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Adolescents and Peer Pressure
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Peers provide an opportunity for teens to meet their needs, to feel capable, to belong, to be respected, and to have fun. While young people often experience these needs being met within the family, the peer group provides unique and different opportunities to meet these needs. The peer group encourages autonomy, mutuality, and experimentation with self guided roles. While many families assist teens to find out who they really are and to help teens feel proud and confident of their unique traits, backgrounds, and abilities, the peer group may often be more accepting of the feelings, thoughts, and actions associated with this search for self- identity.

Although there is a common perception that "peer pressure" is the reason for many negative behaviours of adolescents, in reality, peers are necessary and crucial in helping adolescents make successful transitions. Peers can and do act as positive role models. Peers can and do demonstrate appropriate social behaviours. Peers often listen to, accept, and understand the frustrations, challenges, and concerns associated with being a teenager.

Much research has shown that peer pressure has a much greater impact on adolescent behavior than any other factor. Think about it. Your teenager spends many more of his or her waking hours with peers than with family members. The interaction is direct, and much more powerful than the influence of teachers and other authority figures. Peer pressure tends to have more of an effect on children with low self-esteem. If a child feels compelled to fit in, the teen may do things that go against his or her beliefs simply to be part of the group.

Peer pressure can lead to experimentation with drugs and alcohol, sex, skipping school, and various high-risk behaviors. If you notice a sudden change in your child's appearance, clothing, and attitude, especially if accompanied by secretive behavior, he or she may be succumbing to the influences of peers. You should be especially alert to sudden changes in the friends who make up their core peer group. An unexplained change in the type of friends you child associates with would indicate that your child is vulnerable to new influences that may not be positive.

How can parents, who spend far less time with their children than do their peers, have an influence on their teens? Parents need to set clear expectations for behavior, establish rules about communicating where and with whom their teenagers are spending their time, and should pre-set consequences for lying about activities or where they are going. By communicating your expectations, your adolescent cannot claim they "did not know" that you would be upset.

One of the most difficult issues can be when a teen decides to hang out with the "wrong crowd." Parents often find it is difficult to control such behavior. They will lament that when they forbid their teen to hang out with certain people, those people become a virtual magnet for their teen. Often by simply setting the rules about communicating their whereabouts, you will limit the effects of any peer group. However, if you really believe that a particular peer group is negatively impacting your child, it is important to deal with the reasons your teen is being influenced in this direction. He or she may have problems with self-esteem and self-confidence and feel it is necessary to fit in anyway possible, even if it means fitting in with a negative peer group. Parents will not change the teen's attitude by forbidding access to these peers. They can only change the attitude by dealing with the primary issues that cause it in the first place. An adolescent is drawn to a particular group because it "feeds" them in some way. If they are choosing the wrong group, there is a fundamental core issue that needs to be addressed therapeutically before any significant change can occur.



Talk to your teen. State clearly that you do not have a problem with their friends as people. You understand that that your teen’s friends can make mistakes – just like your teen made a mistake. But you do have a problem with the risk-taking behavior and there needs to be a change on your teen’s part and on their friend’s part in order for you to be build an action plan with your teen. Address changing the behaviors that are concerning you in the plan and allow your teen to come up with different options to these behaviors. Learn more about the problem behavior and use your discipline skills as necessary. Limit your teens unsupervised time with the friends that were involved until you feel comfortable to slowly give back more of these privileges. You will need to be more involved with your teen at this time and offer more supervised activities with their friends.

Take caution: don’t allow your teen to place all of the blame at their friend’s feet. This is an easy out and may be the way to even bigger problems for your teenager down the road. Even if your teen’s friend was 90% accountable for the misbehavior, you still need to hold your teen accountable so that he can actively deal with the problem and move on. Part of learning how to make the right choices is learning how to deal with mistakes.



When Parents Don't Approve


You may not be comfortable about your son or daughter's choice of friends or peer group. This may be because of their image, negative attitudes, or serious behaviors (such as alcohol use, drug use, truancy, violence, sexual behaviors).



Here are some suggestions:



· Get to know the friends of your teen. Learn their names, invite them into your home so you can talk and listen to them, and introduce yourself to their parents.

· Do not attack your child's friends. Remember that criticizing your teen's choice of friends is like a personal attack.

