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The Narrative of a life of Fredrick Douglas
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Here is a transcript of a video about Narrative Writing. Generate 25 questions. Intro to Narrative Writing What is Narrative Writing? You today, I want to introduce you to the basics of narrative writing. Narrative writing is writing that tells a story. It can be real or imagined, that is, nonfiction or fiction. It has a beginning, middle, and end. That is, it includes the basic elements of a plot exposition, rising action, conflict, climax, falling action, and resolution. And it's full of interesting details. The author's purpose in writing a narrative is to entertain the reader. There are three main types of narrative writing. The first is a personal narrative when a writer shares a true story from his or her own life. We could also say this type of narrative is autobiographical. The second type of narrative is biographical when a writer shares a true story from another person's life. The third type of narrative is fictional. When a writer tells an invented story, short stories, and novels are fictional narratives. The Process of Writing a Narrative While we could add to this list, there are five important parts of a narrative that I especially want you to remember as you write your own narrative. These parts of a narrative include setting, characters, plot, point of view, and dialogue. The first part of a narrative is the setting , where, and when the narrative takes place. The setting affects both the plot and characters in your narrative, so it's important to spend some time brainstorming where, when, and in what conditions your story takes place. The second part of a narrative is the characters , the people, animals or creatures involved in a story. Remember that your story must have a protagonist, the character facing the problem, and an antagonist the character or force causing the problem. Take some time while planning your narrative to focus on your characters beyond the characters names and roles they play in the story. Think about whether you'd like them to be flat with very few character traits or round with many character traits. Also think about which characters in your story will remain static or unchanged, and which characters will be dynamic, undergoing an important change in your narrative. The third part of a narrative is the plot , the sequence of events in a narrative. Take some time to think carefully through your story's plot. How will it begin and how will it end? What conflicts will your characters encounter? What is the climax or turning point of your story? How will the problems be solved? Creating a storyboard or labeling a plot diagram are both good tools for planning your story's plot. The fourth part of a narrative is the point of view , which is the perspective from which a narrative is told. You can choose to write your narrative in first person, writing a personal narrative from your own point of view, or you can choose a character in a fictional narrative to tell your story. Another option is to write your narrative in the third person point of view, telling the story from the perspective of an unseen narrator that is not a character in the story. Finally, the fifth part of a narrative is dialogue. The words the characters speak in your story dialogue can establish the setting, show characterization, foreshadow events, or advance the action in a narrative. Dialogue brings your narrative to life. It's important to review how to punctuate dialogue, following grammatical rules for using quotation marks, commas, and other N marks such as periods and question marks. As you begin writing your narrative, I'll help you break down each step of the process. But hopefully this introduction gives you a basic understanding of what narrative writing is, and hopefully it sparks some ideas for you to begin planning your own narrative.
What is Historical Fiction? Historical fiction is stories set in the past. Yes, it sounds like a paradox or contradiction, but historical means factual elements and fiction means not real. However, there are things that we must pay attention to as people studying this genre. Historical fiction seeks to recreate the appearance of a time past, reconstructing characters, events, movements, ways of life, and the spirit of a bygone day. The time period--and its portrayal--is at the core of the story. Historical Fiction is written with a careful balance of research and creativity, they transport readers to another time and placeâwhich can be real, imagined, or a combination of both. Many historical novels tell stories that involve actual historical figures or historical events within historical settings, though other elements such as persons or events might be fabricated. Historical fiction often presents actual events from the point of view of fictional people living in that time period. In some historical fiction, famous events appear from points of view not recorded in history, with fictional characters either observing or actively participating in these actual events. Historical figures are also often shown dealing with these events while depicting them in a way that has not been previously recorded. Other times, a historical event is used to complement a story's narrative, occurring in the background while characters deal with situations (personal or otherwise) wholly unrelated to that historical event. Sometimes, the names of people and places have been in some way altered. Historical fiction depicts settings that tend be real and drawn from history, and often contains actual historical persons, but the main characters tend to be fictional. Writers of stories in this genre, while penning fiction, attempt to capture the manners and social conditions of the persons or time(s) presented in the story, with due attention paid to period detail and fidelity. Historical fiction is found in books, magazines, art, television programming, film, theater, video games and other media. Writers of this genre are given artistic license in regard to presentation and subject matter, so long as it does not deviate in significant ways from established history. NOTE: When authorâs include elements from one time period in another time period this is called Anachronism. For example, if one of the knights of the Round Table wore a wristwatch or a character during the Civil Rights era made a call using a cell phone.
Dionysian- As distinguished from Apollonian, the word refers to sensual, pleasure-seeking impulses Dramatic Irony -A circumstance in which the audience or reader knows more about a situation than a character Elegy - A poem or prose selection that laments or meditates on the passing or death of something or someone of value Ellipsis- Three periods (...) indicating the omission of words in a thought or quotation Elliptical Construction - A sentence containing a deliberate omission of words Hyperbole- Overstatement; gross exaggeration for rhetorical effect Idyll- A lyric poem or passage that describes a kind of ideal life or place Image- A word or phrase representing that which can be seen, touched, tasted, smelled, or felt In Medias Res - A Latin term for a narrative that starts not at the beginning of events but at some other critical point Indirect Quotation A rendering of a quotation in which actual words are not stated but only approximated or paraphrased
