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Important step for Welsh cancer treatment

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THE FIRST NHS Wales cancer patient to receive proton beam therapy in Wales has started treatment at the Rutherford Cancer Centre South Wales in Newport.

The Newport centre is approved by the Welsh Health Specialised Services Committee (WHSSC) to provide high energy proton beam therapy to adult patients, referred from the NHS in south Wales.

Professor Roger Taylor, Senior Clinical Advisor and Consultant Clinical Oncologist at the Rutherford Cancer Centre South Wales, said: “The availability of proton beam therapy at a local clinic is an important step forward in cancer care in the UK and we are pleased to be able to provide treatment for this young man.

“Whilst proton therapy is not a panacea for all types of cancer, we have seen where it can be beneficial in treating a range of tumours. Working with the NHS in Wales means that adult patients have an option to be treated closer to home.”

Jamie Powell, Centre Manager at the Rutherford Cancer Centre South Wales, said: “Providing access to the Rutherford Cancer Centres for NHS patients is something we have been working towards and we are pleased to announce this on World Cancer Day. Our centre and services in Newport are supported by NHS Wales clinical, hospital and research facilities and we look forward to continuing to provide excellent care in a high-quality and technologically advanced environment.”

The Rutherford Cancer Centre South Wales was the first clinic in the UK to provide high energy proton beam therapy and treated the first non-NHS patient with high energy proton beam therapy in the UK in April of last year.

Rupert Lowe, chairman of Proton Partners International, said: “As someone who had to travel abroad to receive proton beam therapy, I am delighted to be reporting on World Cancer Day today that the situation is changing at last in the UK.

“We were extremely proud to treat the first proton beam therapy patient in the UK last April and scores more have benefited from this treatment without having to travel abroad. We are also pleased to see the development of proton beam therapy facilities within the NHS.

“We are delighted to have been commissioned by health commissioners in Wales to treat adult NHS patients with proton beam therapy and are very proud that our first NHS patient began treatment today.

“The UK Government recently set out an ambitious 10-year plan for the NHS which includes major commitments to tackling cancer. We firmly believe that given the magnitude of the challenge, a collaborative approach among healthcare providers will achieve the best results for patients.”

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Health

The challenge of loneliness

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Living with loneliness: An issue for public health and society

INTERNATIONAL experts, including researchers from Swansea University, have published a letter in The Lancet medical journal calling for a unified approach to addressing the global challenge of loneliness.
In response to the growing concerns about the rates and consequences of loneliness, international experts based in universities, research and public health organisations have been working together to help address this issue.
The signatories include experts from the Institute of Public Health in Ireland; Columbia University; George Mason University; University of Auckland; Swansea University; Ulster University; St James’s Hospital; University of Chicago; Trinity College Dublin; Boston College; University of California; Vrije Universiteit Amsterdam; and Brunel University London.
The letter is based on discussions of international researchers at a meeting hosted in Belfast by the Institute of Public Health in Ireland. This has led to the establishment of an International Loneliness and Social Isolation Research Network.
While demographic shifts suggest that the number of people experiencing loneliness will increase, experts say that it is important to recognise that most older adults are not chronically lonely and that young adults are also affected.
Experts say that loneliness can be defined as a “subjective negative experience that results from inadequate meaningful connections”, and have called for a standardised approach to defining and measuring loneliness to help inform those developing policy and services in this area.
The expert group added that charities, community sectors, and governments, who are delivering programmes often have inadequate evidence to plan from and need a more coherent message from research, and a stronger evidence base.
And while more research is needed to find out the full consequences of loneliness, the evidence shows association with poor health and wellbeing, non-communicable diseases, and depression.
Professor Vanessa Burholt from the Centre for Innovative Ageing, in the College of Human and Health Sciences at Swansea University, said that in a time when as a society we have never had more opportunities to connect with people, there is a growing focus on loneliness and its association with poor health outcomes.
She said: “Our understanding of loneliness is still limited and is often stereotypical. While it is often confused with a lack of social engagement, the reality is that some people with lots of friends can still feel lonely and those who live alone may not.
Although loneliness is a very personal experience, addressing loneliness is not simply a matter for individuals but is also an issue for public health and society as a whole. By building evidence and pooling expertise, we can support governments and policymakers to make better-informed decisions to address this challenge.”

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Protect your children from flu

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Protect your children from flu

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CAT1i-17.jpg – Flu vaccination: ‘Really important’ protection for children

Story:
PARENTS in Pembrokeshire are being urged to protect their children against flu
Flu is circulating and parents of 2 and 3-year-olds in Pembrokeshire are being asked to ensure their children receive the nasal spray flu vaccine as soon as possible.
Flu can be serious for children and every year children in Wales need treatment in Intensive Care Units because of flu. If you are in a risk group and think you have flu, it is important to speak to your GP surgery or community pharmacy as soon as possible.
Ros Jervis, Director of Public Health at Hywel Dda UHB, said: “We are starting to see more cases of flu so it is really important that as many of our youngest population are protected by the nasal spray vaccine.
“Having a flu vaccine will help protect your child from flu and protection starts around two weeks after having the vaccine.
“It also helps reduce the chance of children spreading flu to others who are at high risk from flu, such as young babies, grandparents, and those with long-term health conditions.”
If your child was aged 2 or 3 years old on 31 August 2019 contact your GP as soon as possible to book an appointment.
If you think you may have flu you can check your symptoms using the NHS Direct Wales symptom checker.

