Pain Perception And Processing In Alzheimers Disease

Pain Perception And Processing In Alzheimers Disease Alzheimers patients feel pain as powerfully as others. Pain perception and processing are not diminished in Alzheimers disease, thereby raising concerns about the current inadequate treatment of pain in this highly dependent and vulnerable patient group. Pain activity in the brain was just as strong in the Alzheimers patients as in the healthy volunteers. In fact, pain activity lasted longer in the Alzheimers patients. Pain may be even more bewildering to more severely affected patients. The experience of pain may be more distressing for these patients on account of their impaired ability to accurately appraise the unpleasant sensation and its future implications. Doctors can use a tool called the Pain and Discomfort Scale or PADS. Its a system for evaluating pain based on facial expressions and body movements. People caring for someone with Alzheimers disease or other dementias can do an even better job than doctors can. Caregivers have an incredible capacity even beyond doctors to know the behavior of the person they are caring for and to look for the times they are in discomfort or pain. The trick is to watch the facial expressions and movements of patients when they are not in pain, both during sleep and waking hours. Using this as a baseline, you should be attentive to circumstances where they seem agitated, where eye contact is altered, where there is grimacing or a facial expression indicative of discomfort. As Alzheimers disease progresses towards the later stages, the ability of the affected person to communicate becomes increasingly compromised. Caregivers can no longer ask are you comfortable? or, are you in pain? and get a reliable answer. A caregiver has to interpret what behavior means. Are shouts, screams, severe withdrawal, aggression, due to confusion, something else, or are they signs of pain?   The way in which a normal person experience pain differs. Pain is a subjective experience. People who have problems communicating are disadvantaged. Research into the prevalence of pain in elders in nursing homes is estimated at between 40 and 80 percent. There is evidence that people with cognitive disabilities may have an even higher risk of being under-medicated for pain. Painful conditions such as arthritis, cancer, urine infections are sometimes not treated with painkilling medications. Even when people can communicate effectively research suggests that observers tend to assume that people over-report pain either verbally or in their facial expressions.   Effective pain management for people with dementia is a complex issue. Families and health professionals caring for people with dementia have to acquire new skills and it can be a rather hit and miss situation. The first step in pain management is assessment of the discomfort. Acute pain syndromes commonly follow injuries, surgical procedures, etc. and require standard analgesic or narcotic management. Acute pain syndromes are expected to last for brief periods of time, i.e., less than six months. Pain that persists for over six months is termed chronic pain. Chronic non-malignant pain requires a more complex strategy to minimize the use of narcotics and maximize non- pharmacological interventions. Acute pain rarely produces other long-term psychological problems, such as depression, although acute discomfort will produce distress manifested by acute anxiety or agitation in the demented patient. Mildly demented patients can become agitated or anxious with pain because they rapidly forget explanations or reassurances provided by staff. Amnestic individuals may forget to ask for PRN non-narcotic analgesics such as acetaminophen and these patients need regularly scheduled medications. Disoriented patients do not realize they are in a health care facility and aphasic patients may not comprehend the staffs inquiry about pain symptoms. The symptoms of pain expressed by patients with moderate to severe dementia include anxiety, agitation, screaming, hostility, wandering, aggression, failure to eat, and failure to get out of bed. A small number of demented individuals with serious injury may not complain of pain, e.g., hip fractures, ruptured appendix, etc. Assessment of pain in the demented patient requires verbal questioning and direct observation to assess for behaviors that suggest pain. Standardized pain assessment scales should be used for all patients; however, these clinical instruments may not be valid in persons with dementia or psychosis. The past medical history may be valuable in assessing the demented resident. Individuals with chronic pain prior to the onset of dementia usually experience similar pain when demented, e.g., compression fractures, angina, neuropathy, etc. These individuals can be monitored carefully and non-narcotic pain medication can be prescribed as indicated, e.g., acetaminophen on a regular basis, anticonvulsants for neuropathy. The management of pain in any person requires careful consideration about the contribution of each component of the pain circuit to the painful stimulus. Neuropathic pain is produced by dysfunction of the nerve or sensory organ that perceives and transmits noxious stimulus to the level of the spinal cord. Persons with serious back disease may have herniated discs that compress specific nerve roots. This pain is often positional and produces spasms of the musculature in the back. The brain interprets pain in a highly organized systematic pattern. Discrete brain regions interpret and translate painful stimuli from specific body regions, e.g., arm, leg, etc., misfire in that discrete brain region will misinform the person that