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PubMed2004

Airborne cat allergen reduction in classrooms that use special school clothing or ban pet ownership.

BACKGROUND: Allergens from furred animals are brought to school mainly via clothing of pet owners. Asthmatic children allergic to cat have more symptoms when attending a class with many cat owners, and some schools allocate specific resources to allergen avoidance measures. OBJECTIVE: The aim of the current study was to evaluate the effect of school clothing or pet owner-free classes compared with control classes on airborne cat allergen levels and to investigate attitudes and allergic symptoms among the children. METHODS: Allergen measurements were performed prospectively in 2 classes with school clothing, 1 class of children who were not pet owners, and 3 control classes during a 6-week period in 2 consecutive years. Portable pumps and petri dishes were used for collection of airborne cat allergen, and a roller was used for sampling on children's clothes. Cat allergen (Fel d 1) was analyzed with enzyme-linked immunoassay and immunostaining. Both years, questionnaires were administered to the children. RESULTS: We found 4-fold to 6-fold lower airborne cat allergen levels in intervention classes compared with control classes. Levels of cat allergen were 3-fold higher on clothing of cat owners than of children without cats in control classes. Pet ownership ban seemed less accepted than school clothing as an intervention measure. CONCLUSION: For the first time, it has been shown that levels of airborne cat allergen can be reduced by allergen avoidance measures at school by using school clothing or pet ownership ban, and that both measures are equally efficient. The clinical effect of these interventions remains to be evaluated.

Air↗
PubMed1998

A Comparison of Skin Temperatures and Clothing Microclimate During Moderate Intermittent Exercise in the Cold Between One and Two Layers of Cotton and Polypropylene Underwear.

The purpose of this study was to compare the effects of 2 kinds of underwear made from hydrophobic and hydrophilic fabrics on the mean skin temperatures and clothing microclimate (temperature, humidity) in participants performing intermittent exercise in cold environmental conditions. One or 2 layers of cotton underwear (C1, C2) with a 2-piece long-sleeved shirt and long-legged trousers, and 1 or 2 layers of polypropylene underwear (P1, P2) with a 2-piece long-sleeved shirt and long-legged trousers were used as experimental underwear. In addition, the participants wore a 2-piece ski suit as 100% polyester clothing including 100% polyester padding. Ten young adult females volunteered as participants. The experiments were performed in a climatic chamber at an ambient temperature (Ta) of 0°C and an air velocity of 0.26 m s-1. The major findings are summarized as follows: (a) Although the clothing microclimate humidity was not different within the ski suit of outer clothing between C1 and P1, it was significantly higher in P2 than in C2; (b) Clothing microclimate temperature inside the ski suit did not differ between C1 and P1, whereas it was significantly higher in P2 than in C2; (c) The thermal gradient between innermost and outermost of clothing microclimate at back level did not show any difference between C1 and P1, but it was significantly higher in C2 than in P2. These results are discussed in terms of thermal physiology and clothing sciences.

clothing microclimate↗
PubMed1998

Evaluation of clothing systems to determine heat strain.

This article describes the basic evaluation process and test methodology employed when temperature extremes for clothing systems must be considered as part of the U.S. Army's Health Hazard Assessment for material in the development and acquisition process. The goals of the evaluation are to select clothing systems that minimize the hazards of heat strain and to predict the heat strain for persons wearing such clothing. Clothing evaluations begin with biophysical assessments that determine the thermal characteristics (vapor permeability and insulation) for textiles via guarded hot plate tests and for clothing systems via thermal manikin tests. The results from biophysical tests can be used to select the textile and/or clothing with the best thermal characteristics. The data from manikin evaluations also can be used in prediction modeling. Human physiological testing is best done in a controlled laboratory environment, although for realism and user acceptability field trials may also be conducted. Proven test and measurement methods must be employed, and tests must control for confounding variables; subjects serve as their own controls, and test environment and procedures are consistent between trials. The process and test methodology described can be applied to the evaluation of civilian clothing systems as well as to the military systems for which they were developed.

Hot Temperature↗
PubMed2005

Clothing size as an indicator of adiposity, ischaemic heart disease and cardiovascular risks.