A. Arundhati Roy B. Jhumpa Lahiri C. Salman Rushdie D. Anita Desai ________________________________________ 2. The Lowland was published in: A. 2001 B. 2013 C. 2010 D. 2005 ________________________________________ 3. Which earlier work earned Lahiri the Pulitzer Prize? A. The Namesake B. Unaccustomed Earth C. Interpreter of Maladies D. The Lowland ________________________________________ 4. The novel is primarily about: A. Technology and modernity B. Immigration, family, and political violence C. Business rivalry D. Mythology and folklore ________________________________________ 5. The two central brothers in the novel are: A. Rahul and Anil B. Subhash and Udayan C. Gogol and Ashoke D. Amit and Nikhil ________________________________________ 6. Where did the brothers grow up? A. Mumbai B. Dhaka C. Calcutta D. Delhi ________________________________________ 7. Udayan becomes involved in: A. Peace activism B. Cinema C. Naxalite movement D. Business ________________________________________ 8. Subhash moves to: A. London B. Rhode Island C. Toronto D. Chicago ________________________________________ 9. Udayan is killed in: A. Jail B. A riot C. The lowland near his house D. A car accident ________________________________________ 10. Why does Subhash marry Gauri? A. Love B. To protect her and her unborn child C. Financial benefit D. Family pressure ________________________________________ 11. Gauri eventually: A. Becomes a politician B. Starts a business C. Leaves her family D. Returns to India ________________________________________ 12. Subhash raises Bela: A. With Gauri B. Alone C. With help from his parents D. In India ________________________________________ 13. Bela grows up believing: A. Udayan is her father B. Subhash is her father C. She has no father D. Her father died in war ________________________________________ 14. The setting of political unrest is linked to: A. Partition B. Naxalbari uprising C. Independence movement D. Civil War ________________________________________ 15. The narrative style uses: A. Magical realism B. Non-linear structure C. Poetry D. Second-person narration ________________________________________ 16. Gauriâs character represents: A. Traditional motherhood B. Obedient wife C. Intellectual autonomy and emotional detachment D. Political activism ________________________________________ 17. Belaâs character signifies: A. Rebellion against education B. Second-generation identity struggle C. Complete assimilation D. Materialistic living ________________________________________ 18. Memory in the novel functions as: A. A simple recollection B. A haunting presence affecting identity C. A forgotten history D. A symbolic decoration ________________________________________ 19. The lowland itself symbolizes: A. Wealth B. Stability C. Transitional, unstable space D. Escape ________________________________________ 20. Lahiriâs prose style can be described as: A. Flowery and ornate B. Minimalistic and restrained C. Dramatic and verbose D. Highly poetic ________________________________________ 21. Water imagery reflects: A. Joy and happiness B. Power and victory C. Memory and emotional fluidity D. Evil ________________________________________ 22. Which theory applies strongly to this novel? A. Structuralism B. Postcolonial hybridity C. Absurdism D. Modernism ________________________________________ 23. Postcolonial hybridity is linked to: A. Complete assimilation B. Identity in-between cultures C. Traditional values D. Language fluency alone ________________________________________ 24. Which character best reflects second-generation identity conflict? A. Gauri B. Bela C. Subhash D. Udayan ________________________________________ 25. What does Subhash struggle with most? A. Career failure B. Language C. Guilt and secrecy D. Wealth ________________________________________ 26. Udayanâs ideology centers on: A. Business growth B. Armed communist revolution C. Religious reform D. Education ________________________________________ 27. The novel shows how political violence leads to: A. Personal healing B. Economic prosperity C. Emotional trauma across generations D. Cultural unity ________________________________________ 28. Betrayal appears as: A. Only political B. Only emotional C. Both political and familial D. A background idea ________________________________________ 29. The genre of the text best fits: A. Fantasy B. Realistic political family saga C. Science fiction D. Thriller ________________________________________ 30. The narrative constantly shifts between: A. Dream and reality B. India and America C. Past and future India D. Fiction and nonfiction ________________________________________ 31. Homi Bhabhaâs "third space" represents: A. Physical land B. A zone of cultural in-betweenness C. A literal building D. A heavenlike vision ________________________________________ 32. Gauri symbolizes: A. Traditional widowhood B. Female agency vs social expectation C. Blind loyalty D. Economic dependence ________________________________________ 33. Bela unknowingly inherits: A. Udayanâs ideology B. Gauriâs academic passion only C. Subhashâs calmness D. Grandparentsâ wealth ________________________________________ 34. Lahiri uses silence to: A. Avoid details B. Deepen psychological complexity C. Reduce story relevance D. Simplify events ________________________________________ 35. A major structural device is: A. Letters B. Non-linear flashbacks C. Mythic storytelling D. Metafiction ________________________________________ 36. Which text offers a migrant theme comparison? A. The God of Small Things B. The White Tiger C. The Namesake D. Train to Pakistan ________________________________________ 38. The Naxalite movement first emerged in: A. Mumbai B. Naxalbari village C. Delhi D. Kerala ________________________________________ 39. Which theme repeats strongly? A. Celebration of success B. Silence and secrets C. Fantasy D. Heroism ________________________________________ 40. What does Bela do as an adult? A. Becomes a doctor B. Engages in environmental activism C. Joins corporate life D. Moves into politics ________________________________________ 41. The immigrant experience in the novel is portrayed as: A. Full belonging B. Alienation and partial belonging C. Achievement D. Liberation ________________________________________ 42. Which idea does Lahiri question through Gauri? A. Heroism B. Maternal expectation C. Religious devotion D. Wealth ________________________________________ 43. Subhash represents: A. Pure rebellion B. Survival and adaptation C. Anti-immigrant sentiment D. Total withdrawal ________________________________________ 44. Lahiriâs writing expects readers to: A. Passively accept the plot B. Read emotional subtext in silences C. Ignore symbols D. Only enjoy the story ________________________________________ 45. The lowland as a metaphor mainly signifies: A. Joy B. Unstable cultural ground C. Triumph D. Isolation from family ________________________________________ 46. Why is The Lowland considered significant? A. Its fantasy themes B. Its deep engagement with politics & identity C. Its humor D. Its romantic style ________________________________________ 47. Which comparative author also writes about diaspora identity? A. Chetan Bhagat B. Amitav Ghosh C. Premchand D. Ruskin Bond ________________________________________ 48. Udayanâs death drives the plot because: A. Family hides it B. It forces new relationships & trauma C. People forget him D. It has no consequence ________________________________________ 49. The narrative ends emphasizing: A. Closure and peace B. Lasting consequences of secrets C. National identity D. Religious conflict ________________________________________ 50. Scholars study this work because it explores: A. Only Indian history B. Trauma, diaspora, gender & politics C. Folk storytelling D. Comedy
