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Gene study on depression’s origins

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HUNDREDS of genes have been newly linked to depression, shedding light on the origins of the condition and highlighting personality types that could be at risk.

The international study, involving more than two million people, is the largest of its kind. It could inform treatments for the condition, which affects one in five people in the UK and is the leading cause of disability worldwide.

Scientists led by the University of Edinburgh studied information pooled from three large datasets of anonymised health and DNA records and pinpointed 269 genes that were linked to depression.

They also used an innovative statistical method to identify sections of DNA that were common in people with depression and in those who adopted lifestyle behaviours such as smoking.

The findings suggest that depression could be a driving factor leading some people to smoke, but more research is needed to explain why, the team says.

Results also show that neuroticism – a tendency to be worried or fearful – could lead people to become depressed, which could shed light on personality factors that put people at risk. The statistical approach – known as Mendelian randomisation – allows scientists to look at how a condition impacts on behaviour, while ruling out other influences such as age or income.

Anonymised data, used with donor consent, is held by UK Biobank, the personal genetics and research company 23andMe and the Psychiatry Genomics Consortium.

Experts say that the study reflects the importance of data science in understanding mental health.

The study, published in Nature Neuroscience, was funded by the MRC and Wellcome.

Professor Andrew McIntosh, of the University of Edinburgh’s Centre for Clinical Brain Sciences, who led the research, said: “These findings are further evidence that depression is partly down to our genetics.

“We hope the findings will help us understand why some people are more at risk of depression than others, and how we might help people living with depression and anxiety more effectively in future.”

Sophie Dix, Director of Research at mental health charity MQ, who was not involved in the research, said: “This study adds to the weight of evidence that genes are one of the key risk factors in depression, which is also impacted by life events such as social environment and trauma. The value of this could really be seen when looking into the development of personalised treatments – a welcome step, given the dearth of innovation in identifying new approaches. We have seen very little advancement in nearly 50 years for people living with depression and right now the avenues available are not working for everyone.

“The power of this big genetic study is that it can point to systems in the brain which adds to our currently limited understanding in this area. By increasing our understanding of these systems, and how the social environment affects biological risk factors, we can begin to identify new targets for treatments that could help the millions of people worldwide affected by depression.”

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Urgent second dose vaccine appointments issued for mass vaccination centres

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SECOND dose Oxford AstraZeneca appointments for mass vaccination centres across Carmarthenshire, Ceredigion and Pembrokeshire have been urgently issued for week beginning 24 May, Hywel Dda University Health Board has confirmed. 

The health board has identified a technical issue that has caused a delay in appointment letters being issued to people who received their first Oxford AstraZeneca at a mass vaccination centre between Monday 8th March and Sunday 14 March.  

This issue has now been rectified and the health board has urgently posted appointment letters to everyone affected. SMS (text messages) have also been sent to those the health board has mobile numbers for.

 

The technical issue has also resulted in some people who had a first vaccine at a GP practice receiving an appointment inviting them to attend a mass vaccination centre. If you received your first vaccine at a GP practice you must attend your GP practice for your second dose to ensure the correct vaccine is available for you.  

If you have received an invite to attend a mass vaccination centre in error, there is no need to contact the health board as these appointments have automatically been cancelled. Please disregard the mass vaccination centre invite and keep your appointment with your GP or wait for them to contact you with your appointment time if you have not already received one.

Bethan Lewis, Interim Assistant Director of Public Health at Hywel Dda UHB, said: “As soon as we identified there had been a delay with second vaccine appointments being issued to people who had their first Oxford AstraZeneca vaccine at a mass vaccination centre between Monday 8th March and Sunday 14 March we immediately reissued all letters and sent SMS text messages wherever possible. 

“These appointments are due to start Monday 24 May so it is possible some people may receive their appointment letter late and we apologise for this but please don’t worry if this happens to you.   “If you receive your letter and the appointment has past, please contact our booking team on 0300 303 8322 so we can book you a new appointment. We will make sure you have your second appointment on schedule. Please wait to receive your letter before phoning us. We thank you for your understanding and patience.” 

