The+Perversion+of+The+Pap+Smear

__**Name:**__ Challen Krichel __**Assessment number:**__ Assessment 3 WIKI **__Due Date:__** 4/11/2011 **__Subject Code:__** PUB209
 * __The Perversion of The Pap Smear: __**
 * __Student Number:__** n8276285
 * __Tutor's Name:__** Sarah Jordan


 * __Artefact: __**

Taken from: []

=**__The Artefact Explained: __**= This artefact illustrates a male doctor performing a Pap smear test on a female patient. This is a procedure that is conducted by swabbing a sample of cells from the cervix in order to test for abnormal cells that may indicate cervical cancer (Schick, 2010). For this reason, the exam is an extremely invasive procedure and women who partake in this inspection have the task of exposing their genitalia to a physician who is sometimes a complete stranger (Schick, 2010). As a result, ladies often find themselves feeling violated and upset after being given a pap smear by a male physician (Schick, 2010).

=**__The Name of my Public Health Issue Central to my Analysis: __**= The artefact above represents how culturally clued-in our primary and emergency health service providers are when it comes to sex. My topic specifically focuses on the importance of a culturally diverse approach to the delivery of medical assistance and healthcare relating to sexual issues. Through this analysis I will also focus on the delivery of pap smears within the context of cultures which forbid a male doctor from performing such scans on female patients. Finally, through making this evaluation I will justify reasons why it is important for cultural awareness to be a vital factor in the delivery and implementation of sexual health.

=**__My Literature Review: __**= Australian diversity was emphasized  when  the Department of Foreign Affairs and Trade declar ed <span style="color: windowtext; font-family: 'Times New Roman','serif';"> that one in four people living in Australia were born overseas (2011).In effect, <span style="font-family: 'Times New Roman','serif';"> it is important for cultural awareness to be a vital factor in the delivery and implementation of sexual health and safe sex messages in our multi cultural community <span style="color: windowtext; font-family: 'Times New Roman','serif';">. <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">In addition, Australian diversity was highlighted again by another governmental organisation when, the Australian Bureau of Statistics identified Vietnam as Australia’s second largest Asian birthplace for migrants today (2011). In effect, research illustrates that Vietnamese Governmental policy encourages the youth to respect that sex must only be practised within the legal institution of marriage (Nguyen and Liamputtong, 2010). In contrast, there are no standardized sexual groups set up by the Australian Government as sexual decisions are placed in the hands of the individual within the legal parameters of Australia’s common laws (Nguyen and Liamputtong, 2010). This variation causes issues for migrants living in Australia, especially in the Vietnamese culture because this way of life does not allow for the discussion of sexual issues within the family home, while most of the Australian culture does (Nguyen and Liamputtong, 2010). Consequently, unreliable information could be sourced by this culture’s youth from schools, magazines and the internet. Therefore, for health care professionals to effectively understand the needs of different cultures it is imperative for all young people (immigrants and citizens of Australia) to have adequate standardized sexual education so that informed choices about sexual health can be made when appropriate.

<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Furthermore, a journal article by Morton, Kim and Treise highlighted that issues related to sexual education are not just limited to foreigners living in Australia (2011). Another issue is that sexual education campaigns directed at preventing STDs, HIV and Aids are mainly directed at teenagers and middle aged adults (Morton, Kim and Treise, 2011). In contrast, the Centres for Disease Control and Prevention reported that 25% of the population living with HIV are aged 50 years and older (2011). What's more, it was found that although some individuals aged 50 years and older were aware of the risk of STD’s they were uncomfortable about seeking health information from their regular physician, as they felt the physician had the preconception that their patient had an inactive sex life or already gained this knowledge from life experience and age (Morton, Kim and Treise, 2011). These preconceived ideas will lead the patient to take certain health risks due to a lack of information being gained from their local health professional which could indirectly lead to an increase of HIV within our community. A similar approach of awkwardness towards gathering sexual information was highlighted in a research paper by Schick (2010). This paper also found that the Pap smear procedure is currently recommended by the American Cancer Society as the most effective means for detecting cervical cancer (Schick, 2010). Nevertheless, the known benefits of this exam are commonly outweighed by the patient’s concerns, as shown by the Australian Bureau of Statistics with up to 50% of women opting not to receive the procedure due to personal reasons. These reasons differ from person to person, however research suggests that the daunting task of making your privates public, often to the likes of a stranger, can be a definite deterrent (Schick, 2010). As a result, this part of the procedure can be classed as the most influential factor limiting participation. The reasons behind this could branch from social stigmatization which emphasizes that outside of intimate encounters, the exposure of the female genitalia is marginalized to sex workers, strippers and nude models (Schick, 2010). At the best of times this procedure can be embarrassing and research suggests that the act of undressing in the presence of a stranger who is about to examine you can lead to certain anxiety (Schick, 2010). In effect, evidence states that the anxiety experienced by women in response to a Pap smear exam may stem from a fear of pain, discomfort about discussing sexual activity, fear of genital abnormalities or concerns about personal hygiene (Schick, 2010). This anxiety is increased if the practitioner is a male as in most cultures the vagina is one of the most sexualized components of a woman’s body (Schick, 2010). Consequently, the Islamic and Muslim cultures have banned men from participating in gynaecological exams (Morton, Kim and Treise, 2010). I think the choice of refusing the participation of a male gynaecologist from participating in a female’s Pap smear in Australia would not be a cultural issue for new migrants as research by <span class="apple-style-span" style="font-family: 'times new roman','serif'; font-size: 16px;">Australia's National Agency for Healthand Welfare Statistics and Information <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">clearly demonstrates that 49% of doctors are female and it is commonly frowned upon for men to be involved in these kinds of exams (2011).