pain or discomfort is being experienced in that limb or part of the trunk. A person who loses a limb from trauma or amputation may continue to experience painful sensations in the distributions for that limb termed phantom limb pain. Management of chronic pain involves three elements (1) physical interventions, (2) psychological interventions, (3) pharmacological interventions. Physical interventions include basic physiotherapy that incorporates warm or cool compresses, massage, repositioning, electrical stimulation and many other treatments. Dementia patients need constant reminders to comply with physical treatments e.g., using compresses, sustaining proper positioning, etc., and many do not cooperate with some interventions, like nerve stimulators or acupuncture. Physical interventions are particularly helpful in older persons with musculoskeletal pain regardless of cognitive status. Psychological interventions usually require intact cognitive function e.g., relaxation therapy, self-hypnosis, etc. Demented patients generally lack the capacity to utilize psychological interventions; however, management teams should provide emotional support to validate the patients suffering associated with pain. Demented patients may experience more suffering from pain than intellectually intact individuals because they lack the capacity to understand the cause of their discomfort. Fear, anxiety, and depression frequently intensify pain. Pharmacological management begins with the least toxic medications and follows a slow progressive titration until pain symptoms are controlled. Clinicians must distinguish between analgesia and euphoria. Some medications that appear to have an analgesic or pain relieving effect actually have an euphoric effect, which diminishes the patients concern about perceived pain. The goal of pain management is to remove the suffering associated with the painful stimulus rather than making the patient euphoric or high to the point where they no longer care whether they experience pain. Euphoria-producing medications can cause confusion, irritability, and behavioral liability in patients with dementia. Narcotic addiction is not a common concern in dementia patients as these individuals have a limited life expectancy and rarely demonstrate drug-seeking behaviors. Pharmacological interventions always begin with the least toxic, i.e., least confusing, medications. A regular dose of acetaminophen up to 4 grams per day will substantially diminish most pain and improve quality of life. Clinical studies show that regular Tylenol reduced agitation in over half the treated patients. Chronic arthritic pain with inflammation of the joints may also respond to non- steroidal anti-inflammatory (NSAIDS) or Cox-2 inhibitors. The gastrointestinal toxicity associated with NSAIDS is greater than that of Cox 2 inhibitor medications. Patients who fail to respond to non-narcotic analgesics should receive narcotic-like medications, i.e., Tramadol. Patients who fail to respond to maximum doses of Tramadol, i.e., 300 mgs per day, may require narcotic medications.  

Family Communication Plan for Parents of Deaf Children

Family Communication Plan for Parents of Deaf Children There have been many studies conducted concerning children who are born into deaf families who can hear. These studies identify how parents manage this change in life and how they can make the best decisions that can positively impact their children and family. However, a limited number of studies have actually been conducted for children who are born into deaf families who can hear. Moore Lane (2010) state that 90% of deaf parents have hearing children, unfortunately these children have the same amount of attention compared to those who are deaf in hearing families. Purpose The purpose of this review is to establish a plan for children born into deaf families that can best help them and their parents, identify other studies and articles that have researched this, and to identify key gaps that are missing from the research. This study will explore family communication with emphasis on expressiveness, family satisfaction, and motivation. It will also identify how these concepts relate to the roles of interpreting and protecting. Research The research was conducted using the Cornett Library database online, which includes the CINHAL and MEDLINE databases, along with others. We limited our search to scholarly journals only and searched within a five year window so all data would be up to date and accurate. I searched for â€Å"deaf adults† â€Å"children with deaf parents†, and â€Å"nursing and deafness†. I chose the selected articles based on familiarity of ideas, and consistency of information, along with the minor disagreements that each article had. Themes Communication: There are many different theories that try to explain and solve the issue of communication of children and their deaf parents. Koerner and Fitzpatrick (2012) established a communication model by using relational observations. These analyzations created a theory that addressed the level of â€Å"conversational orientation.