of LH. development of secondary sex characteristics in boys. differences between sexes in kisspeptin release are related to a sex- specific and sex steroid-dependent kisspeptin system as estrogen and progesterone modulate kisspeptin activity through the sex-steroid 48 in the infundibular nucleus are involved in negative and positive sex- 48 tal exposure to sex steroids and result in sex-specific differences in steroid feedbacks. kisspeptin release. These sexual dimorphisms are induced by perina- 75,76 4.3 | Adipokines The association between obesity and puberty onset in boys is rather controversial compared with findings in girls. Most studies reported an early onset of puberty in boys associated with increased ate adipose tissue from actual breast tissue. stages are more difficult to assess than female stages as boys lack a more determined marker such as menarche. Thirdly, puberty onset can be indicated by the activation of the HPG axis, and the presence of these secondary sex characteristics is the result of hormonal 2 14,17,22,23,50,51,77,78 BMI, 20,49 all while others reported no associations at Current markers used 79 16,80 or a delayed onset of puberty (Table 1). The presence of excessive adipose tissue can be involved in puberty onset in boys as the secretion of adipokines can modulate both adrenarche and gonadarche. Leptin can affect adrenarche by modulating both the HPG and HPA axes,33 and moreover, androgen levels were positively 55 nal androgen secretion in boys with premature adrenarche was not associated with plasma leptin levels. Nevertheless, enhanced adre- 9 In more detail, 61,62 adiponectin, and individuals with obesity often have high levels of cir- Moreover, inflammatory cytokines, TNF-Îą, and IL-6, inhibit expression of the leptin receptor in the testis. FSH induces spermatogenesis, too. function and role still have to be examined. 64 High leptin and low adiponectin and fat tissue can convert testosterone Both processes might result in the delay 29,61,79 81,82 In men, other adipokines like chemerin are found in the gonads 65 Thus, particularly high leptin and low adiponectin levels stimulate the HPG axis and thereby accelerate the onset of puberty in boys. Additionally, leptin can dysregulate the development of secondary sex characteristics and spermatogenesis by affecting testosterone levels and nutritional sup- port of spermatogenesis. 5 | LIMITATIONS AND FUTURE RESEARCH DIRECTIONS Even though multiple epidemiological studies have shown the link between puberty onset and obesity, there are some important limita- tions. Firstly, determining both the onset and stage of puberty is rather difficult. For instance, assessing the stage of breast develop- ment in girls with obesity is complicated as clinicians should differenti- 2 changes in response to the activated HPG axis. to determine the onset of puberty refer to secondary sex characteris- tics, such as testicular volume in boys and breast development in girls. A more accurate measurement of puberty onset would be to combine secondary sex characteristics with plasma or serum hormone level measurements such as LH, FSH, adipokines, e.g. leptin. Thereby, differences in puberty measurements could explain variations in the age of puberty onset between boys and girls within different Thereby, resistin is expressed in the testes of rats, but its exact 83 Secondly, male pubertal 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 7 of 10 FIGURE 3 Adipokines affecting the initiation of puberty in boys. Leptin activates kisspeptin secretion in KNDy neurons, this activates the production of gonadotropin releasing hormone (GnRH) from the hypothalamus. GnRH stimulates the pituitary gland to secrete follicle stimulating hormone (FSH) and luteinising hormone (LH), activating the production of testosterone from the testes allowing the development of secondary sex characteristics. Leptin also inhibits the production of testosterone, which may cause a delayed onset of puberty. Adiponectin inhibits GnRH release. Low levels of adiponectin, as a result of TNF-Îą and IL-6 expression, lead to a reduced inhibition of GnRH. In response to GnRH release, the pituitary gland will secrete FSH and LH, and the testes will produce testosterone resulting in the development of secondary sex characteristics in boys countries, and In addition, the inclusion of a of puberty. ferent time points is complicated, as subjects examined several decades ago presented pronounced differences concerning lifestyle patterns such as nutrition and exercise habits. Lastly, obesity or over- weight is often determined by BMI, a classification based on weight and height measurements. Additionally, it is important that all studies studies or across continents, ethnicities proper age range (8-16 years) is important when assessing the onset (Figure 4). 12-15,17,20-23,49,77-79,84,85 30,47 Furthermore, comparison between studies from dif- 86 Specifically in children, BMI is often dependent on age and growth use the same anthropometric standards and sex-specific cut-offs. 13,14,16-23,49-51,77-80 fat and would represent a more accurate measurement in its regard. Based on this review, several suggestions can be made for further research. Firstly, the roles of adipokines like resistin, chemerin, visfatin, and omentin in puberty onset, fertility, and sexual maturation should be examined in detail. Secondly, future research examining the onset of puberty should combine indicators of puberty onset (e.g. breast development or testicular volume) with plasma or serum hor- mone measurements such as LH, FSH, sex-steroids, adipokines (e.g. spurts. ment in case of growth spurts. distribution of body fat should be taken into account in determining puberty and obesity in children. For instance, the body adiposity index (BAI), which was introduced in 2011 by Bergman et al.,87 uses hip cir- cumference and height in order to estimate the percentage of body 87 Thereby, BMI is a less accurate measure- F I G U R E 4 87,88 Therefore, both percentage and Average age of puberty onset in Europe, China, and the United States according to several studies from Table 1. Age of puberty onset ranges from 8.47 to 13.33 years in girls and from 8.63 leptin), and body fat distribution (e.g. BAI,87 waist-hip ratio's and/or dual-energy X-ray absorptiometry (DXA)2). Additionally, defining con- sistent and general measurements of puberty in both boys and girls, combined with a proper age range (8-16 years), would facilitate the comparisons between different studies and their results. 12-15, 17, 20-23, 25-29, 31 to 13.7 years in boys. included if average age of markers used to assess puberty was not reported. Pink: girls. Blue: boys Studies (Table 1) were not 39, 56 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 8 of 10 NIEUWENHUIS ET AL. 6 | CONCLUSION In conclusion, epidemiological data regarding obesity and puberty onset in girls show similar outcomes as adiposity results in the early onset of puberty in girls. 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Ann Epidemiol. 2017;27(3):187-93.e2. 16. Glass NA, Torner JC, Letuchy EM, et al. The relationship between greater prepubertal adiposity, subsequent age of maturation, and bone strength during adolescence. Journal of bone and mineral research: the official journal of the American Society for Bone and Min- eral Research. 2016;31(7):1455-1465. 17. Holmgren A, Niklasson A, Nierop AF, et al. Pubertal height gain is inversely related to peak BMI in childhood. Pediatr Res. 2017;81(3): 448-454. 18. Kaplowitz PB, Slora EJ, Wasserman RC, Pedlow SE, Herman- Giddens ME. Earlier onset of puberty in girls: relation to increased body mass index and race. Pediatrics. 2001;108(2):347-353. 19. Kelly Y, Zilanawala A, Sacker A, Hiatt R, Viner R. Early puberty in 11-year-old girls: Millennium Cohort Study findings. Arch Dis Child. 2017;102(3):232-237. 20. Lazzeri G, Tosti C, Pammolli A, et al. Overweight and lower age at menarche: evidence from the Italian HBSC cross-sectional survey. 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 âonset of puberty and adiposity/obesityâ, âonset of pubertyâ, âchildren with obesityâ, âadipose tissueâ, âchildhood obesityâ, âadiposityâ, âobesityâ, âadipokine(s)â, âHPG axisâ, âadipokines ovary/ova- riesâ, or âadipokines testesâ, either alone or in combination. Selection criteria used were English language, longitudinal or cross-sectional studies assessing the onset of puberty, including menarche, thelarche, spermarche, or voice break, combined with high BMI or obesity/adiposity, and articles assessing or reviewing adipokines and its effects on the reproductive system. 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. 9 of 10 21. Lian Q, Mao Y, Luo S, et al. Puberty timing associated with obesity and central obesity in Chinese Han girls. BMC Pediatr. 2019; 19(1):1-7. 22. Deng Y, Liang J, Zong Y, et al. Timing of spermarche and menarche among urban students in Guangzhou, China: trends from 2005 to 2012 and association with Obesity. 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Circulating plasma leptin and IGF-1 levels in girls with premature adrenarche: potential implications of a preliminary study. Horm Metab Res. 2001;33(3):138-143. 34. Cousminer DL, WidĂŠn E, Palmert MR. The genetics of pubertal timing in the general population: recent advances and evidence for sex-spec- ificity. Curr Opin Endocrinol Diabetes Obes. 2016;23(1):57-65. 35. Marshall WA, Tanner JM. Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969;44(235):291-303. 36. Lacroix AE, Whitten R. Physiology. Treasure Island (FL): Menarche. StatPearls. StatPearls Publishing; 2018. 37. McDowell MA, Brody DJ, Hughes JP. Has Age at Menarche Chan- ged? Results from the National Health and Nutrition Examination Sur- vey (NHANES) 1999â2004. J Adolesc Health. 2007;40(3):227-231. 38. de Muinich Keizer SM, Mul D. Trends in pubertal development in Europe. Hum Reprod Update. 2001;7(3):287-291. 39. Talma H, SchĂśnbeck Y, van Dommelen P, Bakker B, van Buuren S, Hirasing RA. Trends in menarcheal age between 1955 and 2009 in the Netherlands. PLoS ONE. 2013;8:e60056-e60056. 40. Kaplan HS, Lancaster JB. An evolutionary and ecological analysis of human fertility, mating patterns, and parental investment. Off- spring: Human fertility behavior in biodemographic perspective. 2003;1: 170-223. 41. Mitan LA. Menstrual dysfunction in anorexia nervosa. J Pediatr Adolesc Gynecol. 2004;17(2):81-85. 42. Xu H, Li P-H, Barrow TM, et al. Obesity as an effect modifier of the association between menstrual abnormalities and hypertension in young adult women: Results from Project ELEFANT. PLoS ONE. 2018; 13(11):e0207929-e0207929. 43. Tauqeer Z, Gomez G, Stanford FC. Obesity in women: insights for the clinician. J Womens Health (Larchmt). 2018;27(4):444-457. 44. de Ridder CM, Thijssen JH, Bruning PF, Van den Brande JL, Zonderland ML, Erich WB. Body fat mass, body fat distribution, and pubertal development: a longitudinal study of physical and hormonal sexual maturation of girls. J Clin Endocrinol Metab. 1992;75(2): 442-446. 45. Lassek W, Gaulin S. Brief communication: menarche is related to fat distribution. Am J Phys Anthropol. 2007;133(4):1147-1151. 46. Loomba-Albrecht LA, Styne DM. Effect of puberty on body composi- tion. Curr Opin Endocrinol Diabetes Obes. 2009;16:10-15. 47. Simonneaux V, Bahougne T. A multi-oscillatory circadian system times female reproduction. Front Endocrinol. 2015;6:1-15. 48. Marques P, Skorupskaite K, George JT, Anderson RA. Physiology of GNRH and gonadotropin secretion. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. Endotext.org: South Dartmouth (MA); 2000. 49. Barcellos Gemelli IF, Farias EDS, Souza OF. Age at menarche and its association with excess weight and body fat percentage in girls in the Southwestern Region of the Brazilian Amazon. J Pediatr Adolesc Gynecol. 