OBJECTIVE: To relate subjects' clothing sizes to waist circumference, body mass index (BMI) and to the risks of ischaemic heart disease, hypertension and diabetes mellitus, and to derive cut-off levels of clothing size that correspond to increased health risks. DESIGN: Cross-sectional study. Setting Glasgow Royal Infirmary. PARTICIPANTS: A stratified subsample of 201 men and 161 women aged 27-67 years from the Glasgow monitoring coronary (MONICA) risk factor survey. MAIN OUTCOME MEASURES: Measured waist, weight and height, blood pressure and history of ischaemic heart disease (angina, myocardial infarction or angioplasty), hypertension and diabetes mellitus, and medications. RESULTS: There were 15.5% of men and 11.2% of women with ischaemic heart disease, 14.9% of men and 12.4% of women with hypertension, and 4.5% of men and 3.1% of women with diabetes mellitus. Age and smoking adjusted prevalences of these cardiovascular risks, as well as increased adiposity (waist circumference > or =102 cm in men, > or =88 cm in women or BMI > or = 30 kg m(-2)) rose with increasing clothing size. Clothing size correlated (P < 0.001) linearly with indices of adiposity. Clothing sizes which correspond to waist circumference action level 1 (94 cm in men, 80 cm in women) and action level 2 (102 cm in men, 88 cm in women) or to standardized BMI cut-offs (25 and 30 kg m(-2)) were estimated. Height has minimal influences on clothing size. Compared with men with trouser waist below 36 inches or women with UK dress size below 16, the age and smoking adjusted odds ratios for the risk of having at least one of the major health problems (ischaemic heart disease, hypertension or diabetes mellitus) were 3.9 (95% CI: 1.8-8.3) in men and 7.0 (95% CI: 2.5-19.4) in women who had trouser size > or =38 inches or UK dress size > or =18, respectively. CONCLUSIONS: The present study showed that men and women with large clothing size are at increased risk of ischaemic heart disease, hypertension and diabetes mellitus. Men's trouser size equal or larger than 38 in the UK and USA or 97 in Europe and women's dress size equal or larger than 18 in the UK or 16 in the USA or 48 in Europe could be used to promote self-awareness of increased health risks by the general public.

Adiposity↗
PubMed1998

Concentrations of cat (Fel d1), dog (Can f1) and mite (Der f1 and Der p1) allergens in the clothing and school environment of Swedish schoolchildren with and without pets at home.

To investigate whether our hypothesis that cat and dog owners bring allergens to public areas in their clothes was true or not, we studied the levels of Fel d1, Can f1, Der p1 and Der f1 in dust from the clothes and classrooms of children in a Swedish school. We also investigated the levels of allergen in different areas in the four classrooms used by the children. Thirty-one children were selected in four classes, forming three groups: cat owners, dog owners and children without a cat or dog at home. Furthermore, a group of children with asthma was included. Cat and dog allergens were detected in all 57 samples from clothes and classrooms. Mite allergen Der f1 was detected in low concentrations in 6 out of 48 and Der p1 in 5 out of 46 samples investigated. The concentrations of Can f1 were higher than those of Fel d1 in samples from clothes (geometric mean: 2676 ng/g fine dust and 444 ng/g) and classrooms (Can f1: 1092 ng/g, Fel d1: 240 ng/g). The dog owners had significantly higher concentrations of Can f1 (8434 ng/g fine dust) in their clothes than cat owners (1629 ng/g, p < 0.01), children without cat or dog (2742 ng/g, p < 0.05) and children with asthma (1518 ng/g, p < 0001). The cat owners did not have significantly higher levels of Fel d1 (1105 ng/g) in their clothes compared to the other three groups. (D: 247 ng/g, nCnD: 418 ng/g) but the levels were significantly higher than for all children without a cat at home (345 ng/g, p < 0.05). No concentrations of mite allergen and low concentrations of Fel d1 and Can f1 were found in the children's hair. There were significantly higher concentrations of Fel d1 and Can f1 in dust from curtains than in samples from floors and bookshelves (p < 0.05). There was no significant difference between the allergen concentrations in samples from curtains and from desks and chairs, including the teachers' chairs, the only upholstered furniture in the rooms. Our results support the hypothesis that cat and dog owners bring allergens to public areas in their clothes and support other studies showing that textiles and upholstered furniture function as reservoirs of cat and dog allergens. Thus, children with asthma and other allergic diseases will be exposed to cat and dog allergens at school and by contact with pet owners, even if they avoid animal allergens at home.

