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Inside Health

BBC

Description

Dr Mark Porter demystifies health issues, separating fact from fiction and bringing clarity to conflicting health advice, with the help of regular contributor GP Margaret McCartney
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Shielding%3B+Pandemic+Lexicon%3B+Southampton+Hospital%3B+Doctor+rejects+NHS+Superhero+Tag
access_time8 days ago
Tanya has rheumatoid arthritis, a compromised immune system and heart problems. Getting the virus is a risk she cannot take and this is the tenth week that she's been isolating at home with her husband and teenage daughter. But how long will this last and will she have to self isolate in her own home away from her family for the foreseeable future, if her daughter goes back to school? Tanya talks to Claudia about the impact of the pandemic on her life and says why those in the shielding group must not be forgotten.

The arrival of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in the human population has popularised vocabulary that was previously the preserve of scientists and medics. In just a matter of weeks, phrases like the R Number, Herd Immunity, Case Fatality Rate and All Cause Mortality have become part of everyday language. A new pandemic lexicon has emerged. Inside Health regular Dr Margaret McCartney and Professor Carl Heneghan, Director of the Centre for Evidence Based Medicine at the University of Oxford, discuss the meanings of these very precise descriptions and reveal their personal bugbears, the misuse of such terms.

And in her final visit for this series to University Hospital Southampton, Inside Health's Erika Wright, talks again to Trevor Smith, Divisional Director for Medicine, about the enormous challenges ahead as the hospital adapts to living with Covid-19. And she talks about the Banksy art work currently hanging at the hospital which reveals a Super Nurse displacing the traditional comic book superheroes, Batman and Spiderman.

Healthcare workers have been lionised as heroes, putting themselves on the front line, risking their own lives, to save others. It's a sentiment which troubles some. Dr Michael FitzPatrick, a gastroenterologist in Oxford and Co-chair of the Royal College of Physicians Trainees Committee, describes why heroes are almost entirely the wrong comparators for healthcare workers.


Producer: Fiona Hill
Longest+Stay+Covid-19+Patient%3B+Health+Inequalities%3B+Agoraphobia%3B+Covid-19+Testing
access_time15 days ago
Claudia Hammond on the longest known stay for a Briton with COVID-19 in intensive care. A month ago Respiratory Physiotherapist Gemma Bartlett at University Hospital Southampton highlighted the case to Inside Health. At that stage the patient was at day 28: now Erika Wright catches up with Gemma again for a good news update on the patient who is at a staggering 58 days on a ventilator and has been speaking for 3 weeks. There are many unknowns about COVID-19 but one aspect that is not disputed is how the virus has laid bare pre-existing health inequalities. It does not effect us all in the same way and those with underlying health conditions such as heart disease, obesity and diabetes are at a higher risk of poorer outcomes if they get the virus. Linda Bauld from Edinburgh University and Chair in Behavioural Research at Cancer Research UK says this is the time to reset the health inequalities clock. And Laura Bartley, who began having severe symptoms of agoraphobia five years ago, explains her experience of lockdown. Plus resident sceptic GP Margaret McCartney explains her concerns about the current Covid-19 testing strategy.
Acute+Kidney+Injury+with+Covid-19%3B+Passive+Immunisation%3B+Online+GPs%3B+face+mask+interactions
access_time22 days ago
There are a number of complications following infection with Covid-19 that doctors are continuing to find in hospitals. One of the most significant is an acute kidney injury or AKI which can come alongside the disease and NICE has just published rapid guidance to help healthcare staff on the Covid frontline who are not kidney specialists. Inside Health’s Erika Wright has been following staff at Southampton General Hospital during the coronavirus outbreak and meets Kirsty Armstrong, Clinical Lead for Renal Services, to discuss managing kidneys and Covid.

Could injecting blood donated from a patient who has recovered from Covid 19 into someone who is ill help the recipient recover too? It’s a potentially viable treatment with a long history, known as convalescent plasma therapy, and trials of this technique against Covid are beginning around the world. We hear from Jeff Henderson, Professor of Medicine at Washington University in St Louis, on progress in the world’s largest trial of this passive immunisation against the virus in the US, and from James Gill, Honorary Clinical Lecturer at Warwick Medical School, who’s been following the latest game-changing refinement of this therapy.