2016;29(5):482-488. 50. Aksglaede L, Juul A, Olsen LW, Sorensen TI. Age at puberty and the emerging obesity epidemic. PLoS ONE. 2009;4:1-6, e8450. 51. Ribeiro J, Santos P, Duarte J, Mota J. Association between over- weight and early sexual maturation in Portuguese boys and girls. Ann Hum Biol. 2006;33(1):55-63. 52. Budak E, Fernandez Sanchez M, Bellver J, Cervero A, Simon C, Pellicer A. Interactions of the hormones leptin, ghrelin, adiponectin, resistin, and PYY3-36 with the reproductive system. Fertil Steril. 2006;85(6):1563-1581. 53. Castellano JM, Tena-Sempere M. Metabolic control of female puberty: potential therapeutic targets. Expert Opin Ther Targets. 2016; 20(10):1181-1193. 54. Venancio JC, Margatho LO, Rorato R, et al. Short-term high-fat diet increases leptin activation of CART neurons and advances puberty in female mice. Endocrinology. 2017;158(11):3929-3942. 55. l'Allemand D, Schmidt S, Rousson V, Brabant G, Gasser T, Gruters A. Associations between body mass, leptin, IGF-I and circulating adrenal androgens in children with obesity and premature adrenarche. Eur J Endocrinol. 2002;146(4):537-543. 56. BĂśttner A, Jr K, MĂźller G, et al. Gender Differences of adiponectin levels develop during the progression of puberty and are related to serum androgen levels. J Clin Endocrinol Metabol. 2004;89(8):4053- 4061. 57. Unanue N, Bazaes R, IĂąiguez G, Cortes F, Avila A, Mericq V. Adre- narche in Prader-Willi syndrome appears not related to insulin sensi- tivity and serum adiponectin. Horm Res. 2007;67(3):152-158. 58. Michalakis K, Mintziori G, Kaprara A, Tarlatzis BC, Goulis DG. The complex interaction between obesity, metabolic syndrome and repro- ductive axis: a narrative review. Metabolism: clinical and experimental. 2013;62(4):457-478. 59. Machinal-Quelin F, Dieudonne MN, Pecquery R, Leneveu MC, Giudicelli Y. 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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 goverEff..rs of ott.-PoFllat i What woLrld hoppen ro our colnrry i, it is ovetsp.pulored? When our counrry is ovâŹ.-populdted, re @ âŹxpâŹri.nce rh⏠foll.wirg: Food is our bdsic h@d. WhâŹn thâŹ.Cs an ih.re.se ir populdtion it neans thar hore ,@d is iealed. It rheds ho .naJgh food, rrtrple irll srruggle wirh eddr othâŹr in ordeLro âŹ!'r- As o l!fllr, lhde rill be o f@d -- , ond ou, now]nert of on ihdiyiduol fron d c..tair - the move$eni o, on individudl our of o cerrain pla.e which help râŹduce ihe populotion of th6t fr ArcihâŹ. b.sic ned is w.ra. Wde. shorroge ocu.s when there is on ircreare of hu,nber of p@ple ro be $pptied. rn owr-popur.t d ore.s, woler is rdiorâŹd, Ir rEB rhoi supplies like ti,tWSS ond ,IWSI can'i $pply enoish worer. Do you hdve enough supply of sai.. in your oreo? Aside f.om food alld worer, shelier is olso ohe o, our inportant heeds. As the populoiion ihcre.!e!, building n.w hoLr!âŹs or rheltâŹr is limit.i. To find solulion to this prcblâŹn, some goverihent og.ncies dnd orhs non{ovâŹIhrehl offi.iofs (N6O) .onvefied sot@ ti.elields, du,np site. dnd nountcirlr inlo flbdivisions dnd relidentiols. Sut whot uould be ths effect o{ coMrtiig .i@fields to .6idâŹnri6l uits in our food supply? z , 2 Z Z :'", becouse there ore no enough space for prcpex garbage dkposol. ^s o râŹsulr, sore peoPle lend to ihrow'their gorbdge onywh.fâŹ. oorbdge baones brc{niry ond rursing ground of iEecrs and onidols ihot @se horm ro pe.ple. Dec.yiry garboge olso produces r,hpleaiant odor ard ehen burn if pmduces pois.nour qds @lled nelhohe As ihe populdtion incrâŹa3*, the 9d6.9e dso incraes. nris is T't ,,8 T H Wha you de living in on oa-populdi.d pla@, you moy oqaiae halrh prcblerns. Ir is be@@. the woi.r srpply is limit.d ihct will l..d you to poor hygi.ni. hobirs. In plo.4 like rhis, the surrouhdiigs naybe uniidy. o focrorthoi @uld oko cfFe.t your h4l'th. The common oilments rhot yd @uld oc$rire in ovesfDpllarâŹd ploces ore bEnchil is, o5l hnq. diqrrha and rube.culosis. 7,\ ,\\ \1" 6. Lnck of Herlrh sarvice llosi Pelple in 6n oM-populciâŹd 6ra 90 ro rubli. heilrh @trtas ond governhent hospirols be6u.e ii prcvides fr@ @Eulrorion oid los @sr rEdicdrions. A3 a ..suli, lhâŹs⏠gow.nnenr dgâŹrciB b.@ne itud.4$re in mcetiig ihe n eds b..ou!⏠df ihsrfficiâŹnr funds. Lock of medicol personnel ,o odmaiisiâŹI is also s problen in mosr hosptols evâŹn rhere or. od.audtc supply of hedicire!. 7_ Do you how wlry rhe crim⏠roi⏠hexs ih becdur⏠fiDre pe.ple o.e fnJrrctâŹd d@ ro sLfficiâŹ.i naE io supp.rr their forniliG. ouf country inclY{ses? If is uh.mploymâŹni dnd hdve no arinet .re u$dv grâŹ{rer ia dn dq-popltdled ra whq. tl, , a, v, tlr I E. Air ard WatâŹr Pollutioh How dir be.o'nes pollutâŹd? I11⏠dir b@'nâŹs p.llurn be.4ne of rhe hormfolgoees thot ser. produ.4 by the fdcioriâŹs and vehicles. Itete {octories ond whi.l6 @ fuel ro run nochiB ond .JBin6. In ,h⏠prc.ess, they give our Cdrboh Dioxide ond other ho.6ful gars.r such 6 Nittugei Oxide, Corbon l oioxide dnd Le.d iiio the oir. Do you know whot .ontdbute io ihe incrâŹasing number of whides qnd foctories? It is ihe inc.6e o, populdtion. As whdt I hove dis.!sse!, wirh a lihired sra.e 9@bd9e disposalie one of the problens thot .o!ld ise i, dh o!er-pop!,.tâŹd ploce. exn,jple ot thie orc rhos⏠pelpl⏠livi,rg oh the raverside teid 'ro ,hrou, lheir gEr&ge Hde you seen 'th. P6si9 river or the Tulyahan river? Did you {ind it Whdr do you think i! ihe effâŹ.t of ihis ih the.re4iures sho lives ih Ahothd f6do.s thal could.on rlbule to wdtd pollutioh dre oil s?ills, gorbqg⏠fro,n boa, or ships ahd som⏠ihdust.iol wosre. 9. Ite l@96f p4.enroge group. Individuols who orc this grclp. of olr popllarioh is compos.n of the working @pobla of s'rpporting ,heir fomilies nok !-up Though rhas group hol& the lojgeei percenroge of d. populaiion, rhis olso becomer one o{ oveFpopulored problâŹ]ns bâŹ4use there ore rc jobs awildble fo. oll of iha10. Erergy Shortdge ltere will be on energy shortdge iJ ihe populdtion incre63"l be.dise rhe d.,nand i. âŹle.iriciry is high. Why is thai wh.n th. PoPqldion inclE.g, rhe d4ord in el4tricity is high? Ir B be.ouse there $,ould be 8to.e hdsat dnd blildirys to lighr ond nore el?riric oPPliohces ro run. rt.6rcznho!3.Ef+ed Whor is rhe grernho@ effâŹ.r? In whoi say il c.uld offect c2 6re.hhG. effed is rhe wdrniltg of rhe drltlosphee. lvhen the 5un worft rhe.nrrh s1jrf.@, sone of rhe h@r goâŹJ bo.k ro rhe ornos?herc. Air an the dtnDsphere which is C@boi Dioxid. ,rops ihe heot 6hd it mok6 the a.th very worm. As ihe populdtion coniinuou!|,l gtol4 , the gt@rl$use etfe.t b@res no.e visible. Ir is becaosu ,hera ore mo.e focrories snd whicl.s iha, produce wdstâŹs ond fuma5 which cduses more C{.bo. Diodde ir the ormosphere. As a rcsutt, ,herc eiould be nore h4, ,rop in the ornosphere uhich osk6 th. @ih nuch wornerIf this will hoppen continuously, ,h⏠fish ih th⏠ocah *ill diâŹ, ricerields/f@mlands will dry too due to lh⏠wcm clitnole 12. Destruction of rhe Ozone Loyer A5 whot you hove l@med lrheh you de in v5-6, rhot the qzore ldver is 'the proiecrive loyâŹ. of the olnosPhdâŹ. ft protects us {rom the homful effects of ultrdviolei rays of the su. Do you khow ,hot our Ozore lolâŹt q4. dQ4tt\!ci.d? Il olreadY hod holes lhai dllow the ulrroviolet rdys to .4dt ihe @rrh. How do6 this hdpPei? Does th. in rc$e of poPuldioh h@⏠sonething 'to do tr,lh ir? Yes, rhe I6i grov/irts PoPuldiion .odribuied o lot be@use 6 th' populotion incre3es, rhe u5e of refrigerd'tors, dâŹrosol lProvs 6nd pl4srics 6bo ihcre&s6. The sid producls coiiojn chemicol called Chlorofluorocdrbons (CFCS) which is mix wafh ihe dir in ihe ormosPherâŹ. As o resulr. ihe hcrmfirl chernicol râŹoches the Prolectiw ldver dnd lhrowh. hole in {hid ult@iolzi cahders aid cai4.ct3 ,F.*Y.iis hi!586$qâŹ9.7,- Ho$ doas dcid rdin form? Is cid roii hdmful ro rEn? 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Thes⏠drc nisi, Do you krcw ihot Nuclerr power slotionr Use .adiodctive ,ndie.ials in producirE fuels, yet, rhey do and those .odioactiw rndlqlotE gi\e otf radio'ting en.rgy thoi is harmrul 'to livirq thilEs. wlren rodiotion enlert ihe body ot living things it {ill srq rhere for o lorg ,eriod of ri'ne. Exonple fhe rodiqtion vG srilled to the c.m. Then rhe @rn will be aie by rhe chicken, the .odiotion o the c.rn 'rill also 'tronsfâŹr to the chi.kâŹn. Wha on individuol als ihe nat of the chickeh sith mdiarion, helshe rill .ko oblorb ihe rodi@.tirc mtaid that will destrcy hB/her .âŹlls ond ruket hnn/hd si.r. Over-populoiion .on leld to food shoridgâŹ, wdter shorroqe, housiB problâŹms, qdrbog⏠problâŹrs, lock of halrh sdi.e. tisa ol clit@ rote, oir ond woiâŹr pollution, uhanpl6ynat, eiergy 5horr69e, grenhoq3⏠efreci, desrruction o( th. ozo@ lat/e?, rci.l roi. olld e.lâŹd. watta [t comes from the GREEK name "Epilepsia" which means "taking hold of or seizing". - It is a disorder characterized by: recurrent seizures. SEIZURES R ectment transient attacks of: R epresent: R esult from: ASSOCIATED WITH: somatic, psychic, or, autonomic clinical featmes. clinical features of abnormally hyperexcitable cortical neurons. paroxvsmal and excessive electrical neuronal discharges. EEG changes & may be disturbance of consciousness. same causes of convulsions 1. Idiopathic epile~ ⢠It is the commonest cause. no cause can be detected ( 65 % ) ⢠It may be associated with positive family history in some cases. ⢠It starts in the l st & 2nd decades in the form of: -- Grand ma! epilepsy. Petit mal epilepsy. Myoclonic epilepsy. Atonic seizures. 2. Secondary epilepsy A. Local causes in the brain: l. Congenital: 2. Traumatic: cerebral palsy. a cause can be detected cerebral contusion or laceration. 3. Inflammatory: 4. Neoplastic: 5. Degenerative: 6. Vascular: encephalitis, brain tumours. mening1t1s, presenile dementia. brain abscess. stroke (especially hemon-hagic), hypertensive encephalopathy. B. General causes with secondary effects on the brain: I. Toxic: 2. Iatrogenic: 3. Metabolic: 4. Endocrinal: 5. Organ failure: 6. Heart disease: 7. Nutritional: - Alcohol, cocaine, lead. - Lidocaine, INH. - j glucose & ! glucose. - Hypoparathyroidism. - Hepatic failme. - Adam's Stoke's attacks. - Pellagra. - Botulism, tetanus. - Ambilhar, Amphetamine, Aminophylline. - j Ca & ! Ca. - Hype1thyroid crisis. - Renal failure. - Fallot's tetralogy. - j Na & ! Na. - Vitamin B6 deficiency. 8. Physical: 9. HYSTERICAL. - High fevers. - Heat stroke. 136 137 CLINICAL PICTURE 1. GENERALISED SEIZURES " Excessive electrical discharges from cortical neurons in BOTH hemispheres simultaneously " I. II. 1. Grand Mal Epile~: 1. Pre-ictal stage "attacks of tonic-clonic convulsions " (aura) It is a warning sign of a coming attack. It may be: ⢠Somatic: ⢠Psychic: ⢠Autonomic: 2. Ictal stage Myoclonus, Hallucinations. Tachycardia, (seizure) Sudden loss of consciousness: Parasthesias. Sweating. for seconds to minutes. -- Tonic phase (few seconds) o The UL & LL: o o o o The HEAD: The JAWS: CYANOSIS: are extended. is retracted to one side & the eye balls rolled up. are firmly clenched, with biting of the TONGUE. due to impaired respiration. There may be incontinence of urine. Clonic phase (few minutes) o The UL & LL: o The HEAD: 3. Post-ictal stage - It may be: ⢠Somatic: ⢠Psychic: ⢠Autonomic: Drug of choice: contract & relax repeatedly & rapidly. jerks forcibly. (sequelae) Todd's paralysis(< 24 hours, due to neuronal exhaustion). Confusion. Vomiting. Carbamazepine (Tegretol) or Phenytoin (Epanutin) Petit Mal Epilepsy: "attacks of loss of consciousness " " Absence " It starts in childhood & improves at puberty & usually disappears at the age of 20. 2. It is NOT PRECEEDED by aura & NOT FOLLOWED by sequelae. 3. It is usually PRECIPITATED by: hyperventilation 4. It is characterized by: or photic stimulation. sudden loss of consciousness of short duration (few seconds). 