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Sexologist Magnus Hirschfeld and Transgender Reassignment Surgery

(TRS)

Author: Nicoleta Dumitrescu


Co-authors: Lorena Elena Vatra, Ana Maria Tibuleac
Scientific Coordinator: Professor Anca Sava, MD, PhD

Introduction: Prior to the 20th century, trans people were included into the wide
group of sexually deviant people that described their behavior. Also, the society had
repressive attitudes towards the pathological sexual behavior. Grounded in a cultural-
historical approach, we investigated the Hirschfelds theoretical and practical
contributions to transgender reassignment surgery (TRS) in pre-Nazi Germany.

Materials and Methods: We search the medical, historical and sociological literature
on the importance of sexologist Magnus Hirschfeld in TRS.

Results: Magnus Hirschfel, a homosexual himself, argued that sexual orientation is


innate and not a deliberate choice, and developed a pluralistic theory of sexuality,
which claimed that most humans are not complete male or complete female, but
sexual variations naturally-occurring in human population, such as hermaphrodite,
homosexual, and transvestite. However, Hirschfeld was the first who introduced the
term "transvestite" in medical literature. In 1919, he founded the "Institute for Sexual
Science", the first of its kind in the world, designed both to deepen scientific
knowledge about sexuality and for sexual deviation therapy. Starting with 1922, some
experimental attempts at TRS were realized on Hirschfelds recommendation, but
these surgeries were simply removal of the sexual organs of the patient.
First complete male-to-female TRSs were reported in 1931. Due to intensive
advertising, the most famous case of a TRS, which increased the fame of the Institute
and its director, Hirschfeld, was the Danish artist Einar Wegener, who became a
woman named Lili Elbe. The operations consisted in castration, followed by
psychological tests conducted by Hirschfeld, then penectomy, transplant of human
ovaries and vaginoplasty.

Conclusion: Magnus Hirschfeld brought relevant contributions to sexology as an


academic discipline by his theory of intermediaries and naming new sexual
categories. Also, he was the first who supported the TRS that now become a part of
transvestites therapy

Keywords: Magnus Hirschfeld, Sexology, Transgender Reassignment Surgery


Palliative Care Survey Assessment in Medical Students at U.M.F. Gr. T.
Popa
Author: Daniela Frunza
Co-author: Professor Mihail Gabriel Dimofte MD
Scientific Coordinator: Vladimir Poroch M.D, Melindi Brink

Introduction: This study reports an analysis of survey data obtained from a sample
of medical students (n=151) from the Romanian, English and French sections
enrolled in the palliative care course at the University of Medicine and Pharmacy
Gr. T. Popa during the spring 2017 semester. We hypothesized that students with
prior coursework or internships in palliative care, or first-hand experience with
dying patients, would score higher in the pre-test survey assessment than others.

Materials and Methods: The survey consisted of 24 true-or-false statements


covering topics such as basic definitions, conditions of eligibility for palliation,
palliative care in relation to curative or active treatments as well as life-sustaining
treatments, timing of palliation, parties involved in decision-making, news-bearing
and communication, drug usage, palliative sedation, etc. Surveys were handed out in
the first week and last week of clerkship with the aim of comparing pretest and
posttest results.

Results: Subject areas with scores under 50% were noted as most problematic. Forty
percent agreed that palliative care can be given at any moment and stage of any
illness; 11% acknowledged that multiple hospitalizations or Emergency Room visits
warrant eligibility for palliative care; 37% disagreed that life-sustaining treatments
were specific to end-of-life care; 13% disagreed that it is not acceptable for
physicians to give uncertain information regarding a diagnosis or prognosis; 25%
disagreed that it is not important where the patient experiences dying and death as
long as optimal medical care is provided; 23% disagreed that opioids are first-line for
cancer pain; and 40% disagreed that late stage cancer requires higher caloric intake
than early stages.

Conclusion: For now, we conclude that the subject areas of palliative care eligibility,
life-sustaining treatments, news-bearing, place of dying and death, drug usage, and
caloric intake are unclear to medical students. This research is still in progress and
definitive results will be published later on.

Keywords: Palliative Care, End Of Life Care, Terminal Patient Care


Parents Who Refuse to Vaccinate Their Children, Make Their Decision
on an Uninformed Basis
Author: Petra-Caroline Mayaya
Co-authors: Dea Dobre, Maria-Luciana Loghinoaia
Scientific Coordinator: Associate Professor Liviu Oprea MD

Introduction: In a world with rapid access to all kind of information and theories, the
danger of being misinformed, due to lack of basic knowledge to understand
information or due to poor quality data is higher than ever before. Lately, the number
of people refusing to vaccinate their children or simply being against the concept of
vaccination has increased alarmingly. This is a significant issue on the grounds that
the effectiveness of immunization depends on the number of immunized persons in a
given community (herd effect). The present study is aimed at understanding why
some people oppose to vaccinate their children.