Just as the rest of us have been getting better at zoom meetings and remembering to unmute ourselves when we want to speak, so have GPs who are now getting rather good at having online consultations. Will this change the way we “go to the doctor” forever or is there sometimes no substitute for face to face contact? Dr Margaret McCartney gives a GP’s insights.

As more people begin to wear face masks what kind of impact does it have on communication when a person’s mouth is covered up and it’s hard to tell whether someone is happy or cross? Claudia discusses this question with George Hu, a clinical psychologist in Shanghai where masks have now become ubiquitous, and Alexander Todorov, Professor of Psychology at Princeton University and author of the book “Face Value : The Irresistible Influence of First Impressions”. Are we more versatile in interpreting a masked person’s mood or intentions than we think?

Producer: Adrian Washbourne
Diabetes+%26+Covid-19%3B+Southampton+Critical+Care%3B+Antigen+Tests%3B+Cytokine+Storm
access_time29 days ago
Evidence from China, Italy, the USA and now the UK shows categorically that people with diabetes can get seriously ill if they're infected with the new coronavirus. Researchers are trying to untangle the risks for Type 1 and Type 2 but so far, diabetes isn't included in the government's high risk patient group. NHS England's National Specialty Advisor, Professor Partha Kar, tells Claudia Hammond that he believes an individual risk calculator which will enable people to work out their own risk, and so shield themselves accordingly, will be the best way forwards. In the meantime, Dr Kar says, glucose control is essential and people should check their ketone levels as soon as they start to feel unwell. BBC Radio Science Unit producer Beth and her husband Andy (who has Type 1 diabetes) describe to Claudia their experience of Andy getting very ill with Covid-19. They discovered ketone levels appeared at much lower blood glucose levels than normal, something that Dr Kar says appears to be a feature of Covid-19 infection.

Erika Wright is back at University Hospital Southampton NHS Foundation Trust. Clinical lead and consultant in critical care, Dr Sanjay Gupta, talks about success giving critically ill patients oxygen using non-invasive ventilation: CPAP - continuous positive airway pressure. He also describes patients reorganising the hospital's critical care into four sections: patients positive for Covid, negative for Covid, those waiting for test results and those who test negative but are symptoms positive. Nationally, he tells Erika, those who falsely test negative, is between 5-10%.

And Inside Health contributor Dr Margaret McCartney delves into the accuracy of antigen swab tests (the test that tells you whether you have the virus or not). False negatives, test results that report the person doesn't have the virus when in fact they do, have serious implications for health care professionals, who might return to work on the basis of a mistaken result. Caution is advised, Dr McCartney advises, when symptoms contradict the test result.

A cytokine storm is a variant on a hyperactive immune reaction, where the body thinks its own tissues are invaders. Cytokines are small proteins that trigger more immune activity or less. In a cytokine storm the cytokines rage through the bloodstream, throwing our immune system out of balance and leading to severe illness and even death. This hyper inflammation has been seen in Covid-19 patients and Dr Jessica Manson, consultant rheumatologist at University College London Hospitals and co-chair of the national group of hyper inflammation doctors, tells Claudia what is and isn't known about how to treat cytokine storms in patients with coronavirus.

Producer: Fiona Hill
Smoking+vs+Covid-19%3B+non-urgent+treatments%3B+loneliness+surveys%3B+Southampton+update%2C+covid+and+the+law.
access_time1 month ago
It's well established that the best thing smokers can do for their health is to quit. Smoking contributes to many of the underlying conditions that undermine recovery from coronavirus and it is pretty clear that a coronavirus patient who smokes will likely have a worse outcome than one who doesn't. The FDA in the US recently went so far as to suggest smoking might increase the risk of contracting the virus at all. Nevertheless, existing data coming from various studies of patients around the world appear to show smaller numbers of smokers amongst the hospitalized cases than might be expected from local smoking populations. There are fewer smokers than there should be in the data. But why?