5. It may be associated with: ⢠High frequency ( 50 attacks / day). ⢠Falling to the ground without warning. ⢠Jerky movements of the head & UL Drug of choice: (myoclonic petit mal). Valproate (Depakine) or Succinimide (Zarontin) 137 138 Ill. M oclonic Seizures: "attacks of involuntary clonic movements " - It is characterized by: sudden, jerky, shock-like INVOLUNTARY muscle contraction. ⢠The jerks are bilateral contractions, mainly of the shoulders and arms. ⢠However, some patients repmtjerking in the lower limbs, trunk, or head. - It may be of 2 types: - Occurs singly ⢠Simple: ⢠As a pait of: I Drug of choice: IV. Atonic seizures: (no loss of consciousness). - Grand mal epilepsy (aura). - Petit mal epilepsy. Valproate (Depakine) or Clonazepam (Rivotril) I - Transient attacks of brief loss of postural tone, often resulting in falls and injuries. 2. PARTIAL SEIZURES "Excessive electrical discharges from cmtical neurons in a ce1tain area in ONE hemisphere" A. Simple seizures: " No disturbance in consciousness " - The CP depends on the site of the hyperexcitable neurones in the cerebral cortex, whether in: "Motor area or Senso,y areas". 1. Motor fits: ⢠Focal fits: ⢠Motor jacksonian fits: 2. General Sensory fits: ⢠Focal fits: ⢠Sensory jacksonian fits: 3. Special Senso1y fits: ⢠Visual hallucinations: ⢠Auditory hallucinations: ⢠Olfactory hallucinations: B. Complex seizures: - SITE: movement of part of a limb or the whole limb. movement of one side of the body (see before). parasthesia of part of a limb or the whole limb. parasthesia of one side of the body (see before). irritation of the visual sensory area. irritation of the auditory sensory area. initation of the uncus. " disturbance in consciousness " The hyperexcitable neurons are in the Temporal lobe "Temporal lobe epilepsy". - DURATION: The seizure lasts few seconds to few minutes. - The seizure starts with A ura, followed by A bsence, Automatism, Amnesia: 1. 2. 3. 4. A ura: A bsence: Automatism: A mnesia: Olfactory hallucinations, Deja-vu phenomenon, Sensation of fear. Absent patient with staring eyes (with no response to conversation). Involuntary Purposeless acts: motor ( eg, lip smacking, chewing) or verbal. No recalling of the seizure. 138 139 3. PARTIAL SEIZURES ~ GENERALISED SEIZURES " Partial seizures may spread to involve the whole brain .- secondarily generalised seizures " . HY-sterical epilepsY ⢠Usually: ⢠The cause: ⢠Incidence: young neurotic Sj2 . psychological & there is no organic lesion. usually occurs in the presence of people. ⢠It is associated with: ⢠EEG: ⢠It is not associated with: normal. ⢠Missed ttt. ⢠Menses. ⢠Alkalosis. anxiety, palpitaion & hyperventilation. tongue biting or incontinence of urine. ⢠Alcohol use & Drug abuse ( e.g. cocaine ). ⢠S timulation by photons & Hyperventilation. ⢠S leep deprivation & Stress & sudden withdrawal of antiepileptic drngs. INVESTIGATIONS 1. EEG: ⢠It is the most specific test for epilepsy because it records the electrical activity of the brain. ⢠It shows specific pattern: 2. LOCAL INVESTIGATIONS: "Epilepsy waves". "CT & MRI of the brain" ⢠To identify or exclude a LOCAL CAUSE of seizures in the brain. 3. GENERAL INVESTIGATIONS: "Laboratory investigations" ⢠To search for a GENERAL CAUSE of seizures, e.g. blood glucose. 139 140 TREATMENT A. General Measures: 1. 2. Moderation of the patient's physical activity. A void the precipitating factors ( Alcohol, hyperventilation, photic stimulation ...... ). 3. A ketogenic diet is encouraged because it will induce acidosis: - Acidosis is beneficial as it raises the threshold of stimulation of the brain cells. B. Specific Treatment: 2. 1. Treatment of the cause in secondary epilepsy. Anti-epileptic drugs: a) Always sta1t with one drug, then add another drug if there is no response. b) Always stop the drugs ONLY if: ⢠The patient stays free of symptoms for at least 2 years. ⢠The patient has a normal EEG. 3. Side effects of Anti-epileptic drugs: I . Skin rash. 2. 3. Bone marrow depression. Ataxia. Drug 1. Barbiturates (Pbenonobarbitone) 2. Hydantoin (Epanutin) 3. Carbamazepine 4. Clonazepam 5. Valproate 6. Succinamide ANTI-EPILEPTIC DRUGS NEW ANTI-EPILEPTIC DRUGS - These drugs are new dtugs that may be used in resistant seizures. 1. Lamotrigine: 200 - 400 mg/ day. 2. Felbamate: 3. Gabapentin: 400- 800 mg/ day. 600 - 1200 mg/ day. \ " General rules for use ": Dose 100-600 mg I day 100-600 mg / day 200-600 mg I day 2-6 mg I day 500-1500 mg I day 500-1000 mg / day Best indicated - Broad spectrum. - Not for petit mal. - Grand mal. - Motor Jacksonian fits. - Grand mal. - Motor Jacksonian fits. - Complex seizures. - Not for petit ma!. - Myoclonic. - Grand mat. - Broad spectrum. - Petit mat. 140 141 STATUS EPILEPTICUS DEFINITION - A medical emergency: 1. Repeated attacks of generalized convulsions, with lack of recove,y of consciousness, 2. Persistent attack of seizure lasting for at least 30 minutes. OR, - If the convulsions are not stopped rapidly, coma deepens & death may occur due to: heart failure or respiratory failure or brain damage or hyperpyrexia. - The most common causes are: sudden withdrawal of anti-epileptic drugs & stroke. TREATMENT A. General Measures: l. Take care of: " ABC " ⢠Place the patient on the ground, to guard against falling from bed. ⢠Mouth gag & 02 inhalation ( endo-tracheal intubation may be needed). ⢠Record the vital signs regularly. 2. Take a sample of: - Venous blood: for the level of: - A.tierial blood: for the level of: 3. a nti-epileptic drugs, a lcohol. pH, p0 2, pC02, HC0 3. Give cerebral dehydrating measures: e.g. Frusemide, cone. Mannitol, Dexamethazone. B. Specific Treatment: - Phenytoin with diazepam (or clonazepam) immediately: 1. Phenytoin: 2. Diazepam: Clonazepam: seizures recur: 15 mg I Kg slow infusion. 5 mg slowly IV, to be repeated after 5 minutes if seizures recur: maximum dose: 20 mg. OR: 2 mg slowly IV, to be repeated after 5 minutes if maximum dose: 6 mg. - If seizures persist after 20 min. of Phenytoin & diazepam: 3. PHENOBARBITONE: - In resistant cases: 200 mg infusion. 4. GENERAL ANAESTHESIA: may be used.Nutrition Notes Nutrition- study of how your body uses food Process by which body uses nutrients How you look and feel Resist diseases and illness How you perform physically and mentally Nutrients: substances in food your body needs to grow, repair and supply energy to your body cells 6 Classes of Nutrients 1.Carbohydrates: 1 gram= 4 calories 2. Protein: 1 gram- 4 calories 3. Fats: 1 gram= 9 calories 4.Water 5. Vitamins 6. Minerals Calorie: measurement of energy in food Metabolism: Rate at which body burns energy(calories) Hunger: physical drive to eat Appetite: pshycological desire for food What influences your food choices: Foods you like Health Reasons Family and Culture Time & Money Advertising Emotions Friends Social Media: Modeling Nutrients Carbohydrates: your bodyâs main source of energy sugars/starches in food 45%-65% of diet #1 source of energy Simple: sugars converted to glucose= energy (fruits, dairy, honey, some manufactured foods) Complex: sugars linked together (starches) (grains, bread, pasta, beans, vegetables) Fiber: tough, indigestible carbohydrates Cleans our digestive system Prevents some types of cancer Prevents heart disease (fruits, vegetables, whole grains,nuts) 2. Protein: growth and repair of body tissues Made up of chemicals called âamino acidsâ Basic building material of all body cells (muscles, bones, skin, internal organs) Secondary source of energy protein(hemoglobin) attaches to oxygen in blood Functions as hormones regulating body functions 10-15% of diet *Body uses 20 Amino Acids found in food ( body produces 11 and 9 must come from diet) Essential amino acids: 9 amino acids body doesn't produce Complete Amino Acids: foods that contain all 9 essential amino acids ( animal products) Incomplete Amino Acids: food products that do not contain all 9 essential amino acids. Fats 15-25% of diet Secondary source of energy Blood clotting Controlling inflammation Maintains healthy skin/hair absorb /transport fat soluble vitamins Regulates body temperature Types of Fat Unsaturated: âgoodâ fat Liquid at room temperature Can help fight heart disease (veg oil, nuts) Saturated: âbadâ fat Solid at room temp Clogs arteries Causes strokes, heart attack, diabetes (animal products, meat, dairy) Cholesterol: waxy like fat substance found in meat products HDL: good type of cholesterol Body creates(liver) Creates cell wall, hormones, and vit D LDL: bad cholesterol- found in foods (clogs arteries) 4. Trans Fat: âone of the worst type of fatsâ Formed by a process called âhydrogenationâ: adding Hydrogen molecules to unsaturated fats to make it more solid and resistant to chemical change. Vitamins A vitamin is a chemical compound that is needed in small amounts for the human body to work correctly. Vitamins are classified as either fat soluble (vitamins A, D, E and K) or water soluble (vitamins B and C). This difference between the two groups is very important. It determines how each vitamin acts within the body. The fat soluble vitamins are soluble in lipids (fats). Fat soluble vitamins can be stored in our body Water soluble vitamins must be taken every day Human body produces some amounts of Vitamin D & KAbstract The main focus of this research is to discuss the perspective of the teamwork and its impaction organizational performance and success. Also highlight the Meanings of Team and its work sprit towards batter organizational performance and specific to its impact on the success of organization that provided the basis for this research study. In this research study a thoroughly focus was on organization and teamwork. The aim of this research is to deliver a participative view of teamwork in the organization, and also discourses the major issues and emphases on the recent work that opens the basis to move research onward. There is much worth in taking a more focus on the essential areas of teamwork. The team signifies the spirit and working capacity of the employees as team to bring organization to the success. The various explanations, definitions, processes, dimensions, team size and benefits etc. regarding the above topic teamwork and organizational success is highlighted. Keywords: Teamwork, Success, Organization, Performance, Work Groups, Employees Introduction It is indeed human beings have learned in their beginning of life to work together as (Team) that have made such a remarkable developments as unique specie. Human beings have experience throughout their social history, lived, loved, grow younger to older and worked together in groups said West M.A. (2012).The mutual social knowledge of living and functioning together creates connection among people, society and families. When work is done cooperatively as a team it can achieve extremely extra work than individually. Team can be defined as in the human society to live, to work and to play and to cooperate with others for particular task. According to John W. Newstrom et al (1993) âteam is the process of assessing performance of workers, passing information and exploring methods to increase performanceâ. If observe closely, one can discover the instances of The Government: Research Journal of Political Science Supplementary Edition Vol. III 88 The Government social (teams) they are functioning either effectively or ineffectively everywhere; organizations, schools, work place, home etc. âCoordinating the events of people is like sand house, making by using a sole particles of sandâ expressed Belbin, R. M.