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Emilia Kolarzyk

Publications and source records attributed to Emilia Kolarzyk.

At least 19 recordsLinked to original sources
PubMed2006

The usefulness of artificial neural networks in the evaluation of pulmonary efficiency and antioxidant capacity of welders.

OBJECTIVE: The aim of the study was to determine if artificial neural networks (ANNs) may be useful to analyse a complex and large set of data derived from smoking welders for the purpose of finding relationships between parameters describing respiratory system efficiency and antioxidant defence. METHODS: A group of 94 welders employed in a big metallurgic enterprise in Krakow, Poland (men only, aged 29-57 years, all active smokers) occupationally exposed to O(3) and NO(x), were the subjects of this study. They underwent biochemical measurements including total antioxidant status (TAS) and the anti-oxidative defence enzymes superoxide dismutase (SOD) and catalase (CT); biominerals: Fe, Cu, Zn, Mg in blood serum and in hair; the concentrations of albumin, bilirubin, uric acid in blood. The determination of respiratory efficiency was based on a "flow-volume" curve and spirometry. The dependant variables for ANNs were: TAS, SOD, CT. Thirty-one subjects with normal values of all spirometric parameters were selected for the final analysis. RESULTS: Statistically valid relationship between TAS and albumin, Zn and Cu in blood and the two pulmonary parameters forced expiratory volume after 1s (FEV(1)) and middle expiratory flow of 25-75% of vital capacity (MEF(25/75)) were found. Zn concentration almost linearly influenced TAS. For Cu a sigmoid curve was obtained. For albumin concentration as well as for FEV(1) a two-stage curve was observed. CONCLUSIONS: ANNs are useful for the reduction of dimensionality and are suited to analyse a complex and relatively large set of parameters when it is unknown which of these are related. ANNs were useful for finding the relationship between the antioxidant defence and the respiratory system capacity in welders who smoke.

Adult↗
PubMed2006

Micronutrients and macronutrients and parameters of antioxidative ability in saliva of women: inhabitants of Krakow (Poland) in the course of uncomplicated singleton pregnancy.

There were two aims of the present study: (1) to evaluate changes of superoxide dismutase (SOD) activity and total antioxidative status measured as the ferric reducing ability of plasma (FRAP) concentration in saliva of pregnant women during the first, second, and third trimesters of singleton uncomplicated pregnancy and (2) to assess possible relations among SOD, FRAP, and intake of macronutrients and micronutrients in daily nutritional rations (DNRs) during pregnancy. Forty pregnant women aged 27.1+/-5.4 yr (examined group) and 40 healthy women (the control group) were recruited for this study. The relationship between FRAP and SOD in saliva and the intake of macronutrients (proteins, carbohydrates, total fat, saturated fatty acid, monounsaturated fatty acids, polyunsaturated fatty acids), minerals (Na, K, Ca, P, Mg, Fe, Zn, Cu, Mn), and vitamins (A, C, E, B1, B2, B6, PP) in DNR was evaluated by clustering analysis with Ward's grouping method. During pregnancy, FRAP and SOD values were lower than in the controls, but only for FRAP were the differences statistically significant (p < 0.001). For the whole pregnancy period, cluster analysis identified two major clusters for which the differentiating variables were SOD and retinoids intake, but different patterns for each trimester of pregnancy were revealed. The following were concluded: (1) FRAP values were the lowest in the second trimester. It suggests that in this trimester of uncomplicated pregnancy, women might be not fully adapted to increased demands for antioxidative mechanisms. (2) Cluster analysis showed that there were no statistical relationships between the intake of micronutrients and macronutrients in DNRs and the SOD or FRAP level in the saliva of pregnant women.

Adult↗
PubMed2005

Assessment of daily nutrition ratios of opiate-dependent persons before and after 4 years of methadone maintenance treatment.