As the University of Edinburgh and CRUK's Prof Linda Bauld tells Claudia, there may be several simple reasons for this, such as data gathering - that patients' smoking status is going unrecorded or unverified. But a study last week from France goes so far as to suggest that nicotine itself, know to disrupt some of the receptors viruses use to enter cells, may be conferring some kind of a protection. It is just a hypothesis, but while the dangers of smoking tobacco still stand, studies on covid-19 patients using nicotine patches might be worthwhile. And if you are trying to quit, nicotine replacement therapy might be an even better idea just now than was thought.

Inside Health's resident GP Dr Margaret McCartney talks of her concerns for NHS non-urgent treatments being side-lined under the current virus squeeze, and some of her hope for the future. Professor Pamela Qualter and Dr Margarita Panayioutou describe why lockdown is an important time to do more psychological research into the effects of loneliness and other responses while we have the chance.

And in this week's update from Southampton General, where Inside Science's Erika Wright has been speaking to frontline health workers every week, Mr Robert Wheeler, a surgeon and clinical law expert muses on some of the legal aspects of our coronavirus response.
Southampton+update%3B+health+anxiety%3B+death+certifications%3B+fast-track+drug+screening
access_time1 month ago
Every week we’re heading to Southampton General Hospital, where we’ve heard a lot about the doctors and nurses doing amazing work. But this week Erika Wright has been talking to Gemma Blanchett who does a job you might not even associate with the virus or with intensive care – and that’s physiotherapy. Gemma is a respiratory physiotherapist who has the joy of watching some recover with her extraordinary help.

Recovery is going to be a long haul for some and can even take time for those who’ve had the virus with mild symptoms at home. So what do we know about how long a complete recovery takes? James Gill GP and Honorary Clinical Lecturer at Warwick Medical School discusses the latest insights.

For people who have already found themselves worrying excessively about their health or who have an obsessive compulsive disorder related to hand washing, this is a particularly difficult time. With all of us now on the look-out for symptoms, Claudia Hammond speaks to Jo Daniels, a Senior Lecturer in Clinical Psychology at Bath University who specialises in health anxiety, and David Adam, author of the Man Who Couldn’t Stop – an intimate account of the power of obsessional thoughts.

There’s been a lot of discussion about how to get accurate numbers for the people who have died from the virus outside hospital and one issue that’s been raised is whether doctors are wary of putting Covid-19 on a death certificate, when there’s been so little testing in the community. GP Margaret McCartney examines the current dilemmas.

Amidst a host of trials to find effective treatments against Covid19, are there existing drugs which no one has thought of yet? We hear from Dr Lindsay Broadbent whose team at Queens University are testing more than a thousand drugs on human lung cells infected with Covid19 in the lab, to see what might work for both mild and more severe infection.

Producer Adrian Washbourne
Covid-19+drug+trial%3B+Mental+health+alone%3B+Southampton+update%3B+Antarctica%27s+lockdown+lessons
access_time2 months ago
A range of potential treatments have been suggested for Covid-19 but nobody knows if any of them will turn out to be more effective in helping people recover than the usual standard hospital care which all patients will receive. Inside Health regular Dr Margaret McCartney talks to Claudia about how the first randomised trials are now setting out to test some of these suggested treatments with unprecedented speed and adaptability as potential new drug candidates emerge.

During lockdown some find their mental health is put at higher risk. Katie Connebear is a mental health campaigner and blogger who was diagnosed with bipolar disorder eight years ago. She has experienced psychotic episodes and has coping strategies in place for when she feels her mental health deteriorating. She offers her thoughts on how to make small progressive steps in the absence of family and friends who she normally relies on when times are difficult.

We’ve the latest in Inside Health’s regular visits to test the temperature at Southampton General Hospital. During the current pandemic maternity wards have to make sure that the birth of babies happens in a way that keeps expectant mothers, their birth partners and staff safe from the virus. Government advice includes pregnant women in the “vulnerable group" who need to take extra steps to socially distance, with extra attention after 28 weeks. Consultant obstetrician Jo Mountfield is keen to allay pregnant women’s concerns.