(2010). Moreover it is one of the general myths that the skill of team member is more important than their vigor, attention and determination for the tasks. Another widespread myth is that the team members are not alone accountable for the achievements or failures of their tasks the truth is that the members are the small parts in the teams and their individual abilities effect on the various results in team. The working relationships exist among team that might sight these relationships at different levels of involvement or relationships among the members as they move towards the degree of communication, integration and commitment increases. Terry L.G. et al (1980) expressed that âThe skills are essential if members have to work together efficiently in complex situations, only development of skills and relationships, involvement on the task regarding the particular task might be selected for reaching at target that is considered as a definition of a teamâ. Team often perform higher when they work together with sprit that enable them to achieve a collective goal at the workplace, it is not only benefits to the organization also affects the workers confidence and success. Cooperating on various tasks reduces workloads for all team members and enables them to share duties or ideas. Work as a team is the part of everyone's life, as one is a member of a family team, staff team, school team, and community teams etc., so as to understand how to work effectively as a team member. Especially there is a need when task is threatened with increasingly many problems for example; the energy problem has effects on organization, family life, and social development and the multi-dimensional nature of many problems require a scientific skill based problem solving approach. Terry L.G, et al (1980) expressed that âThe skills, competencies and efforts of team by setting priorities the team can have better impact on the problems solving such efforts can reduce work load, work duplication, and produce a result better than separate effortsâ. There are some processes of teamwork by adopting those the objectives can be achieved easily. Le Pine, et al, (2008) identified10 teamwork processes that fall in three categories following are those. TEAMWORK PROCESSES TRANSITION PROCESSES â˘Mission analysis â˘Goal specification â˘Strategy formulation ACTION PROCESSES â˘Monitoring progress toward goals â˘Systems monitoring â˘Team monitoring and backup behavior â˘Coordination INTERPERSONAL PROCESSES â˘Conflict management â˘Motivation and confidence building â˘Affect management Team Work 89 Teamwork process reduces the work stress on every member which permits members to complete given important task of organization; teamwork offers members an opening to pledge with each other. Also it develops relations between the members who start a teamwork they usually sense appreciated on productive accomplishment of task. It may be cited one of the best instances of surgical team; where surgeon is assisted by his team; nurses, anesthetist and experts etc., everyone knows that their success depends upon the teamwork. In addition they are devoted to the aim that is human life it is easy to succeed with best teamwork. The important role of manager is the team building, trust building, confidence building, in the team to achieve the task. In the Situation where all team members contribute the task, it develops the positive relationship in the team that improves the trust of team members.âFunctions effectively members of team must be flexible, committed, trusting each other and help to each otherâs in the progress and the achievement of goalsâ Expressed PlamĂnek (2008). The accountability of every member in the team must be increased so that they do not let each other down therefore they do their best for the achievements of their teams. In contrast, working alone on a task the pressure is generally high in team in those cases of small confidence impacts fewer on members. Team consists on members who always vary from each otherâs in skills, knowledge and abilities but working together that is an opportunity for them to gain skills and knowledge from each otherâs that they had never before. Working alone on a task is a challenge and using the ideas of each other brings them to come up with a mutual resolution and the achievement of the task. Nowadays theoretical development and research has rested largely a new trend that is emerging within the organizations as an essential process of teamwork. Teamwork has brought a new move in the research and development to the inputs and outputs that bound, constrain and impact on the team processes within organizations said Ilgen, D.R. (1999). The world is changes fast, any one set of instructions canât be sufficient, changes needs flexible members, teams and organizations so as to be effective on task. This paper suggests that in teams members must use the exclusive human abilities. Cannon B.et al (1995) has prĂŠcised dimensions of teams into three categories: Team dimensions 1-Cognitions: include associations, task team-mate characteristics, team mission, objectives, norms, and resources, team role interaction patterns, skills, roles, and team orientation. 2-Skills: consist on adaptability, shared situational awareness and mutual concept to conflict resolution. 90 The Government 3-Attitudes: symbolize motivation, collective potency, shared vision, team cohesion, mutual trust, collective orientation and importance of. Teamsize Researchers have given different approvals about the best size of team as Katzenbachetet al (1993) suggested that the teams should comprise on a dozen or so members which are enough to achieve a task. Although seven is the best size of the team in the organizational practices said Scharf, A. (1989). Several views of researchers are expressed in the literatures and it is difficult to decide which better is because their opinions are based on their own observations. The team size matters in the proper output and performance however from an empirical research it is also difficult to decide the suitable team size and what to accept. This study suggests that team size has a practical link with efficacy such as few or many member shave impact on the performance but size matters. Proper size of team improves the performance maximum stated Campion M. A et al (1996).These different results are expected due to the fact that appropriate team size is required for task, environment and situation where team works. However, larger teams can also experience coordination problems that delay performance. Sheppard, J. A. (1993) expressed that the question of best teamâs size is a complex one; more research is required on this topic to explain the impact of team size on given definite task. Literature Review Across many different organizations and industries teamwork is focused to increase the performance of employeesâ their unity and also create work culture. Organizations those regularly develop new ideas or products using a project-based approach and assemble teams in order to focus responsibilities to achieve the object. Researchers have given dissimilar meanings of âteamsâ. Dyer W.G. (2007) said that âteams are groups of people who trust in cooperation, if members are expert the success of goal is more possibleâ. It is essential due to the problemsolving cooperation added from many minds of team members working on a resolution of problems. Team members contribute their thoughts together to make exclusive plans for dealing with problems and this unity enhance the result due to interaction, trust and teamwork. Teamwork means a "work done by several companions with each doing a part but all subordinating personal prominence to the efficiency of the whole" Merriam, (2012). In addition combined employees are expected less hostile to each other and accepting more of each otherâs decisions. Unity of employees can increase the flow of work in organization. When employeeâs working together as a team, they learn from each other that awareness is based on their personal experiences and from coworkers; Team Work 91 employees from different departments may acquire knowledge from each other. The main object for organizations is to hold the team effort to achieve output and quality; team is a key to achieve quality productivity. According to Maddux et al (2003) âsome of the organizations have major benefits from the use of teamwork which are showed in the following chart: Benefits of Teamwork 1 Improving quality of work life for employees 2 Reducing absenteeism and increasing turnover 3 Increasing innovation and change 4 Improving organizational adaptability and flexibility A real team is mostly one where members are allowed to take decisions that how to complete task. That authority enables them to control the work process, decreases the outside control and increases the sense of duty for work. Team always feels superiority on workplace and they rely on each otherâs being there. PlamĂnek (2008) said that âaffiliation with teamwork gives member a sense of belonging, interaction and recognition of successâ. These actions support to remove the sense of loneliness of team member in organization. Effective teams can also improve efficacy through communication and trust between the team members, quality of work and decrease in absenteeism contribute to positive impact on team. Involving employees in teamwork helps the organization remain open to new ideas.âThe world of organizations is shifting individualism is out and collectivism is in, power is out, empowerment is in.â stated G. M. Parker (1998). This study discovers the experiences and difficulties of teamwork that employees and organizations are facing nowadays due to big transformation and enlarged globalization. In recent years a remarkable amendment has been emerged in the belief of team working organizations. The modern study has explored that the scope of teamwork have been appeared in system rooted in belief, and employees accept changes that denoting a modern organizational system. The organizations which are responsive to the changes appear to achieve greater satisfaction. Although it may be suggested that, the managers should assess the values and beliefs of their employees to play more dedicated role in the development of organization by making sprit to face the modern challenges. Organizational cultural is much significant and it has the excessive impact on the performance of organization and employeesâ but it is quiet arguable topic that the culture of teamwork can be developed according to the requirement. It is difficult to specify the relationships and to assess the reliable set of values to use as they believed symbol across the entire organizations. This review study focus that 92 The Government there is a great influence of organizational culture on the assumptions, values, and beliefs on the individualsâ considerations, actions and performances and so is vice versa, through learning, and training process. However the researchers believe that the organizational setup aids to unite employees of diverse cultures and dissimilar social backgrounds, traditions and have their own beliefs to work. Creating a positive teamwork culture it has several diverse aspects are goal setting, conflict resolution, empowerment, ability to accomplish tasks, measuring output and consideration for other teamwork cultures stated Pack L, et al April 27, (2012). Team work in the organization delivers employees the wisdom of unity; understand to each otherâs, and reducing conflict. In addition teamwork in organization inspires employee for impartiality by affirming that no one is ignored in the organization and all treated equally. It is known that a team in organization is bound and sincere to work with dedication to bring the success. If the employees are committed and recognize the teamwork values and its benefits, as a part of the organization they can contribute a lot to the achievement of organization. One can finds the informal instances of team at these level, family, society, community, tribe and work groups etc., and formally team appears at the level of departments, functional groups, and other organizational