† Families with a high degree of conversational orientation tended to be able to freely communicate about any topic. This kind of communication led to high satisfaction within all family members. This theory states that every family is unique, so it is up to each separate family member to contribute to how they best like to communicate so their satisfaction is higher within the family, or environment. Olson (2011) used created the Circumplex Model of Marital and Family Systems and established a model that stated that communication, cohesion, flexibility, and family relationships are key to creating a healthy family balance. Expressiveness: With both theories, it is important for family members to express themselves with their own opinions and ideas to continue positive communication. Schrodt (2015) conducted a survey that questioned young adult children about their family communication. Schrodt (2015) states that the â€Å"perceptions of family expressiveness have a sizable, direct association with perceptions of family cohesiveness and flexibility†. Schrodt also voiced the when family members communicate effectively, it lowers stress within the family structure, and it also helps to lower the stress levels of members outside the family unit as well (Schrodt 2015). Cohesiveness is formed when family members commit to the idea that they are going to converse with each other about both the negative and the positive things that are happening to them as well as the other people within the family. It is also important that the flexibility within the family happens. This can only occur when each family member learns how to properly deal with the information that is being discussed. Family Satisfaction: The satisfaction family members have towards one another directly relates to the type of communication they have with each other. Burns Person (2011) conducted an online survey where two family members answered questions related to three categories: relationship talk, joking around, or summarizing their day. The study concluded that the three categories were predictors of the family’s satisfaction towards one another. A sense of unity was formed when family member discussed one of these three topics, and this led to a higher family satisfaction. Caughlin (2013) states that â€Å"a family’s satisfaction rate can be measured only by the family members’ standards they have set for themselves and their family as a unit.† This emphasizes that all families are different and although satisfaction can be generalized through the previously mentioned studies, these situations should be recorded and investigated more thoroughly, as every family communicates differently. Motives: Children communicate with their parents for many different reasons. Barbato, Graham Perse (2013) identified two key variables when children communicate with their parents: inclusion and control. Children will learn how to properly communicate with their parents because the main thing they truly want is to be included in their family’s conversations. Children should learn how to communicate with their parents so they can explain their ideas, ask questions and feel a sense of belonging. Also, children communicate to gain certainty with what is going on around them to feel more in control of their environment. Barbato, Graham Perse (2013) concluded that children are influenced by how their parents communicated. In the study, many children embraced the same communication habits as their parents. Limitations and Gaps All research studies have limitation that need to be considered. In the Burns and Pearson (2013) article they state that â€Å"future research should begin looking at families individually as units and then making comparisons with other family units to have a more accurate interpretation of ‘‘families’’ and not individuals. Complimenting these results with observations may also provide more validation.† Also in the Schrodt (2015) article, they state that the sample size that they used was too limited both in ethnic diversity and in number. This could have been easily corrected by expanding the number of individuals that participated and the different ethnic family that were included as well. Finally, Barbato, Graham, Perse (2013) states in their article that certain fundamental gap was noted after their study was performed with the age group of 12-16 year old females. There were only five female girls aging from 12-16 years old, compared to 20 childr en from every other age group tested, making this the weakest point in their study. Method Method Choice: In order to conduct my own inductive study, I would use a qualitative method throughout because I would be concerned about the effect family communication is impacted as a whole, not just only how the parent’s deafness impacts the family. Also, I would look for a similarity between the parents’ deafness and the family communication. I would study this by analyzing real participants it affects and in the actual environment with the communication occurs. To guarantee credibility, I would use three methods to form my data. The three methods I would use would be personal interview, focus groups, and ethnographic research. The ethnographic research would enable authentic reactions within a real life environment and provide a unique opportunity to view this interaction between a child and parent. Personal interviews could help better understand a person’s motives and feelings, and focus groups could help new ideas form. Sample Selection: For selecting a sample, I would use the Texas Association for the Deaf and receive a list of families that are living with hearing children and deaf parents. I would contact these families and explain my study and ask if they wanted to be a part of it. I would then choose a nonrandom sample of the participants that meet three criteria. First, they must be between 10 and 18 years old in order to answer all questions asked in the study. Secondly, they must live within a 20 mile radius of the Dallas Fort Worth area so I can properly and personally contact them all. Finally, both parents of the children chosen must be deaf. The minimum amount of families I would want to observe would be five. Overall, I would like to interview between 20 and 30 children Procedure: In the ethnographic research, I would only be an observer. I would witness applicants both in a public setting and at their personal home, knowing that the participants might act differently because of my presence. For personal interviews, I would have a pre-determined list of questions and would give opportunity to ask new questions depending on the direction of the interview. The interview is estimated to last between 45 minutes to an hour, depending on the extent of the participant. One question that I would ask would be, â€Å"Do you use regularly use voicing or sign language when you communicate with your parents?