And with isolation set to continue, we can also learn from people who have lived in a different kind of lockdown – and one that was in many ways more extreme. Beth Healey is an intensive care doctor currently working in Switzerland who spent 14 months at Concordia research station in the Antarctic, investigating how the team coped with living in such an isolated environment She reveals the similarities in life there and life under lockdown here.

Producer Adrian Washbourne
Covid-19+and+moral+injury%3B+Asthma%3B+Southampton+update%3B+Mental+health+services
access_time2 months ago
Claudia Hammond reports on Covid-19 and "moral injury" - when the virus peaks, some healthcare staff will find themselves in a situation never faced before, forced to make decisions they would never normally have to make. This puts them at risk of a so-called “moral injury” which might harm their mental health. It’s more often associated with life in the armed services and Neil Greenberg, Professor of Defence Mental Health at Kings College London, explains how he's applying lessons from research in the military to support staff starting work at the new Nightingale Hospital in London. And some of the million recipients of letters saying they should shield themselves by not going out at all for 12 weeks are people who have asthma. Margaret McCartney examines the evidence for how those with asthma receiving letters were selected. Plus the latest dispatch from University Hospital Southampton: consultant Chris Hill explains that the emergency department has been split into Red and Blue areas based on the probability of arrivals having Covid-19. And what’s happening to mental health services during this time of crisis when seeing someone face-to-face needs to be avoided as much as possible? Claudia finds out from psychiatrist Dr Sri Kalidindi.

Producer: Erika Wright
Dispatches+from+University+Hospital+Southampton%3B+Covid-19+and+loss+of+smell%3B+intensive+care+access%3B+coronavirus+home+care
access_time2 months ago
When hospitals are full of patients, they're said to be "hot". The coronavirus crisis will push up the temperature of hospitals across the UK and in the first in a special series of weekly dispatches from the medical front line, producer Erika Wright will be taking the temperature of University Hospital Southampton - or The General - in Hampshire (which services almost two million people in the south of England) as they cope with the influx of Covid-19 patients. In this first dispatch, Erika talks to the Divisional Director for Medicine, Dr Trevor Smith, who says as patients have been moved out of this large teaching hospital to make space for coronavirus patients, the hospital's current temperature reading is "cold", but all staff know that this will soon change.

This virus is deeply frightening for everybody, but often for older people and those with underlying health conditions it is even worse. The fear is that if hospitals are overflowing, then crude cut-offs by, for example, age, might determine who does or doesn't, get a a bed in intensive care. But Dr Mark Roberts, consultant in acute and geriatric medicine and chair of the British Geriatric Society in Northern Ireland, tells Claudia that health care professionals don't and wouldn't make such arbitrary decisions based on age. Instead, he says, decisions about access to intensive care beds (or in-patient care) will continue to be made at the bedside, with compassion, and with a focus on who has the greatest capacity to benefit.

Some people have already decided that they won't go to hospital if NHS services are overwhelmed but they do want reassurance that they would get urgent care at home should they become seriously ill. Retired GP Dr Lyn Jenkins has written to the Prime Minister calling for this to be addressed as a priority. He's in good health, only 69 years old, but believes that he has a moral obligation not to use up scarce hospital resources if critical care beds can be given to younger people. For those who need it, he wants a quick response team to bring pain relief and supplementary oxygen and importantly, the presence of another person, a carer, so people who were very sick wouldn't be alone.

GP and Inside Health regular Dr Margaret McCartney talks to Claudia about supplies of personal protective equipment and whether long-promised supplies are finally arriving and she delves into the evidence to find out whether the loss of a sense of smell or taste could be a symptom of coronavirus. Listener Rachel says she can't smell cheese, garlic or lavender oil and she's worried that she could have the virus.