Materials and Methods: A survey was conducted among the Romanian population,
in order to determine the reasons and the sources of those refusing to vaccinate their
child.

Results: The results show that parental refusal in Romania is based on unreliable
sources, that range from inaccurate web articles to questionable public figures.
Furthermore, the majority opposing to vaccination, dismiss it firsthand, before even
talking to a specialist about it.

Conclusion: Identifying the reasons behind the refusal might help doctors to better
understand the parent and how to deliver the information in order to achieve their
primary goal as physicians, which is to give to their patient - the child, in this case -
the best care possible.

Keywords: Vaccine, Parental Refusal, Uninformed Decision


A Study of the Most Common Fears Regarding Organ Donation.
Author: Dea Dobre
Co-authors: Petra Caroline Mayaya, Luciana Loghinoaia
Scientific Coordinator: Associate Professor Liviu Oprea MD

Introduction: Organ transplantation raises significant ethical issues. There is a


shortage of organ donors all over the world. In the US alone one person is added
every ten minutes to the national transplant waiting list and other 22 die each day
waiting for a life-saving organ. This is due to peoples reluctance to becoming organ
donors, which in part is attributed to lack of information or even misinformation.
There is little scientific data with respect to peoples beliefs on organ donation in
Romania.
Therefore we propose a study that aims to understand peoples opinion regarding
organ donation. This may help debunk common misconceptions that lead to the
refusal of organ transplantation and donation.

Materials and Methods: We conducted a study by using an online survey to see how
many of the most popular myths are believed by the general public and whether they
play a significant role in the decision-making process. We collected data on the most
common misconceptions and potential fears regarding organ donation.

Results: Most people tend to be fine with the idea that their organs could be donated
after death but have a slight aversion to the idea of altruistic donation while still alive.
This may be due to the fact that humans generally fear any type of surgical procedure,
the pain and potential harm it can cause. We are including specific results extracted
from the questionnaire to address the exact issues people have expressed distress
about.

Conclusion: Educating people by offering detailed fact-based explanations on the


matter is most important, as they tend to react better to things that they fully
understand. Overcoming the natural human fear of invasive procedures may be one
way to combat the lack of organ donors.

Keywords: Vaccine, Parental Refusal, Uninformed Decision


Is It Acceptable For Healthcare Professionals to Befriend Their Patients
on Social Media?
Author: Wajeeha Rahmani
Co-authors: Anna-Maria Louka, Imane Bouazza
Scientific Coordinator: Reza Mohamed Parker MD

Introduction: For our generation, social media plays a pivotal role in everyday life, it
is a useful tool for communication and sharing information. Nowadays, having
contact online is frequent and considered normal. However, regarding healthcare
professionals, this can interfere with doctor-patient relationships. The aim of our
study is to gain an insight on the views healthcare professionals in Romania hold
about interacting with patients on specific social networks.

Materials and Methods: We conducted an original online questionnaire in January


2017, consisting of 8 questions, referring to the quality, frequency, and privacy of
social media usage. The survey was posted on various Facebook groups across
Romania. We got responses from students from all year groups as well as doctors,
obtaining a wide selection of views. Our questions were focused on Facebook.

Results: The survey was completed by 141 people of which 85.7% were Medical
Students within Romania; 94.6% revealed that they use their social media platforms
daily. More specifically, on the question Are your Facebook posts open to the
public? 6.1% answered that everything is public, where 33.3% mentioned that only
few of their posts can be seen by everyone. Furthermore, when asked whether they
accept patients friend requests, 52 individuals admitted to accepting.

Conclusion: Healthcare professionals should restrain themselves from initiating out


of office contact with patients unless there is professional reasoning behind it. They
should also realize that content posted on their social media can be interpreted
negatively by their existing and future patients as well as influence patient
compliance. Physicians should be trained how to tackle such issues regarding the
usage of social media. The distinct barriers of doctor-patient relationship must be
maintained under all circumstances.

Keywords: Survey, Doctor-Patient Relationship, Social Media


Mental Illness Stigmatization among Medical Students: A Survey-Based
Analysis
Author: Maria Orita
Co-author: Ruxandra Ionescu, Jyoti Anafack
Scientific Coordinator: Simona Ionescu, MD, PhD

Introduction: During their studies, medical students interact with different types of
patients, including mentally ill ones. These patients are more at risk of being
stigmatized because they can be perceived as different, unpredictable and violent.
This makes it harder for them to seek treatment and to get better. Since medical
students represent the next generation of professionals who are going to interact with
mentally ill patients, our goal is to research whether they stigmatize these patients and
to which extent.