The aim of the study was the evaluation of the changes in nutritional habits of opiates dependent persons during 4 years of attendance in methadone maintenance treatment conducted by the Department of Toxicology of CMUJ in Kraków. These criteria were fulfilled by 30 persons (23 males and 7 females). They were examined before the methadone treatment and after 4 years of treatment. During Initial and final examinations for each of examined person the 24-hour recall had been performed three times. The information about daily supply of main nutrients (proteins, fats, fatty acids, carbohydrates, dietary fibre, cholesterol), minerals (calcium, iron, phosphorus, zinc, sodium) and vitamins (vitamin A, B1, B2, niacin, C) were obtained. The results were compared with daily norms (N) recommended on the safe level of intake. The normal range was established on the level +/-10% of normal values (+/-10% N). The changes between the results of following examinations were tested by using the t-student test. After 4 years of methadone treatment an increase in energy, vitamins, minerals and main nutritional ingredients intake was noted in women group. In men group a decrease in energy, proteins and carbohydrates intake was noted and fats intake, mainly unsaturated fatty acids, was increased. Vitamins were consumed in lower amounts and among minerals lower consumption in case of iron and sodium was noticed. In comparison with the recommended values in the initial examination in women group too low intake concerned fibre and vit. A, B,, calcium, iron, zinc and magnesium was noticed. In group of men too low intake (below recommended values) of energy, carbohydrates, fiber, vit. B1, B2, C, niacin, calcium and magnesium was noticed. After 4 years of methadone maintenance treatment in group of women too low intake only of vit. B1 and iron was noticed. In group of men it concerned vit. B1, B2, C, niacin and minerals such as calcium, iron, magnesium and zinc.

Adult↗
PubMed2005

Nutritional status of the opiate dependent persons after 4 years of methadone maintenance treatment.

The aim of the study was to evaluate the nutritional status of opiate dependent patients before and after 4 years of participation in the methadone maintenance treatment. The examinations were performed in 30 opiates addicted persons (7 women and 23 men). The initial examination (exam 1) was done during the patients qualification for the methadone program, preceding methadone administration and final examination (exam 2) after 4 years of the treatment. In order to estimate the nutritional status body mass, the height, the arm circumference and the thickness of the triceps and subscapular fat-skin folds were measured. On the basis of them the BMI and mid arm muscle circumference (MAMC) were counted. The measurements of the body composition (using the bioimpedance method) were performed. The changes between the results of subsequent examination were tested using the t-Student test. In the examination that took place after 4 years of follow-up, body weight loss in the group of women was observed (mean--1.7 kg). It was followed by the decrease of BMI value (from 20.3 to 19.8 kg/m2). In both examinations the percentage of fatty tissue in general body mass was significantly below recommended values (10.7% in both examinations--the recommended values are 20%-22%). In the group of men an increase in body weight (mean--8.8 kg) and BMI value (from 23.3 to 25.9 kg/m2) was noticed. Arm circumference, muscle arm circumference and fat-skin folds values were increased. The analysis of particular body components showed increased fatty body mass (11.9% in the first and 18.5% in the second examination--the recommended values 16-19%) together with the decrease of lean body mass and body water.

Adult↗
PubMed2005

The changes in taste preferences during 4 years period of methadone maintenance treatment.

The aim of the study was the analysis of the changes in the kind and the frequency of particular nutritional products consumption by opiate addicted persons during 4-year lasting methadone programme. There were 30 opiate addicted patients under examination (23 men and 7 women). Food consumption quality was estimated with the use of the Intake Frequency of Food Products Questionnaire. The examinations were performed before methadone administration had started, after 9 months and after 4 years of methadone maintenance treatment. Three categories of consumption frequency were established: rarely, moderately and often. The classification of different products was done with the use of hierarchic cluster analysis. For general illustration of the data the consumed products were compared by the means of hierarchical cluster analysis (this was done with the help of Euclidean distances and the Ward's algorithm). Then the k-means (with k=3) method was used in order to identify groups of products that were similarly often consumed. Each k-means analysis was performed separately for each examination. This was done in order to find out the products that change the cluster from one examination to another. Twenty labile products were identified. The examined products were moving between the adherent categories. This means that the consumption pattern undergoes some changes over the course of methadone therapy. Additionally, the analysis of the diet of this group of people shows improper and unhealthy nutritional behaviours: too big intake of sweets and too low intake of complex carbohydrates, fish and vegetable fats. This was especially visible at the beginning of the therapy, later this unfavourable diet habits changed but not to the desired level.

Adult↗
PubMed2005

[Interpersonal relations in the consciousness of pupils and students].