Received: 26 November 2019 Revised: 10 January 2020 Accepted: 19 January 2020 DOI: 10.1111/obr.13005 PEDIATRICS/PHYSIOLOGY Adipokines: A gear shift in puberty DesirĂŠe Nieuwenhuis | NatĂ lia Pujol-Gualdo Amanda J. Kiliaan Department of Anatomy, Radboud university medical center, Donders Institute for Brain, Cognition and Behaviour, Preclinical Imaging Center PRIME, Nijmegen, The Netherlands Correspondence Amanda J. Kiliaan, PhD, Associate Professor, Department of Anatomy, Donders Institute for Brain, Cognition, and Behaviour, Preclinical Imaging Center PRIME, Radboud university medical center, 6500 HB Nijmegen, Geert Grooteplein 21N 6525 EZ Nijmegen, The Netherlands. Email: amanda.kiliaan@radboudumc.nl Funding information Europees Fonds voor Regionale Ontwikkeling (EFRO), Grant/Award Number: BriteN 2016 1 | INTRODUCTION The prevalence of obesity in adolescents and children is increasing in | Ilse A.C. Arnoldussen | Summary In this review, we discuss the role of adipokines in the onset of puberty in children with obesity during adrenarche and gonadarche and provide a clear and detailed overview of the biological processes of two major players, leptin and adiponectin. Adipokines, especially leptin and adiponectin, seem to induce an early onset of puberty in girls and boys with obesity by affecting the hypothalamic-pituitary- gonadal (HPG) axis. Moreover, adipokines and their receptors are expressed in the gonads, suggesting a role in sexual maturation and reproduction. All in all, adipokines may be a clue in understanding mechanisms underlying the onset of puberty in child- hood obesity and puberty onset variability. KEYWORDS adipokines, obesity, puberty 1,2 the age of 5 years were overweight or were with obesity in 2016, and 3 Obesity is defined by an excessive accumulation of white adipose tissue (WAT), and it is often indicated by a body mass index (BMI) 4 above 30. Two main types of adipose tissue were described: WAT and brown adipose tissue (BAT), which differ in morphology and func- 5-7 Ilse A.C. Arnoldussen and Amanda J. Kiliaan contributed equally to this work. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Š 2020 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of World Obesity Federation Obesity Reviews. 2020;21:e13005. wileyonlinelibrary.com/journal/obr 1 of 10 https://doi.org/10.1111/obr.13005 alarming rates. Specifically, worldwide, 41 million children below this number is expected to increase to 70 million in 2025. obesity is associated with various severe health complications, includ- ing increased risk of diabetes mellitus type 2, hypertension, heart dis- eases, and disturbances in sex hormone levels. 5,6 and mitochondria and plays a role in thermogenesis. Adipocytes in tion. BAT consists of adipocytes containing multiple lipid droplets WAT contain only a few mitochondria and a single lipid droplet. Adipose tissue has several functions including the storage of energy, thermogenesis, and the production and secretion of adipokines Generally, two physiological processes, adrenarche and gonadarche, 11,24 Childhood 5,7,8 a key role in puberty onset. Puberty is known as a period through which the body changes physically, being a physiological process resulting in the maturation of children, i.e. they develop sexual characteristics and obtain reproduc- 9,11 Adipokines are involved in a number of physiological processes including blood pressure, metabo- lism, glucose, and vascular homeostasis and may play amongst others 8-10 (hormones, cytokines, and peptides). tive functions. between obesity and puberty,2,12-23 the biological mechanisms under- lying obesity and puberty onset remain unclear. Hereafter, we review in detail the role of adipokines in the onset of puberty in childhood obesity. Although many studies have shown associations 2 | INITIATION OF PUBERTY PHYSIOLOGICAL PROCESSES IN THE interact to regulate the onset of puberty. During adrenarche, the adrenal cortex secretes steroid hormones (including 2 of 10 NIEUWENHUIS ET AL. androstenedione, dehydroepiandrosterone, dehydroepiandrosterone sulfate (DHEAS), androstenedione, and cortisol), insulin-like growth factor, and growth hormone, which contribute to the pubertal insights on new genetic loci (e.g. melanocortin-4 receptor, mitochon- drial carrier 2, and mitogen-activated protein kinase 13) and on sev- eral pathways that regulate the timing of puberty; however, it partly 34 9,24,25 Both adrenarche and gonadarche are involved in the development growth spurt, body odor, skin oiliness, and skeletal maturation. explains puberty timing variation. Thereby, defining the role of 25 adipokines is of importance in elucidating the variability in puberty as the expression of adipokines is sex-specific and is altered with body composition, adiposity, and during growth spurts. Moreover, adipokines and their receptors are expressed in gonads and several brain regions suggesting involvement in the onset of puberty and sex- ual maturation. Lastly, adipokines interfere in processes regulating timing and duration of puberty, for instance in the HPA and HPG axes which are both key players during adrenarche and gonadarche. Involvement of adipokines in the onset of puberty and specifically in individuals with obesity will be further reviewed in the next 2,24 3 | Puberty onset in girls is assessed using different markers, such as thelarche (breast development), menarche (the start of of pubic hair. pituitary-gonadal (HPG) axis is activated,2,26 and several hormones have been identified to participate in the activation of the HPG axis During gonadarche (Figure 1), the hypothalamic- 2,27 Kisspeptin, neurokinin B, and dynorphin are released by specialized including kisspeptin, neurokinin B, dynorphin, leptin, and ghrelin. 28 key regulator of the pulsatile secretion of gonadotropin releasing neurons, the KNDy neurons in the hypothalamus. Kisspeptin is a 29,30 B stimulates, and dynorphin inhibits the release of kisspeptin, which hormone (GnRH) from the hypothalamus. In addition, neurokinin implies that both coordinate a pulsatile release of kisspeptin. 31 Sub- sections. sequently, the activated HPG axis induces the pituitary gland to secrete luteinising hormone (LH) and follicle stimulating hormone (FSH). As a result, gametogenesis occurs, and the gonads will release sex hormones. Consequently, secondary sex characteristics develop including breast development in girls and an increased testicular vol- 2,26,32 is possibly due to differences in levels of body fat, hypothalamic-pitui- THE ONSET OF PUBERTY IN GIRLS ume in boys. The age at puberty onset varies greatly among individuals, which 19 35 menstruation), and pubic hair development. 33 genome-wide association studies have provided important new tary-adrenal (HPA) axis activity, and genetic background. Recent The average age of However, this age differs between cultures and ethnicities, and since 1980, age at menarche is girls at start of menarche is 12.4 years. 36 significantly decreasing. 36-39 F I G U R E 1 Hormonal regulation in the initiation of puberty in boys and girls. The secretion of kisspeptin, neurokinin B, and dynorphin from KNDy neurons initiate the release of gonadotropin releasing hormone (GnRH) from the hypothalamus. This activates the pituitary gland to produce and secrete luteinising hormone (LH) and follicle stimulating hormone (FSH), which in turn stimulate the gonads to produce estrogen and testosterone in girls and boys, respectively 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 3 of 10 T A B L E 1 Summary of included studies Authors Year Country Study Design Primary Outcome Sex Sample Size (n) Age (y) Data Collection Lian et al21 2019 China Cross-sectional Puberty starts earlier in Chinese Han girls with obesity compared with Chinese Han girls with normal weight. Girls 2996 9-19 2012 and 2013 Biro et al12 Lazzeri et al20 2018 USA 2018 Italy Longitudinal Cross-sectional Body mass index had a greater effect on age at menarche than did race and ethnicity. Girls 946 6-16 2004-2014 Li et al23 2018 China Longitudinal For both, boys and girls, a higher BMI (ie, overweight and obese) is associated with earlier onset of puberty Girls Girls Boys Girls 542 Deng et al22 Flom et al15 2017 China Cross-sectional Increased BMI is associated with early timing spermarche and menarche. Boys Girls Girls 1278258 9-15 2005-2012 He et al24 Holmgren et al17 2017 China 2017 Sweden Cross-sectional Longitudinal Onset of puberty is not related to obesity in boys. Boys Boys Girls Girls 782 7-17 972 929 5839 Kelly et al19 2017 UK 2016 Brazil 2016 USA Longitudinal prospective cohort Higher BMI in girls is associated with the onset of menstruation at an earlier age. 11 10-18 11-17 Barcellos Gemelli et al25 Cross-sectional Longitudinal Excess weight is associated with early age of menarche. Girls 727 2014 2003-2009 Glass et al16 Lee et al26 In girls, but not in boys, greater adiposity is associated with the earlier onset of puberty. Boys Girls 135 Cabrera et al27 Leonibus et al14 2014 USA 2013 Italy Cross-sectional Longitudinal Thelarche occurred earlier than recently reported, while age of menarche remained unchanged. Girls 610 3-17.9 2007 2005-2012 Currie et al13 2012 Europe, USA, Canada Cross-sectional Overweight/obesity during childhood predicts the early onset of puberty in girls. Girls 20410 11, 13, 15 2005-2006 2017 USA Prospective birth cohort Overweight/obese status at the age of 7 ye was associated with increased risk of early menarche 788 From birth to menarche occurred Pregnancies 1959-1966 2016 USA Cross-sectional Boys with overweight enter puberty earlier compared with boys with normal weight or obesity, while puberty starts later in boys with obesity compared with boys with normal weight and overweight. Boys 3872 6-16 2005-2010 Overweight during childhood shows a relation with the early onset of puberty in girls. 