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It is considered as a period of transition from childhood to adulthood. They are no longer children yet not adults. It is characterized by rapid physical growth, significant physical ,emotional, psychological and spiritual changes. Adolescents constitute 22.8% of population of India as on 1st march 2000. They are not only in large numbers but are the citizens and workers of tomorrow. The problems of adolescents are multi- dimensional in nature and require holistic approach. A large number of adolescents in India are out of school, malnourished, get married early, working in vulnerable situations, and are sexually active. They are exposed to tobacco or alcohol abuse. Need for Adolescent Care : Need for Adolescent Care "A world fit for children is one in which ... all children, including adolescents, have ample opportunity to develop their individual capacities in a safe and supportive environment". Slide 4: STAGES Who is Adolescent? : Who is Adolescent? No longer a child but not yet an adult Age Groups WHO Defines- Adolescents- 10-19 years Youth - 15 – 24 Years Young People – 10 – 24 Years What is Adolescence?World Health Organization : What is Adolescence?World Health Organization A phase which involves - Progression from appearance of secondary sexual characteristics (puberty) to sexual and reproductive maturity Development of adult mental process and identity Transition from total social-economic dependence to relative independence Slide 10: Adolescence : 10 – 19 years Early Adolescence : 10 – 13 years Middle adolescence : 14 – 16 years Late adolescence : 17 – 19 years Youth : 15 – 24 years Young people :10 - 24 years Global Demographic and Socio-economic information on Adolescents : Global Demographic and Socio-economic information on Adolescents Population 1.1 billion are Adolescents. 1 in every 5 human on this planet is Adolescent. 85% of them live in Developing Countries. Global Demographic and Socio-economic information on Adolescents : Global Demographic and Socio-economic information on Adolescents Education Formal education is very important School Provide environment for - acquiring knowledge, building literacy and thinking skills. Offer a setting for health screening and services. In least developed countries 13% girls and 22% boys enroll for secondary education. Global Demographic and Socio-economic information on Adolescents : Global Demographic and Socio-economic information on Adolescents Employment Many do not complete secondary education. Seek work in informal sector. 73 million work in conditions that are detrimental to their health. Many millions live and work on street – are at greater risk for substance use and sexual abuse. Global Demographic and Socio-economic information on Adolescents : Global Demographic and Socio-economic information on Adolescents Poverty Relative and absolute poverty continues to grow. Pressure to earn a living at an earlier age – Hinders education Exposes them to exploitation by unscrupulous adults Challenges in adolescent development and health in INDIA: : Challenges in adolescent development and health in INDIA: 45% of adolescent girls under nourished 20% of adolescent boys under nourished Early marriage 26% < 15yrs – girls, 54% < 18yrs 20 – 30% adolescent boys sexually active 10% adolescent girls sexually active 59% adolescents know about condoms 49% adolescents know about contraceptives 4.5% drug abuse 50% of all HIV positive new infections are in the age group of 10 – 25yrs Adolescent abortion 1 – 4.4millions Slide 16: INDIAN ACADEMY OF PAEDIATRICS PROPOSAL: 1999 = Family Education for adolescents 2000 = Teenage care clinic in the hospitals 2001 – 2003 = Teenage care wards for girls and boys in the hospitals 31st July Every year = Teenage day 25 – 31st July Every year = Teenage week Slide 17: The following changes are taking place during adolescent period: Biological changes – onset of puberty Cognitive changes – emergence of more advanced cognitive abilities Emotional changes – self image, intimacy, relation with adults and peers group Social changes – transition into new roles in the society Slide 18: Impact of adolescence: 1) Lack of formal or informal education 2) School dropout and childhood labour 3) Malnutrition and anemia 4) Early marriage, teenage pregnancies 5) Habits and behaviours picked up during adolescence period have lifelong impact 6) Lot of unmet needs regarding nutrition , reproductive health and mental health 7) They require safe and supportive environment 8) Desire for experimentation 9) Sexual maturity and onset of sexual activity 10) Transition from dependence to relative independence Slide 19: Ignorance about sex and sexuality Lack of understanding Sub optimal support at family level Social frustration