Adolescent↗
PubMed1996

Heat strain in protective clothing following hot-wet or hot-dry heat acclimation.

The purpose of the present study was to compare the heat strain while wearing nuclear, biological, and chemical (NBC) protective clothing following a hot-wet (HW) or hot-dry (HD) heat acclimation protocol. Twenty-two males were assigned to groups HW (n = 7), HD (n = 8), or control (C, n = 7). Subjects were evaluated during continuous treadmill walking while wearing lightweight combat clothing and during intermittent exercise while wearing the NBC protective clothing. While wearing Combat clothing, greater decreases in rectal temperature (Tre), mean skin temperature (Tsk), and heart rate were observed for both acclimation groups. For the NBC clothing trials, lower Tre, Tsk, and heart rates were observed only for group HW. The time required for Tre to increase 1.0 degrees C and 1.5 degrees C was significantly delayed for groups HW and HD. Sweat evaporation increased for HW, whereas no change was found for HD. The most significant changes in Tre, Tsk, and heart rate while wearing the NBC protective clothing occur following heat acclimation that involves wearing the clothing during exercise.

Acclimatization↗
PubMed1994

Physiological tolerance to uncompensable heat stress: effects of exercise intensity, protective clothing, and climate.

This study determined the influence of exercise intensity, protective clothing level, and climate on physiological tolerance to uncompensable heat stress. It also compared the relationship between core temperature and the incidence of exhaustion from heat strain for persons wearing protective clothing to previously published data of unclothed persons during uncompensable heat stress. Seven heat-acclimated men attempted 180-min treadmill walks at metabolic rates of approximately 425 and 600 W while wearing full (clo = 1.5) or partial (clo = 1.3) protective clothing in both a desert (43 degrees C dry bulb, 20% relative humidity, wind 2.2 m/s) and tropical (35 degrees C dry bulb, 50% relative humidity, wind 2.2 m/s) climate. During these trials, the evaporative cooling required to maintain thermal balance exceeded the maximal evaporative capacity of the environment and core temperature continued to rise until exhaustion from heat strain occurred. Our findings concerning exhaustion from heat strain are 1) full encapsulation in protective clothing reduces physiological tolerance as core temperature at exhaustion was lower (P < 0.05) in fully than in partially clothed persons, 2) partial encapsulation results in physiological tolerance similar to that reported for unclothed persons, 3) raising metabolic rate from 400 to 600 W does not alter physiological tolerance when subjects are fully clothed, and 4) physiological tolerance is similar when subjects are wearing protective clothing in desert and tropical climates having the same wet bulb globe thermometer. These findings can improve occupational safety guidelines for human heat exposure, as they provide further evidence that the incidence of exhaustion from heat strain can be predicted from core temperature.

Adult↗
PubMed1996

Effects of two kinds of underwear on thermophysiological responses and clothing microclimate during 30 min walking and 60 min recovery in the cold.

Thermophysiological responses and clothing microclimate under the influences of different underwear materials were compared during walking and recovery in the cold. Two kinds of underwear were used: two layers of cotton underwear with two-piece long-sleeved shirt and long-legged trousers (C), two layers of polypropylene underwear with two-piece long-sleeved shirt and long-legged trousers (P). In addition, the subject put on a two-piece ski suit of 100% polyester including 100% polyester padding. Seven adult females served as subjects in this study. The test was done in a climatic chamber at an ambient air temperature of 2 degrees C, a relative humidity of 65% and an air velocity of 0.14 m.s-1. The subject walked on a motor-driven treadmill with a 6 km/h speed for 30 min followed by 60 min recovery. Rectal temperature, skin temperatures, clothing microclimate (temperature, humidity), metabolic heat production and heart rate were measured. Furthermore, subjective ratings on thermal sensation, sweating/shivering sensation, clothing wettedness sensation and skin wettedness sensation for whole body were asked. The major findings are summarized as follows: 1) Mean skin temperature was not significantly different during walking, but it was significantly higher in P than in C during the recovery. 2) The absolute humidity of innermost layer and outermost layer were not significantly different during walking, but it was significantly higher in P than in C during the recovery. 3) Clothing microclimate temperature of innermost was not significantly different during the first half of walking, but it was significantly higher in C than in P during the second half of walking and significantly lower in C than in P during the recovery. Clothing microclimate temperature of outermost was not significantly different during walking, but it was significantly higher in P than in C during the recovery. 4) Metabolic heat production for the last 10 min during recovery tended to be higher in P. 5) The degree of skin wettedness sensation and clothing wettedness sensation for whole body was significantly higher in P during walking and recovery. Thus, it was concluded that two kinds of underwear with different properties to moisture could influence, not only clothing microclimate, but also physiological parameters like skin temperatures and metabolic heat production in the cold differently.