6535 4259 695 11 15 5.8-12.2 2009/2010 2013/2014 2014-2017 Higher BMI during childhood is associated with early puberty. 2008 and 2009 2000-2002 Obesity during childhood is related to the earlier onset of puberty. Boys Girls 84 123 71 (Continues) 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 4 of 10 NIEUWENHUIS ET AL. 3.1 | Fat storage For the initiation of puberty, the timing of stimulation and/or inhibi- tion of different hormones is important, and additionally, a certain amount and distribution of body fat is needed in order to start menar- che, which emphasizes the importance of body fat. From an evolution- ary point of view, body fat increases in mammalian females during puberty onset, and it highlights the need to guarantee a healthy preg- 40 women with anorexia nervosa. particularly body fat localized predominantly on the gluteofemoral fat depots, is profoundly associated with start of menarche, more than nancy, offspring, and maternal survival. fat, sex-hormones, and neuroendocrine alterations can evolve in men- strual dysfunction, for instance, in women with severe obesity or in 41-43 44-46 to gluteofemoral fat depots suggesting that leptin may convey infor- amount of total body fat. mation on body fat distribution to the hypothalamus during puberty. An improper level of body Importantly, body fat distribution, Blood leptin levels are strongly related 45 3.2 | HPG axis The HPG axis is activated by the release of kisspeptin resulting in the release of GnRH from the hypothalamus, and LH and FSH from the pituitary gland. In girls, FSH is involved in the development of the folli- cles in the ovaries, and it promotes the secretion of estrogen. LH stim- ulates the production of androgen hormones and induces ovulation 48 9,47 the release of kisspeptin and neurokinin B, and kisspeptin thereby (Figure 1). The secretion of estrogen has an inhibitory effect on inhibits the GnRH release from the hypothalamus. pattern of GnRH is important for the regulation of the menstrual cycle. This roughly 28-day-cycle comprises several phases, including the follicular phase and luteal phase. During the follicular phase, increasing levels of FSH stimulate the maturation of follicles and the production of estrogen from the ovaries. This in turn inhibits the release of FSH from the pituitary gland. A high level of estrogen will induce the production of LH by the pituitary gland, resulting in ovula- tion. The matured follicle secretes progesterone thereby inhibiting the release of GnRH. When the corpus luteum is demolished, there is less 48 3.3 | Adipokines According to results from studies reported in Table 1, girls with obe- sity enter puberty earlier compared with girls with normal higher leptin concentrations inhibit the intake of food and increases inhibition of GnRH. As a consequence, the cycle will start again. whole process, starting from the activated HPG axis, results in the development of the secondary sex characteristics in girls including 9,47 thelarche and menarche. 13,14,16-23,49-51 weight. these girls might be found in the secretion of adipokines. For instance, leptin is positively associated with the amount of body fat. Generally, energy expenditure. 9,52-54 An explanation for the early onset of puberty in The expression This TABLE 1 (Continued) Authors Year Country Study Design Primary Outcome Sample Sex Size (n) Age (y) Data Collection Herman-Giddens et al28 2012 USA Cross-sectional Observed mean ages of beginning genital and pubic hair growth and early testicular volumes were earlier than in past studies, depending on the characteristic and race/ethnicity. Boys 4131 6-16 2005-2010 Sorensen et al29 Aksglaede et al30 2010 2009 Denmark Denmark Cross-sectional/longitudinal Longitudinal Puberty onset at earlier ages was associated with an increased BMI in boys. Boys 1528 5.8-19.9 1991-1993/2006-2008 1930-1969 Juul et al31 Ribeiro et al32 2007 2006 Denmark Portugal Retrospective cohort Cross-sectional Higher BMI is associated with early voice break. 11-15 10-15 1990-1999 Kaplowitz et al18 Abbreviation: BMI, body mass USA Cross-sectional The early onset of puberty in Caucasian girls is likely related to an increased BMI. 5-12 1992-1993 2001 index. The higher BMI in boys and girls at 7 y of age, the earlier they enter puberty. Boys 21 612 Girls 135 223 Boys 463 Boys 382 Girls 437 Girls 10 750 Early sexual maturation in boys and girls is associated with overweight. 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 5 of 10 Leptin may possibly play a role in adrenarche as its plasma level increases with higher levels of body fat and as it can modulate both girls. 33 ing adrenarche. In coherence, in children with obesity, the androgen These findings suggested that lower reproductive status was associated with higher total adiponectin concentrations and that a higher reproductive status was related to higher HMW adiponectin the HPA and HPG axes. These axes are functionally integrated dur- DHEAS was positively associated with leptin levels. Nevertheless, concentrations in girls. In addition, individuals with obesity often another study showed that enhanced adrenal androgen secretion in girls with premature adrenarche was not explained by leptin or BMI 55 ated with androgen levels in girls ; however, it was not related to levels. and IL-6. TNF-Îą alters, and IL-6 inhibits the expression of 56 8 In addition, the adipokine adiponectin was negatively associ- 57 differences of adiponectin seem to develop during the progression of 56 adiponectin (Figure 2). Thereby, a low level of total adiponectin and/or high levels of inflammatory cytokines in individuals with obe- sity can promote the onset of puberty. Many more adipokines are secreted by WAT including omentin, 52,65-67 9,36,62,68 adrenarche in girls with Prader-Willi syndrome. Interestingly, sex puberty. adrenarche; however, both are not required factors. Thus, leptin and adiponectin might be able to influence In gonadarche, leptin can stimulate the secretion of kisspeptin, and subsequently activation of the HPG axis, which eventually increases the expression of estrogen and androstenedione in the ova- 58 2,60 65-67 The expression of these ries (Figure 2). Ob gene in WAT, resulting in the synthesis and secretion of leptin. Thus, high levels of leptin promote onset of puberty in girls via secre- tion of kisspeptin, and estrogen stimulates leptin secretion addition- ally. Moreover, adiponectin can affect the HPG axis due to the expression of adiponectin receptors in the hypothalamus, pituitary In return, estrogen stimulates the expression of the 59 gland, and gonads. onset as it inhibits the secretion of kisspeptin and GnRH in the hypo- thalamus and the release of GH and LH in the pituitary gland, and 2,60-62 52,60 63 girls with central precocious puberty (CPP). Moreover, total adiponectin had negative correlations with progression of puberty in girls (defined by Tanner stages), whereas HMW adiponectin had FIGURE 2 Adipokinesaffectingthe initiation of puberty in girls. Leptin stimulates the release of kisspeptin in KNDy neurons, which activates the hypothalamus to produce gonadotropin releasing hormone (GnRH). In response to the release of GnRH, the pituitary gland secretes follicle stimulating hormone (FSH) and luteinising hormone (LH), which stimulates the ovaries to release estrogen resulting in the formation of secondary sex