† In the focus group, I would use a facilitator who could both speak and use sign language. I would also take record the answers the participants stated and any other comments that could be useful concerning their communication within their family. After the data is collected, I would draw conclusions from it once it is interpreted and analyzed. Discussion and Conclusion The goal of this literature review was to establish a plan for children born into deaf families that can best help them and their parents, identify other studies and articles that have researched this, and to identify key gaps that are missing from the purposed research. Its intent was also to discuss family communication with emphasis on expressiveness, family satisfaction, and motivation. Overall, children with deaf parents can and do communicate with them every day. The goal, however, is to support and help them and their parents better communicate with each other in order to create a healthy and happy family dynamic. This will help within the nursing community by improving communication with deaf patients and will greatly help in healthcare service areas throughout the world. Though this is seen differently with each family because every family is unique, the goal is the same, and with more work and improvement in this field, we can make a difference and see lives changed. References Barbato, C., Graham, E., Perse, E. (2013). Communicating with the family: An examination of the relationship of the family communication environment and interpersonal communication motives. The Journal of Family Communication, 3(3), 123-148. Burns, M., Pearson, J. (2011). An investigation of communication atmosphere, everyday dialogue, and family satisfaction. Communication Studies, 62(2), 171-185. doi: 10.1080/10510974.2010.523507 Caughlin, J. (2013). Family communication standards what defining excellent family communication and how standards associated with family satisfaction? Human Communication Research, 29(1), 5-40. Koerner, A., Fitzpatrick, M. (2012). Toward a theory of family communication. Communication Theory, 12(1), 70-91. Moore, M., Lane, H. (2013). For hearing people only. Rochester: Deaf Life Press. Olson, D. H. (2010). Circumplex model of marital and family systems. Journal of family therapy, 22(2), 144-167. Schrodt, P. (2015). Family strength and satisfaction as functions of family communication environments. Communication Quarterly, 57(2), 171-186. doi: 10.1080/01463370902881650

Technology Advances Enterprise-Wide Planning Essay -- Technology Busin

Technology Advances Enterprise-Wide Planning Enterprise resource planning (ERP) systems utilize internal and external management information across an entire organization (Alshare & Lane, 2011). This systems embraces finance/accounting, manufacturing, sales and service, customer relationship management, and many more. The ERP system uses an integrated software application that helps the system to become automated. Its purpose is to facilitate the flow of information between all business functions inside the boundaries of the organization and manage the connections to outside stakeholders (Alshare & Lane, 2011). ERP systems typically include the following characteristics: a complex system that operates in real time without relying on periodic updates, a common database that supports all functions, a consistent model throughout each module and installation of the system without much hassle and development (Wixom, Watson & Werner, 2011). In 1990 Gartner Group first carried out the ERP as an extension of material requirements planning and ERP came to represent a larger whole, reflecting the evolution of application integration beyond manufacturing (Alshare & Lane, 2011). By the mid–1990s ERP systems addressed all core functions of an enterprise. Governments and non–profit organizations also began to employ ERP systems. The ERP systems experienced rapid growth in the 1990s because the year 2000 problem and introduction of the Euro disrupted legacy systems. Many companies took this opportunity to replace such systems with ERP. This rapid growth in sales was followed by a slump in 1999 after these issues had been addressed. The ERP systems, in the beginning, focused on automating back office functions that did not directly af... ...eed to take this into consideration. In the deployment presented in this paper, we have achieved ROI in both R2R control and FDC related to the early deployment phases. The APC technical and business models will allow organizations to complete the remaining phases, and migrate into new areas such as fault prediction and APC incorporation with yield management. References Alshare, K. A., & Lane, P. L. (2011). Predicting Student-Perceived Learning Outcomes and Satisfaction in ERP Courses: An Empirical Investigation. Communications of AIS, 2011(28), 571-584. Wixom, B. H., Watson, H. J., & Werner, T. (2011). Developing an enterprise business intelligence capability: The norfolk southern journey. MIS Quarterly Executive, 10(2), 61-71. Moyne, J. (2009). A blueprint for enterprise-wide deployment of advanced process control. Solid State Technology, 52(7), 35-37.