The quality, satisfaction and being pleased of life depend on proper relations in the family, in the group of persons at the same age and at school or at the University. The aim of this study was the estimation of interpersonal relations in the chosen group of Cracovian secondary school pupils and medical students thanks the examinations conducted by auditory system with the use of an inquiry "Woman Self Image and Social Ideal". There were 713 persons belonging to 2 groups included in the examination: Group I: 313 pupils, including 128 boys and 185 girls attending to the second and third classes of two Cracovian secondary schools: Group II: 400 students of Medical Department and Health Protection Department of Collegium Medicum, Jagiellonian University in Cracow--106 male students and 294 female students. In the actual analysis the answers given to 64 questions of the "Interpersonal problems Inventory" questionnaire were estimated. Every question contained 5 possibilities: no, a little bit, more or less, much, very much. The hierarchy of these problems was estimated with the use of the method of step wise regression on the basis of the frequency of opposite answers to the particular questions. The most often the young persons stated (74%-63%) that it is never difficult for them to make a present to somebody else, to feel happy about one's happiness and to show positive emotions to others. About half of the examined persons (60%-47%) thought that they were never aggressive to others, that they never put their needs on the first position and they were not afraid of contacts with other people. In the questions connected with one's own personality determining the frequency of answers given to particular dystractors was not strongly marked e.g.: It is difficult for me to be alone: no (39%I/35%II), a little bit (18%I/16%II), moderately (13%I/11%II), much (13%I/18%II), very much (17%I/20%II); I am too credulous: no (46%I/37%II), a little bit (26%I/ 26%II), moderately (12%I/18%II), much (9%I, 12%II), very much (7%I, 7%II). The frequency of opposite answers with negative meaning as a rule did not exceed 5%.

Adolescent↗
PubMed2005

[The image of oneself--in the opinion of Cracovian pupils and students].

A proper and of many directions development of young person's personality requires the acceptance of oneself with the skill of individual identity building and being autonomic person. With the end with safety time in childhood young man has to make a confrontation of formed by over-protective parents image of oneself with perception of him/herself by persons at the same age or by adults. This confrontation may often appear to be disadvantageous. It may lead to the development of acquired emotional deficiency syndrome. Young person loses self confidence, cannot lose, does not undertake any risk or actions requiring obstinacy and endurance. The examination embraced 857 persons (457 pupils of second and third classes of Cracovian secondary schools and 400 students of Collegium Medicum, Jagiellonian University, Cracow. On the basis of selected questions from "Eating Disorders Inventory" questionnaire being a part of "Woman Self Image and Social Ideal" inquiry it was stated that: 1. About 1/3 of examined persons wanted to avoid their parents being disappointed but the safety of childhood time was desired (always or usually) by 10% of pupils and 8% of students--more often women than men. Half of the examined persons both pupils and students rarely or never show such desires. 2. 13% of examined persons think that the requires of adult life are far too big--more often in the group of men that in the group of women. 3. Approximately 8% of examined persons want to be somebody else. 56% of examined women and 83% of examined men want to be who they are. 4. High level of expectations towards oneself show more or less 26% of pupils and students, a little bit less give contrary answer. The examinations did not show important differences in the aspect of analyzed problems between students and schoolchildren.

Adolescent↗
PubMed2004

Lung function and breathing regulation parameters during pregnancy.

AIM: The aim of this study was to evaluate the changes in lung function and breathing regulation parameters measured in women who did not suffer from any respiratory system disorders (in comparison with body mass index values obtained before pregnancy) in any particular trimester of pregnancy. METHODS: The study was carried out on 51 pregnant women aged 26.6 +/- 4.9 years and 40 healthy women (control group). Spirometry, flow-volume loop, respiratory resistance (RRS), and respiratory pattern were evaluated using computerized spirometer "Lungtest," Poland. The examinations were performed in the first, second, and third trimesters of pregnancy. RESULTS: The statistically significant differences during pregnancy were stated in cases of tidal volume (VT) and minute ventilation (MV) (whereas breath frequency was nearly on the same level), inspiratory drive (VT/TI) and also occlusion pressure (P0.1), RRS, and peak expiratory flow (PEF). We observed a correlation between BMI at the baseline with P0.1, MV, and VT/TI. CONCLUSIONS: We conclude that BMI at the baseline seems to predict the increase in MV, occlusion pressure, and inspiratory drive. The fact that RRS values increase during pregnancy and both forced expiratory volume (FEV1) and FEV1% forced vital capacity (FVC) values remain at the same level may reflect the effect of the autonomous nervous system on the respiratory tract.