units. The employees feel a greater sense of achievement for being a part of an organization, if they attain team work, having freedom to work not forced. The system gives best performance to achieve recognition and credit from their managers and it will increase their effort that helps them to contribute the organizational performance. Each team batter knows about their role and how to achieve tasks. The true spirit of teamwork gives benefit to organization in maintaining its standard by which it becomes identified. The team defines its specialty, and the way it is doing task that is perceived by the organization as well as its managers and it is secured by appreciation. Employees identify what they believe; that exist in their belief system and those understandings call them to change their views to develop and raise attention towards batter performance. The literature contains sufficient definitions of teamwork and the word team is used to denote a set of generally developed as to learn collective values, attitudes and cooperation to work. The study praises that the teamwork is mostly related with the team success for instance, Wagner (1995) described that âin the team individual is less valued and group is more valued, withâ. It is found in the study that individualismcollectivism both regulates the relationships between team size, standing, and cooperation that have better effects on the cooperation of individualists rather than the cooperation of collectivists. Team Work 93 Conclusion The main concentration of this research paper is to examine more in-depth the fundamental of teamwork and its effectiveness to achieve the organizational goals. Teamwork provides vast amounts of knowledge and information, cultural differences each of these building a culture of teamwork and the skill to make the valuable solutions of the problems. To work efficiently, team members need a good understanding of how to do their job, to achieve goal and for that a basic way to ensure understanding is training, then they have to be motivated to do a job. Team is a vital activity of organization, when organization desires to perform sound it has to be confident that team functions effectively. Consequently it is compulsory to know how team performs, what manners within a team happen, and how they make decisions. If there is knowhow of teamwork events, it can be effective for the tasks that they have to accomplish. Organizations build up their own culture through tradition, history and structure these values can be accepted by team workers of an organization. The values and assumptions are the vital tools of organizations and are used as guidance for team. These have to do mostly with the basic dignity and worth of all members of team and the ability, necessity for them to solve the problems and work for the positive change. Through this review study is concluded that there is a good impact of teamwork on the organizations doings and success. Subsequently in recently developed literature there is a great focus amongst the social scientists and scholarsâ in their discussion on the above topic teamwork. The above study is also an evidence of little effort to assess the significance of teamwork in organizations success. teams in organizIntroduction to Free Fall A free-falling object is an object that is falling under the sole influence of gravity. Any object that is being acted upon only by the force of gravity is said to be in a state of free fall. There are two important motion characteristics that are true of free-falling objects: ⢠Free-falling objects do not encounter air resistance. ⢠All free-falling objects (on Earth) accelerate downwards at a rate of 9.8 m/s/s (often approximated as 10 m/s/s for back-of-the-envelope calculations) Because free-falling objects are accelerating downwards at a rate of 9.8 m/s/s, a ticker tape trace or dot diagram of its motion would depict an acceleration. The dot diagram at the right depicts the acceleration of a free-falling object. The position of the object at regular time intervals - say, every 0.1 second - is shown. The fact that the distance that the object travels every interval of time is increasing is a sure sign that the ball is speeding up as it falls downward. Recall from an earlier lesson, that if an object travels downward and speeds up, then its acceleration is downward. Free-fall acceleration is often witnessed in a physics classroom by means of an ever-popular strobe light demonstration. The room is darkened and a jug full of water is connected by a tube to a medicine dropper. The dropper drips water and the strobe illuminate the falling droplets at a regular rate - say once every 0.2 seconds. Instead of seeing a stream of water free-falling from the medicine dropper, several consecutive drops with increasing separation distance are seen. The pattern of drops resembles the dot diagram shown in the graphic at the right. The Acceleration of Gravity It was learned in the previous part of this lesson that a free-falling object is an object that is falling under the sole influence of gravity. A free-falling object has an acceleration of 9.8 m/s/s, downward (on Earth). This numerical value for the acceleration of a free-falling object is such an important value that it is given a special name. It is known as the acceleration of gravity - the acceleration for any object moving under the sole influence of gravity. A matter of fact, this quantity known as the acceleration of gravity is such an important quantity that physicists have a special symbol to denote it - the symbol g. The numerical value for the acceleration of gravity is most accurately known as 9.8 m/s2. There are slight variations in this numerical value (to the second decimal place) that are dependent primarily upon on altitude. We will occasionally use the approximated value of 10 m/s2 in order to reduce the complexity of the many mathematical tasks that we will perform with this number. By so doing, we will be able to better focus on the conceptual nature of physics without too much of a sacrifice in numerical accuracy. g = 9.8 m/s2, downward Look It Up! Even on the surface of the Earth, there are local variations in the value of the acceleration of gravity (g). These variations are due to latitude, altitude and the local geological structure of the region. Recall from an earlier lesson that acceleration is the rate at which an object changes its velocity. It is the ratio of velocity change to time between any two points in an object's path. To accelerate at 9.8 m/s2 means to change the velocity by 9.8 m/s each second. If the velocity and time for a free-falling object being dropped from a position of rest were tabulated, then one would note the following pattern. Time (s) Velocity (m/s) 0 0 1 - 9.8 2 - 19.6 3 - 29.4 4 - 39.2 5 - 49.0 . Observe that the velocity-time data above reveal that the object's velocity is changing by 9.8 m/s each consecutive second. That is, the free-falling object has an acceleration of approximately 9.8 m/s2. Another way to represent this acceleration of 9.8 m/s2 is to add numbers to our dot diagram that we saw earlier in this lesson. The velocity of the ball is seen to increase as depicted in the diagram at the right. (NOTE: The diagram is not drawn to scale - in two seconds, the object would drop considerably further than the distance from shoulder to toes.) Representing Free Fall by Graphs ⢠Early in Lesson 1 it was mentioned that there are a variety of means of describing the motion of objects. One such means of describing the motion of objects is through the use of graphs - position versus time and velocity vs. time graphs. In this part of Lesson 5, the motion of a free-falling motion will be represented using these two basic types of graphs. Representing Free Fall by Position-Time Graphs A position versus time graph for a free-falling object is shown below. Observe that the line on the graph curves. As learned earlier, a curved line on a position versus time graph signifies an accelerated motion. Since a free-falling object is undergoing an acceleration (g = 9.8 m/s/s), it would be expected that its position-time graph would be curved. A further look at the position-time graph reveals that the object starts with a small velocity (slow) and finishes with a large velocity (fast). Since the slope of any position vs. time graph is the velocity of the object (as learned in Lesson 3), the small initial slope indicates a small initial velocity and the large final slope indicates a large final velocity. Finally, the negative slope of the line indicates a negative (i.e., downward) velocity. Representing Free Fall by Velocity-Time Graphs A velocity versus time graph for a free-falling object is shown below. Observe that the line on the graph is a straight, diagonal line. As learned earlier, a diagonal line on a velocity versus time graph signifies an accelerated motion. Since a free-falling object is undergoing an acceleration (g = 9,8 m/s/s, downward), it would be expected that its velocity-time graph would be diagonal. A further look at the velocity-time graph reveals that the object starts with a zero velocity (as read from the graph) and finishes with a large, negative velocity; that is, the object is moving in the negative direction and speeding up. An object that is moving in the negative direction and speeding up is said to have a negative acceleration (if necessary, review the vector nature of acceleration). Since the slope of any velocity versus time graph is the acceleration of the object (as learned in Lesson 4), the constant, negative slope indicates a constant, negative acceleration. This analysis of the slope on the graph is consistent with the motion of a free-falling object - an object moving with a constant acceleration of 9.8 m/s/s in the downward direction. The Kinematic Equations The goal of this first unit has been to investigate the variety of means by which the motion of objects can be described. The variety of representations that we have investigated includes verbal representations, pictorial representations, numerical representations, and graphical representations (position-time graphs and velocity-time graphs). In Lesson 6, we will investigate the use of equations to describe and represent the motion of objects. These equations are known as kinematic equations. There are a variety of quantities associated with the motion of objects - displacement (and distance), velocity (and speed), acceleration, and time. Knowledge of each of these quantities provides descriptive information about an object's motion. For example, if a car is known to move with a constant velocity of 22.0 m/s, North for 12.0 seconds for a northward displacement of 264 meters, then the motion of the car is fully described. And if a second car is known to accelerate from a rest position with an eastward acceleration of 3.0 m/s2 for a time of 8.0 seconds, providing a final velocity of 24 m/s, East and an eastward displacement of 96 meters, then the motion of this car is fully described. These two statements provide a complete description of the motion of an object. However, such completeness is not always known. It is often the case that only a few parameters of an object's motion are known, while the rest are unknown. For example as you approach the stoplight, you might know that your car has a velocity of 22 m/s, East and is capable of a skidding acceleration of 8.0 m/s2, West. However you do not know the displacement that your car would experience if you were to slam on your brakes and skid to a stop; and you do not know the time required to skid to a stop. In such an instance as this, the unknown parameters can be determined using physics principles and mathematical equations (the kinematic equations). The BIG 4 The kinematic equations are a set of four