Capital Punishment Essay - Benefits of the Death Penalty :: Argumentative Persuasive Essays

Benefits of the Death Penalty Have you ever thought about if the person next to you is a killer or a rapist? If he is, what would you want from the government if he had killed someone you know? He should receive the death penalty! Murderers and rapists should be punished for the crimes they have committed and should pay the price for their wrongdoing. Having the death penalty in our society is humane; it helps the overcrowding problem and gives relief to the families of the victims, who had to go through an event such as murder. First, people should know the history of the death penalty. The death penalty has a long history dating back to the 16th Century BC. "In 16th Century BC Egypt, a death sentence was ordered for members of nobility, who were accused of magic. They were ordered to take their own life. The non-nobility was usually killed with an ax"(Burns). During the 18th Century BC, King Hammurabi of Babylon had a code that arranged the death penalty for 25 different crimes although murder was not one of them (Burns). The death penalty has been around since the time of Jesus Christ. Executions have been recorded from the 1600s to present times. From about 1620, the executions by year increased in the US. It has been a steady increase up until the 1930s; later the death penalty dropped to zero in the 1970s and then again rose steadily. US citizens said that the death penalty was unconstitutional because it was believed that it was "cruel and unusual" punishment (Amnesty International). In the 1970s, the executions by year dropped between zero and one then started to rise again in the 1980s. In the year 2000, there were nearly one hundred executions in the US (News Batch). On June 29, 1972, the death penalty was suspended because the existing laws were no longer convincing. However, four years after this occurred, several cases came about in Georgia, Florida, and Texas where lawyers wanted the death penalty. This set new laws in these states and later the Supreme Court decided that the death penalty was constitutional under the Eighth Amendment (Amnesty International). The very first legal executions came in the United States was during the Revolutionary War against Great Britain. British soldiers hung the first person to die by the death penalty, Nathan Hale, for espionage (Farrell).

The Change in Scrooge’s Character :: A Christmas Carol Charles Dickens Essays

The Change in Scrooge’s Character How does dickens show the change in scrooge’s character in ‘A Christmas Carol’, look closely at the language used and how this influences the reader In 1843 Charles dickens wrote ‘A Christmas Carol’ partly to make people aware of the terrible conditions of the children of the poor. In 1843 he visited the field lane ragged school and was appalled by what he saw there/ ragged schools catered for the very poorest, hungry children who roamed the streets, trying to teach them the basic skills of reading and writing. He had also been shocked by a parliamentary report by the children’s employment commission. Dickens was the most popular novelist of the day and he soon realized that far more people would take notice of the terrible conditions of the poor if he wrote about them in a story. ‘A Christmas carol’ was published on 17th December 1843 and by the 24th he had sold 6,000 copies. Dickens called it a most prodigious success., the greatest, I think, have ever achieved. ‘A Christmas carol’ is still widely read today and appears in many versions including illustrated re-telling of the story for young children. Hardly a Christmas goes by without a version of ‘A Christmas carol’ appearing on TV in one form or another. The name of the main character, scrooge, has come into general use in the English language meaning ‘a miserly or mean person’. In ‘A Christmas carol’ Dickens shows scrooge as an evil, nasty man by using a long list of adjectives, he’s described with this sentence â€Å"Oh! But he was a tight fisted hand at the grindstone, scrooge! A squeezing, wrenching, grasping, scraping, clutching, covetous old sinner! Hard and sharp as flint, from which no steel had ever struck out generous fire; secret, and self-contained, and as solitary as an oyster† Another way to show this is the way he talks to people, e.g. when his nephew invites him to his Christmas party but he turns him down and calls Christmas a ‘Humbug!’ and even worse, when 2 charity workers ask him for a donation for the poor children, he says send them to the work houses, if they would rather die they better do it, and decrease the surplus population. This shows how much of a cold hearted, covetous sinner he is. Dickens makes us feel like he’s an evil man, he’s selfish and says he’d rather the children die than donate his money to charity. When the ghost of Marley visited scrooge in the night, he was shocked, he first saw Marley’s face as the doorknob, then he was frightened further when the ghost of Marley opened the door from the outside when

LGBTQ Youth Homelessness