Adult↗
PubMed1999

Clothing selection behavior of the aged women for thermal comfort.

Wearing behavior and thermoregulatory responses of five young women (YG; 20 +/- 1 yr) and five aged women (AG; 65 +/- 3 yr) to indoor cold in summer were investigated in this study. The subjects were exposed to 21.0 +/- 0.5 degrees C and 55 +/- 5% RH while seated during a 90-minute experiment. The subjects were allowed to select and wear for thermal comfort clothing whenever they needed additional clothing during the experiment. Rectal temperature (Tre) and temperatures of 7 sites (head, chest, forearm, hand, thigh, leg, foot) of the skin of the subjects were measured every 10 minutes. Mean skin temperature (Tsk) of the subject was obtained every 10 minutes. First selection time of additional clothing was monitored and weight of selected total clothing was calculated. The results for this study were as follows: Tre and Tsk gradually decreased in YG and AG, however Tre decreased less than Tsk which decreased greater in AG than YG (p < 0.01). AG's first selection of additional clothing and thermal sensation response were slower than YG's. Furthermore, total clothing weight was less in AG than YG. It was concluded that clothing selection behavior would modify the intrinsic thermoregulatory responses of the aged women to the cold stress in the summer.

Adult↗
PubMed2001

Japanese and Korean elderly people's evaluation of clothing colors for elderly people.

This study evaluated the clothing colors in the elderly. We took photos using the elderly as models, displayed them on a computer screen, and produced 75 colors of the clothing in the elderly using computer graphics. The 75 colors were evaluated by Japanese and Korean elderly women. We compared the ideal colors for and the colors actually worn by elderly people in Japan and Korea. Japanese and Korean elderly women differed concerning their ideal clothing color and their most often worn color. The images concerning clothing colors also differed between the two groups, suggesting differences in their views related to clothing. Japanese elderly women tended to view clothing as a means of expressing their individuality, while Korean elderly women tended to view clothing as a means of expressing their character.

Aged↗
PubMed1998

Effects of different types of clothing on circadian rhythms of core temperature and urinary catecholamines.

This study investigated the effects of three different types of clothing on the circadian rhythms of core temperature and urinary catecholamines. One type of clothing consisted of long-sleeved shirts, full-length trousers, and socks (Type L, 1,042 g); the second type was of half-sleeved shirts and knee-length trousers (Type H, 747 g); the third type was of Type H during the daytime and Type L during night sleep (Type M). Six healthy females participated in this study where rectal temperature, skin temperatures, heart rate, and urinary catecholamines were continuously measured for 37.5 h at an ambient temperature of 23.8 +/- 0.2 degrees C and a relative humidity of 60 +/- 5%. The results were as follows: (1) The nocturnal minimum of rectal temperature decreased significantly in the sequence Type L < Type M < Type H clothing, and 27.2 and 12.4% of the circadian amplitude were influenced by type of clothing during the daytime and the nighttime, respectively. (2) The rise of skin temperatures in the extremities increased significantly more after the subjects retired for sleep with Type M or Type H clothing than with Type L. (3) Urinary catecholamines decreased more in the evening and increased more in the morning with Type H and Type M clothing than with Type L. These results show that the circadian rhythm of core temperature, especially the nocturnal minimum value, was influenced by the type of clothing worn not only during the nighttime, but also during the daytime.

Adolescent↗
PubMed1997

The safety of injecting insulin through clothing.