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Withybush woes as new consultation launched

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• Health Board says coronavirus has had a major impact on services • New hospital could be built between St Clears and Narberth
• It’s a similar plan which led to protests involving thousands of locals in 2018

MORE than 18,000 people have signed the petition opposing the decision to downgrade Withybush General Hospital, but that was three years ago, and it seems that the health board may have forgotten the locals’ anger.

The health board is launching a consultation exercise to “deliver on our long-term commitment for a healthier mid and west Wales”

Steve Moore, Chief Executive of Hywel Dda UHB, said: “The global pandemic has had a major impact on all areas of our lives so it’s crucial that the health board considers, reflects and learns from this extraordinary period. This engagement exercise will allow the public to tell us in their own words how COVID-19 has affected their health and care, and access to it.

“I would encourage as many people as possible to participate.” 

Under similar proposals to those first unveiled in 2018 a new district general hospital would be built on the border between Carmarthenshire and Pembrokeshire providing A&E services, while in some of the options Carmarthen’s Glangwili hospital would also lose services, including A&E.

The people of Pembrokeshire protested. They protested outside the hospital, they marched through Town, they took their placards to the Senedd.

There was no one, it seemed, who wanted a new super hospital ‘up the line’.

Save Withybush Hospital protests back in 2018 in Haverfordwest

Ten months ago, the First Minister and Health Minister of Wales were united in their decision not to offer any reassurances to the safeguarding of A&E services at Withybush Hospital.

With the July 2020 u-turn of Cwm Taff health board not to remove services at Royal Glamorgan Hospital, the ministers have come under pressure to offer reassurances to the future of Withybush services.

Mark Drakeford said last summer that the decision was down to local health boards, with Vaughan Gething, Health Minister taking a similar stance.

Withybush has already seen the downgrade to its maternity services, with it now being a mostly daytime service with expectant mums with pregnancy complications or those giving birth after 5pm mostly having to travel across the border into Carmarthenshire to give birth. Other departments have also been shrunk on what locals call “a salami slicing away of local services”

Speaking at a Plenary last year Vaughan Gething, was asked by Pembrokeshire MS Paul Davies, the Welsh Government’s position on the delivery of A&E services at Pembrokeshire and if they would remain at Withybush.

Mr Davies said: “You’ll be aware, there is a strong campaign to retain A&E services at Withybush General Hospital.

“Given the recent news that Cwm Taff health board has decided to retain A&E services at The Royal Glamorgan Hospital, the people of Pembrokeshire are now looking at that decision and, quite rightly, asking for the same safeguards.”

The Health Minister said that the decision to overturn the removal of services at Royal Glamorgan Hospital, was made after they were able to recruit more staff which would help them safely deliver that service. Recruitment problems have often been cited as a key problem at Withybush Hospital in recent years.

Mr Gething said, “The member will also know, over a long period of time, the challenges that have been faced in delivering healthcare across Wales and the plans for the future delivery of healthcare.”

He added “The health board is now planning for the continued provision of essential and key services alongside caring for patients affected by Covid-19.”

However, although the Welsh Government is desperately trying to distance itself from its unpopular decisions on local health provision, the buck stops with it.

In November 2018 hundreds of people took to the streets to oppose the downgrading of Withybush. But now it is clear that the plan of a new hospital further away from Pembrokeshire’s population centres and industrial complexes is still on the cards.

Surprisingly, the exact cost of the new hospital, and its exact location, is yet to be determined but the health board is hoping to finalise a ‘programme business case’ in the coming weeks which will then be submitted to the Welsh Government this summer.

A full business case can be signed off by March 2024, The Pembrokeshire Herald understands.

Protestors outside Withybush at the 2018 protests

The health board has said the plan to reshape the way people receive medical treatment in west Wales is part of the “ongoing process” that is now under way with an engagement exercise running until June 21.