equations that can be utilized to predict unknown information about an object's motion if other information is known. The equations can be utilized for any motion that can be described as being either a constant velocity motion (an acceleration of 0 m/s/s) or a constant acceleration motion. They can never be used over any time period during which the acceleration is changing. Each of the kinematic equations include four variables. If the values of three of the four variables are known, then the value of the fourth variable can be calculated. In this manner, the kinematic equations provide a useful means of predicting information about an object's motion if other information is known. For example, if the acceleration value and the initial and final velocity values of a skidding car is known, then the displacement of the car and the time can be predicted using the kinematic equations. Lesson 6 of this unit will focus upon the use of the kinematic equations to predict the numerical values of unknown quantities for an object's motion. The four kinematic equations that describe an object's motion are: There are a variety of symbols used in the above equations. Each symbol has its own specific meaning. The symbol d stands for the displacement of the object. The symbol t stands for the time for which the object moved. The symbol a stands for the acceleration of the object. And the symbol v stands for the velocity of the object; a subscript of i after the v (as in vi) indicates that the velocity value is the initial velocity value and a subscript of f (as in vf) indicates that the velocity value is the final velocity value. Each of these four equations appropriately describes the mathematical relationship between the parameters of an object's motion. As such, they can be used to predict unknown information about an object's motion if other information is known. In the next part of Lesson 6 we will investigate the process of doing this. Kinematic Equations and Problem-Solving The four kinematic equations that describe the mathematical relationship between the parameters that describe an object's motion were introduced in the previous part of Lesson 6. The four kinematic equations are: In the above equations, the symbol d stands for the displacement of the object. The symbol t stands for the time for which the object moved. The symbol a stand for the acceleration of the object. And the symbol v stands for the instantaneous velocity of the object; a subscript of i after the v (as in vi) indicates that the velocity value is the initial velocity value and a subscript of f (as in vf) indicates that the velocity value is the final velocity value. Problem-Solving Strategy In this part of Lesson 6 we will investigate the process of using the equations to determine unknown information about an object's motion. The process involves the use of a problem-solving strategy that will be used throughout the course. The strategy involves the following steps: 1. Construct an informative diagram of the physical situation. 2. Identify and list the given information in variable form. 3. Identify and list the unknown information in variable form. 4. Identify and list the equation that will be used to determine unknown information from known information. 5. Substitute known values into the equation and use appropriate algebraic steps to solve for the unknown information. 6. Check your answer to ensure that it is reasonable and mathematically correct. The use of this problem-solving strategy in the solution of the following problem is modeled in Examples A and B below. Example Problem A . Ima Hurryin is approaching a stoplight moving with a velocity of +30.0 m/s. The light turns yellow, and Ima applies the brakes and skids to a stop. If Ima's acceleration is -8.00 m/s2, then determine the displacement of the car during the skidding process. (Note that the direction of the velocity and the acceleration vectors are denoted by a + and a - sign.) The solution to this problem begins by the construction of an informative diagram of the physical situation. This is shown below. The second step involves the identification and listing of known information in variable form. Note that the vf value can be inferred to be 0 m/s since Ima's car comes to a stop. The initial velocity (vi) of the car is +30.0 m/s since this is the velocity at the beginning of the motion (the skidding motion). And the acceleration (a) of the car is given as - 8.00 m/s2. (Always pay careful attention to the + and - signs for the given quantities.) The next step of the strategy involves the listing of the unknown (or desired) information in variable form. In this case, the problem requests information about the displacement of the car. So d is the unknown quantity. The results of the first three steps are shown in the table below. Diagram: Given: Find: vi = +30.0 m/s vf = 0 m/s a = - 8.00 m/s2 d = ?? The next step of the strategy involves identifying a kinematic equation that would allow you to determine the unknown quantity. There are four kinematic equations to choose from. In general, you will always choose the equation that contains the three known and the one unknown variable. In this specific case, the three known variables and the one unknown variable are vf, vi, a, and d. Thus, you will look for an equation that has these four variables listed in it. An inspection of the four equations above reveals that the equation on the top right contains all four variables. vf2 = vi2 + 2 ⢠a ⢠d Once the equation is identified and written down, the next step of the strategy involves substituting known values into the equation and using proper algebraic steps to solve for the unknown information. This step is shown below. (0 m/s)2 = (30.0 m/s)2 + 2 ⢠(-8.00 m/s2) ⢠d 0 m2/s2 = 900 m2/s2 + (-16.0 m/s2) ⢠d (16.0 m/s2) ⢠d = 900 m2/s2 - 0 m2/s2 (16.0 m/s2)*d = 900 m2/s2 d = (900 m2/s2)/ (16.0 m/s2) d = (900 m2/s2)/ (16.0 m/s2) d = 56.3 m The solution above reveals that the car will skid a distance of 56.3 meters. (Note that this value is rounded to the third digit.) The last step of the problem-solving strategy involves checking the answer to assure that it is both reasonable and accurate. The value seems reasonable enough. It takes a car a considerable distance to skid from 30.0 m/s (approximately 65 mi/hr) to a stop. The calculated distance is approximately one-half a football field, making this a very reasonable skidding distance. Checking for accuracy involves substituting the calculated value back into the equation for displacement and insuring that the left side of the equation is equal to the right side of the equation. Indeed it is! Example Problem B Ben Rushin is waiting at a stoplight. When it finally turns green, Ben accelerated from rest at a rate of a 6.00 m/s2 for a time of 4.10 seconds. Determine the displacement of Ben's car during this time period. Once more, the solution to this problem begins by the construction of an informative diagram of the physical situation. This is shown below. The second step of the strategy involves the identification and listing of known information in variable form. Note that the vi value can be inferred to be 0 m/s since Ben's car is initially at rest. The acceleration (a) of the car is 6.00 m/s2. And the time (t) is given as 4.10 s. The next step of the strategy involves the listing of the unknown (or desired) information in variable form. In this case, the problem requests information about the displacement of the car. So d is the unknown information. The results of the first three steps are shown in the table below. Diagram: Given: Find: vi = 0 m/s t = 4.10 s a = 6.00 m/s2 d = ?? The next step of the strategy involves identifying a kinematic equation that would allow you to determine the unknown quantity. There are four kinematic equations to choose from. Again, you will always search for an equation that contains the three known variables and the one unknown variable. In this specific case, the three known variables and the one unknown variable are t, vi, a, and d. An inspection of the four equations above reveals that the equation on the top left contains all four variables. d = vi ⢠t + ½ ⢠a ⢠t2 Once the equation is identified and written down, the next step of the strategy involves substituting known values into the equation and using proper algebraic steps to solve for the unknown information. This step is shown below. d = (0 m/s) ⢠(4.1 s) + ½ ⢠(6.00 m/s2) ⢠(4.10 s)2 d = (0 m) + ½ ⢠(6.00 m/s2) ⢠(16.81 s2) d = 0 m + 50.43 m d = 50.4 m The solution above reveals that the car will travel a distance of 50.4 meters. (Note that this value is rounded to the third digit.) The last step of the problem-solving strategy involves checking the answer to assure that it is both reasonable and accurate. The value seems reasonable enough. A car with an acceleration of 6.00 m/s/s will reach a speed of approximately 24 m/s (approximately 50 mi/hr) in 4.10 s. The distance over which such a car would be displaced during this time period would be approximately one-half a football field, making this a very reasonable distance. Checking for accuracy involves substituting the calculated value back into the equation for displacement and insuring that the left side of the equation is equal to the right side of the equation. Indeed, it is! The two example problems above illustrate how the kinematic equations can be combined with a simple problem-solving strategy to predict unknown motion parameters for a moving object. Provided that three motion parameters are known, any of the remaining values can be determined. In the next part of Lesson 6, we will see how this strategy can be applied to free fall situations. Or if interested, you can try some practice problems and check your answer against the given solutions. Kinematic Equations and Free Fall As mentioned in Lesson 5, a free-falling object is an object that is falling under the sole influence of gravity. That is to say that any object that is moving and being acted upon only be the force of gravity is said to be "in a state of free fall." Such an object will experience a downward acceleration of 9.8 m/s/s. Whether the object is falling downward or rising upward towards its peak, if it is under the sole influence of gravity, then its acceleration value is 9.8 m/s/s. Like any moving object, the motion of an object in free fall can be described by four kinematic equations. The kinematic equations that describe any object's motion are: The symbols in the above equation have a specific meaning: the symbol d stands for the displacement; the symbol t stands for the time; the symbol a stands for the acceleration of the object; the symbol vi stands for the initial velocity value; and the symbol vf stands for the final velocity. Applying Free Fall Concepts to Problem-Solving There are a few conceptual characteristics of free fall motion that will be of value when using the equations to analyze free fall motion. These concepts are described as follows: ⢠An object in free fall experiences an acceleration of -9.8 m/s/s. (The - sign indicates a downward acceleration.) Whether explicitly stated or not, the value of the acceleration in the kinematic equations is -9.8 m/s/s for any freely falling object. ⢠If an object is merely dropped (as opposed to being thrown) from an elevated height, then the initial velocity of the object is 0 m/s. ⢠If an object is projected upwards in a perfectly vertical direction, then it will slow down as it rises upward. The instant at which it reaches the peak of its trajectory, its velocity is 0 m/s. This value can be used as one of the motion parameters in the kinematic equations; for example, the final velocity (vf) after traveling to the peak would be assigned a value of 0 m/s. ⢠If an object is projected upwards in a perfectly vertical direction, then the