<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">In a research article by Vauclair and Fischer it was found that a person’s values were commonly seen as the motivations that guide, justify and explain their attitudes and behaviours (2011). It was also found that a person’s values can change over time but they are mainly influenced by religion, culture and their level of education (Vauclair and Fischer).Therefore, through understanding a patient’s values, a health care professional will be able to underpin their attitudes and behaviours towards gaining sexual information by evaluating the patient’s religion, culture and their education level on the specific topic being addressed. <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Meanwhile, females are the main cultural group that are affected by this public health issue. As a result, research involving a vast amount of blogs found a trend that emphasised that females were opposed to ever having a male gynaecologist participate in their Pap smear exam. The reasons behind this trend are based on the patient suspecting that the male physician would have ulterior motives, with the individual’s values and experiences being their foundation for their attitudes and behaviours towards this procedure. An example of this was seen when a lady stated that <span style="color: black; font-family: 'times new roman','serif'; font-size: 16px;">she would never, at any time, want to put herself in a situation where she might feel that the gynecologist was doing anything outside of the scope of the exam for their own personal pleasures, she also felt that a male doctor was more likely to do this than a female one (Little, 2008). Furthermore, another female stated on her blog that <span style="font-family: 'times new roman','serif'; font-size: 16px;">male doctors are still men and as a result through visiting a male gynaecologist for such an intimate exam like a Pap smear constitutes a violation of family life and molestation by a health official holding professional power over their patient and the public (JLS, 2004). <span style="color: black; font-family: 'times new roman','serif'; font-size: 16px;"> These blogs emphasize the need for public awareness about pap smears because this kind of information is causing a negative stigmatization towards the already sensitive topic of cervical cancer screenings. <span style="color: black; font-family: 'Times New Roman','serif'; font-size: 16px;">Public awareness for this issue is vital as <span style="color: #333333; font-family: 'times new roman','serif'; font-size: 16px;">Cervical cancer is the second most common cancer in women worldwide, with about 500 000 new cases and 250 000 deaths each year <span style="color: black; font-family: 'Times New Roman','serif'; font-size: 16px;">(World Health Organisation, 2011). <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">These annual statistics are alarming because the majority of cervical cancer fatalities could be preventable if they were detected in the early stages by procedures such as the Pap smear (Schick, 2010).Awareness for this issue is important because even though pap smears are an invasive procedure they are the only tool today that is available effectively and efficiently identify cervical cancer. As a result, health professionals need to focus on the comfort of their patient more by having it be a mandatory option for ladies to request if they want a male physician to be present at their pap smear or not.
 * __<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Cultural and Social Analysis: __**

<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">This picture subtly grasps the many factors involved in a pap smear done by a male practioner. One of these factors is the definite anxiety felt by the patient illustrated by the ladies’ toes being clenched and her hand being close to her genital area as if she was attempting to protect herself from the practioner. This image also depicts the practitioner as holding his medical instrument as if it were a weapon of some sort. The picture is a great case in point for my specific topic because it encompasses the vulnerability felt by the patient and the authority held by the physician. Also, I feel the physician looks unprofessional as he is not clean shaven, he is wearing denim jeans and his demeanour emphasizes an unprofessional and almost unclean physician. As a result, I feel that due to the lack of power being given to the patient and the amount of dignity that given up, it should be ban for males to participate in this procedure. Being a male, I have learnt about the vulnerability ladies feel when partaking in pap smears. I came to the conclusion that male gynaecologists should not be involved in pap smears because it only adds additional pressures to this already stigmatised procedure. I feel that in my career as a Paramedic I will request where appropriate if a female patient would want a female physician to examine her instead of myself because patient comfort is a always priority. __**Learning Engagement and Reflection Task:**__
 * __<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Analysis of the Artefact and my Own Learning Reflections: __**
 * __Subject:__** Definitely a great WIKI