Producer: Fiona Hill
COVID-19+PPE%3B+Secondary+Pneumonia%3B+Viral+Load%3B+Trauma+Care+in+Fort+William
access_time2 months ago
Margaret McCartney on COVID-19 and how the military has been deployed to get protective equipment supplies to critical care staff. Dean of the Faculty of Intensive Care Medicine, Dr Alison Pittard tells of the difficult ethical decisions staff are facing. And Professor Carl Heneghan - suffering from COVID-19 symptoms himself - explains the importance of fast action when treating secondary pneumonia in the elderly; while Deirdre Hollingsworth explains the term "Viral Load". Plus Margaret McCartney visits the famous Belford Hospital in Fort William - specialising in hostile environment trauma - and hears a story of intense mountain rescue.
Covid-19+Intensive+Care+Beds%3B+Ibuprofen%3B+Laser+and+Glaucoma%3B+Faecal+Incontinence
access_time3 months ago
The UK has one of the lowest numbers of critical care beds in Europe but as the coronavirus threatens to engulf us, drastic measures are being taken to increase capacity. Dean of the Faculty of Intensive Care Medicine, Dr Alison Pittard, tells Saleyha that the NHS has been asked to plan for doubling, trebling and then quadrupling the number of critical care beds. So far, health authorities in England, Northern Ireland, Scotland and Wales have identified how they can increase the number of beds from just under 5,000 to around 10,000 but as Nicki Credland, Chair of the British Association of Critical Care Nurses says, increased beds mean more specialist intensive care nurses in numbers that can't be invented overnight. Additional non-specialist staff are being earmarked to help fully qualified intensive care nurses in the current virus crisis.

Dr Margaret McCartney addresses the confusion around two medications: ibuprofen for viral symptoms and the potential risks to Covid-19 patients who are using ACE inhibitors for their high blood pressure or heart failure.

Meanwhile away from coronavirus, Saleyha reports on new advances for the treatment of glaucoma, a condition which involves increased pressure to the eye and damage to the optic nerve. It's usually treated using eye drops, but laser treatment could be coming to a hospital near you. Saleyha watches as Gus Gazzard, Professor of Ophthalmology at University College London, uses a laser to treat the high pressure in Veenay Shah's right eye. Evidence from the LiGHT trial, which showed the laser works for newly diagnosed glaucoma patients, is likely to lead to new NICE guidelines which could give patients the choice: eye drops or laser.

Faecal incontinence is one of the most debilitating conditions and patients can go for years without even seeking help. But at Sandwell General Hospital in West Bromwich, a revolutionary non-surgical approach is transforming lives. Called the FINCH service, Lead Nurse Kelly Stackhouse, colorectal consultant Rajeev Peravali and patients 21 year old Lara and 74 year old John, tell Saleyha how the new approach works.

Producer: Fiona Hill
Coronavirus+Special
access_time3 months ago
Inside Health gets exclusive access into Ysbyty Gwynedd, the Bangor emergency department, to see how they are preparing staff to deal with coronavirus patients arriving at the front door. Although advice is for patients to stay at home and call 111, some will be sick enough to need hospital admission. For that outcome, staff need to be properly fitted for face masks and trained in putting on personal protection equipment or PPE. Saleyha works in the department and Inside Health follows her getting kitted out with the help of Tim Hamilton Jones, an ED staff nurse tasked with the job of getting everyone ‘fit tested’.

GP Dr Margaret McCartney talks about the evidence on face masks and the different types that are out there and gives the latest information on the incubation period for COVID19.

It’s estimated that 80% of cases will be able to recover at home but 20% may need hospital care. Reports coming from Italy describe the demand on intensive care beds for patients with coronavirus because of the disease’s potential impact on the lungs. Dr Alison Pittard, Dean of the Faculty of Intensive Care and herself a practising ITU consultant in Leeds tells Inside Health about plans for increasing critical care bed capacity, in the NHS. The service is however already stretched before the disease has even taken hold here.

As the government works out a plan of action to support the NHS to cope at this time, Inside Health talks to the British Red Cross, already working in hospitals across Wales, about supporting staff during the normal pressures, even before coronavirus struck. We hear from support workers within the Emergency Department and get an insight into what they do.