Cristina Oliveira Mark Barnes DATE   3 May 2018 LGBTQ youth homelessness The largest and de most powerful nation in the world the United States fell in taking care of their youth. Four million and two hundred thousand children and young adults don't have home in the United States. Youth Homelessness is a national crisis in urban, suburban and rural communities. Lesbian, gay , bisexual, transgender (LGBTQ) make up to only five to seven percent of the general youth population. Forty percent of homeless in the United states are LGBTQ. The statistics is not accurate because lots of them are living with friends they are called â€Å"couch surfing† frequently jumping from one house to another. Others are living with people trading sex for food and shelter. They are kids between 11-24 years old. How this situation starts? Surprisingly LGBTQ are bullied at home, rejected because of their sexual orientation or gender identity, physically, emotional or sexual abuse; aging out of foster care system, and financial and emotional neglect. The problems didn't stop there they are reject and are bullied also at school, in the workplace and social settings. They are kicked out of a family and society for being who they are and this trauma is a part of the lives of these young people. Kids need acceptance, they need experience an environment that supports them for being themselves.Family rejection leads to a host additional risk factors for LGBTQ youth, regardless of their housing status. For example, according to the Family Acceptance Project, LGBTQ youth who come from highly rejecting families are more than eight times as likely to have attempted suicide as LGBTQ peers with no family rejection.While homeless, LGBTQ youth are also at greater risk for traumatic experiences including: engaging in survival sex that often results in sexual assault, victimization, substance abuse, mental health problems, promiscuity, HIV, STDs, social violence, stigma and discrimination.

Adolescent Sexual Behavior Essay

Introduction Adolescent sexual behavior refers to sexual feelings, behavior, and development in adolescents. It is a stage of human sexuality. The sexual behavior of adolescents is influenced by their culture’s norms and mores, their sexual orientation and the issues of social control. Sexuality is a cultural issue. For humans, sex is a matter of cultural meaning and personal choice than biological programming. Costs and Benefits of Sexual Behavior According to a 2004 study, the rates of adolescent sexual intercourse and birth rates to teenagers in the United States have declined, but a majority of adolescents have been engaging in sexual intercourse before completing high school. 42% of high school students did not use a condom during their last sexual encounter and 14% engaged in sexual activity with approximately four partners. Reducing adolescent sexual activity and the risk for sexually transmitted diseases is a priority under Healthy People 2010, a set of health objectives for the nation to achieve over the first decade of the new century. (Deptula, Shoeny, Slavick, 35) Studies show that there is a link between sexual attitudes and sexual behavior. Attitudes are related to condom use and sexual activity is for both younger and older adolescents. Not surprisingly, high school students reported that positive attitudes toward sex were related to engagement in sexual activity. It was particularly concerning sexual pleasure. Worries about pregnancy and sexually transmitted infections were related to condom use. Theories suggest that attitudes are a key part in the process of making behavioral decisions. The Health Belief Model, a psychological model that attempts to explain and predict health behaviors, is determined by focusing on the attitudes and beliefs of individual. The Decisional Balance model postulates that behavioral decisions are made by assessing and comparing relative gains or losses associated with behavioral engagement. The factors include: costs for the individual and  significant others as well as approval from oneself and significant others. In a study that examined the Costs and Benefits of condom use it was found that the ratings for perceived behavioral costs of protection remained constant over time while perceived benefits of birth control and condom use were associated with behavior change. (Deptula, Shoeny, Slavick, 35) The relation between attitudes and sexual decision-making may also be influenced by the impact of demographic factors such as age, gender, and religion, on attitudes. Boys had more positive attitudes towards sex than girls and girls had more positive views of abstinence. Males also had more liberal attitudes towards premarital casual sex and anxiety, fear and guilt concerning sexuality. They were also more likely to report greater benefits associated with sexual activities than females. Despite the gender differences in attitudes, the beliefs that each held are important predictors for both males and females. Attitudes towards sex become more positive with age and the gender differences in attitudes decreased with age. When an analyses conducted to determine is attitudes words sexual activity were majorly associated with engaging in sexual behavior, it was revealed that adolescents who had never engaged in sexual activity reported more cost associated with intercourse and fewer benefits