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					Love is all you need? Focusing on adolescents' life concerns from an ecological point of view
Article Abstract: Research into life concerns among a sample of young people in a rural area in the centre of Sweden has established that adolescents have a range of worries. The intensity of these worries differs between age groups and genders. Concerns about peer acceptance seem to emerge earlier than previous research has indicated, while concerns about love emerge later than was previously believed. There is no peak at any age in concerns about relationships with parents

Read more: Adolescence is the most fascinating and crucial stage in the life of an individual. Adolescence covers 10 to 19 years of life. It is the period of rapid physical changes and deep emotional changes. Adolescents form significant proportion of the population of any nation, and the care of the adolescents should be of great concern for every pediatrician. Why We Are Concerned About Adolescence? Adolescence represents high risk period in human life cycle and requires special attention by everyone involved in health care. Importance should be given to the nutrition and physical growth. An adolescent is under lots of pressure from parents, teachers, peer group and the society. Adolescence is viewed as a period of stress. About to 10 to 20 % of adolescents experience severe emotional reactivity. They show impulsive behavior and rebelliousness. Personality development is completed during adolescence. It is also the time for deciding the future career. Hence proper scientific guidance is necessary during adolescence to lead them towards successful adulthood. Stress in Adolescence Teenagers experience strong feelings of anxiety, confusion, pressure to succeed, financial uncertainty, and other fears while growing up. Stress is a normal universal human experience and proper management of stress in adolescents is highly essential for success in life. Common causes of stress include exam related stress, other school related stress, personal stress and family related stress.

Symptoms of stress An adolescent under stress may present with emotional, behavioural or psychosomatic symptoms. Deterioration in scholastic performance and lack of concentration in studies are common presentations of a student under stress. And hence, any adolescent presenting with forgetfulness and scholastic backwardness needs individualised evaluation to find out the underlying stress. Anxiety, depression and even deliberate self harm can occur in an adolescent under stress. Stress can lead an adolescent towards alcohol or other substance abuse. Psychosomatic symptoms are quite common and it manifests in the form of somatoform disorders in adolescents. The common somatoform disorders seen in adolescents include pain disorder, somatoform autonomic dysfunction and conversion disorders. How to prevent stress related problems in adolescents Role of family members Adolescence is a period of growth and change. So it is essential that parents are always willing to support them and guide them in the correct direction. Parents should give them all the love, care and affection they wish for. Recognize their good deeds and complement them. Parents should also point out their mistakes and motivate them to excel in life. Express concern, but not criticism. Be a good role model and friend. Responsibilities of Adolescents Use adolescence as a time of training by accepting more responsibility for doing the duties in the best way. Peer group pressure is significant during this period. It is not just something to be used as an excuse when someone gets into trouble! Be assertive to avoid unwanted peer pressure, as well as negative influences by media. Peer group can have tremendous influence on your life, so be friendly with positive people and be a positive person yourself. Try to be empathetic with parents and teachers. Improve the study skills and be a motivated student. Management of Stress Role of experts in Adolescent Guidance Individualized detailed evaluation after establishing good rapport is essential to find out the underlying stress in adolescents. They need counseling to improve self esteem and motivation. Associated learning problems should be managed with individualised remedial training programmes. Family guidance is also an essential aspect of the management of stress in adolescents. Life skills training helps adolescents to deal effectively with demands and challenges of everyday life.

Conclusion Adolescence is the period of prime importance in the life of a person. Hence care of adolescents is the need of the hour. Its the duty of the parents, teachers and health professionals to guide adolescents towards excellence in life.

Cancer in adolescents and young adults. Psychosocial concerns, coping strategies, and interventions
Adolescent cancer patients present a unique challenge to health care professionals because of the impact of the disease and its treatment on the successful acquisition of age-appropriate developmental milestones, as well as the psychosocial concerns raised by the illness itself. Understanding normal adolescent development provides a framework for identifying psychosocial concerns, predicting problems, and developing appropriate interventional strategies for adolescents with cancer. A comprehensive support program with specific goals of promoting adjustment to the illness and providing a basis for community reentry by strengthening recognized coping strategies based on identified psychosocial concerns is described as a model

Parental concerns about adolescent mental health
Adolescence is a rough period for teens, kids and parents, but here are ten things to watch for as you and your child navigate the teen years.