Producer, Erika Wright
Hard+Sell+for+Private+Cataract+Surgery%3B+Language+in+Healthcare%3B+Specialist+Medical+Travel+Clinic
access_time3 months ago
Inside Health hears from two patients, Surinder Biant and Sam Begum who went for a free eye check up with Optical Express. Both were surprised by a diagnosis of cataracts when previous eye tests hadn't uncovered these. Both felt that they were given a hard sell and felt pressurised to have cataract surgery and both had independent second opinions which brought the diagnosis and proposed treatment into question. And the President of the Royal College of Ophthalmologists, Mike Burden, explains what cataracts are and how doctor and patient can decide together when surgery is required.

GP and regular Inside Health contributor, Dr Margaret McCartney talks about the language we use in healthcare which blames both patients and doctors unfairly. Words and phrases like "compliance", "bed-blocker" and "unnecessary admissions" are singled out as particular culprits.

The travel clinic at The Hospital for Tropical Diseases in London aims to help people with complex medical conditions get to where they need or want to go for work, family or just some winter sun. We meet Elisabeth, who is partially sighted and wants to travel to East Africa with her grandson; Robert who has lymphoma but is far more concerned that he won't be able to fly to a country he loves, Japan, and to Robin, who wants to start a career in Uganda but is allergic to some of the components of essential vaccines. Dr Nicky Longley, consultant in infectious disease and travel medicine runs the clinic.


Producer: Fiona Hill
Cigarette+Filters%3B+Sepsis
access_time3 months ago
Chris van Tulleken examines cigarette filters - the tobacco industry's hidden marketing tool. He talks to historian Robert Proctor, author of The Golden Holocaust and May van Schalkwyk explains why she wrote her paper 'No More Butts'. Plus Margaret McCartney discusses whether the media portrays a balanced view of Sepsis.
Air+Pollution%3B+Infectious+Disease+and+Healthcare+Staff%3B+Hymenoplasty
access_time4 months ago
Evidence is building about the impact of air pollution on health, but the relationship between the cocktail of chemicals, gases and particles in the air we breathe and the direct effect on an individual's health is a tricky one to prove. Dr Farrah Jarral cycles to Kings College London to hear about a new study by researcher in respiratory toxicology, Dr Ian Mudway, which revealed, to the surprise of Ian and his colleagues, that particles from brake dust had the same damaging impact on our lung immune system as that familiar culprit, diesel exhaust. It's a result that demonstrates that the toxic risk to our health doesn't just come out of the exhaust pipe and suggests the concept of a zero emissions vehicle might need further work.

COPD or Chronic Obstructive Pulmonary Disease is an umbrella term for a range of respiratory conditions that used to be known by names like emphysema or chronic bronchitis. COPD flare ups or exacerbations are the second largest cause of emergency hospital admissions in the UK. Dr Jennifer Quint, consultant physician in respiratory medicine at the Royal Brompton Hospital tells Dr Farrah Jarral about a world-first study where the individual air pollution exposure of COPD patients was tracked in real time to find out how toxic air can make their condition worse.

What's it like for healthcare professionals working on the front line of infectious disease outbreaks? Dr Michael Kiuber, a consultant in emergency medicine at University Hospital Southampton NHS Foundation Trust, volunteered to treat patients with the deadly infection, Ebola, in Sierra Leone and he describes the challenges to Farrah of caring for very sick adults and children while taking every safety step to avoid contracting the Ebola virus himself. And Inside Health regular contributor, Dr Margaret McCartney outlines the challenges for the NHS in planning how to protect staff as the UK grapples with the global outbreak of Covid-19.

There's a growing trade in female cosmetic genital surgery including hymenoplasty, which claims to the restore the hymen to its virginal state. Scores of private clinics in the UK are offering the procedure with advertising claims like "Get your virginity back!" and "Restore your innocence within one hour!". Dr Leila Frodsham, consultant gynaecologist, specialist in psychosexual medicine and spokesperson for the Royal College of Obstetricians and Gynaecologists discusses the ethics of the procedure.