characteristics in girls. Estrogen stimulates the production of leptin. Adiponectin inhibits GnRH release resulting in reduced levels of GnRH and thereby a delayed onset of puberty. TNF- Îą and IL-6 inhibit the production of adiponectin and therefore stimulate the onset of puberty In detail, adiponectin is a regulator of puberty thereby inhibiting the onset of puberty (Figure 2). with obesity often have low levels of adiponectin. et al. showed that total adiponectin was significantly lower, whereas high molecular weight (HMW) adiponectin was significantly higher in ment. 55 63 develop a chronic low-grade inflammatory state, which can be indi- cated by a high level of circulating inflammatory cytokines like TNF-Îą 64 Individuals Sitticharoon positive associations with LH levels and the progression of puberty in 63 visfatin, resistin, and chemerin. and visfatin are expressed in the ovaries. adipokines in the ovaries suggests a role within the reproductive sys- tem; however, the exact biological processes have to be examined. Thus, specifically leptin, adiponectin, and inflammatory cytokines pro- duced by WAT could be permissive key players during an early onset of puberty in girls with obesity. As an exception, HMW adiponectin seems to have a stimulatory effect on peripheral repro- ductive function as HMW is not able to cross the blood brain 63 barrier. 4 | Markers that are used to assess puberty onset in boys are THE ONSET OF PUBERTY IN BOYS spermarche, voice break, testicular volume, and pubic hair develop- 35 spermarche develop in the early stages of puberty onset, voice In women, omentin, chemerin, While pubic hair development, larger testicular volume, and 69 testicular volume increases, which occurs at an average age of break usually appears in later stages of puberty. Generally, first 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 6 of 10 NIEUWENHUIS ET AL. 11.9 years, followed by the development of pubic hair at 12.2 years of average, and lastly, boys experience spermarche around an aver- 55 related with leptin levels. Thereby, leptin plausibly has a minor impact in adrenarche in boys. Since leptin receptors are found in the hypothalamus, pituitary gland, and testes, they might be involved in the onset of puberty by affecting the HPG axis during gonadarche. Leptin stimulates the release of kisspeptin and GnRH, and as a consequence, it accelerates the onset of puberty (Table 1, Figure 3). In contrast, adiponectin inhibits the secretion of GnRH, GH, LH, and FSH therewith delaying the onset of puberty. However, adiponectin levels are generally lower in men compared with women and even lower in men with obe- age age of 13.4 years. 70 4.1 | Fat storage Many aspects of the reproductive physiology are energetically demanding,71 and therefore, an adequate energy level is necessary. In boys, a dynamic change in body composition occurs around the age of 10 to 13 years, in which they gain approximately 40% of sity. culating inflammatory cytokines. levels can stimulate the HPG axis and therewith an early onset of puberty in boys. Nevertheless, leptin can inhibit the production of tes- 72 mostly consisting of lean mass, which causes exhaustion of most of fat. Subsequently, a growth spurt follows in which they gain tissue 72 in boys, an adequate amount of body fat is important in the onset of their body fat. These alterations in amount of body fat indicate that 4.2 | Puberty in boys is initiated by the release of kisspeptin. As mentioned before, this activates the HPG axis, resulting in the release of GnRH from the hypothalamus, and consequently the release of LH and FSH 9,74 puberty. tosterone from the testes, to estrogen (Figure 3). of the development of secondary sex characteristics in boys. Additionally, leptin can affect fertility in men as it can modulate the nutritional support of spermatogenesis, and moreover, dysfunction of spermatogenesis is associated with an increased leptin level and 73 58 2,60-62 HPG axis from the pituitary gland (Figure 1). and LH stimulates the secretion of testosterone from the testes, which inhibits the release of kisspeptin from the KNDy neurons and 9,48 in men, the release of kisspeptin is more consistent, causing a con- 29,48 subsequently GnRH from the hypothalamus. receptors expressed on KNDy neurons. In humans, KNDy neurons Contrarily to women, LH-induced testosterone levels lead to the stant release of LH. development of secondary sex characteristics in boys. differences between sexes in kisspeptin release are related to a sex- specific and sex steroid-dependent kisspeptin system as estrogen and progesterone modulate kisspeptin activity through the sex-steroid 48 in the infundibular nucleus are involved in negative and positive sex- 48 tal exposure to sex steroids and result in sex-specific differences in steroid feedbacks. kisspeptin release. These sexual dimorphisms are induced by perina- 75,76 4.3 | Adipokines The association between obesity and puberty onset in boys is rather controversial compared with findings in girls. Most studies reported an early onset of puberty in boys associated with increased ate adipose tissue from actual breast tissue. stages are more difficult to assess than female stages as boys lack a more determined marker such as menarche. Thirdly, puberty onset can be indicated by the activation of the HPG axis, and the presence of these secondary sex characteristics is the result of hormonal 2 14,17,22,23,50,51,77,78 BMI, 20,49 all while others reported no associations at Current markers used 79 16,80 or a delayed onset of puberty (Table 1). The presence of excessive adipose tissue can be involved in puberty onset in boys as the secretion of adipokines can modulate both adrenarche and gonadarche. Leptin can affect adrenarche by modulating both the HPG and HPA axes,33 and moreover, androgen levels were positively 55 nal androgen secretion in boys with premature adrenarche was not associated with plasma leptin levels. Nevertheless, enhanced adre- 9 In more detail, 61,62 adiponectin, and individuals with obesity often have high levels of cir- Moreover, inflammatory cytokines, TNF-Îą, and IL-6, inhibit expression of the leptin receptor in the testis. FSH induces spermatogenesis, too. function and role still have to be examined. 64 High leptin and low adiponectin and fat tissue can convert testosterone Both processes might result in the delay 29,61,79 81,82 In men, other adipokines like chemerin are found in the gonads 65 Thus, particularly high leptin and low adiponectin levels stimulate the HPG axis and thereby accelerate the onset of puberty in boys. Additionally, leptin can dysregulate the development of secondary sex characteristics and spermatogenesis by affecting testosterone levels and nutritional sup- port of spermatogenesis. 5 | LIMITATIONS AND FUTURE RESEARCH DIRECTIONS Even though multiple epidemiological studies have shown the link between puberty onset and obesity, there are some important limita- tions. Firstly, determining both the onset and stage of puberty is rather difficult. For instance, assessing the stage of breast develop- ment in girls with obesity is complicated as clinicians should differenti- 2 changes in response to the activated HPG axis. to determine the onset of puberty refer to secondary sex characteris- tics, such as testicular volume in boys and breast development in girls. A more accurate measurement of puberty onset would be to combine secondary sex characteristics with plasma or serum hormone level measurements such as LH, FSH, adipokines, e.g. leptin. Thereby, differences in puberty measurements could explain variations in the age of puberty onset between boys and girls within different Thereby, resistin is expressed in the testes of rats, but its exact 83 Secondly, male pubertal 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License NIEUWENHUIS ET AL. 7 of 10 FIGURE 3 Adipokines affecting the initiation of puberty in boys. Leptin activates kisspeptin secretion in KNDy neurons, this activates the production of gonadotropin releasing hormone (GnRH) from the hypothalamus. GnRH stimulates the pituitary gland to secrete follicle stimulating hormone (FSH) and luteinising hormone (LH), activating the production of testosterone from the testes allowing the development of secondary sex characteristics. Leptin also inhibits the production of testosterone, which may cause a delayed onset of puberty. Adiponectin inhibits GnRH release. Low levels of adiponectin, as a result of TNF-Îą and IL-6 expression, lead to a reduced inhibition of GnRH. In response to GnRH release, the pituitary gland will secrete FSH and LH, and the testes will produce testosterone resulting in the development of secondary sex characteristics in boys countries, and In addition, the inclusion of a of puberty. ferent time points is complicated, as subjects examined several decades ago presented pronounced differences concerning lifestyle patterns such as nutrition and exercise habits. Lastly, obesity or over- weight is often determined by BMI, a classification based on weight and height measurements. Additionally, it is important that all studies studies or across continents, ethnicities proper age range (8-16 years) is important when assessing the onset (Figure 4). 