UCC Journals (Univ. College Cork)
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Evaluating the efficacy and safety of MDMA for the treatment of Post Traumatic Stress Disorder: a systematic review
No full textBackground: Posttraumatic stress disorder (PTSD) affects approximately 5-7% of the population, with conventional treatments often proving inadequate for some patients. Recent studies suggest that methylenedioxymethamphetamine (MDMA) combined with psychotherapy may offer a novel therapeutic approach. This systematic review evaluates the efficacy and safety of MDMA-assisted psychotherapy for the treatment of PTSD in individuals with chronic, treatment-resistant forms of the disorder.
Methods: A comprehensive search was conducted in PubMed, OVID, Scopus, Cochrane databases, and select reference lists for randomized controlled trials (RCTs) evaluating MDMA as a treatment for PTSD. Eligibility criteria included RCTs with participants with confirmed PTSD diagnoses using standardized clinical assessments.
Results: In the RCT studies, there are significant reductions in PTSD symptoms (p<0.05) in those with MDMA-assisted psychotherapy compared to those with placebo and psychotherapy; dose-dependent improvements were observed in various measurements scales (specifically in CAPS-IV/CAPS-5 scores). Open-label trials further demonstrated improvements in PTSD symptoms when given MDMA-assisted therapy (p<0.05) and long-term analyses of studies demonstrated that effects of MDMA-assisted therapy were maintained for a minimum of 12 months post-intervention(p<0.05). Adverse effects were transient and mild to moderate, including anxiety, headache, fatigue, muscle tension, and insomnia.
Conclusion: Extant data suggests that MDMA-assisted psychotherapy for PTSD demonstrates significant symptom reduction, with sustained efficacy up to 12 months post-treatment. Functional unblinding is a major methodological challenge, which makes it difficult to interpret the magnitude of the effect MDMA has in the treatment of treatment-resistant PTSD. Future research should refine methodologies and explore long-term safety and efficacy in diverse populations
Public and patient involvement - a moral obligation in medical research
No full textPublic and patient involvement (PPI) is a research approach that can be defined as conducting research “with” or “by” the public as opposed to the conventional “on” or “to inform” the general public. PPI can involve members of the public being involved throughout the research process from establishing research priorities, through co-designing research methodologies, all the way to outcome interpretation and dissemination. In this article we seek to examine why PPI is a critical piece of the medical research puzzle by improving research planning, as well as providing the patient with a voice to foster impactful outcomes, and demonstrate why it not only generates fruitful research, but is a moral obligation for the individual
From bias to better care: cultural competency in primary care
No full textImplicit bias in healthcare significantly impacts patient care, especially in increasingly diverse populations. Primary care physicians, often the first point of contact for patients, play a crucial role in addressing these disparities. Studies show that implicit biases affect clinical judgment, treatment recommendations, and empathy, leading to poorer patient outcomes and satisfaction, particularly among marginalized groups. Cultural competency, encompassing awareness, attitudes, skills, and knowledge, is vital for delivering equitable and patient-centered care. However, many physicians feel unprepared for intercultural interactions, with nearly half lacking formal training in cultural and linguistic competency during medical education. This deficit perpetuates disparities in diagnostic evaluations, adherence to treatment, and health outcomes.
By prioritizing cultural competency in primary care, healthcare systems can reduce disparities, improve patient satisfaction, and ensure holistic care. Advancing these initiatives is essential to achieving health equity and better outcomes for marginalized populations
Cultural and ethical considerations in Obstetrics and Gynaecology - a narrative review
No full textThe field of obstetrics and gynecology (OBGYN) is integral to women\u27s health, encompassing preventive care, pregnancy, and reproductive health. However, significant cultural, racial, and ethical challenges persist, impacting patient outcomes and equity. This narrative review highlights key issues in OBGYN care, including disparities driven by communication barriers, racial bias, and restricted access to reproductive services. The relationship between language discordance and obstetric trauma for non-English speakers, emphasizing the need for interpreter services and bilingual proficiency among providers. Racial bias manifests in higher maternal mortality rates for Black women and inadequate pain management due to unfounded beliefs about biological differences. Ethical challenges also arise, concerning access to abortion and prenatal screening services, with wide global variation in legislation and implementation. In Ireland, restrictive laws and a lack of universal non-invasive prenatal testing (NIPT) highlights barriers to informed decision-making. Future directives emphasize fostering diversity in healthcare teams, implementing educational programs to address stigma, and advocating for inclusive policies that ensure equitable care. By addressing these challenges, OBGYN care can evolve to reflect the principles of equity, representation, and inclusivity, ultimately improving outcomes for diverse patient populations
Differences between the clinical manifestation of adult-onset and childhood-onset Systemic Lupus Erythematosus
No full textIntroduction: Systemic lupus erythematosus is a multi-system autoimmune disorder that affects approximately 1500 people in Ireland. The cause of SLE is multifactorial and involves genetic, environmental, and hormonal influences. Most commonly diagnosed in women (10:1) and between ages 15–44, international studies have shown differences between childhood-onset SLE (COS) and adult-onset SLE (AOS), however, no such research exists in Ireland.