Adolescence is a tough time for both kids and parents. So many changes are going on the teenager's life – physical, emotional, and social. Here are ten things to watch for as you and your child

navigate the teen years. Depression is probably the most common mental health problem in adolescence. Teenagers are known to be temperamental, but depression goes far behind a little moodiness. These are the signs to look for. Your child is constantly withdrawn and grouchy. He loses interest in activities he used to enjoy. He has trouble sleeping or his sleep habits drastically change – for example, he starts staying awake all night and sleeping all day. Your teenager starts having trouble at school when he has always been a good student. He has frequent stomachaches or other ailments and his doctor can find nothing physically wrong with him. He has unexplained bouts of anger or lethargy, and may be oversensitive to criticism. The teen may use drugs or alcohol. He may even talk about death and suicide. Eating disorders affect girls much more often than boys. Anor causes the teenager to starve herself. She thinks she is overweight when she may in fact be very thin. An anorexic teen might exercise excessively and be secretive about food. At the extremes, she will only weigh about 85% of her normal body weight. When a teen has bulimia, she will eat a large amount of food at meals but will purge herself of it later by vomiting. The bulimic teen also believes that she is very fat regardless of her true weight. She might also use diet pills or laxatives to help lose weight. Self-injuring behaviors, such as cutting or burning oneself, may result from feelings of loneliness, emptiness and disconnection from others. The teenager may feel unable to communicate her emotions and may feel that she is not allowed to express anger or sadness. This behavior is more common in adolescent girls than boys. Look for cuts on the teen's arms and legs. If the teen insists on wearing long-sleeved shirts and long pants in warm weather, she might be hiding the scars from cutting or burning herself. Social anxiety disorder reveals itself in a real fear of public situations, such as speaking before a class or dating. The teen might be perfectly comfortable with some public activities, such as playing sports, while being terrified of others. The teen might sweat profusely, blush, become short of breath, and have a rapid heartbeat. He might be unable to concentrate. He will try to avoid the situations that make him uncomfortable. He might refuse to go to school and turn down party invitations. Bipolar disorder, or manic-depression, evinces itself in extreme mood swings. In the manic stage, the teen will be overconfident,

believing that he can do anything whether it is really possible or not. He will engage in risky behavior, such as using drugs and alcohol or being sexually promiscuous. The teen will jump from one interest to another without completing any one project. In the depressive stage, he might withdraw from all his friends and his family. He might cry all the time, and express feelings of worthlessness. He will not be able to handle even the mildest criticism and will have no energy for the things he loved to do. He might think of suicide. Upsetting events may trigger the bouts of mania or depression. Obsessive-compulsive disorder (OCD) is characterized by the performance of rituals for more than one hour per day. The rituals might include counting, doing things a set number of times, or washing one's hands an excessive amount of times each day. The teen with OCD might be obsessed with making sure that objects are in a certain order, or lined up in a specific way. The rituals are performed in order to drive out obsessive thoughts. These thoughts might be about harm coming to a parent, sexual thoughts that are frightening or disgusting to the teen, violence, or being convinced that everything he touches is unclean or covered with germs. Even though the teenager with OCD realizes that his compulsive actions are pointless, he is unable to stop them. Being bullied is all too common in adolescence. Bullies generally pick on kids who are perceived as weak, different or unpopular. The bully will try to get a group of people to harass and intimidate the victim with him. While boy bullies may use physical violence, girls tend to bully by gossiping about or ignoring the victim. Signs that a child is being bullied might include unexplained bruises, coming home from school without some personal possessions, coming home hungry because he had no lunch, sleeping poorly, and unexplained physical ailments such as stomach aches and headaches. The teen may try to avoid places where he will see the bully, such as school, and start to do poorly in school. Being bullied does great damage to a teenager's self-esteem. A teenager who is a bully, on the other hand, has high self-esteem and expects everyone around him to do as he wishes. He is aggressive and has little empathy for others. Drug and alcohol abuse may occur during your child's teen years. Teenagers like to experiment. They may experience pressure from their friends and classmates to try alcohol and drugs. Some teenagers will become dependent upon them. Signs that your teen may have a problem with drugs or alcohol are lessened personal hygiene; hangover symptoms such as vomiting and headaches; bloodshot eyes; used rags (They are used with inhalants.), empty