Inadequate school syllabus about adolescent health Misdirected peer pressure in absence of adequate knowledge Lack of recreational, creative, and working opportunity Slide 20: ADOLSCENT PROBLEMS Why Adolescents are Important? : Why Adolescents are Important? They are a demographic force. They are an economic force. They are the future health. They have a right to participate What are Adolescent Health Problems? : What are Adolescent Health Problems? Young Adolescents Malnutrition General Health Problems Menstrual Problems Mental Health Problems Early and Unprotected Sex Addictive Behaviors Accidents and violence Sexual Abuse Depression and Suicide Eating Disorders. What are Adolescent Health Problems? : What are Adolescent Health Problems? Young Adolescents Can not bear the responsibility of their own health Lack knowledge about the physical changes happening in body Such concerns – low self esteem and depression Need reassurance and Support What are Adolescent Health Problems? : What are Adolescent Health Problems? Malnutrition Shortage of food – priority for babies – inadequate adolescent diet – delayed/impaired development. Girls – fed last and fed least – pubertal delay – small pelvis. Baby mothers – less equipped to withstand complications (physically immature body) MMR higher in anemic adolescent mothers Undernourished Adolescent Mother – LBW Babies What are Adolescent Health Problems? : What are Adolescent Health Problems? General Health Problems Same illnesses but Less likely to recognize symptoms More likely to underestimate their importance Least likely section to go for early treatment afraid about outcome, worried about stigma, and do not have confidence on treatment. Parents actively take care of health of young children Parents feel adolescents responsible for their heath needs – as they become more independent Conditions like Asthma and Epilepsy become uncontrolled – as considered responsible for self medication. What are Adolescent Health Problems? : What are Adolescent Health Problems? They must learn - recognizing the early symptoms of common diseases - when, where and how to seek a check up & treatment What are Adolescent Health Problems? : What are Adolescent Health Problems? Menstrual Problems Without proper knowledge – fail to understand normal and to recognize menstrual problems School Health Checkups usually fail to identify these What are Adolescent Health Problems? : What are Adolescent Health Problems? Mental Health Problems May first become apparent in Adolescence No frame of reference available with them Thus fail to Recognize and Seek medical treatment What are Adolescent Health Problems? : What are Adolescent Health Problems? Early and Unprotected Sex Sexual activity is more common than available official data – evidenced by increased no. of- Unwanted Pregnancies Unsafe Abortions Steep Rise in HIV Early and unprotected sexual experience is not planned, and with no knowledge of consequences What are Adolescent Health Problems? : What are Adolescent Health Problems? Predisposing Factors for Early and Unprotected Sex Adolescents live in Increasingly sexualized societies Impact of Media – Electronic and Print Rapid Growth of cities and breakdown of traditional family structure – Erode protective cultural layer Conflict and forced migration – put them at risk Pressured in to desperate situations – forced into sex for survival sp. during economic hardships etc. Trend – earlier sexual maturation while late marriage What are Adolescent Health Problems? : What are Adolescent Health Problems? Early and Unprotected Sex – Results In STI 1 in 20 young people every year 7000 young people every day are infected with HIV Early and Unprotected Sex – Remedy Abstaining from Sex Delaying the onset of first sexual experience Increasing the level of protection through condoms What are Adolescent Health Problems? : What are Adolescent Health Problems? Addictive Behavior (Risk Taking) Do not assess the long term consequences Alcohol and drugs – further reduce caution and judgment May appear to be a way out for one who sees no positive solution – but actually is a way to more serious problems Expensive and illegal habits – draws them to crime What are Adolescent Health Problems? : What are Adolescent Health Problems? Accident and Violence Deaths and Injuries are more common in them Unintentional Injuries is the leading cause of Death in many countries Vulnerable both as victims and perpetrators Violence with in home is usually not treated seriously. What are Adolescent Health Problems? : What are Adolescent Health Problems? Sexual Abuse For millions – sex is linked with – cruelty, violence and abuse – family members or adults with privileged access. Women are conditioned to be submissive to men – thus early marriage, birth spacing, unprotected