__**Page:**__**//"Are You Sexy Enough for Sports?"//**

__**Word Count:**__ 200 words

=
I agreed with you when you mentioned that magazine articles like the one illustrated in your artefact portray women for their sex appeal instead of their professional talent. Also, I appreciated the fact that you commented on how this kind of publicity can lead to an increase of participation and interest by male viewers in female sports. As you said this participation could be for the wrong reasons and there is no doubt that there is gender inequality in the majority of sports but why would one want to attack an outlet for publicity that is actually improving the support for these sports? This is a viable outlet of the media because once male spectators have been to a professional fixture including these ladies it would be hard for them not to appreciate their professional abilities. In effect, through having these stars on display for the wrong reasons (sex appeal) male spectators would become definite fans of the sport for the right reasons (professional abilities) once they have witnessed these athletes in action. This feeds into the social theory that in the media sex definitely sells and the more publicity a sport gets the better it will do with spectators.======

__**<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">References: **__

<span style="font-family: 'times new roman','serif'; font-size: 16px;">Australia's National Agency for Health <span class="apple-style-span" style="font-family: 'times new roman','serif'; font-size: 16px;">and Welfare Statistics and Information. Australia's <span style="font-family: 'times new roman','serif'; font-size: 16px;">health <span class="apple-style-span" style="font-family: 'times new roman','serif'; font-size: 16px;">(2011). R <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">etrieved 20 October 2011 from http://www.aihw.gov.au/search/?q=doctors <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Australian Bureau of Statistics. (2011). Australian Historical Population Statistics. Retrieved <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">20 October 2011 from http://www.abs.gov.au/ausstats/abs@.nsf/mf/3105.0.65.001 <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Centres for Disease Control and Prevention. (2011). Global HIV/AIDS. Retrieved <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">20 October 2011 from http://www.cdc.gov/globalAIDS/default.html <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Department of Foreign affairs. (2011). Australia in Brief A divers people. Retrieved 20 <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">October 2011 from http://www.dfat.gov.au/aib/society.html <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">JLS. (2004, January 21). Re: Seeing a male gynecologist is adultery if not rape <span class="apple-style-span" style="font-family: 'times new roman','serif'; font-size: 16px;">[Online forum <span style="font-family: 'times new roman','serif'; font-size: 16px;">comment] Retrieved from http://www.gossiprocks.com/forum/laughs-oddities/109219-seeing-male-gynecologist-adultery-if-not-rape-wtf.html <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Little, T. (2008, September 9). Female vs. Male Gynecologist - Preference? [Online forum <span style="font-family: 'times new roman','serif'; font-size: 16px;">comment]. Retrieved fromhttp://www.thetfp.com/tfp/ladies-lounge/140037-female-vs-male-gynecologist-preference.html// //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Morton, C.R., Kim, H., Treise, D. (2011). Safe Sex After 50 and Mature Women’s // //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Beliefs of Sexual Health. //The Journal of Consumer Affairs, //45(3), 372–390.// //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Nguyen, A. H., Liamputtong, P. (2010). Culture and sex education: the acquisition of sexual // //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">knowledge for a group of Vietnamese Australian young women. //Ethnicity & Health, //15(4), 343 – 364.// //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Ripley, V. (2011). Promoting sexual health in women who have sex with women. In M.Taylor & J. Preston (Eds.), //Art & Science Sexual Health //(pp. 41- 46).////<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">New York, NY: Nursing Standard. // //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Schick, R. S. (2010). Examining the Vulva: The Relationship between Female Genital // //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Aesthetic Perceptions and Gynaecological Care. [Online Submission]. Retrieved from ProQuest Database. (UMI Number 3380327) // //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Scott, E.M. (2011) Risky Adolescent Sexual Behaviors and Reproductive Health in Young // //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Adulthood. //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;"> Perspectives on Sexual and Reproductive Health, //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;"><span class="skype_pnh_print_container">43(2) 110-118 <span class="skype_pnh_container"><span class="skype_pnh_mark">begin_of_the_skype_highlighting <span class="skype_pnh_highlighting_inactive_common"><span class="skype_pnh_textarea_span"><span class="skype_pnh_text_span">43(2) 110-118  <span class="skype_pnh_mark">end_of_the_skype_highlighting. doi: 10.1363/4311011 // //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">Vauclair, M.C., Fischer, R. (2011). Do cultural values predict individuals’ moral attitudes? A // //<span style="font-family: 'Times New Roman','serif'; font-size: 16px;">cross-cultural multilevel approach. //European Journal of Social Psychology.//41(1) 645-657. doi: 10.1002/ejsp.794 <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">World Health Organisation. (2011). Sexual and Reproductive Health. Retrieved 20 October <span style="font-family: 'Times New Roman','serif'; font-size: 16px;">2011 from http://www.who.int/reproductivehealth/topics/cancers/en/