12-15,17,20-23,49,77-79,84,85 30,47 Furthermore, comparison between studies from dif- 86 Specifically in children, BMI is often dependent on age and growth use the same anthropometric standards and sex-specific cut-offs. 13,14,16-23,49-51,77-80 fat and would represent a more accurate measurement in its regard. Based on this review, several suggestions can be made for further research. Firstly, the roles of adipokines like resistin, chemerin, visfatin, and omentin in puberty onset, fertility, and sexual maturation should be examined in detail. Secondly, future research examining the onset of puberty should combine indicators of puberty onset (e.g. breast development or testicular volume) with plasma or serum hor- mone measurements such as LH, FSH, sex-steroids, adipokines (e.g. spurts. ment in case of growth spurts. distribution of body fat should be taken into account in determining puberty and obesity in children. For instance, the body adiposity index (BAI), which was introduced in 2011 by Bergman et al.,87 uses hip cir- cumference and height in order to estimate the percentage of body 87 Thereby, BMI is a less accurate measure- F I G U R E 4 87,88 Therefore, both percentage and Average age of puberty onset in Europe, China, and the United States according to several studies from Table 1. Age of puberty onset ranges from 8.47 to 13.33 years in girls and from 8.63 leptin), and body fat distribution (e.g. BAI,87 waist-hip ratio's and/or dual-energy X-ray absorptiometry (DXA)2). Additionally, defining con- sistent and general measurements of puberty in both boys and girls, combined with a proper age range (8-16 years), would facilitate the comparisons between different studies and their results. 12-15, 17, 20-23, 25-29, 31 to 13.7 years in boys. included if average age of markers used to assess puberty was not reported. Pink: girls. Blue: boys Studies (Table 1) were not 39, 56 1467789x, 2020, 6, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/obr.13005, Wiley Online Library on [10/03/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License 8 of 10 NIEUWENHUIS ET AL. 6 | CONCLUSION In conclusion, epidemiological data regarding obesity and puberty onset in girls show similar outcomes as adiposity results in the early onset of puberty in girls. The majority of the studies examining boys with obesity indicate an early onset of puberty, while not all reported an earlier onset of puberty. In detail, high leptin, TNF-Îą, and IL-6 levels combined with low adiponectin levels stimulate the activation of the HPG axis in girls and boys with obesity, and 5, 45, 50, 51 REFERENCES 1. Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. May- o Clin Proc. 2017;92(2):251-265. 2. Reinehr T, Roth CL. Is there a causal relationship between obesity and puberty? The Lancet Child & adolescent health. 2019;3(1):44-54. 3. WorldHealthOrganization. Facts and figures on childhood obesity. 2017. 4. Guglielmi V, Sbraccia P. Obesity phenotypes: depot-differences in adipose tissue and their clinical implications. Eat Weight Disord. 2018; 23(1):3-14. 5. Gomez-Hernandez A, Beneit N, Diaz-Castroverde S. Escribano O. 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FUNDING INFORMATION This research was funded by Europees Fonds voor Regionale Ontwikkeling (EFRO), project BriteN 2016. ORCID Ilse A.C. Arnoldussen Amanda J. Kiliaan https://orcid.org/0000-0002-7395-5284 https://orcid.org/0000-0002-2158-6210 13, 14, 16-26, 29-32 Furthermore, several receptors Nevertheless, We conclude Search strategy We searched PubMed for articles published before Novem- ber 15th, 2019 using relevant keywords, including âonset of puberty and adiposity/obesityâ, âonset of pubertyâ, âchildren with obesityâ, âadipose tissueâ, âchildhood obesityâ, âadiposityâ, âobesityâ, âadipokine(s)â, âHPG axisâ, âadipokines ovary/ova- riesâ, or âadipokines testesâ, either alone or in combination. 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Health 11/12 Review for Final Exam Core Concepts - Mental and Emotional Health, Substance Abuse Prevention, Safety and Violence Prevention, Family Life and Human Sexuality, Disease Prevention and Control, Healthy Eating Health Education Skills - goal setting, decision making, accessing information/resources, analyzing influences, communication, self-management, advocacy DIMENSIONS of Wellness - social, spiritual, emotional/mental, environmental, financial, intellectual, multicultural, occupational, physical, sexual RISK factors - anything that increases the risk of disease, injury, or illness. PROTECTIVE factors - anything that decreases the risk of disease, injury, or illness. INTERNAL health factors - health factors that can be either hereditary and genetic or acquired elements -- include smoking and personal diet or eating habits. Example â a genetic predisposition to an illness. EXTERNAL health factors - health factors that are part of the direct outer environment, the geographical location, micro-organisms, socio-economic elements that could affect an individual's health. Example â being unable to afford mental health services. Unit 1- Managing Personal and Community Wellness Explain Maslowâs Hierarchy of Needs in your own words using the image provided. Explain how each Social Determinant of Health may impact a personâs health. Levels of Disease Prevention ⢠PRIMARY The goal is to avoid conditions altogether. ⢠SECONDARY The goal is early detection. ⢠TERTIARY The goal is to minimize the damage (manage). Define the following terms. Fads/Trends Sleep hygiene Driver safety Unit 2- Investigating Social Ecological Factors on Well-Being Socio-Ecological Model â The SEM examines how health behaviors form based on characteristics of individuals, communities, nations and levels in between. Each level overlaps with other levels signifying how the best public health strategies are those that encompass and target a wide range of perspectives. Interpersonal (personal) health vs. intrapersonal (relationship) health Health INEQUITY - systemic, ingrained and unjust barriers that prevent segments of the population from having the opportunity of health leading to health disparity. IMPLICIT BIAS - a form of bias that occurs automatically and unintentionally, that nevertheless affects judgments, decisions, and behaviors. Research has shown implicit bias can contribute to unequal access to quality healthcare, negative patient-provider relationships and interactions; and create mistrust in the healthcare system and practitioners among patients. This can contribute to health disparities. Health DISPARITY - represents a difference in health between populations. It is often used to describe disease burden and other negative health outcomes socially disadvantaged groups may face. Health EQUITY - The opposite of health inequity. It describes a system that supports a high standard of health and healthcare for all people. Racism - Beliefs, attitudes, institutional arrangements, and acts that tend to denigrate individuals or groups because of phenotypic