bottles, or pipes in his room; needle marks; and drastic changes in sleeping and eating habits. Teenagers may also be pressured into sexual activity when they are not ready for it. Girls may feel the need to dress in a more provocative way than they feel comfortable with, just to fit in. The message of many of the movies, television shows, and music aimed at teens today is that being sexually active at an early age is a good thing and that the teen who is not is really out of it. Girls may feel pressured to have sex when they are not emotionally ready. Boys who have absorbed the message of having sex at all costs may make inappropriate comments to the girls they know and some have even forced girls into sexual acts. Sexual harassment suits have been files against high schools because of the prevalence of inappropriate comments and touching in these schools. Finally, the teenager may be under a lot of stress because of the demands of school, family, outside activities, and even a job. Many teenagers today try to do too much. They take on the hardest classes in order to get into a better college. They have a multitude of after school activities, leaving them less time to do their homework (or to relax), which in turn may cause them to stay up very late and not get enough sleep. Add a part-time job and the normal ups and downs of relationships with families and friends into this mix, and it is a sure recipe for stress. The best thing you can do for your teenager during these tumultuous years to listen to him and love him. Always let him know that you are there for him, no matter what. Get professional help for your teen when appropriate, such as when he is depressed or has an addiction to drugs or alcohol. Intervene for him at school if he is being bullied or sexually harassed. With you as your teen's champion and guide, he will make it safely through this difficult time. Abstract on HIV Almost a third of all people with Human Immunodeficiency Virus (HIV)/(AIDS) Acquired Immunodeficiency Syndrome are between the ages of 15 and 24. Every minute, six young people under the age of 25 become infected with HIV. This study of HIV infection was carried out over a two-year period with 33 HIV-positive adolescents, at SSG hospital, Vadodara. The most common mode of transmission (MOT) was the vertical route in 21(64%) cases followed by the sexual route in four (12%) cases. The mean time for disease progression was 13 years in cases acquiring infection through vertical transmission (VT). Reasons for slow progression in these cases, in spite of the high prevalence of malnutrition and infectious diseases in a developing country like India, should be studied. Both parents were positive in 12 of 21 VT cases and eight were orphans. Multiple cases in the same family made treatment and care difficult. Only eight of

the 21 VT cases were tested, due to positivity in their parents, while the rest were tested on being symptomatic, suggesting delayed testing. Late diagnosis led to a delay in the initiation of antiretroviral treatment (ART), influencing the growth and development of adolescents. Twentyone cases sought treatment when they had already developed AIDS, thus preventing us from early intervention. Nine cases were on ART. These cases faced problems like dose adjustments, adherence, and availability of pediatric formulations.
Adolescents’ Concerns and RH Needs
Both survey and qualitative study explored adolescents’ concerns and RH needs both from their own perspective and from adult perspectives. Adolescents’ concerns In general, adolescents are concerned about education, jobs, health problems, and attention by elders. Adolescents who are in schools as well as out of schools both are concerned about continued education. Girls are specially worried, as they perceive that their parents might arrange marriage for them, and then their education will not continue. Some married adolescent girls also expressed great eagerness to continue their studies. They perceive that education would help them in developing self-esteem and would give them a higher status in their in-laws’ household. Adolescents are also worried about monetary support for continuing their studies. Some adolescents who are out of school expressed that they are in dire need of a job. These adolescents are concerned about earning money and taking care of their families. In one extreme case, an adolescent girl aged 18 years, living in a rural area and working in a jute mill, commented, "I do not think about marriage or love-affairs at the moment. I do not have time for that. My father is very old, and he cannot earn money. I have to take care of our family. I work in a jute mill on a daily basis. The mill is three miles away from my place, and I go there on foot. When I do not have work I can not manage food for my family. So, my only thinking is how to manage food for them, nothing else..." A number of adolescents are concerned about health problems which include: menstrual problems and vaginal discharge for girls; wet dream, masturbation, and size and shape of penis for boys. Some adolescents expressed worry about the lack of attention given to adolescents by both families and government. As elders and community people are not paying proper attention to them, according to them, they are getting involved in many self-destructive activities, such as drug and alcohol addiction. A comment made by an urban adolescent boy aged 19 years, "Unemployment is a major factor for youths to be considered. We have left our study, now we have nothing to do. So, we are getting involved in many bad activities, such as taking drugs and alcohol, roaming around, involving with girls, or going to brothels. There will be no improvement of youth society until the government engages them in different productive activities." Community concerns regarding adolescents Qualitative data suggest that community members/parents are worried about adolescents. They are mainly concerned about marriage for their girls, pre-marital affairs, smoking, drug and alcohol addition, and continued education. It was found almost universal among the community people that they are worried about the marriage of their girls. Parents are always searching for a suitable bride-groom if they have an adolescent girl. They also feel socially insecure about their girls due to an increasing incidence of violence against women, kidnapping, and rape. The community people are also concerned about love affairs which are generally considered 'bad' by the society, and many adults perceive that these affairs will lead to pre-marital sex. Parents of adolescent girls are vitally concerned about interaction of their