Materials and Methods: We have sent a questionnaire to over 180 medical students
from Gr. T. Popa University of Medicine and Pharmacy in Iasi in order to assess
their understanding and knowledge of mentally ill patients. This research is based on
the views of students from the Romanian section of general medicine, from the 1st
year to the 6th year of study, on mental illness. We then statistically interpreted the
diagrams from the collected information.

Results: We found that stigma regarding mental illness is a problem among medical
students, regardless of the year of studies in which they are in, reflecting the
misconceptions of society in general about this issue. This offers the possibility to
address the prejudices against mentally ill patients by informing and educating
students from the beginning of their medical training.

Conclusion: The knowledge of medical students about mental illnesses needs to be


improved in order for them to appropriately take care of patients suffering from these
conditions when they will become doctors. Changing their perception will lead to
positive changes in their medical practice and in society in general.

Keywords: Mental illness, Stigma, Medical students


Educating GPs on the Importance of Early Detection and Screening in
Intimate Partner Violence
Author: Olaru Adina
Co-author: Lupu Loredana, Amaranducai Luminita
Scientific Coordinator: Damian Simona Irina MD

Introduction: Intimate Partner Violence (IPV) is an endemic problem worldwide. In


Romania, the problem is so pervasive that 1 in 3 women are victims of abuse from
their partner or husband. The issue is sometimes so normalized that it has only been
handled officially since 2014 and only in the framework of marital abuse. It is
therefore not surprising that many people are unaware of what constitutes violent
behavior and how they can get help. Furthermore, general practitioners (GPs), who
are often the first to come in contact with victims, frequently miss or ignore early
signs of abuse, either from lack of knowledge or because they feel unprepared to deal
with IPV. It is therefore vital to implement targeted training and screening to help
these physicians recognize and help people at risk.

Materials and Methods: We devised a survey to assess perception of IPV within the
general population and posted it on social media groups, receiving 1016 responses.
Furthermore, we performed a literature research on PubMed Central that yielded 22
relevant articles regarding the effect of family physician involvement in detecting
abuse.

Results: The answers were representative for the general population, with
respondents aged 16 to 68 years. Of those who were victims of abuse (32.3%), 35%
did not discuss with anyone because they were embarrassed, 17.39% were scared and
54.78% believed no one would care or help. From the literature research the most
common barriers for GPs in detecting IPV were: feeling unprepared or
uncomfortable, lack of time, patient unresponsiveness and not understanding their
role in IPV.

Conclusion: IPV is almost always detected when serious suffering has already
occurred. Considering the socio-economic impact of abuse and its extent nationally, it
is important that GPs train to recognize and screen for victims and provide the
psychological and informational support that they need.

Keywords: Abuse, Screening, Women


Behavioral Addiction among Students in Romania
Author: Ben Salem Mohamed Amine
Scientific Coordinator: Gallaby Kaisser MD, Alexandra Bolos, MD

Introduction: While most people will usually associate addiction with alcohol,
tobacco or other drugs, there is another type of addiction that is not related to any
kind of substance. Behavioral addiction is a very serious addiction and it is worldwide
spread.

Materials and Methods: Behavioral addiction is a very complex phenomenon with a


big diversity of morphologies and consequences. It can go from gambling to video
games, workouts, Internet, sex and so many other domains. This diversity made the
evaluation of the presence of such an addiction, the evaluation of risks and impact
among a given population so hard to make. All this did not stop us from at least trying
to identify the potential behavioral addictions present among the Romanian students
between the ages of 18 and 25. In this work we are identifying the most common ones
and how they do affect the students life from 4 perspectives: Socially, Economically,
Physically and Psychologically. We will also debate the association of substance
dependence to behavioral addiction and also the association of this kind of addiction
to certain kinds of personalities.

Results: This work will show us really how big is this problem among students, while
also giving us a potential to avoid it if we can associate it to certain conditions and
pre-existing problems and types of personalities.

Conclusion: We believe that the present technological boom is creating new kinds of
phenomenons that we are not used to, one of which is the behavioral addiction. It
might not be obvious but it certainly has an impact on our lives in general and we
think it is worth to study.

Keywords: Addiction, Behavior, Students


The Impact of Medical Awareness on Parents Decision to Vaccinate
Author: Ramascanu Elena-Ana
Co-author: Melindi Brink, Daniela Frunza
Scientific Coordinator: Professor Mihail Gabriel Dimofte MD

Introduction: Vaccinations dont just protect vaccinated children, but also those that
are too young to be vaccinated. Henceforth, vaccinations protects the community
from epidemics. Although the outcomes of vaccines are widely successful, the
effectiveness of it depends on the public readiness to comply. In recent years parents
started questioning the safety of vaccines, to the extent that some parents have even
refused to vaccinate children. Therefore the aim is to determine the degree of
knowledge parents have on vaccines to see where the medical community can educate
parents on the importance of vaccination.