sex or unfaithful partner. Much sexual abuse takes place in home and is never reported Homeless –street adolescents are more vulnerable Young women may trade sex Increase in world trade sexual exploitation of young people – “sex Tourism” UNICEF estimates – 1 million adolescents are recruited in commercial sex trade What are Adolescent Health Problems? : What are Adolescent Health Problems? Depression and suicide Common with Low self esteem They feel they have no future and are useless Reduces the quality of life Likely to take risk with own health Depression can lead to suicide 90,000 young people commit suicide every year. What are Adolescent Health Problems? : What are Adolescent Health Problems? Eating Disorder Obesity and eating disorders exist along with malnutrition From early age adolescents are under pressure to be ultra thin – impact of media Bulimia and anorexia can permanently damage physical and mental health. Obesity – if failed to deal in time may lead to serious health problems. ADOLESCENT HEALTH PROBLEMS : ADOLESCENT HEALTH PROBLEMS Anorexia nervosa Obesity & overweight Adolescent pregnancy Micronutrient deficiency Emotional problems Behavioural problems Substance abuse & injuries Sexually transmitted infection Thinking and studying problems Identity problems Slide 38: Reasons for adolescent reluctant to seek help FEAR UNCOMFORTABLE WITH OPPOSITE HEALTH WORKER POOR QUALITY PERCEPTION LACK OF PRIVACY CONFIDENTIALITY CUMBERSOME PROCEDURE LONG WAITING TIME PARENTAL CONSENT OPERATIONAL BARRIER LACK OF INFORMATION FEELING OF DISCOMFORT PREVENTION : PREVENTION HEALTH EDUCATION SKILL BASED HEALTH EDUCATION LIFE SKILL EDUCATION FAMILY LIFE DUCATION COUNSELLING FOR EMOTIONAL STRESS NUTRITIONAL COUNSELLING EARLY DIAGNOSIS & MANAGEMENT OF MEDICAL AND BEHAVIOURAL PROBLEM Estimates of Disease Burden : Estimates of Disease Burden DALY – (Disability Adjusted Life Year) Time based measure to quantify burden. Includes – Years of Premature Deaths & Years lived with disability. 1 DALY is 1 lost year of Health Few Figures !!! : Few Figures !!! Young People represents 15% of total Burden 90% of DALYs lost in Developing Countries Main contributory factors Sexual and Reproductive Health Problems (STIs, HIV) Mental Illness Endemic and Chronic Diseases Nutritional Problems Drug use and Substance Abuse Accidents and Injuries Maternal Conditions Risk Factors for Global Burden : Risk Factors for Global Burden Why pay attention to Adolescent Health? : Why pay attention to Adolescent Health? To reduce death and disease in adolescents To reduce the burden of disease in later life To invest in health — today and tomorrow To deliver on human rights To protect human capital Why Invest in Adolescent Health? : Why Invest in Adolescent Health? Health Benefits Current & Future Health Intergenerational Effects Economic Benefits Improved Productivity Return On Investments Alleviate Future Health Cost As a Human Right Guiding Principals for Adolescent Health Programming(UNFPA, UNICEF & WHO) : Guiding Principals for Adolescent Health Programming(UNFPA, UNICEF & WHO) Adolescence is a time for opportunity and risk Not all adolescents are equally vulnerable Adolescent Development underlies prevention of Health Problems Problems have common roots and are interrelated Social environment influences adolescent behavior Gender considerations are fundamental Summary : Summary Adolescents represent a positive force in society, now and for the future. They face dangers more complex than previous generations faced, and often with less support. The development needs of adolescents are a matter for the whole of civil society. Health services play a specific role in preventing health problems and responding to them. Many changes are needed in order for health services to become adolescent friendly. Slide 47: Conclusion: This adolescent period is hazardous for adolescent health due to absence of proper guidance and counselling. Family has a crucial role in shaping the adolescents behaviour They have to ensure a safe, secure, and supportive environment for the adolescents. Family members in the community to be informed and educated about this problem. A positive and encouraging attitude has to be developed among the family members and parents. School teachers should be trained on adolescent health. Community leaders play a vital role on adolescent health care. Nutrition: Why should you care ? : Nutrition: Why should you care ? Happiness is nothing more than good health and a bad memory. Albert Schweitzer Physical Growth Body image Brain Daily activities Sports performance Prevention of diseases Healthy Diet: Why is it important in this age ? : Healthy Diet: Why is it important in this age ? You gain 25% of adult height, 50% of adult weight and 40% of adult bone mass