daughters with males and pre-marital affairs, because if a girl is known to be involved in a pre-marital affair, she is regarded as a 'bad girl' in the society and it is not easy to arrange a marriage for her. The community people also perceive pre-marital affairs as becoming more prevalent. A number of them consider it an effect of satellite TV: "Now-a-days boys and girls of 12/13 years old have an inclination toward band music, but in the past they were fascinated by sports. The satellite TV is influencing them a lot. Naked films are shown through this TV, but at the same time, some good programmes are also shown. We always pick up the bad things. Boys and girls are picking up things that do not match with our culture. They develop inclination toward opposite sex and maylead to pre-marital sex . .TEXT MESSAGE I’ve been thinking about text messaging and whether parents are concerned about their child’s use of this social media. My own children are too young for this and don’t have cell phones; however, as a middle school teacher, I’ve been seeing how widespread texting has become, and I have concerns. A parent of one of my students was recently telling me about her 12 year old son receiving “interesting” text messages from a female classmate; another friend related how her 7th grader regularly receives dozens of texts a day up to 11 p.m. from classmates and friends of both sexes. Is texting just akin to the talking on the phone that we parents engaged in as young adolescents? Some things to consider: Texting gives your child a privacy in conversation that he or she may not be ready for, and may be inappropriate. Texting allows for an immediacy in written conversation that opens the door to impulsive, potentially hurtful words. Texting removes the inhibitions of face-to-face or even over the phone conversations, and may result in inappropriate messages. Text messaging is a simple idea, but despite its extreme brevity is really a complex form of communication, simply for the lack of context (i.e., emotion, expression, descriptive words) it provides for any texting conversation. Some suggestions for adolescents regarding text-messaging: 1. Consider the worst possible interpretation your words could have, or the worst possible situation that could result from them. Know that text messages, especially abbreviations, can be unclear or ambiguous, and not read how you intended. 2. Don’t have extended conversations via text messaging. This opens the door for every sort of problem, like miscommunication, misunderstanding, and hurt feelings. 3. Don’t be impulsive. Be mindful of your words. (This is a great rule of thumb for any kind of communication.) Text-messaging has a great potential to be a cyber-bullying tool. Or gossip tool. Or flirtation device. Or (fill in the blank).

4. Use texts to communicate information or facts, not feelings. If it’s getting too personal or intimate, stop. Personalize it with a phone call or in person, and if that thought makes you uncomfortable, you shouldn’t be texting this message. Parents, consider putting strict time/place/person limitations on your child’s text-messaging, such as “no texting after 7 p.m,” “no texting in your bedroom,” or “no texting with members of the opposite sex.” Or simply, “no texting.” Dear reader, what do you think of text-messaging among young adolescents? Are you a parent with experience in this area? Do you feel helpless at the hands of modern social media? What rules have you instituted in your household? ."

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