velocity at which it is projected is equal in magnitude and opposite in sign to the velocity that it has when it returns to the same height. That is, a ball projected vertically with an upward velocity of +30 m/s will have a downward velocity of -30 m/s when it returns to the same height. These four principles and the four kinematic equations can be combined to solve problems involving the motion of free-falling objects. The two examples below illustrate application of free fall principles to kinematic problem-solving. In each example, the problem solving strategy that was introduced earlier in this lesson will be utilized. Example Problem A Luke Autbeloe drops a pile of roof shingles from the top of a roof located 8.52 meters above the ground. Determine the time required for the shingles to reach the ground. The solution to this problem begins by the construction of an informative diagram of the physical situation. This is shown below. The second step involves the identification and listing of known information in variable form. You might note that in the statement of the problem, there is only one piece of numerical information explicitly stated: 8.52 meters. The displacement (d) of the shingles is -8.52 m. (The - sign indicates that the displacement is downward). The remaining information must be extracted from the problem statement based upon your understanding of the above principles. For example, the vi value can be inferred to be 0 m/s since the shingles are dropped (released from rest; see note above). And the acceleration (a) of the shingles can be inferred to be -9.8 m/s2 since the shingles are free-falling (see note above). (Always pay careful attention to the + and - signs for the given quantities.) The next step of the solution involves the listing of the unknown (or desired) information in variable form. In this case, the problem requests information about the time of fall. So t is the unknown quantity. The results of the first three steps are shown in the table below. Diagram: Given: Find: vi = 0.0 m/s d = -8.52 m a = - 9.8 m/s2 t = ?? The next step involves identifying a kinematic equation that allows you to determine the unknown quantity. There are four kinematic equations to choose from. In general, you will always choose the equation that contains the three known and the one unknown variable. In this specific case, the three known variables and the one unknown variable are d, vi, a, and t. Thus, you will look for an equation that has these four variables listed in it. An inspection of the four equations above reveals that the equation on the top left contains all four variables. d = vi ⢠t + ½ ⢠a ⢠t2 Once the equation is identified and written down, the next step involves substituting known values into the equation and using proper algebraic steps to solve for the unknown information. This step is shown below. -8.52 m = (0 m/s) ⢠(t) + ½ ⢠(-9.8 m/s2) ⢠(t)2 -8.52 m = (0 m) *(t) + (-4.9 m/s2) ⢠(t)2 -8.52 m = (-4.9 m/s2) ⢠(t)2 (-8.52 m)/(-4.9 m/s2) = t2 1.739 s2 = t2 t = 1.32 s The solution above reveals that the shingles will fall for a time of 1.32 seconds before hitting the ground. (Note that this value is rounded to the third digit.) The last step of the problem-solving strategy involves checking the answer to assure that it is both reasonable and accurate. The value seems reasonable enough. The shingles are falling a distance of approximately 10 yards (1 meter is pretty close to 1 yard); it seems that an answer between 1 and 2 seconds would be highly reasonable. The calculated time easily falls within this range of reasonability. Checking for accuracy involves substituting the calculated value back into the equation for time and insuring that the left side of the equation is equal to the right side of the equation. Indeed it is! Example Problem B Rex Things throws his mother's crystal vase vertically upwards with an initial velocity of 26.2 m/s. Determine the height to which the vase will rise above its initial height. Once more, the solution to this problem begins by the construction of an informative diagram of the physical situation. This is shown below. The second step involves the identification and listing of known information in variable form. You might note that in the statement of the problem, there is only one piece of numerical information explicitly stated: 26.2 m/s. The initial velocity (vi) of the vase is +26.2 m/s. (The + sign indicates that the initial velocity is an upwards velocity). The remaining information must be extracted from the problem statement based upon your understanding of the above principles. Note that the vf value can be inferred to be 0 m/s since the final state of the vase is the peak of its trajectory (see note above). The acceleration (a) of the vase is -9.8 m/s2 (see note above). The next step involves the listing of the unknown (or desired) information in variable form. In this case, the problem requests information about the displacement of the vase (the height to which it rises above its starting height). So d is the unknown information. The results of the first three steps are shown in the table below. Diagram: Given: Find: vi = 26.2 m/s vf = 0 m/s a = -9.8 m/s2 d = ?? The next step involves identifying a kinematic equation that would allow you to determine the unknown quantity. There are four kinematic equations to choose from. Again, you will always search for an equation that contains the three known variables and the one unknown variable. In this specific case, the three known variables and the one unknown variable are vi, vf, a, and d. An inspection of the four equations above reveals that the equation on the top right contains all four variables. vf2 = vi2 + 2 ⢠a ⢠d Once the equation is identified and written down, the next step involves substituting known values into the equation and using proper algebraic steps to solve for the unknown information. This step is shown below. (0 m/s)2 = (26.2 m/s)2 + 2 â˘(-9.8m/s2) â˘d 0 m2/s2 = 686.44 m2/s2 + (-19.6 m/s2) â˘d (-19.6 m/s2) ⢠d = 0 m2/s2 -686.44 m2/s2 (-19.6 m/s2) ⢠d = -686.44 m2/s2 d = (-686.44 m2/s2)/ (-19.6 m/s2) d = 35.0 m The solution above reveals that the vase will travel upwards for a displacement of 35.0 meters before reaching its peak. (Note that this value is rounded to the third digit.) The last step of the problem-solving strategy involves checking the answer to assure that it is both reasonable and accurate. The value seems reasonable enough. The vase is thrown with a speed of approximately 50 mi/hr (merely approximate 1 m/s to be equivalent to 2 mi/hr). Such a throw will never make it further than one football field in height (approximately 100 m), yet will surely make it past the 10-yard line (approximately 10 meters). The calculated answer certainly falls within this range of reasonability. Checking for accuracy involves substituting the calculated value back into the equation for displacement and insuring that the left side of the equation is equal to the right side of the equation. Indeed, it is! Kinematic equations provide a useful means of determining the value of an unknown motion parameter if three motion parameters are known. In the case of a free-fall motion, the acceleration is often known. And in many cases, another motion parameter can be inferred through a solid knowledge of some basic kinematic principles.Animal Rights and Diet Success Criteria I can explain key terms which describe the type of diets people have I can explain the advantages and disadvantages of different types of diet Animal Rights and Diet Match up the terms with the meaning Term Meaning Omnivore - eats fish but no other type of meat Vegetarian - eats most types of meat and vegetables Pescetarian - doesnât eat any products that come from animals Vegan - doesnât eat meat but will eat dairy products like milk Place the different diets on a spectrum All meat No animal products at all Vegetarian Vegan Omnivore Pescetarian Omnivore Omnivore Most people in the UK are omnivores Match the countries with the amount of meat eaten per person per year Country Meat per person per year India 9.9 kg USA 4.4 kg Bangladesh 120 kg UK 111.5kg Nepal 84.2 kg Australia 4 kg Numeracy How much meat is consumed in the UK per year? (Amount of meat eaten X the UK population) 2. How much meat is consumed in Bangladesh per year? (Amount of meat eaten X the Bangladesh population) Country Meat per person per year USA 120 kg Australia 111.5kg UK 84.2 kg Nepal 9.9 kg India 4.4 kg Bangladesh 4 kg UK â 64 million Bangladesh â 165 million http://www.telegraph.co.uk/travel/maps-and-graphics/world-according-to-meat-consumption/ 7 Why do people eat meat? Discuss Tradition (their family has always done it) Culture (celebrations) Taste Convenience Nutrients such as B12, protein and iron Consumption of meat is rising across developing countries because higher incomes generally mean more meat eating. Pescetarian "Yeah, I'm a vegetarian." "But that looks like fish you're eating." "Oh yeah, I eat fish.â An estimated 5% - 6% of people in the UK are pescetarians. How many people is this? Approx. 3.6 million Calculation â 66,000,000 /100 x 5.5 = 3,630,000 9 Which group is cuter? Animals Fish 10 People often donât feel as much love for fish as they do for fluffy, cute mammals. The may think fish donât feel pain. They may be fussy. They think fish isnât meat. Not farmed as much as mammals; can be wild. To get nutrients they wouldnât get from just vegetables and grains. (Omega 3 is in plants but in higher concentrations in oily fish) Why are people pescetarians? https://www.vegsoc.org/sslpage.aspx?pid=753 http://articles.mercola.com/omega-3.aspx Fish â In a perfect world, fish can provide you all the omega-3s you need. Unfortunately, the vast majority of the fish supply is now heavily tainted with industrial toxins and pollutants, such as heavy metals which include mercury, lead, arsenic, and cadmium, PCBs, and radioactive poisons. These toxins make eating fish no longer recommended. 11 Vegetarianism Vegetarians will not eat any meat or product that comes from the slaughter of animals e.g. gelatine. About 3% of the UK population are vegetarian. How many people is this? 1.9 million 12 Why are people vegetarian? They donât like the idea that animals are killed so they can eat Health reasons Donât like meat Brought up vegetarian Environmental reasons Religious reasons (e.g. some Buddhist, Hindus) Watch the following clip twice. The second time, write down the fact which surprises you the most. https://www.youtube.com/watch?v=VW6wfpHFdaI The World Health Organization has classified processed meats â including ham, salami, sausages and hot dogs â as a Group 1 carcinogen (same as smoking/alcohol) which means that there is strong evidence that processed meats cause cancer. Red meat, such as beef, lamb and pork has been classified as a 'probable' cause of cancer. 