during adolescence. Deposition of muscles in boys (50%) Deposition of fat in girls Preparation for future healthy mother and father Healthy Diet: How does it prevent diseases ? : Healthy Diet: How does it prevent diseases ? Obesity/under-nutrition Hypertension/heart disease Type-2 Diabetes Mellitus Osteoporosis/Dental caries Anemia Vitamins and Mineral deficiencies Cancer Healthy Diet: Deciding the right amount : Healthy Diet: Deciding the right amount Actual need varies with physical activity Physically active people have higher energy needs If you have low physical activity then you can become obese even with low intake. Therefore, Energy intake should balance energy expenditure. Healthy Diet: Food intake : Healthy Diet: Food intake Carbohydrates e.g. Rice, Chapati Protein-based e.g. Milk, Egg, Dal and Meat. Salads, Vegetables Fruits Increase fiber Decrease oily foods ‘No’ to soft drinks CARBOHYDRATES : CARBOHYDRATES Major and immediate source of energy. Complex carbohydrates recommended High-sugar foods not preferred. Grains, cereals, fresh fruits, vegetables FATS : FATS Source of essential fatty acids. Unsaturated fat recommended. e.g. Corn, cottonseed, Til oil, soybean, and sunflower oils contain about 50% polyunsaturated fat. Saturated fats increase cholesterol levels. PROTEINS : PROTEINS Daily requirements Boys = 0.29-0.32 g/cm height Girls = 0.27-0.29 g/cm height 0.8 – 1.2 g/kg bodyweight High intensity athletes = 1.2-1.8 g/kg Pulses, lentils, soya, dairy products and animal food products. Looks can be deceiving : Looks can be deceiving Iron Zinc Iodine Calcium Increased need during adolescence Needs met by a well-balanced diet Vitamin D Thiamin Riboflavin Niacin Vitamin B 12 Vitamin C Folic acid Sources – Fruits, fresh milk, sprouted beans etc. Iron : Iron Anemia is most common nutritional deficiency in adolescents. Increased red cell mass during adolescence. Daily need Boys = 12 mg/d & Girls = 18 mg/d Green leafy vegetables, jaggery, wet dates, whole-grain, dried beans, peas & dried fruits, nuts & fortified wheat products, eggs, red meat etc. Zinc : Zinc Second most abundant trace mineral in the body. (next to iron) Necessary for normal growth. Clinically apparent deficiency rare. Daily need = 15 mg Green leafy vegetables, wheat germ, whole grains meat, cheese, eggs, poultry, liver. Calcium : Calcium Most bone mass acquired during adolescence. Typical intake of calcium = about 800 mg/ d Daily need = 1300 mg Consumption of soft drinks & caffeine contribute substantially to low calcium intake in adolescents. Bone mass deficiency may is irreversible. Milk and its products, yogurts, cheese, paneer, banana. What is ‘Normal’ eating ? : What is ‘Normal’ eating ? Eating is regulated by hunger and satiety i.e. feeling full Eating should be at regular intervals Choose healthy snacks and food, If you eat healthy and exercise regularly you can occasionally enjoy high fat and high calorie junk foods. Good eating habits : Good eating habits Maintain hygienic habits Eat slowly, chew properly Avoid TV viewing or reading while you eat Small frequent meals Never skip meals, specially breakfast Don’t overeat Do healthy snacks exist ? : Do healthy snacks exist ? Yes, and in plenty. Snacks like fresh fruits, sprouted beans and nuts are nutritious and healthy. Avoid energy dense snacks like burgers. “Empty calories” – High sugar drinks Aerated drinks interfere with bone density and can damage teeth Why is Fast Food unhealthy ? : Why is Fast Food unhealthy ? High in calorie, fat, sodium and low in fiber which can cause Obesity, Hypertension, Heart diseases, Diabetes, Cancer etc. Contains preservatives Choose low-calorie and low-fat meals, snacks and desserts Have low fat or skim milk drinks. The Middle Path: Making Junk food healthy : The Middle Path: Making Junk food healthy Replace the Cheese with Paneer or low-fat cheese Add plenty of vegetables Replace frying with grilling or baking Replace white bread, maida noodles or maida pizza base with whole-grain wheat Have low-fat or skimmed milk based products Breakfast: The most important meal : Breakfast: The most important meal Brain Food Improves performance in studies Improves physical activities Does not contribute to overweight Keeps you healthy Skipping breakfast associated with obesity High sugar breakfast causes a high sugar level which dips fast making you more hungry and you eat more sugary food PHYSICAL ACTIVITY: Why is it important ? : PHYSICAL ACTIVITY: Why is it important ? PHYSICAL ACTIVITY: Types of physical activity : PHYSICAL ACTIVITY: Types of physical activity Daily Chores: walking, climbing stairs, cycling, household activities, etc. Exercise: planned & structured subset of leisure time physical activity undertaken for improving or maintaining physical fitness. 