Methods: This retrospective cohort study analysed patient records from Cork University Hospital’s (CUH) Rheumatology Department (November 2023-June 2024). A convenience sampling method was used, and eligible participants were identified from the hospital database of referral letters. Categorical variables of symptoms and autoantibodies were analysed using Fisher’s exact test and logistic regression for significant findings.
Results: A total of 71 patients (COS = 24, AOS = 47) were included in this study. The mean age at diagnosis was 28.01 ± 11.57 years. Malar rash was significantly more common in COS (17, 70.8%) compared to AOS (17, 36.2%). Polyarthritis/polyarthralgia was significantly more prevalent in AOS (43, 91.5%) than in COS (7, 70.8%). While autoantibody profiles revealed no significant differences, low complement C4 levels were significantly more prevalent in COS (16, 66.7%) compared to AOS (15, 31.9%). Finally, Lupus Nephritis, while also insignificant, was also more prevalent in COS (11, 45.8% vs 17, 35.2%).
Conclusion: The higher prevalence of malar rash and complement deficiency in COS suggests a more pronounced immune response in younger patients. Although statistically insignificant, trends such as higher fever incidence increased lupus nephritis rates in COS highlight areas for further research. These findings increase the understanding of SLE in Ireland and underscore the importance of age-specific considerations in diagnosis and management. Future multicenter collaboration could offer deeper insights into regional variations and help refine treatment approaches
2024 Society for Italian Studies (SIS) Postgraduate Colloquium: "Memory and Italian Culture"
No full textEvent: 2024 Society for Italian Studies (SIS) Postgraduate Colloquium &#x201C;Memory and Italian Culture&#x201D;Venue: University College CorkDate: 6 December 202
Anarchyism and Democracy: A Conceptual Analysis
No full textThis paper is a conceptual analysis of anarchy/ism and democracy, the aim of which is to assess the compatibility between the two concepts. By conceptually outlining anarchism and the history of democracy as a word, the paper presents that both anarchism and democracy, in its radical form, attempt to achieve self-government. It submits \u27radical democracy\u27 as a nuanced, reconciling bridge between the two concepts to that aim. From the perspective of the models of democracy, radical democracy is seen as a mix of the \u27best\u27 features of the participatory and deliberative frameworks. Connected to this above all is the literature content of Charles D. Lummis (1996) and Lincoln Dahlberg (2012) on the topic of radical democracy. The anarchist scholarship is divided regarding the compatibility between anarchy/ism and democracy. The pro-democracy arguments are often reduced to viewing anarchism as radical democracy without the state in the likes of David Graeber or Wayne Price. The anti-democrats purvey democracy as another form of rule requiring abolishment (Markus Lundstr&#x00F6;m, 2023; William Gillis, 2020). Inspired by the perspective of Amedeo Bertolo (1999) and Laurence Davis (2020), this article takes position that anarchism is the most radical form of democracy while anarchy goes beyond it. In outlining radical democracy\u27s three main characteristics - (i) maintaining political power among the people, (ii) radical extension of equality and liberty, (iii) challenging oppressive power relationships - the rest of the article reviews some anarchist, anti-democratic arguments presented in the written Mutual Exchange Symposium, titled \u27Anarchy & Democracy\u27 and organised by the Centre for a Stateless Society in 2017 (republished in 2020). In doing so the article offers three main, novel, a priori arguments in favour of the pro-democracy camp on the level of theory by elaborating on the aforementioned characteristics
Review: Kincora: Britain’s Shame — Mountbatten, MI5, the Belfast Boys’ Home Sex Abuse Scandal and the British Cover-Up, by Chris Moore
No full textEoghan Fitzgerald reviews Kincora: Britain\u27s Shame — Mountbatten, MI5, the Belfast Boys’ Home Sex Abuse Scandal and the British Cover-Up (2024), written by Chris Moore and published by Merrion Press (ISBN: 9781785375545)