OBJECTIVE: Many of the "antiseptic" practices recommended by health care professionals for insulin injection have been successfully challenged as unnecessary. Since people with diabetes have long been observed to inject their insulin through their clothing, this study was undertaken to determine the safety and perceived benefits of administering insulin by this "rogue" technique. RESEARCH DESIGN AND METHODS: Fifty people with insulin-treated diabetes were randomized into a 20-week single-blinded prospective crossover study comparing the conventional subcutaneous injection technique (with skin preparation) to an experimental injection technique through clothing. Skin assessment, glycated hemoglobin levels, and leukocyte count were determined before randomization, at 10 weeks (before crossover), and again at 20 weeks (at completion). The participants injected through a single layer of fabric, which ranged from nylon to denim. Problems, benefits, type of clothing, and other comments were recorded by the subjects in an injection log. RESULTS: Forty-two (84%) subjects completed the study. The mean age was 41 years (range, 23-63 years), 50% were women, 86% were Caucasian, and 80% had type I diabetes. The mean duration of diabetes was 14 years (range, 1-33 years). Fifty-one percent had > 16 years of education. The demographic characteristics of the dropouts were similar to those who completed the study. Over the 20-week period approximately 13,720 injections were performed by participants. None of the subjects experienced erythema, induration, or abscess at injection sites. Neither the glycated hemoglobin levels nor the leukocyte counts differed between the conventional and experimental regimens. During the injection-through-clothing phase of the study, only minor problems, such as blood stains on clothing and bruising, were recorded in the logbooks. However, subjects reported that injection through clothing offered benefits such as convenience and saving time. CONCLUSIONS: It is safe and convenient to inject insulin through clothing.

Adult↗
PubMed1992

Perceived clothing deprivation: further evidence.

The purpose of this study was to extend the conceptualization of perceived clothing deprivation among three groups of adolescents: 161 skateboarders, 61 baseball players, and 336 general high school students. Perceived clothing deprivation, the dependent variable, was measured by two previously developed scales, Inability to Buy and Clothing Deprivation Relative to Peers. Regression analysis of self-reported economic stress indicated that the combination of lower income and increased demand was positively related to both clothing deprivation factors. Group membership was not significantly associated with Inability to Buy but was with Clothing Deprivation Relative to Peers. Both male sports groups reported greater perceived dissatisfaction than the general population of high school students. These results support the idea that perceived clothing deprivation is self-defined and peer-dependent among adolescents and support the proposition that clothing deprivation reflects primarily influence of dynamic rather than stable variables.

Adolescent↗
PubMed1999

Heat balance when wearing protective clothing.

This issue of the Annals of Occupational Hygiene is dedicated to the topic of heat stress evaluation. For this evaluation, several evaluation programs and international standards are available. In order to understand the reasoning and underlying theory behind these programs and standards, a basic knowledge of heat exchange processes between workers and their environment is needed. This paper provides an overview of the relevant heat exchange processes, and defines the relevant parameters (air and radiant temperature, humidity, wind speed, metabolic heat production and clothing insulation). Further it presents in more detail the relation between clothing material properties and properties of clothing ensembles made from those materials. The effects of clothing design, clothing fit, and clothing air permeability are discussed, and finally an overview of methods for the determination of clothing heat and vapour resistance is given.

Body Temperature Regulation↗
PubMed2001

Evaluation of flexible cloth electrodes for electrodermal activity recording.

BACKGROUND: Instrument selection for recording physiological data in flight studies requires careful attention to subject comfort and non-interference with aircrew activities. Several electrode types and recording sites may be used to examine electrodermal activity (EDA). Placement of electrodes on the foot minimizes interference with physical activity and reduces motion artifacts; however, use of conventional, hard-plastic-encased metal (PEM) electrodes within a flight boot can produce discomfort and pressure-induced artifacts. HYPOTHESIS: When applied with proper electrolyte gels, thin, flexible, silver-impregnated cloth electrodes should acquire EDA signals qualitatively similar to those acquired using conventional, PEM electrodes. METHODS: EDA responses evoked by light flashes, auditory stimuli and valsalva maneuvers were recorded with cloth and PEM electrodes simultaneously from both feet of 4 male subjects. Performance of cloth vs. PEM electrodes and variability of signals recorded with the same electrode type were examined by placing pairs of selected electrodes on each foot of the subjects. Placements were balanced with respect to age and handedness of the subject and the number of trials with each electrode type placed on the left or right foot. RESULTS: Qualitatively similar signals were recorded with cloth and PEM electrodes. Cloth electrodes showed more variability between electrodes of the same type. CONCLUSION: For EDA recording, cloth electrodes can perform at least as well as PEM electrodes, making it practical to take advantage of the cloth electrodes' flexibility and lower profile.