characteristics or ethnic group affiliation. DISCRIMINATION - An unjust differential treatment of a person or a group. PRIVILEGE- The unearned access to resources and social power that are only available to some because of their membership within certain social groups. OPPRESSION is the act of taking away choices from others and can be defined as a system that maintains advantage and disadvantage based on social identities and that acts on multiple levels from interpersonal to institutional and societal. (internalized, interpersonal, institutional, structural) Systematic Oppression - Intentional disadvantage of groups of people based on their identity while advantaging members of dominant group (race, gender, sexual orientation, language, size, ability, etc.). Intersectionality - The complex, cumulative way in which the effects of multiple forms of discrimination (such as racism, sexism, and classism) combine, overlap, or intersect especially in the experiences of marginalized individuals or groups Unit 3- Accessing Resources and Communicating to Support Mental and Emotional Health What is anger? What is anxiety? What is stress? STRESSORS are the things that cause stress. Stressors can be internal and external. A stressor may be a one-time or short-term occurrence, or it can happen repeatedly over a long time. INTERNAL Stressors - are made by your belief system and the way you evaluate yourself. Examples include pessimistic attitude, negative self-talk, deep need to be perfect, low self-esteem or body image, unhealthy standards for self. EXTERNAL Stressors - are stressful things that happen in your surroundings and/or in your environment. Examples include busy schedules, work problems, family issues, financial trouble, social problems, injury, unforeseen circumstances. Socio-economic issues are also a part of external stressors such as poverty, violence, and racism. Define the following mental health conditions. Depression Eating disorders NSSI Non-suicidal self-injury Grief/Loss Suicide prevention A.C.T. ⢠ACKNOWLEDGE- Tell them in a caring way that you recognize that they are having a problem ⢠CARE- You can show you care by actively listening - put away anything else you are doing, make eye contact, sit down, ask questions. ⢠TELL-(call 988 for additional help and support) - Tell them it is important that they speak with a trusted adult. Help them figure out who this may be and offer to go with your friend. A social norm is an unwritten, informal rule meant to guide behavior among the of society. It distinguishes between acceptable and unacceptable, good and bad, and so on. Social norms can influence a person with emotional or mental health disorders, access to care and stigmatize their situation. STIGMA- a mark of disgrace associated with a particular circumstance, quality, or person. ⢠Self-stigma - This describes the internalized stigma that people with mental health conditions feel about themselves. ⢠Public stigma - This refers to the negative attitudes around mental health from people in society. ⢠Institutional stigma - This is a type of systemic stigma that arises from corporations, governments, and other institutions. Unit 4- Evaluating Risks of Substance Use and Abuse Harm Reduction - a set of practical strategies and ideas aimed at reducing negative consequences associated with drug use. Explain how each level of the Social Ecological Model is impacted by addiction. Individual Relationship Community Society SEM Level Contributing/Risk Factors to substance use Preventative/Protective Factors for substance use Individual Interpersonal/Relationship Community Society Unit 5- Analyzing Influences to Examine Ways to Increase Safety and Reduce Violence HATE CRIME - a crime, usually violent, motivated by prejudice or intolerance toward an individualâs national origin, ethnicity, color, religion, gender, gender identity, sexual orientation, or disability. Explain how the media influences violence in society. The Pyramid of Hate Explain the escalation of hate using the Pyramid of Hate visual. List several hate crime motivators. Example: age HEALTHY Relationship Signs - comfortable pace, trust, honesty, independence, respect, equality, kindness, taking responsibility, healthy conflict, fun UNHEALTHY Relationship Signs - intensity, possessiveness, manipulation, isolation, sabotage, belittling, guilting, volatility, deflecting responsibility, betrayal Sexual Assault is a sexual behavior WITHOUT consent. Human trafficking - the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, using force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery. Sex trafficking - commercial sex act induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age. Trafficking happens using⌠⢠Force - using violence to control someone. ⢠Fraud - using lies to control someone. ⢠Coercion - using threats to control someone. Unit 6- Family Life and Human Sexuality Agency - A belief about yourself and the extent to which you can act on that belief. ⢠The ability to choose freely oneâs own narrative. ⢠To embrace the idea that I am the cause (or agent) of my own thoughts and actions. ⢠Personal agency is a personal responsibility for who we are, what we experience, what we do about that experience, and how we shape our world to give us more of the experiences we want. SEXUAL Agency ⢠The ability to choose your own interests and desires vs. what we see in the media or othersâ perceptions ⢠The ability to identify, communicate, and negotiate oneâs sexual needs ⢠The ability to initiate behaviors that allow for the satisfaction of those needs Sexually Explicit Material - photographs, videos, films, magazines, and books whose primary themes, topics, or depictions involve sexuality that may cause sexual arousal. Sexual scripts - thoughts, patterns, or behavior that a person has about themselves in a romantic or sexual context. It is how people picture themselves or want to project themselves in front of others. Reproductive Rights of Teens - In Maryland, teens have the right to an abortion, keep their child, obtain and use birth control, paternity tests, adoption, give up custody of their child within 10 days of birth (Safe Haven Law). ⢠REPRODUCTIVE RIGHTS- legal rights and the freedom of the individual to control decisions regarding contraception, abortion, sterilization and childbirth. ⢠SAFE HAVEN LAW- a distressed parent who is unable or unwilling to care for their infant can safely give up custody of their baby, no questions asked. CONSENT is an agreement between participants to engage in sexual activity. ⢠It is clearly and freely communicated, verbal, and affirmative. Consent CANNOT be given if⌠⢠A person is underage, one or both partners is intoxicated or incapacitated by drugs or alcohol, one partner is asleep or unconscious, one partner feels pressured, threatened or intimidated, or one partner holds a position of power or authority over the other. Unit 7- Advocating for Enhanced Nutrition, Food Systems, and Health Outcomes Dietary Guidelines for Americans Guideline 1: Follow a Healthy Dietary Pattern at Every Life Stage Guideline 2: Customize and Enjoy Food and Beverage Choices to Reflect Personal Preferences, Cultural Traditions, and Budgetary Considerations Guideline 3: Focus on Meeting Food Group Needs with Nutrient-Dense Foods and Beverages, and Stay Within Calorie Limits Guideline 4: Limit Foods and Beverages Higher in Added Sugars, Saturated Fat, and Sodium, and Limit Alcoholic Beverages FOOD DESERT- a neighborhood where there is little or limited access to healthy and affordable food such as fruits, vegetables, whole grains, low-fat milk and other foods that make up the full range of a healthy diet. FOOD INSEQURITY lack of access to a sufficient amount of food because of limited funds. More than 49 million American households are considered food insecure and are vulnerable to poor health as a result. PROCCESED FOODS- any raw agricultural commodities that have been washed, cleaned, milled, cut, chopped, heated, pasteurized, blanched, cooked, canned, frozen, dried, dehydrated, mixed or packaged â anything done to them that alters their natural state.