Adult↗
PubMed2004

[Intake of nutrients in daily nutritional ratios by opiate dependent persons during methadone maintenance therapy].

The aim of the study was the evaluation of the nutritional habits of the opiates dependent persons before and during methadone maintenance treatment. We examined 48 persons (36 males and 12 females) three times: first time before the methadone treatment, then after 2 months of treatment, and third time after 9 months of treatment. During each examination we performed 24-hour recall four times. Collected data were processed by author's software in order to get information about daily supply of main nutrients (proteins, fat, fatty acids, carbohydrates, dietary fibre, cholesterol), minerals (calcium, iron, phosphorus, zinc, sodium) and vitamins (vitamin A, B1, B2, niacin, C). The changes between the results of following examinations were tested by using the t-Student test. The results were compared with daily norms recommended on the safe level of intake for each age and gender group. In the majority of cases the diet of examined persons was quite reach in protein, but we noticed too low daily intake of fats, essential fatty acids, some minerals (calcium, iron, magnesium, zinc) and vitamins B1, B2 and C. After 2 months of methadone treatment the daily intake of fats, saturated fatty acids, essential fatty acids, cholesterol, dietary fibre, some minerals and vitamins decreased in men group, but in the last examination we noticed renewed growth in quantity of those nutrients in daily diet of examined persons. We did not observe it in the group of women.

Adult↗
PubMed2004

[Nutritional status of opiate-dependent persons before and during methadone maintenance therapy].

The aim of the study was to evaluate the nutritional status of opiate dependent patients who where classified to participate in the methadone maintenance treatment and to give the answer to the question how the nutritional status of these patients was changing during this programme. We examined 48 persons (12 women aged 21-37 years and 36 men aged 20-46 years). All of them were participants of the methadone maintenance treatment. The patients were examined three times: first time just before the methadone treatment, then after 2 months and third time after 9 months of treatment. The anthropometrics measurement: body weight and height (it allowed us to calculate the BMI), two skin fat folds and the measurements of the body composition (using the bioimpedance method) were performed. The changes between the results of subsequent examination were tested using the t-Student test. As a result of the first examination we showed out that the majority of patients had a proper nutritional status evaluated by BMI. Poor nutritional status has been more often found than excessive nutritional status among examined patients, especially in the group of women. During the nine months of methadone maintenance treatment the statistically significant growth of body weight was observed and it derived from the increasing fat body mass and muscle mass. As a result of that we noticed the diminishing number of underweight people. More of examined people had overweight and in the group of men even obesity.

Adult↗
PubMed2003

Pattern recognition methods in evaluation of the structure of the laboratory data biominerals, antioxidant enzymes, selected biochemical parameters, and pulmonary function of welders.

A wide set of biochemical and spirometrical parameters was applied to a group of 41 welders. The obtained parameters were analyzed by the pattern recognition method: principal-components analysis (PCA) and mutual contribution analysis (MCA). The aim of the investigation was to find out which of 23 parameters had an influence on the pulmonological indices of COPD. It was found that PCA gave a substantial reduction of dimensionality. The most relevant parameters were Fe, Zn, Cu (all elements in blood, not in hair), FEV1, MEF50, bilirubin, TAS, and SOD. Only the relationships of MEF50, Cu, and TAS were statistically valid.

Adult↗
PubMed2003

Antioxidant enzymes and pulmonary function in steel mill welders.

It is known that high levels of nitric oxide and ozone lead to disturbances of the balance between oxidants and antioxidants. The purpose of this study was to investigate ventilatory parameters in relation to the antioxidant status measured as total antioxidant status (TAS), superoxide dismutase (SOD) and catalase (CT). The study group consisted of 94 welders, aged 41.2 +/- 10.0 years, employed in the Steel Mill in Kraków, Poland, and exposed to nitric oxides and ozone in concentrations exceeding the threshold limit values. The control group consisted of 115 unexposed healthy workers aged 40.8 +/- 10.2 years. All the subjects under study were smokers. Determination of ventilatory efficiency was based on a "flow-volume" curve and spirometry. TAS was measured using reagents from the Randox Laboratories Ltd, SOD according to Fridovich and CT with Aebi's method. It was found that in the group of welders, the concentrations of TAS, CT and SOD were lower compared to controls (TAS-1.15/1.33 mmol/ml; CT-18.1/28.4 m/gHb, SOD-767.6/855.6 U/gHb). The incidence of extreme obstructive pulmonary disease and small airway disease in the welder group was more frequent than in controls. Changes in the concentration (or activity) of antioxidant parameters cannot be used as early markers of ventilatory dysfunction, although the values in the lowest class of TAS, SOD and CT showed a significantly larger number of welders than controls.