Producer: Fiona Hill
Coronavirus+Transmission%3B+Breakfast%3B+Women+and+Heart+Attacks%3B+Personal+digital+assistants
access_time4 months ago
Farrah Jarral on Coronavirus transmission and the difference between a cough and a sneeze. Why is health research and media coverage about Breakfast often contradictory? Farrah meets senior lecturer Javier Gonzalez and Professor James Betts from the department for health at the University of Bath. And Margaret McCartney discusses the complex issue of inequalities between men and women when diagnosing heart attacks. Plus Farrah talks to Dr Ruth Chambers, clinical lead for a project in Stoke on Trent that assesses the benefits of personal digital assistants in the home.
Respiratory+Syncytial+Virus%3B+Coronavirus+Vaccine%3B+Unnecessary+Vaginal+Examinations%3B+Compassion+Fatigue
access_time4 months ago
It's not a household name but RSV or Respiratory Syncytial Virus is responsible for 30,000 children under five ending up in hospital every year in the UK. The virus can cause serious infections of the lungs and airways (like pneumonia and bronchiolitis). Hannah and Sean from Oxfordshire had baby girls, Millie and Freya, born prematurely in October last year. Just weeks later, the twins spent 12 days in intensive care and then 3 days in the high dependency unit at the John Radcliffe Hospital in Oxford with bronchiolitis caused by RSV. Andrew Pollard, Professor of Paediatric Infection and Immunity at the University of Oxford tells James, the BBC's Science and Health Correspondent, about the dangers of RSV in lower income settings where the virus claims more babies' lives under 12 months old than any other disease apart from malaria. Hopes are that a vaccine for RSV to protect children during the vulnerable first years is imminent.

And as one of the world's leading experts on vaccinations (and chair of the UK's Joint Committee on Vaccination and Immunisation) Professor Pollard tells James that he is confident that a vaccine for the coronavirus, which some experts have suggested could become a pandemic, could be developed by the end of this year.

Inside Health regular contributor Dr Margaret McCartney raises the issue of unnecessary vaginal examinations. A new American study in JAMA Internal Medicine suggests that more than half of the bimanual pelvic examinations performed on girls and women aged 15 to 20 in the USA are potentially unnecessary and could cause harm. The fact this is still routine for many American women contradicts clear guidance which states there is no evidence for such internal examinations to be carried out in healthy girls and women who don't have symptoms. It doesn't happen in the NHS, Margaret reports, but they are carried out in the private sector under the banner of "well women checks".

Could you tell somebody that they were going to die? Could you comfort family members after their loved one has passed away? Crucially could you do this as part of your job, day in, day out, without it affecting you? James talks to nurses at the Royal Marsden Hospital in Surrey which has been raising "compassion fatigue" as an occupational hazard within the profession.

Producer: Fiona Hill
28%2F01%2F2020
access_time4 months ago
James Gallagher, the BBC's health and science correspondent discusses the Coronavirus and how GP's have been advised to manage a patient at risk. He meets listener's Rich and Lucy who have asked about Probiotics and gut health in early life after one of their twins had a vaginal delivery while the other a C-section. They want to know whether the different types of birth might impact on the good bacteria passed from mother to child, evidence for the potential impact on long term health and whether probiotics can help. Plus Pill Organisers and whether arranging medicines into one single packet is always a good idea. And a life changing treatment for Haemophilia A.
Remote+and+Rural+Healthcare
access_time4 months ago
Nigel Edwards, Chief Executive of the health think tank the Nuffield Trust, joins Dr Margaret McCartney for this special programme about the challenges of remote and rural healthcare.
Margaret travels by boat from Mallaig to the Hebridean islands of Eigg, Muck, Rum and Canna off the north west coast of Scotland where, after 100 years the islanders lost their resident doctor. When it was clear there wouldn't be a replacement, the islanders and NHS Highland instead opted for a radical new healthcare model.
Taking inspiration from indigenous tribes in Alaska, the NUKA model has been adapted for the Small Isles and it is very different, with a high level of community engagement. The idea is that local people own their own healthcare rather than having healthcare delivered to them, as passive recipients.
Local people are trained up in first aid and become salaried Rural Health and Social Care Workers. They are the eyes and ears of healthcare professionals. Volunteers also act as First Responders coordinating helicopter and lifeboat rescues in emergencies.
Dr Margaret McCartney joins GP Dr Geoff Boyes on his weekly visit to Eigg and discovers how the community has adapted to this new way of delivering care. She hears from Gill McVicar, former NHS Highland Director of Transformation and Camille Dressler, chair of the Small Isles Community Council, about how the reorganisation was managed; from Julie McFadzean about the new health and rural health and social care worker role; from Sheena Kean, the Eigg healthcare practice manager who makes sure everything runs smoothly and to Eigg residents about how they think their new healthcare model is working.