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Research breakthrough in schizophrenia

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WHAT comes to mind when you hear ‘schizophrenia’? Hallucinations and delusions? Cognitive impairment? Feeling withdrawn from everyone around you? Apathy? With all the above being symptoms of this mental disorder, and with 1 in every 100 people affected, each individual’s life becomes a relentless battle, struggling with habitual activities, social interaction, and general wellbeing and self-care.
Current treatments help to reduce the severity of symptoms and allow patients to maintain a more functional daily life. However, antipsychotic medications, which are typically required lifelong, are not guaranteed to work for all schizophrenia patients, with only about 4 in 5 people benefitting usually.
Advances in scanning have allowed researchers for the first time to show lower levels of a protein found in the connections between neurons in the living brains of people with schizophrenia.
The researchers, who conducted the scans at the psychiatric imaging facility at the MRC London Institute of Medical Sciences, say these changes could underlie the cognitive difficulties seen in schizophrenia and provide targets for research into new treatments.
Synapses are the junctions between neurons. Neurons communicate across the synapse via neurotransmitters; chemicals that transmit the nerve signal.
Researchers investigated the relationship between synaptic density and schizophrenia, questioning whether a reduction in these brain connections is present in schizophrenia and whether they result from treatment with antipsychotic drugs.
The study was inspired by findings from previous post-mortem studies that demonstrated synaptic reductions in the brains of schizophrenia patients compared to healthy controls.
Measuring synaptic protein levels in living patients was not possible before the development of a new PET (Positron Emission Tomography) radioactive tracer that binds to a specific protein associated with synapses. Being “one of the first centres in the world” to have access to this, Professor Oliver Howes, Head of the Psychiatric Imaging Group at the MRC LMS, and his team grasped this opportunity to investigate synaptic loss in schizophrenic brains through the synaptic marker protein SV2A, which is found on the nerve terminal preceding the synapse and is involved in regulating neurotransmitter release.
The team found lower levels of SV2A in the brains of schizophrenia patients, indicating a reduction of synapses. Certain areas exhibited significantly lower levels, such as the frontal cortex which coordinates use, recall and processing of memory, planning complex cognitive behaviour and personality expression. These findings were supported by the understanding that these areas are associated with some of the major cognitive impairments seen in schizophrenia, thus providing a potential clue that synaptic loss may underlie these problems.
But to test whether the loss was a result of the illness or in fact due to treatment, a preclinical study was conducted in rat models investigating the effect of antipsychotic drugs on the levels of SV2A. They found that the antipsychotics did not contribute to the synaptic loss seen in schizophrenic patients, thereby reinforcing their overall findings.
So, what does this mean for the development of schizophrenia treatment?
If the synaptic loss is an underlying key contributor in the disease, further research into the mechanisms could lead to exploring ways to prevent this loss. Moreover, since microglia, known as the immune cells of the brain, play a role in mediating synaptic pruning, there is also potential to target microglia and see if it could introduce a way of preventing excess synaptic loss; an investigation that the team have already begun.
“The human brain, with its approximately 100 trillion synapses, is an extraordinarily complex organ,” says Dr Ellis Chika Onwordi of the Psychiatric Imaging Group and first author of this study. “Having the means to characterise the distribution of these synapses in the living brain, and to find differences in synaptic distribution between patients with schizophrenia and healthy controls, represents a significant advance in our ability to study the neurobiology of schizophrenia.”
Professor Oliver Howes, who led the study, said: “Our current treatments for schizophrenia only target one aspect of the disease – the psychotic symptoms – but the debilitating cognitive symptoms, such as loss of abilities to plan and remember, often cause much more long-term disability and there’s no treatment for them at the moment. Synaptic loss is thought to underlie these symptoms.
“Our lab at the MRC London Institute of Medical Sciences is one of the few places in the world with this new tracer, which means we’ve been able for the first time to show there are lower levels of a synaptic protein in people with schizophrenia. This suggests that loss of synapses could underlie the development of schizophrenia.
“We need to develop new treatments for schizophrenia. This protein SV2A could be a target for new treatments to restore synaptic function.”
The people with schizophrenia who were scanned had all received antipsychotic medication, so the researchers wanted to exclude this as a factor in the synaptic dysfunction. They gave antipsychotic drugs, haloperidol and olanzapine, to rats for 28 days and found it did not affect the levels of the protein SV2A.
Professor Howes said: “This is reassuring as it’s suggesting that our antipsychotic treatments aren’t leading to loss of brain connections.
“Next we hope to scan younger people in the very early stages to see how synaptic levels change during the development of the illness and whether these changes are established early on or develop over time.”

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