Adult↗
PubMed2003

[Dietary habits and nutritional status of secondary school pupils].

Proper nutrition is one of the main factors which influence peoples harmonious development. Teenagers media promote the patterns of physical appearance and behaviour that can cause and strengthen inadequate nourishment habits. People having problems with self-esteem may develop dangerous dysfunctions like anorexia or bulimia. The aim of this work was checking the number and quality of meals eaten by 13-15 year old student of secondary school in Niepołomice. A research has been carried out among two hundred students (111 girls and 89 boys) The way of nutrition on the basis of the questionnaire by Starzyńska and the frequency of incorrect nutritional behaviors on the basis of Eating Attitudes Test-26 (EAT26) were estimated. It was revealed too small consumption of dairy products, whole meal bread, and pulse crops. Such diet lowers nutritive and mineral components in organism. It may effect further health condition of grown people. Girls are more liable to suffer from the negative influence of media because it is a lot more difficult for them to accept their figure. Also disturbed eating attitudes and behaviour are observed particularly among girls in adolescence period.

Adolescent↗
PubMed2003

[Nutritional model and nutritional behaviors depending on BMI value among students of the Collegium Medicum of Jagiellonian University in Cracow].

The aim of this work was the estimation of the way of nutrition and incorrect nutritional behaviors among students of Collegium Medicum at Jagiellonian University. There were 538 students of Faculty of Medicine, Dentistry and Health Care Department of Collegium Medicum, Jagiellonian University Cracow included in the examination. We estimated: the way of nutrition on the basis of the questionnaire by Starzyńska including menu estimation. the frequency of incorrect nutritional behaviors on the basis of standardized version of modified questionnaire (Eating Disorders Inventory-EDI), weight-height proportions by calculation of BMI values in all cases. Underweight (BMI < 18.5 kg/m2) was observed in 52 examined persons (9.7%), correct weight-height proportions were observed in 416 persons (77.3%), overweight and obesity (BMI 25-34.7 kg/m2) in 70 persons (13%). The comparison of three distinguished groups considering BMI showed statistically important differences (chi 2 test--p < 0.01) in the amount of meals consumed per day. Less than 3 meals per day were eaten more frequently by persons with underweight (21.15%) than by persons with correct body mass (11.56%) and overweight (7.14%). In the aspect of frequency of consumption of particular groups of products statistically important differences between groups with underweight, normal weight and overweight were not stated. Nevertheless many incorrect attitudes in the way of nutrition were noticed. 32% of students consumed animal proteins in less than 75% of all eaten meals per day, 32% of students did not eat milk products or cheese every day. 36% ate fruit and vegetables once a day or even less. Only 26% of persons ate whole-meal bread, cereals or pulse every day. Feeling angry or powerless was more often experienced by students with underweight than with normal weight or overweight. On the other hand eating something during studying and feeling better after eating was more often visible by students with overweight than by students with correct or too low values of BMI.

Adult↗
PubMed2003

[Disordered eating attitudes in medical students of Jagiellonian University].

The aim of this study was to evaluate the prevalence of preoccupation with weight indicators and disordered eating behaviours among medical students of Jagiellonian University, Krakow and Identify the factors associated with these indicators and behaviours. The studied population included 538 medical students of Jagiellonian University. The broad range of symptoms of eating disorders was assessed by using the Eating Attitudes Test 26 (EAT26). The way of nutrition was analysed by using the questionnaire with menu score by Starzyńska. Body Mass Index (BMI) was calculated for all examined persons. The EAT26 score above the recommended cut-off of 20 was obtained in 48 (8.9%) students. The predispositions towards eating disorders were presented in all range of BMI value, but the intensity of this disorders was particularly strong in the group of students with underweight. They were scared of being overweight and they were permanently thinking of being thinner. They especially avoided food rich in carbohydrates. Fortunately they didn't vomit after meals and rarely felt like vomiting after eating. The obtained results indicate some mistakes in food consumption of the studied group of medical students.