· Help your teen understand the difference between image (expressions of youth culture) and identity (who he or she is).

· Keep the lines of communication open and find out why these friends are important to your teenager.

· Check whether your concerns about their friends are real and important.

· If you believe your concerns are serious, talk to your teenager about behavior and choices -- not the friends.

· Encourage your teen's independence by supporting decision-making based on principles and not other people

· Let your teen know of your concerns and feelings

· Encourage reflective thinking by helping your teen think about his or her actions in advance and discussing immediate and long-term consequences of risky behavior.

· Remember that we all learn valuable lessons from mistakes

February 23, 2008 | 2:52 AM Comments  0 comments

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Adolecents and Drug Use
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

It’s hard to fight drug use among teens, but it can be done. Young people are more intelligent than we often give them credit for being. If we talk with them about specific drugs and their negative effects, it will go a long way towards winning the battle against teen drug use
It’s also interesting and important to note that parental involvement plays a vital role. The strongest declines in drug use occurred during years when more parents and guardians were talking to their kids about the risks of drug use, and the kids were exposed to anti-drug messages in the media. Some statistics actually show an increase of drug use during years when parental involvement was down, even if anti-drug media exposure was up.

Factors associated with increased risk for any type of illicit drug use include at least one or more of the following:

Poor parent-child relations. Studies show that living in a stressful home environment with relatively little parental support and monitoring places adolescents at greater risk for drug use.
Family environments that model drug use. Adolescents are more likely to use drugs if someone in their home uses drugs. For example, parents who use drugs may practice poor parenting which may increase the risk of drug abuse for adolescents. Also, parental or sibling drug use sets a model of acceptable inappropriate behavior for teens, makes it seem like a normal part of life, and may encourage its acceptance by youth.
Peer drug use. During adolescence, peers become a major influence because of the increased time spent with them outside of the home. Some teens feel pressured to fit in and do what their friends are doing. Consequently, teens that have friends who use drugs are more likely to use drugs themselves.

High risk communities. Living in communities where drug use is widespread not only makes drug accessibility easier, but also normalizes the act of using drugs.
Low self-esteem. Adolescents who do not have positive views of themselves, or who lack support and encouragement from others are more likely to use drugs.
Poor school achievement. Teens who have negative attitudes toward school and low expectations of academic success are at increased risk of drug use. Also, teens who use drugs typically exhibit declines in grades, and inconsistent attendance at school.
What Are the Consequences
The effects of drug use vary by type of drug and frequency of use, however, some

consequences may include the following:

Mental and physical health problems. Teens who use drugs are at greater risk for developing a number of health problems including attention deficit disorder, anxiety disorders, phobias, and depression.

Increased likelihood of drug use later in life. Early drug use has been linked to positive attitudes toward drug use. Consequently, teens who begin drug use early are at risk for continued drug habits into and through adulthood.
Involvement in other illegal activities. Drug use has been linked to higher tolerance of deviant behavior among adolescents. This results in increased criminal activity for drug users compared to non-drug using peers.
Increased likelihood of death. Drug use increases the odds of death from accidental or intentional drug overdoses as well as engagement in other unsafe behaviors (e.g., driving under the influence).

What Can Parents Do

Communication is key in dealing with any type of risk taking behavior during the teen years. The hectic pace of work and school can sometimes estrange family members, especially parents and teens. But make the effort to keep in touch with your teen. Find out what's going on in his or her life. The best way to find out if your teen is using drugs is to just ask. During adolescence, parents may feel that their influence over their teen's life is waning, but in fact, you have more power than anyone to prevent your child from using drugs. Here are some things that you can do to encourage your child to "Just Say No."

Stay connected with your teen. Keeping up to date with your teen's interests and friends is an important step in creating a warm, communicative, and open environment. If your teen feels that you are available and easy to talk to, then he or she will be more likely to share concerns that might lead to risk taking behavior.