30-60 minutes every day Sports: involves competition. It may become an occupation. PHYSICAL ACTIVITY: Importance : PHYSICAL ACTIVITY: Importance This includes : Cardio-respiratory i.e. Heart & Lung fitness Muscle strength Endurance & flexibility Television and Obesity : Television and Obesity Excessive TV watching is associated with weight gain specially when associated with increased snacking with junk food and aerated drinks TVsterol Combine TV watching with physical activity like stationary bicycling, or spot jogging PHYSICAL ACTIVITY: Keeping in shape : PHYSICAL ACTIVITY: Keeping in shape It is recommended to have 30-60 min. moderate physical activity on weekdays, four days a week It is not necessary to exercise continuously Can be divided into 10 -15 minutes of activities several times through the day Nutrition & Exercise: Myths : Nutrition & Exercise: Myths Girls don’t need muscle stretching exercises You can become obese if you leave exercise Expensive food and vitamins are needed for good health and machines for exercise Sona-chandi Health drinks Key points : Key points Proper Nutrition & Regular Physical Activity are very important for Growth Prevention of illness Future health Slide 76: END HYGIENE : HYGIENE From Head To Toe Knock Knock : Knock Knock Who’s There? Jean.Jean Who? Hi Jean!What’s That Smell? Hygiene : Hygiene From the Greek word “hygies” Meaning “healthy, sound” What is Personal Hygiene? : What is Personal Hygiene? Regular Routine of Personal Care Washing and Grooming Your Hair Your Face Your Skin Your Teeth Your Ears Your Hands Your Nails Your Feet Hair : Hair Brushing your hair cleans and stimulates hair and scalp. Brush from roots to tips to spread natural oils along the whole length of hair. Shampoo regularly Hair : Hair How do I choose a shampoo? Is my hair Oily, or is my hair Dry? Do I need conditioner? What will stop the DANDRUFF??? Dandruff : Dandruff What is it? Dry itchy scalp White flakes on head and shoulders What causes it? Skin cells that grow and die off too fast Fat eating fungus on scalp that grow out of control and feeds off the oil on the hair follicles ACNE : ACNE Acne is created when oil from the oil glands mix with the dead cells and plug up the hair follicles in the skin it creates a “whitehead.” A “blackhead” is when the air touches the plug, the plug turns black Acne : Acne Acne : Acne What makes acne worse? Oil-based makeup, suntan oil, hair jells and spray. For girls, menstruation Squeezing or picking at blemishes Hard scrubbing of the skin Who gets acne? Boys and girls during their teen years. Boys may get it worse because they have more skin oil. If your parents had bad acne, chances are you may get it bad too. Acne Myths : Acne Myths 1: Does chocolate cause zits? A: NO 2: Does Extra washing help clear zits? A: No, the extra scrubbing irritates skin and could make them worse. 3: Does acne leave scars? A: Yes, you can reduce the scarring by NOT PICKING and avoid excessive scrubbing. Ears : Ears Wash ears daily with a wash cloth don’t forget behind the ears Do not use Qtips in ears it will smash the ear wax deep into the ear canal Did you know…..?? Ear wax is usually removed when you chew food or gum Dental Hygiene : Dental Hygiene What causes cavities? Sugar and Plaque together creates bacteria that causes tooth decay. Tooth Decay can be transmitted through the mouth from someone who may have tooth decay bacteria. How to avoid tooth decay. Daily dental hygiene routine that consist of brushing for 2-4 minutes and flossing. See a dentist every 6 months Halitosis : Halitosis Bad Breath… Caused by the activity of certain types of oral bacteria Other causes: Food stuck in teeth Sinus problems Stomach problems Body Odor : Body Odor What causes body odor? Perspiration and bacteria mixed together Apocrine glands under the arms and in the groin secrete odors Poor hygiene Poor diets or some foods such as onions and garlic Treatments… The use antiperspirants decreases perspiration and cover odor with a manly smell Daily baths or showers using soap and scrubbing the entire body with a washcloth Change clothing daily Maintain a healthy diet Body Odor : Body Odor So many choices… What would be best for me…??? Fingernails and Toenails : Fingernails and Toenails File fingernails in one direction Cut toenails straight across – never cut into corners Protect against ingrown toenails by avoiding tight shoes, very high heels Athletes Foot : Athletes Foot Tinea Corpois – Fungal Infection – Athletes Foot Keep feet and skin clean and dry Change socks daily Avoid walking barefoot in public areas Throw away worn-out shoes and never borrow other people’s shoes Make Hygiene part of your daily routine : Make Hygiene part of your daily routine Slide 96: END Slide 97: THANK YOU You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.