Good day this is Chris today we will be doing a quick walkthrough on ISO 14001 2015 Environmental Management System and its main clauses let's get started ISO 14001 2015 Environmental Management System is a globally recognized standard for environment Management systems or EMS an EMS is a framework that organizations use to manage their environmental impact comply with regulations and improve their environmental performance the standard outlines are requirements for an EMS including the development of an environmental policy the identification of environmental aspects and impacts the establishment of objectives and targets the implementation of operational control monitoring and measurement systems and the ongoing review and Improvement of the system ISO 14001 is a flexible standard that can be used by organizations of any size or type regardless of their environment impact or level of environment performance it provides a practical framework for organizations to manage their environmental impact reduce environment risks and demonstrate their commitment on sustainability to their stakeholders here is the standard that provides a structured approach to develop an EMS which includes several key steps one organizations must develop an environmental policy that outlines their commitment to environmental sustainability this policy should be communicated to all employees and stakeholders two organizations must identify their environmental aspects and impacts this involves identifying the activities products and services that have an impact on the environment as well as the potential environmental consequences of those impacts three once the environmental aspects and the impacts have been identified organizations must establish environmental objectives and targets these objectives and targets should be specific measurable achievable relevant and time-bound 4. after setting objectives and targets organizations must Implement operational controls and establish monitoring and measurement systems to ensure that they are meeting their objectives and targets finally organizations must review and continually improve their EMS this involves conducting regular audits reviewing the EMS to ensure that it remains relevant and effective and making any necessary changes or improvements the main Clause of iso 14001 2015 apart from its scope normative references and terms and conditions that the main Clauses of iso 14001 2015 can be listed as context of the organization leadership planning support operation performance evaluation and Improvement Clause 4.0 context of the organization is about understanding the organization and its context understanding the needs and expectations of the interested parties determining the scope of the Environmental Management System EMS and Environmental Management System itself Clause 5.0 talks about leadership and commitment Environmental Policy organizational roles responsibility and authorities Clause 6.0 planning focuses on actions to address risk and opportunities as well as environmental objectives and planning to achieve them Clause 7.0 support are detailed requirements on resources competence awareness communication that includes external and internal communication documented information that involves creating updating in control of documented information Clause 8.0 operation talks about operational planning and control as well as emergency preparedness and response overall the design of iso 14001 2015 provides guidelines to form a system that is structured to cater the requirements of stakeholder needs and expectations to drive life cycle perspective and Energy Efficiency as pictured here Clause 9.0 performance evaluation provides guidelines to monitoring measurement analysis and evaluation evaluation compliance and management review an additional note here is that ISO 19011 2018 guidelines for auditing Management Systems which is an audit process that will determine the scope to establish the audit criteria by collecting evidence evaluating the evidence and then draw a conclusion based on the findings as pictured here [Music] finally Clause 10.0 Improvement talks about how Improvement is an integral factor to an effective Environmental Management system through General non-conformity and corrective action and continual Improvement talking about Improvement it is always continual in putting efforts towards the betterment of the existing system here is a snapshot of the main Clauses of iso 14001 2015 [Music] I hope you find this video useful we are industry experts specialized in management system consultancy and Industry relevant corporate training give us a call and let us help you drive your business excellence and upskill your employees to elevate workplace efficiency [Music] CREATE 10 MCQ AND 2 SAQ QUESTIONS BASED ON THE ABOVE PARAGRAPH
Filmic Techniques Based on the work of Brad Smilanich Mis-en-Scene: originally a French theatrical term arrangements of all the visual elements of the stage area in film â âthe contents of the frame and the way those contents are organizedâ include: lighting, costume, dĂŠcor, props, camera movement or distance . . . all photographic decisions etc. Proxemics: Spatial relationship among characters within the mis-en-scene Rule of Thirds: a compositional rule of thumb in painting, design, photography etc. suggests image divided into 9 equal parts with two vertical and two horizontal lines important elements of the mis-en-scene should be placed along these lines and their intersections some suggest aligning with intersections makes for more interesting pictures than just centreing the subject Proxemics Camera Distance: Quite literally, how far the camera is from the subject being filmed The Hand Camera Camera Distance: Quite literally, how far the camera is from the subject being filmed Extreme Close Up: Singles out one small portion of the body or object Used to intensify emotion, or show reaction Camera Distance: Close up Shot: Shows head of character or small significant object Used to show emotions Camera Distance: Medium Shot: shows figures from the waist up allows character to be seen within background Camera Distance: Long Shot: shows figures from feet up similar to the âstageâ in live theatre orients audience to figures within a location or surrounding Camera Distance: Extreme Long Shot: Sometimes called an âestablishing shotâ Panoramic view of an exterior location orients audience to a location Camera Distance: Camera Angle: Cameraâs angle of view relative to the subject being photographed High Angle Shot: looks down on the subject often used to make the subject look small and insignificant (in combination with camera distance) puts the camera (audience) in âpowerâ position Camera Angle: Low Angle Shot: looks up at the subject often used to make the subject look large and powerful puts the camera (audience) in a âsubmissiveâ position Camera Angle: Flat Angle Shot: camera on same plane as the subject feels most ânormalâ to an audience Camera Angle: Canted Shot: frame is unbalanced in relation to the subject may indicate a symbolic unbalance in the character Camera Angle: Camera Movement literally the camera moving with or around or to follow the subjects in the mis-en-scene or frame Camera Movement: Tilting Movement camera moves up or down on a horizontal axis similar to head nodding movement may be used to show subjects relation to surroundings Camera Movement: Panning Movement camera moves side to side on a vertical axis similar to head shaking movement may be used to establish setting Camera Movement: Dolly Movement camera mounted on a vehicle that moves along with the subject (camera moves, not pivots) follows the subject to signify something important Camera Movement: Crane Shot camera mounted on a crane or boom permits camera to move in & out, up & down, backward & forward often used for high aerial establishing shots Misc. Shots: Hand Held: camera carried to seem jerky, giving ârealistic feelâ Push In: camera moves up to a characterâs face to indicate an epiphany (realization) Spiral: camera circles subject for effect End for ELA 20-2 and 10-1 Shot Transitions/Editing: artificial editing done to string together multiple shots to create a narrative scene or sequence a cut is the change from one shot to another usually separated in to âsoftâ and âhardâ cuts Jump Cut: an instantaneous change from one shot to another this can be very natural or may disorient the audience, depending on how it is used Transitions/Editing Swish Pan: A pan where the speed of the camera is so fast that images are blurry used often to connect events in different settings that are connected by time Transitions/Editing Dissolve: transition where one shot gradually dissapears while another shot gradually appears often used to suggest change of setting or long time passage i.e. flashbacks Transitions/Editing Fade In/Out: transition where the shot gradually overexposes to white or underexposes to black often used to suggest a lengthy passage of time or change in location Transitions/Editing Wipe: transition where one shot is gradually eliminated as another shot moves onto the screen can be vertically or horizontally often suggests movement of the camera to another location Transitions/Editing Iris In/Out: transition where one shot gradually appears as an expanding circle in the middle of an old image suggests . . .??? Transitions/Editing Shot-Reverse Shot: one character is shown looking (often off-screen) at another character, and then the other character is shown looking "back" at the first character. Since the characters are shown facing in opposite directions, the viewer unconciously assumes that they are looking at each other. Transitions/Editing Two-Shot: Face-up shot of two people. Often used in interviews, or when two presenters are hosting a show. A "One-Shot" could be a mid-shot of either of these subjects. A "Three-Shot", unsurprisingly, contains three people. Transitions/Editing Shot Transitions/Editing: Sound: used to reflect or enhance what is shown visually on the screen can include dialogue, music, sound effects, voiceover etc. Diegetic Sound: sound that has a source in the world of the story dialogue spoken by characters, sound made by objects, or music coming from a source grounded in the story of the film Non-diegetic Sound: sound that has a source outside the world of the story usually part of the score or the soundtrack Parallel Sound: sound that complements the image shown i.e. romantic music during a love scene Counterpoint Sound: sound that contradicts the âfeelingâ of the image a happy song played while images of graphic violence are portrayed Voiceover: voice of a non-visible narrator laid over the scene often provides some comment about the narrative of the film Sound Bridge: used to âsoftenâ the transition between one scene and another takes sound from the next shot and overlays it on the current shot 2-3 seconds earlier than we see the image Examples of Diegetic/Non-Diegetic: In the first clip, the non-diegetic music changes to diegetic music when the main character moves inside of the convenience store. In the second clip, the âduhn duhn duuuuhâ which often is non-diegetic becomes diegetic because it is the band in the passing bus playing that music! End for ELA 20-1 Lighting: Can be used by a director to: Control the mood of a scene guide a viewerâs eye to a specific place in mis-en-scene Emphasize and de-emphasize elements in frame Add texture and color Make people look beautiful, ugly, sinister, or angelic Standard 3-Point Lighting: uses three lights called the key light, fill light and back light forms the basis of most lighting. once you understand three point lighting you are well on the way to understanding all lighting. Key Light: main light usually the strongest and has the most influence on the look of the scene. it is placed to one side of the camera/subject so that side is well lit and other side has shadow. Fill Light: secondary light is placed on the opposite side of the key light used to fill the shadows created by key softer and less bright than key Back Light: placed behind the subject ; lights it from the rear. provides definition and subtle highlights around the subject's outlines. Separates subject from background provides a three-dimensional look. Standard 3-Point Lighting: http://www.zvork.fr/vls/ Try using this simulator to play with lighting with those 3 points.