Begin an ongoing conversation with your teen (vs. giving a one time speech). Make it clear that drug use is not an acceptable behavior in your family and be sure to talk about the reasons why. Talk about the consequences of drug use. Help your teen visualize two futures, one that includes drug use and one that remains drug free. Where do these paths lead? Discuss your teen's life goals and how drug use can hinder them from reaching them.
Empower your teen. Teens tend to want to rebel against their parents' standards or advice. Rather than dictate what your child should or should not do, remind him or her that they have the power of choice and that you trust that they can and will make good decisions.
Teens sometimes abuse substances as a way of alleviating stress. Some experiences in life (e.g., not making the basketball team, breaking up with a girlfriend or boyfriend) are both stressful and painful. Drugs are often sought as a means of temporarily easing pain or stress. Talk to your teen about any stressful events that are going on in his or her life and ways they can effectively handle them.

Know your teen's friends. You can influence your teen's choice of peers by talking with them about the qualities that make a good friend.

Encourage your teen's self-esteem by praising their efforts and achievements. Help them to master the things that they are good at. Show them you care through your involvement in their lives/activities.
Take advantage of teachable moments. These include talking about scenes in movies or news headlines that deal with drug associated topics. Explain your position on these topics and ask your teen how they feel about what they are viewing.
Encourage healthy activities that promote the use of your teen's interests and talents. Most teens are curious and are eager to try something new and challenging. High school is the peak time for both beginning substance use and beginning lifetime habits that include using illegal substances. Your parental example, support, and monitoring has a great influence on your teen's behavior. Talk early and often about the consequences of and alternatives to using illicit drugs.

February 23, 2008 | 2:49 AM Comments  0 comments

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HIV&AIDS Vulnerability Among Adolescents
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Even under stable family and societal conditions, an adolescent's passage into young adulthood is fraught with challenges. As adolescents move away from the prescribed moorings of family to stand on their own, they experience heightened vulnerability. Simultaneously, adolescents are bombarded by internal pressures and simulations. Under these pressures, they seek experiences and feelings of power, peer affiliation and certainty.

To reduce HIV&AIDS vulnerability among adolescents, there is a need to develop strategies and methods for effective curriculum focusing on sex education and life skills especially. Internalizing more participatory learning-teaching method, it is felt that a stronger integration of prevention education vis-à-vis sex & reproductive health approaches is essential for improving the high-quality HIV prevention & care. It is estimated that there are 1.2 billion adolescents in the world. Near about eighty seven percent of these adolescents live in the developing countries. More adolescents do not know what reproductive health is and how to practice safe sex. Most of them are not aware of how to undermine the vulnerability to HIV&AIDS. To make them free from such encumbrance as HIV&AIDS, we have to ensure a healthy and promising environment. It is believed that if the adolescents have qualitative reproductive health literacy ultimately HIV&AIDS prevention programs initiated by NGos will be successful.


Only effective education can ensure qualitative reproductive health literacy. This kind of literacy helps adolescents analyze thoroughly basic information, core messages, values and praxis related to HIV&AIDS prevention. Simultaneously they are able to inculcate caring and supportive attitudes towards people living with HIV/AIDS (PLHA). They possess the basic facts and information bringing about acquisition of knowledge and development of attitudes, values, skills and practices (KAVSP) as to undermining the spread of HIV&AIDS. Consequently they have profound awareness on practicing safe sex, use of condoms, gender equity, and harmful effect of early marriage, premarital sex and unplanned pregnancy.



Reducing HIV&AIDS vulnerability among adolescents may be promoted auspiciously through evaluating the attitudes and values within community based social norms/beliefs, cooperation and teamwork. From the salad days, adolescents have to be guided by active and participatory learning that they may analyze, study ideas, solve problems and apply what they learn. It is important to ensure that active learning would be fast-paced, enjoyable and personally engaging. In this regard, cooperative learning may play a vital role to make the adolescents aware of HIV&AIDS significantly. It is one kind of effective group approaches with a view to learning with common objectives, mutual rewards, shared resources and complementary roles. Through this approach, group members are stimulated to help each other to master the lesson or activity. Thus an atmosphere of mutual trust and respect are established. Eventually the learning environment is warm as well as adolescents are made to express their views, opinions, attitudes and behaviors freely.


Adolescence is the prime and sensitive period of so many physical, emotional and cognitive developments. So adolescents have to experience many changes unexpectedly. In most cases, they remain unaware of how to efficiently cope with these kinds of physical and psychological changes. Attitudes to sexuality are being developed gradually during puberty. In this time, if adolescents are misguided or deprived of acquiring reproductive health literacy they will suffer all the time in their lives. There is no doubt that sexual maturity leads to happiness and fulfillment in future personal and social relationships. So there is no alternative for adolescents to learn about issues related to reproductive health from parents, teachers and other elders for being able to understand and develop a healthy attitude.