13 Veganism Not just a diet Around 1% of the population of UK are vegans. A vegan is described by the Vegan Society as âa philosophy and way of living which seeks to excludeâas far as is possible and practicableâall forms of exploitation of, and cruelty to, animals for food, clothing or any other purpose; and by extension, promotes the development and use of animal-free alternatives for the benefit of humans, animals and the environment. In dietary terms it denotes the practice of dispensing with all products derived wholly or partly from animalsâ Why are people vegan? Why are people vegan? James Aspey: https://www.youtube.com/watch?v=a22XxXP3nU8 Warning: some of the content in this video clip may upset some viewers from 7:14 â 8:11 https://www.youtube.com/watch?v=BtqXeym7H8A Why are people vegan? âDonât want bad karmaâ Feel healthier Reduce chances of diseases. Example heart disease. Donât want to exploit animals Believe in animal rights Sustainability Environment Create a Table of Pros & Cons of Veganism Pros â Cons - Create a Table of Pros & Cons of Veganism Pros Cons No animals have died for you to eat Some people think it is healthier Help the environment Fewer antibiotics/chemicals that are given to some animals Makes you feel good No vitamin B12 so have to supplement Harder to find food at shops or restaurants May be harder to get enough iron May be more expensive to get substitute meats Judged by family and friends Could put farmers out of business Group Work Source 1 Summarise it in your jotter Explain what the source is/what it says What does it suggest? What is your opinion? Feedback to rest of class https://www.youtube.com/watch?v=SYyjel5VuHg Farmerâs PoemContact with the Americas In 1001, Viking sailors led by Leif Erikson reached the eastern tip of North America. Archaeologists have found evidence of the Viking settlement of Vinland in present-day Newfoundland, Canada. The Vikings did not stay in Vinland long and no one is sure why they left. However, Viking stories describe fierce battles with Skraelings, the Viking name for the Inuit. Evidence suggests that Asians continued to cross the Bering Sea into North America after the last ice age ended. Some scholars believe that ancient seafarers from Polynesia may have traveled to the Americas using their knowledge of the stars and winds. Modern Polynesians have sailed canoes thousands of miles in this way. Still others think that fishing boats from China and Japan blew off course and landed on the western coast of North or South America. Perhaps such voyages occurred. If so, they were long forgotten. Before 1492, the peoples of Asia and Europe had no knowledge of the Americas and their remarkable civilizations. The Voyages of Columbus Portuguese sailors had pioneered new routes around Africa toward Asia in the late 1400s. Spain, too, wanted a share of the riches. King Ferdinand and Queen Isabella hoped to keep their rival, Portugal, from controlling trade with India, China, and Japan. They agreed to finance a voyage of exploration by Christopher Columbus. Columbus, an Italian sea captain, planned to reach the East Indies by sailing west across the Atlantic. Finding a sea route straight to Asia would give the Spanish direct access to the silks, spices, and precious metals of Asia. The spice trade was a major cause for European exploration and a reason the Spanish rulers supported Columbusâs voyage. They also wanted wealth from any source. âGet gold,â King Ferdinand said to Columbus. âHumanely if possible, but at all hazardsâget gold.â Crossing the Atlantic In August 1492, Columbus set out with three ships and about 90 sailors. As captain, he commanded the largest vessel, the Santa MarĂa. The other ships were the NiĂąa and the Pinta. After a brief stop at the Canary Islands, the little fleet continued west into unknown seas. Fair winds sped them along, but a month passed without the sight of land. Some sailors began to grumble. They had never been away from land for so long and feared being lost at sea. Still, Columbus sailed on. On October 7, sailors saw flocks of birds flying southwest. Columbus changed course to follow the birds. A few days later, crew members spotted tree branches and flowers floating in the water. At 2 a.m. on October 12, the lookout on the Pinta spotted white cliffs shining in the moonlight. âTierra! Tierra!â he shouted. âLand! Land!â At dawn, Columbus rowed ashore and planted the banner of Spain. He was convinced that he had reached the East Indies in Asia. He called the people he found there âIndians.â In fact, he had reached islands off the coasts of North America and South America in the Caribbean Sea. These islands later became known as the West Indies. For three months, Columbus explored the West Indies. To his delight, he found signs of gold on the islands. Eager to report his success, he returned to Spain. Columbus Claims Lands for Spain In Spain, Columbus presented Queen Isabella and King Ferdinand with gifts of pink pearls and brilliantly colored parrots. Columbus brought with him many things that Europeans had never seen before: tobacco, pineapples, and hammocks used for sleeping. Columbus also described the âIndiansâ he had met, the Taino (ty noh). The Taino, he promised, could easily be converted to Christianity and could also be used as slaves. The Spanish monarchs were impressed. They gave Columbus the title Admiral of the Ocean Sea. They also agreed to finance future voyages. The promise of great wealth, and the chance to spread Christianity, gave them a reason to explore further. Columbus made three more voyages across the Atlantic. In 1493, he founded the first Spanish colony in the Americas, Santo Domingo, on an island he called Hispaniola (present-day Haiti and the Dominican Republic). A colony is an area settled and ruled by the government of a distant land. Columbus also explored present-day Cuba and Jamaica. He sailed along the coasts of Central America and northern South America. He claimed all of these lands for Queen Isabella of Spain. Columbus proved to be a better explorer than governor. During his third expedition, settlers on Hispaniola complained of his harsh rule. Queen Isabella appointed an investigator, who sent Columbus back to Spain in chains. In the end, the queen pardoned Columbus, but he never regained the honors he had won earlier. He died in 1506, still convinced that he had reached Asia. The Impact of Columbusâs Voyages Columbus has long been honored as the bold sea captain who âdiscovered America.â Today, we recognize that American Indians had discovered and settled these lands long before 1492. We also recognize that Columbus and the Europeans who followed him treated the ancient inhabitants of the Americas brutally. Still, Columbusâs voyages did change history. They marked the beginning of lasting contact among the peoples of Europe, Africa, and the Americas. For a great many American Indians, contact had tragic results. Columbus and those who followed were convinced that European culture was superior to that of the Indians. The Spanish claimed Taino lands and forced the Taino to work in gold mines, on ranches, or in Spanish households. Many Taino died from harsh conditions or European diseases. The Taino population was wiped out. Still, the voyages of Columbus signaled a turning point for the Americas. A turning point is a moment in history that marks a decisive change. Curious Europeans saw the new lands as a place where they could settle, trade, and grow rich. Spanish Exploration Continues After the voyages of Columbus, the Spanish explored and settled other Caribbean islands that Columbus had found. They sought gold, land for crops, people to enslave, and converts to Christianity for the Spanish crown. By 1511, they had conquered Puerto Rico, Jamaica, and Cuba. They also explored the eastern coasts of North America and South America in search of a western route to Asia. In 1513, Vasco Núùez de Balboa (bal boh uh) crossed the Isthmus of Panama. American Indians had told him that a large body of water lay to the west. With a party of Spanish soldiers and Indians, Balboa reached the Pacific Ocean and claimed the ocean for Spain. The Spanish had no idea how wide the Pacific was until a sea captain named Ferdinand Magellan (muh jel un) sailed across it. The expeditionâmade up of five ships and about 250 crew membersâleft Spain in 1519. Fifteen months later, it cut through the stormy southern tip of South America by way of what is now known as the Strait of Magellan and entered the Pacific Ocean. Crossing the vast Pacific, the sailors ran out of food: Primary Source âWe remained 3 months and 20 days without taking in provisions or other refreshments and ate only old biscuit reduced to powder, full of grubs and stinking from the dirt which rats had made on it. We drank water that was yellow and stinking.â âAntonio Pigafetta, The Diary of Antonio Pigafetta Magellan himself was killed in a battle with the local people of the Philippine Islands off the coast of Asia. In 1522, only one ship and 18 sailors returned to Spain. They were the first people to circumnavigate, or sail completely around, the world. In doing so, they had found an all-water western route to Asia. Europeans became aware of the true size of the Earth. How Did the Columbian Exchange Affect the Rest of the World? The encounter between the peoples of the Eastern and Western Hemispheres sparked a global exchange of goods and ideas. Because it started with the voyages of Columbus, this transfer is known as the Columbian Exchange. The Columbian Exchange refers to a biological and cultural exchange of animals, plants, human populations, diseases, food, government, technology, the arts, and languages. The exchange went in both directions. Europeans learned much from American Indians. At the same time, Europeans contributed in many ways to the culture of the Americas. This exchange also brought about many modifications, or changes, to the physical environment of the Americas, with both positive and negative results. Changing Environments Europeans introduced domestic animals such as chickens from Europe and Africa. European pigs, cattle, and horses often escaped into the wild and multiplied rapidly. Forests and grasslands were converted to pastures. As horses spread through what would become the United States, Indians learned to ride them and used them to carry heavy loads. Plants from Europe and Africa changed the way American Indians lived. The first bananas came from the Canary Islands. By 1520, one Spaniard reported that banana trees had spread âso greatly that it is marvelous to see the great abundance of them.â Oranges, lemons, and figs were also new to the Americas. In North America, explorers also brought such plants as bluegrass, the daisy, and the dandelion. These plants spread quickly in American soil and modified American grasslands. Tragically, Europeans also brought new diseases, such as smallpox and influenza. American Indians had no resistance to these diseases. Historians estimate that within 75 years, diseases from Europe had killed almost 90 percent of the people in the Caribbean Islands and in Mexico. American Indian Influences on Europe, Africa and Asia American Indians introduced Europeans to valuable food crops such as corn, potatoes, sweet potatoes, beans, tomatoes, manioc, squash, peanuts, pineapples, and blueberries. Today, almost half the worldâs food crops come from plants that were first grown in the Americas. Europeans carried the new foods with them as they sailed around the world. Everywhere, peopleâs diets changed and populations increased. In South Asia, people used American hot peppers and chilies to spice stews. Chinese peasants began growing corn and sweet potatoes. Italians made sauces from tomatoes. People in West Africa grew manioc and corn. European settlers often adopted American Indian skills. In the North, Indians showed Europeans how to use snowshoes and trap beavers and other fur-bearing animals. European explorers learned how to paddle Indian canoes. Some leaders studied American Indian political structures. In the 1700s, Benjamin Franklin admired the Iroquois League and urged American colonists to unite in a similar way. Positive and Negative Consequences Through the Columbian Exchange, Europeans and American Indians modified their environments and gained new resources and skills. At the same time, warfare and disease killed many on both sides. Europeans viewed expansion positively. They gained great wealth, explored trade routes, and spread Christianity. Yet their farming, mining, and diseases took a toll on the physical environment and left many American Indians dead. Despite these negatives, the Columbian Exchange shaped the modern world, including what would become the United States.