Adult↗
PubMed2003

[Self assessment of health and psychical fitness among medical students of the CMUJ in Cracow].

The examination embraced 213 students (129 women--60.6% and 84% men--39.4%) of the fourth year of Collegium Medicum, Jagiellonian University, Cracow. The standardized questionnaire estimating social conditions, lifestyle and health status of examined students was used in our examination. The differences between male and female students were evaluated with the use chi 2 test. 54% of examined persons descended from big cities, 31% from small towns and 15.4% from the countryside. 95.6% of students were single and 4.4% married. During the studies they lived mainly in family houses (35%), in student houses (32%) or they rented a flat (23%). 36.1% of students estimated their health status as very good, 50% as good, 13.1% as not very good and 0.8% as bad. During the medical review it was stated that among chronic diseases allergies (20.2% of male students and 25.6% of female students) were on the first position as far as the frequency was concerned. Chronic bronchitis (11.9% and 8.5% respectively) and eye diseases (9.5% and 14.7%) were on the second and third position. There were not statistically important differences between male and female students in above mentioned problems. On the other hand female students more frequently complained of headaches, feeling nervous or irritable. They were also less self confident. The presented results are a part of Polish examination that estimates health status, social conditions and lifestyle of students of medicine in our country.

Female↗
PubMed2002

[Ventilation efficiency and nervous breathing regulation in ethanol-dependent persons over 50 year of age].

A ventilatory efficiency and nervous breathing regulation in ethanol dependent patients older than 50 years was compared to younger counterparts during controlled, absolute abstinence while hospitalisation in the Department of Clinical Toxicology. Respiratory resistance was the most differential factor: higher in alcoholics compared to the control group and in older alcoholics higher than in younger alcohol dependent patients. Similarly the occlusion pressure was higher in ethanol dependent persons compared to the control group. A normalisation of respiratory function after 9 days of absolute abstinence was stated in the group of younger alcoholics only. The most of respiratory pattern parameters did not change after the abstinence period. Only values of the occlusion pressure was diminished substantially.

Adult↗
PubMed2002

[Social support and proper human relations in high school pupils in relation to psychosomatic disease prevention].

The examination concerned 313 girls and boys from the second and third class of the secondary schools in Kraków. The translated German version questionnaire "Woman Self Image and Social Ideal" was used in the examination; mainly its parts such as: 1. "The social support" which includes 22 questions. 2. "Human Relations" which includes 64 questions. The five step scale of feeling was applied. One of the five possibilities was chosen by the examined persons and analysed. Stepwise regression was performed. More than half of the examined pupils have a good friend, who is helpful any time and who has never lets them down. They are relaxed with him, may discuss important problems and can give him charge over their home in their absence. 5% of the examined pupils could not share psychological problems with any friends and 10% could not count on house or flat care. 10% of pupils often felt as outsiders among other young people, while 1/3 did not experience such a feeling. The need of better understanding, care and support in the family and from close acquaintances was observed by 15%. Simultaneously only 14% claimed that relation in this matter were satisfactory. 19% of examined persons wanted more safety and friendship. Only 14% had a feeling of full safety. Juveniles most often claimed, that it is not difficult for them to buy a gift for another person (71% vs 2%), or cherish happiness of other people (67% vs 0.3%), and to express sympathy to others (65% vs 2.8%). More than half of the respondents judge themselves as non-aggressive against others, that they do not place their own needs above other peoples' needs, and that they are not afraid of contact with others. The frequency of choosing opposite extreme did not exceed 5% of the respondents. With the majority of questions we found a number of answers regarding discussed problem, ex. accepting orders from superiors (never--28%, sometimes--28%, average--21%, often--12%, very often--11%). In analogical proportions we found answers regarding such facts as a being strong and steady person, without bothering of hurting somebody's feelings or taking care of their own goals when anyone else is in need. We showed very differentiated, individual approach of examined adolescents to matters regarding their relations with people important for shaping their attitude towards life. It was also shown, that most of the 16-17 year old adolescents from Krakow enjoy a satisfactory relationship with people important in their lives, on the other hand, it is distressing that almost 20% of the examined pupils do not get enough support, care, safety and understanding either from their peers, families or adults.

Adolescent↗