Vulnerability to HIV&AIDS is skyrocketing in the developing countries jeopardized by lack of qualitative reproductive health literacy among the adolescents. But reproductive health literacy itself offers one of the key hopes against HIV/AIDS epidemic as well as its influential eventualities. In fighting the pandemic, reproductive health literacy comprising transfer of skills and attitudes to reduce adolescents’ vulnerabilities to HIV&AIDS is the most effective means. It is seriously necessary to reduce the fear of HIV&AIDS any how. Reproductive health literacy can do a lot to combat HIV&AIDS facilitating adolescents in attaining the knowledge, attitudes and skills that they need to delay sexual intercourse, reduce their number of sex partners, prevent illicit drug/substance use and avoid infection by using condoms.


The academic curriculum of the developing countries should provide adolescents with opportunities to learn and practice life skills, such as decision-making and communication skills, which can strengthen other important areas of early life development.

February 23, 2008 | 2:44 AM Comments  0 comments

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Health care workers & HIV Prevention
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Occupational exposure to HIV
In many countries for many years health care workers have become infected with HIV as a result of their work. The main cause of infection in occupational settings is exposure to HIV-infected blood via a percutaneous injury (i.e. from needles, instruments, bites which break the skin, etc.). The average risk for HIV transmission after such exposure to infected blood is low - about 3 per 1,000 injuries. Nevertheless, this is still understandably an area of considerable concern for many health care workers.

Certain specific factors may mean a percutaneous injury carries a higher risk, for example:

A deep injury
Terminal HIV-related illness in the source patient
Visible blood on the device which caused the injury
Injury with a needle which had been placed in a source patient's artery or vein
If percutaneous exposure occurs then the site of exposure should be washed liberally with soap and water but without scrubbing. Bleeding should be encouraged by pressing gently around the site of the injury (but taking care not to press immediately on the injury site). It is best to do this under a running water tap.

There are a small number of instances when HIV has been acquired through contact with non-intact skin or mucous membranes. Research suggests that the risk of HIV infection after mucous membrane exposure e.g. splashes of infected blood in the eye, is less than 1 in 1000. If mucocutaneous exposure occurs then the affected area should be washed thoroughly with soap and water. If the eye is affected, it should be irrigated thoroughly.

If intact skin is exposed to HIV infected blood then there is no risk of HIV transmission.

Post Exposure Prophylaxis
Research evidence seems to suggest that the use of anti-HIV drugs in combination with other anti-HIV drugs if given soon after an injury can reduce the rate of transmission. Such treatment is referred to as Post Exposure Prophylaxis (PEP). PEP is recommended for health care workers if they have had a significant occupational exposure to blood or another high risk body fluid which is likely to be infected with HIV. It is recommended that PEP should be commenced as soon as possible after exposure and ideally within the hour.

Although exposure through needle stick injuries can usually be avoided by following good working practices, health care workers should consider the implications of taking PEP. This will help them to make a swift decision in the event of an accident where an injury occurs.

What are Universal Precautions
Employing universal precautions means taking precautions with everybody. If precautions are taken with everyone, health care workers do not have to make assumptions about people's lifestyles and risk of infection. Health care workers should have the right to be able to protect them against infection, whether it is HIV, Hepatitis or anything else.

The following universal infection control precautions are advised by the World Health Organization3 to help protect health care workers from blood-borne infections including HIV:

Wash hands with soap and water before and after procedures.
Use protective barriers such as gloves, gowns aprons, masks, goggles for direct contact with blood and other body fluids.
Disinfect instruments and other contaminated equipment.
Handle properly soiled linen. (Soiled linen should be handled as little as possible. Gloves and leak proof bags should be used if necessary. Cleaning should occur outside patient areas, using detergent and hot water.)
Use of new, single-use disposable injection equipment for all injections is highly recommended. Sterilizable injection should only be considered if single use equipment is not available and if the sterility can be documented with Time, Steam and Temperature indicators.
Discard contaminated sharps immediately and without recapping in puncture and liquid proof containers that are closed, sealed and destroyed before completely full.
Document the quality of the sterilization for all medical equipment used for percutaneous procedures.