compared to those who were sexually active. Engagement in sexual activity was linked to a perception of lower costs and greater benefits for intercourse. The primary purpose of the study was to determine which two aspects of attitudes, cost and benefits, predicted parallel and future sexual activity. The effects of costs were equivalent, if not stronger than benefits. The study also suggested that the perception of costs and benefits were both influential in adolescents’ decisions to engage in sexual activity. Based on the theory of Decisional Balance, it is expected that adolescents who decided to engage in sexual activity would report fewer costs and greater benefits associated with having sex, which is somewhat supported by the study. When the likelihood of intercourse was 50%, the awareness of costs was greater than the awareness of benefits. It appears that although  costs still outweigh benefits, adolescents still engage in sexual activity, suggesting that there are other factors that play a role in the decision to have sex. (Deptula, Shoeny, Slavick, 41) The results of the studies have important suggestions for prevention. The start of sexual activity was predicted by both costs and benefits attitudes. Perception of costs was slightly more influential than benefits in prediction later sexual initiation. It is suggested that both of those dimensions be targeted in order to successfully delay adolescent engagement in sexual activity. In studying the costs, it was revealed that its main focus was on teenage pregnancy. The benefits included social status, personal pleasure and interpersonal connection. The study also revealed that females with high cognitive abilities reports more benefits associated with sex while males with lower cognitive abilities reported fewer costs. The Way Teens Define Sex There is certainly a divide between the teenagers of today and generations before them. The divide has to do with what each generation considers to be sex. According to research done by the Centers for Disease Control and Prevention, more than half of 15- to 19-year olds are engaging in oral sex. Adults say that is a form of sex, but teenagers do not see it that way. A 19-year old sophomore in college stated, â€Å"For most teens, the only form of sex is penetration, and anything else doesn’t count. You can have oral sex and be a virgin,† while most adults consider oral sex as something that is extremely intimate. Sarah Brown, director of the National Campaign to Prevent Teen Pregnancy said, â€Å"What we’re learning here is that adolescents are redefining what is intimate.† Teenagers view oral sex as something that is quite casual so it doesn’t need to be done while in a relationship. (Jayson, 1) Psychologist David Walsh stated that the brain is wired to develop intense physical and emotional attraction during the teenage years as a part of the maturing process and he is disturbed by the way that the media portrays casual sex because it gives teenagers a false image on true intimacy. (Jayson, 2) When a parent discovers that their child in engaging in oral sex, they aren’t sure what to think because of the way that teens are so nonchalant about it and parents weren’t usually doing that as teenagers. This could also be due to the fact that many parents do not believe that their child is the one who engages in such things. The definition of abstinence is changing as well. Everyone has a different definition of sexual abstinence. The most common meaning of sexual abstinence is not having any type of sexual intercourse. Abstinence is often linked with how recently a sexual behavior has occurred. If a certain sexual activity did not occur recently, many teens would describe themselves as abstinent, regardless of their sexual history, while others still define it as not doing anything sexual. It just depends on who you are. The Media’s Influence on Sexual Behavior The mass media is becoming the easiest way for young people to learn about sexual behavior and see it as well. Perhaps it is so influential because the teenage years are when we develop our own sexual beliefs and behaviors and parents are very reluctant to talk about sexual issues. The average adolescent spends six to seven hours using media ranging from television to books. That number could be higher by now because most adolescents now have televisions, computers, DVD players and some sort of audio system in their rooms and other parts of their homes besides their living rooms. Much of the media that adolescents are exposed to include sexual imagery but rarely portray consequences of risky sexual encounters or healthy sexual messages. Many health professionals believe that mass media content showing casual sex with no consequences has resulted in a host of negative behaviors among teens who may be persuaded that teen sexual activity is something â€Å"everyone† does.