Adult↗
PubMed2003

[European standard regarding clothing and protection against ultraviolet radiation].

Overexposure to ultraviolet radiation (UVR) causes skin damage. An increasing awareness of this must result in people consciously wanting to protect themselves from UVR by means of clothing. The first part of the European standard on UVR-protective clothing--about test methods--is now available. In the second part the classification and labelling of UVR-protective clothing are detailed. The degree of protection the clothing provides against UVR is expressed as the ultraviolet-protection factor (UPF). The UPF is inversely proportional to the quantity of UVR which the clothing allows through. UVR-protective clothing which satisfies the European standard will bear the European UPF label '40+'. To obtain this label the entire clothing must have a UPF of at least 40. The wording: 'Sun exposure causes skin damage', 'Only covered areas are protected' and 'The protection offered by this item may be reduced with use or if the material is stretched or wet' must be added to the label.

Clothing↗
PubMed1977

[Evaluation of the effects of cooling clothes on the adaptation to prolonged exertion in high temperatures by miners].

In order to improve the working conditions of coalminers exposed to high ambient temperature, the authors have studied the effects of wearing an under-vest and a cowl covering the head and shoulders made in sponge-cloth and soaked with cold water (cooling clothes). Eight coalminers volunteered for this study which included three sessions of prolonged intermittent exercise performed in a climatic room with the following ambient temperatures:--experiment A (comfortable environment): td = 28 degrees C; twb = 20 degrees C; bare head and bare torso;--experiment B (hot environment) :td = 38 degrees C; twb = 30 degrees C; bare head and bare torso;--experiment C (hot environment and cooling clothes) : td = 38 degrees C; twb = 30 degrees C; wet undervest and cowl soaked with cold water (16 degrees C) every 15 minutes. Each experiment included 5 periods of exercise each lasting 15 minutes separated by periods of rest lasting 15 minutes; the exercises were performed on a bicycle ergometer or on a treadmill and their intensity corresponded to 50% of the maximal oxygen intake. In the comfortable environment (experiment A), all subjects completed the experiment without undue fatigue; the final heart rate was 81/min and the final rectal temperature was 37.6 degrees C; the weight loss never exceeded 1 Kg. In the hot environment (experiment B), all subjects were exhausted at the end of the study which had to be shortened in 2 cases. The final heart rate was 125/min and the final rectal temperature 38.8 degrees C; the weight loss was above 2 Kg. The use of the "cooling clothes" in the hot environment (experiment C) resulted in significantly (p less than 0.001) lower heart rate (104/min), rectal temperature (38.3 degrees C) and weight loss (1.5 Kg); all subjects completed the experiment, none was exhausted and the "cooling clothes" were appreciated by all subjects. We conclude that the "cooling clothes" tested in the present study significantly reduce the physiological and subjective strain due to intermittent work in a hot environment; this cooling system is simple, of low cost and our results indicate that it is will be very useful in climatic conditions similar to those adopted in the present experimental protocol. Its usefulness in less severe climates has to be established but it might be limited by the subjective reactions of the subjects to the transient but sudden sensation of cold given by the "cooling clothes".

Adaptation, Physiological↗
PubMed1978

Evaporative heat loss and clothing.

Several experiments have been conducted on the effect of clothing on evaporative heat loss. 1) The movement of sweat from production to evaporation was observed in nude subjects, on subjects wearing underwear and underdrawers, and on subjects wearing two layers of clothing during a two-hour heat exposure period. The percentage of evaporated sweat was found to be inversely proportional to total sweat loss. When this relation was taken into consideration, it was revealed that the percentage of evaporated sweat was smaller if more layers of clothing were added, or if water-proof or vapor-proof materials were added. 2) Using a so-called "sweating cylinder," the cooling power of water dissipated from the surface of the cylinder was measured when the cylinder was covered with one, two, or three layers of various kinds of cloths. The cooling efficiency (actual evaporative cooling/latent heat of total water lost) was about 95% when the cylinder was uncovered. As more layers of covering cloth were added, the cooling efficiency became less. When the covering cloth touched the wet surface of the cylinder directly and absorbed water, the cooling efficiency was remarkably reduced because a large portion of the water absorbed in the cloth remained unevaporated.

Adult↗