January 28, 2008 | 12:15 AM Comments  2 comments

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Stress
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Stress is the “wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience stress as we re-adjust our lives. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it. How Can I Eliminate Stress from My Life? As we have seen, positive stress adds anticipation and excitement to life, and we all thrive under a certain amount of stress. Deadlines, competitions, confrontations, and even our frustrations and sorrows add depth and enrichment to our lives. Our goal is not to eliminate stress but to learn how to manage it and how to use it to help us.



Insufficient stress acts as a depressant and may leave us feeling bored or dejected; on the other hand, excessive stress may leave us feeling “tied up in knots." What we need to do is find the optimal level of stress, which will individually motivate but not overwhelm each of us. How Can I Tell What is Optimal Stress for Me There is no single level of stress that is optimal for all people. We are all individual creatures with unique requirements. As such, what is distressing to one may be a joy to another. And even when we agree that a particular event is distressing, we are likely to differ in our physiological and psychological responses to it. The person who loves to arbitrate disputes and moves from job site to job site would be stressed in a job, which was stable and routine, whereas the person who thrives under stable conditions would very likely be stressed on a job where duties were highly varied. Also, our personal stress requirements and the amount which we can tolerate before we become distressed changes with our ages. It has been found that most illness is related to unrelieved stress. If you are experiencing stress symptoms, you have gone beyond your optimal stress level; you need to reduce the stress in your life and/or improve your ability to manage it.

How Can I Manage Stress Better Identifying unrelieved stress and being aware of its effect on our lives is not sufficient for reducing its harmful effects. Just as there are many sources of stress, there are many possibilities for its management. However, all require effort toward change: changing the source of stress and/or changing your reaction to it. How do you proceed?



1. Become aware of your stressors and your emotional and Notice your distress. Don't ignore it. Don't gloss over physical reactions. Determine what events distress you. What are you telling your problems. Determine how your body responds to yourself about meaning of these events The stress. Do you become nervous or physically upset? If so, in what specific Can you change your stressors byways



2. Recognize what you can change. Can you reduce their intensity avoiding or eliminating them completely Can(manage them over a period of time instead of on a daily or weekly basis) you shorten your exposure to stress (take a break, leave the physical premises) Can you devote the time and energy necessary to making a change (goal setting, time management techniques, and delayed gratification strategies may be helpful The here)



3. Reduce the intensity of your emotional reactions to stress. Stress reaction is triggered by your perception of danger...physical danger and/or emotional danger. Are you viewing your stressors in exaggerated terms Are you and/or taking a difficult situation and making it a disaster? Are you overreacting and viewing things as expecting to please everyone? Do you feel you must always prevail in every absolutely critical and urgent? Work at adopting more moderate views; try to see the stress as situation? Try to something you can cope with rather than something that overpowers you. Temper your excess emotions. Put the situation in perspective. Do not labour on the negative aspects and the “what if's.

"

4. Learn to moderate your physical Slow, deep breathing will bring your heart rate and reactions to stress. Relaxation techniques can reduce muscle tension. respiration back to normal. Electronic biofeedback can help you gain voluntary control over such things as Medications, when prescribed muscle tension, heart rate, and blood pressure. by a physician, can help in the short term in moderating your physical reactions. However, they alone are not the answer. Learning to moderate these reactions on your own is a preferable long-term solution

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5. Build your physical Exercise for cardiovascular fitness three to four times a week reserves. (Moderate, prolonged rhythmic exercise is best, such as walking, swimming, Maintain your• Eat well-balanced, nutritious meals. •cycling, or jogging). Mix• Avoid nicotine, excessive caffeine, and other stimulants. •ideal weight. Get enough sleep. Be leisure with work. Take breaks and get away when you can. as consistent with your sleep schedule as possible.

6. Maintain your emotional • Develop some mutually supportive friendships/ relationships. •Reserves. Pursue realistic goals, which are meaningful to you, rather than goals others expect some frustrations, failures, and have for you that you do not share. Always be kind and gentle with yourself--be a friend to yourself sorrows.

January 28, 2008 | 12:12 AM Comments  0 comments

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