Materials and Methods: A questionnaire of 23 questions were compiled to


determine the knowledge of the parents pertaining to vaccinations and vaccine
preventable diseases. The English questionnaires were posted on social media and the
Romanian questionnaires were handed out to parents in Sf. Maria Childrens
Hospital, Iasi.

Results: The data collected raised concerns that merely 16% of parents think that
childhood diseases are on the rise. Just 53% reported that a benefit of vaccines are to
protect children from vaccine preventable diseases and its complications.
Slightly less than half of parents think that recommendations by other parents, family
and friends are important. A great deal of parents greatly consider recommendation of
the pediatricians, which give an advantage to doctors to make an impact on parents
decision making. It was compelling to see that only 48% of parents know that by not
vaccinating it increases the risk of epidemiological outbreaks.

Conclusion: This study validated that a large percentage of parents dont have
sufficient information regarding childhood diseases and vaccinations, which doesnt
allow them to make fully educated decisions regarding vaccinating or not. The
medical community should take advantage that pediatricians have a great impact on
the parents decision to provide more accurate information regarding the benefits of
vaccinations.

Keywords: Vaccine, Childhood Diseases, Epidemics


Memory and Learning Outcomes: Influence of Structured Studies on
Neural Plasticity

Author: Amata Thongphetsavong Gautam


Co-author: Imane Bouazza
Scientific Coordinator: Professor Walther Bild, MD, PhD

Introduction: Studies made on correlations between music (specifically, playing


piano) and neural plasticity effectively show a cerebral activity difference in those
who practice an instrument. The present study has as purpose the investigation of the
initial hypothesis: The relation between structured studies and their effects on
memory and an increase of the ability to maintain a constant neural activity, leading
to a higher retention capacity. The relation between a structured/regulated routine
discipline should bemore-likely to lead to a better study-discipline.

Materials and Methods: Students from the National College of Arts Octav
Bancila, Iasi, Romania, of various ages and classes were taken as a test-group for the
study. The grades of the students were screened under strict qualificative and
quantitative parameters, offering a classification that allowed us to create statistical
data and correlate them to the initial hypothesis. A specifically-made questionnaire
was administered to the students, for confirming the understanding of some
influencing factors.

Results: Most students taken in the study, correlating their level through an evident
way of categorization grades were able to show a significant general average
grade, which was able to demonstrate the impact of playing an instrument on the
concerned students, in comparison to those who have not been under a Structured-
Studies system.

Conclusion: We aim to demonstrate the correlation between structured studies/


routine (extra-curricular activities e.g. music classes, sports at a high-level, arts) and
their potential impact on the development of some areas of the brain related to
memory/cognition. Equally, we will demonstrate how the conditioning of the mind to
an instrument or to a regular structured routine, brings discipline that has an impact
on the way the students learn (learning outcomes) and the potential neuroplastic
effects on the brain.

Keywords: Memory Testing, Memory Stimulation, Cognitive Evaluation


Is Suicide Moral? Soul, Rationality or Dogma?

Author: Diana Gabriela Scriminti


Co-author: Raul Alexandru Jigoranu
Scientific coordinator: Assistant Professor Cristina Furnica,MD, PhD;
Teaching Assistant Lacramioara Perianu,MD,PhD

Introduction: Suicide represents a complex humanistic matter, which raises legal,


philosophical, medical and religious issues. According to World Health Statistics,
over 800.000-people/year - commit suicide worldwide. Recently, appearance of
organizations in physicians assisted suicide (PAS, legal in the Netherlands,
Switzerland, Belgium, Luxembourg, Colombia, Canada and 5 USA states) has pushed
forward the legal and moral debates.

Materials and methods: We aimed at investigating whether suicide (including the


assisted one) could be considered immoral and/or proscribed. Additionally, our
concerns were which factors might contribute to the decision making behind the act
itself and to the vision of the society towards individual evaluations.

Results: There is strong division between points of view and acts of the society
regarding suicide.Whether we speak about a simple human being, or institutions (e.g.
the Church), or even the medical world itself, every actor acts like a judge who
prescribes justice for the individual actions. Particularly, as an example, concerning
the psychiatry spectrum, the approach on PAS differs and its justification depends on
individual laws. Theoretically, Mental Health Care should prevent suicides, most of
them being caused by irrational behavior. On the other side of the argument,
following a patients wish for PAS, under legal conditions, is a form of respect and
care, ending an eventual suffering (terminal disease, refusal of blood transfusion in
Jehovahs Witnesses etc.). Moreover, the cornerstone for discussing some of these
issues can be represented by philosophical currents. All these should be taken into
account.

Conclusion: Is suicide moral and to what extent remains an opened question. Current
moral dogmas, like the Hippocratic Oath or the Declaration of Geneva, preclude an
opened viewed of a part of the society. We will probably assist to a paradigm shift
during the next decades.

Keywords: Assisted-Suicide, Ethics, Meta-Analysis

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