According to a new eight-page document published by Hywel Dda entitled ‘Building a Healthier Future After Covid-19’ the pandemic has been a “big challenge” which created an “extremely difficult” period.

The document, seen by The Pembrokeshire Herald, states: “We are progressing plans for a new hospital in the south of the area, somewhere between and including the towns of St Clears, Carmarthenshire, and Narberth, Pembrokeshire. At this early stage, we would welcome site nominations you may have and your views on how we compare possible sites.”

The health board is inviting people’s opinions on a post-Covid future in general and how healthcare is provided across the region today and in the future – pointing out that health and wellbeing centres have been opened in Aberaeron and Cardigan while plans are in the pipeline for similar facilities in Llanelli and Cross Hands.

While many aspects remain uncertain at this stage one thing that has been decided is that the new hospital is to be built between St Clears and Narberth because “this location is the most central to most of the population in the south of the Hywel Dda area”. The site will also have at least 35 acres of “developable land” with “appropriate transport infrastructure”.

A spokesman for the health board said: “The new hospital will be our main site for the network of all our hospitals, providing both urgent and planned care. It will enable us to have more consultants in permanent posts being available more of the time and specialising in areas of care. Consultant-led services will be available 24-hours a day seven days a week.

“We will provide rapid access to specialist assessment and treatment, discharging people as soon as possible so they can receive rehabilitation closer to home. Emergency and unplanned care will be provided in a different building to planned care therefore avoiding the disruption or delay that can occur from high volumes of emergency cases.”

The public is also being asked to nominate sites for a new hospital based on four criteria: (1) The nominated site must be within the zone between and including St Clears in Carmarthenshire and Narberth in Pembrokeshire. This location is the most central to most of the population in the south of the Hywel Dda area. (2) The nominated site should be a minimum of 35 acres of reasonably developable land. (3) The nominated site should have realistic prospects of obtaining planning permission for a new hospital. (4) There should be appropriate transport infrastructure for a major hospital site.

The health board said: “Anyone can have their say on the plans by emailing the health board at hyweldda.engagement@wales.nhs.uk or by calling 01554 899056.”

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Health

Update on local vaccinations for residents aged 18 to 39

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ALL adults aged 18 to 39 living in Carmarthenshire, Ceredigion and Pembrokeshire will be offered Moderna or Pfizer BioNtech for their first COVID-19 vaccine, Hywel Dda University Health Board can confirm.

Today’s announcement states, as a precaution, unvaccinated adults aged 30 – 39 years who are not in a clinical priority group at higher risk of severe COVID-19 disease, will be offered an alternative to the Oxford AstraZeneca COVID-19 vaccine, where possible.  This is already the case with adults under 30 years.

Fewer than 200 people under 39 are booked to receive a first Oxford AstraZeneca vaccine at the Picton Centre on Saturday 8 May. The health board is making every effort to contact everyone affected to offer a new appointment at a session offering the Moderna or Pfizer BioNtech vaccine.

All mass vaccination centres in Carmarthenshire, Ceredigion and Pembrokeshire will provide the  Moderna, Pfizer BioNtech and Oxford AstraZeneca vaccines. Please attend your appointment as planned as your clinic will have the appropriate vaccine for your age.

Ros Jervis, Director of Public Health for Hywel Dda UHB, said: “We understand that today’s announcement may cause some concern. The Oxford AstraZeneca vaccine is a safe and effective vaccine, cases of blood clots with low platelet counts continues to be extremely rare and is thought to be a reaction to first exposure.  The decision to stop using the Oxford AstraZeneca vaccine in those under 40 who have no clinical risk factors reflects the excellent progress we are making in bringing the pandemic under control and the increased supply of the Pfizer BioNTech vaccine. 

“If you have received a first dose of the Oxford AstraZeneca vaccine without suffering any serious side effects, it is recommended that you should complete the course and receive the second vaccine when invited, irrespective of age, in line with JVCI advice.”

The Oxford AstraZeneca vaccine has already saved thousands of lives and remains safe and effective for the majority of the population with over 1 million people have received the AZ vaccine since January.

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