(Hart, 4) Although data shows that adolescents use media very frequently, mass media influences are rarely included as important contexts for adolescents’ sexual socialization. Researchers suggest that media influences showed consistent and significant  association with early adolescent sexual intentions and behaviors. Being male was associated with greater sexual intentions and activity. No religious variable in the study was associated with sexual intentions of behaviors. Perceived sexual permission from the media was also associated with sexual intentions, light sexual activity, and heavy sexual activity. (L’Engle, Brown, Kenneavy, 191) The findings of the study also showed that adolescents who are exposed to more sexual content in their media diets are more likely to engage in sexual intercourse in the near future. The media serves as a â€Å"super peer† for adolescents who wish to seek information about sexuality because it is easily accessible. It has also been said that the information that they receive from the media is different from what they learn from other sexual socialization agents such as parents, school and religion. Media programming rarely shows negative consequences from sexual behavior and depictions of condom and contraception use are very rare, making media users more likely to act the way that they see characters acting because they are seen as realistic and they are not punished for their behavior, making these behaviors convincing to adolescents. (L’Engle, Brown, Kenneavy, 191) Trends and Estimates of Sexual Activity Before getting into the details we must distinguish between sexually experienced and sexually active. Sexually experienced is a teenager who has had sexual intercourse at least once in his/her lifetime. A sexually active teenager is one who has had sexual intercourse in the past three months. The earlier an adolescent has sex, the longer he or she is at risk of pregnancy and contracting an STI. In 2002, approximately one-quarter of never married teenagers has had sexual intercourse before the age of 16. The number increased as age did. Some adolescents who have not engaged in sexual intercourse have engaged in oral sex.(Terry-Humen, Manlove, Cottingham, 3) Since many teenagers do not consider oral sex to be sexual activity, they probably do not concern themselves with the risks of this behavior. Due to  the fact that not many teenage relationships are long term, not all sexually experienced teenagers remain sexually active or are consistently sexually active. Those who are consistently sexually active put themselves at risk for pregnancy and contracting an STI each time they have sex or have sex with a new partner. (Terry-Humen, Manlove, Cottingham, 3) Being in a relationship that teenagers view as romantic is associated with a greater likelihood of having sex. Teenagers with older sexual partners are more likely to engage in sexual intercourse than those with similar age partners. Females are more likely to be in a steady relationship when they have sex for the first time. (Terry-Humen, Manlove, Cottingham, 4) In order to continue with having declines in teen pregnancy and lower the rising rates of STIs, it is suggested that messages of abstinence be reinforced, encourage teenagers to reduce the frequency of sexual activity and partners, educate them about the risks of oral sex, and expand interventions to high-risk populations, such as minority groups. (Terry-Humen, Manlove, Cottingham, 7) Conclusion When it comes to predicting later sexual activity, both Costs and Benefits are important, although attitudes concerning the costs were a bit more influential in predicting sexual activity. It is suggested that both Costs and Benefits be included to hinder sexual activity. Due to the way that every different generation was raised, the way in which we define sex is different to everyone. Baby-boomers see oral sex as something that is very intimate while teenagers see oral sex as something that is casual. The way in which some teenagers behave can end up hurting them in the future because they will not know how to have a long-lasting, healthy relationship. Adolescents who are exposed to sexual content in the media and obtain greater support from the media that is related to sexual behavior have greater intentions to engage in sexual intercourse and other sexual activities. The most obvious ways for teenagers to avoid STIs and unintended teenage pregnancy and childbearing is by delaying sexual initiation or reducing the sexual activity and number of sexual partners as well as improving contraceptive use of those who are sexually active. My Take In my opinion, I think that it’s great that people are trying to reduce the number of teenage pregnancies and STIs in teenagers. I don’t believe that a person should have to be abstinent until marriage or anything like that and I believe that contraception should be used at all times. It is very alarming that kids are having sex at younger ages. I’m with a lot of teens that say that oral sex is not really sex and I think it is due to the time period I’m growing up in. We’re desensitized to these things. I think that it’s important for parents to talk to their kids about sex, even though we probably know more than they think. Many kids I know, as well as myself, surprise our parents with how much we know about sex already because things were different when they were younger. Everything was more hush, hush then. The media is definitely a huge influence on the way that we live our lives today because sex is everywhere and it’s what sells.