Producer: Fiona Hill
Credit Photo of Margaret McCartney: Paul Clarke
When+to+take+Blood+Pressure+Pills%3B+ADHD%3B+Recurrent+Fevers%3B+Head+lice
access_time7 months ago
When is the best time of day to take blood pressure pills? A new study from Spain has hit the headlines, with dramatic results that could change practice but are the findings too good to be true? And why is getting help for ADHD or other behavioural conditions such a struggle for parents, schools and doctors? Plus recurrent fevers - a rare genetic condition that feels like flu every day. And evidence for the best way to get rid of headlice!
22%2F10%2F2019
access_time8 months ago
Dr Mark Porter demystifies health issues, separating fact from fiction and bringing clarity to conflicting health advice, with the help of regular contributor GP Margaret McCartney
Zantac+alert%2C+Newborn+brain+injury%2C+OTC+guide%2C+Surgery+for+reflux
access_time8 months ago
Zantac alert over concerns that the branded reflux treatment is contaminated with a carcinogenic impurity, so what are the risks? And a new device helping to identify Newborn brain injury earlier. An Inside Health Guide to Over the Counter choices and evidence for those that work best - this week Warts and Veruccas; Plus surgery for reflux as an alternative to pills.
Statins+Over+the+Counter%2C+Amyloidosis%2C+Gene+Silencing
access_time8 months ago
There are plans to make high dose statins available over-the-counter without a prescription to improve uptake. Currently around two thirds of people likely to benefit most don't take them, but will these plans make a difference? Amyloidosis is a debilitating rare disease that is often missed: Pam tells her amazing story of recovery and Mark meets the specialists helping her. And news about new gene silencing treatments that could transform the outlook for people with other rare conditions too.
Heparin+and+Pigs%3B+Anticoagulants%3B+Ovarian+Freezing+and+Cancer%3B+Thumb+surgery
access_time8 months ago
Mark Porter reports on shortages of Heparin, a drug to treat blood clots, due to swine fever in Chinese pigs! And staying with anticoagulants Margaret McCartney discusses concerns about taking these drugs along with common pain killers like ibuprofen. Why is this a risky combination? And Alice tells her story of opting for ovarian freezing, the latest technique to preserve fertility when undergoing cancer treatment. Plus a pioneering new type of surgery for arthritis of the thumb.
Prescription+Charges%3B+Acute+Kidney+Injury%3B+MMR+vaccine%3B+Meningitis+in+Students
access_time8 months ago
Why aren't prescription charges free across the whole of the UK? Acute Kidney Injury has shot up the NHS agenda in the last decade. Mark Porter visits Derby Royal Hospital to find out why kidney problems are so common and discovers what's been done to prevent damage to an organ many of us take for granted. Plus the World Health Organisation has removed the UK's measles free status because too few children are being immunised. Could making the vaccine mandatory be the answer? Margaret McCartney examines the evidence. And as the academic term gets underway Inside Health learns of a novel method to help with the prevention of meningitis amongst university students who are at risk of the disease.
Singing+for+breathlessness%2C+aneurysms%2C+sunscreens+and+myasthenia+gravis
access_time10 months ago
Dr Mark Porter finds out about 'singing for lung health', an evidence based therapy for helping people with breathlessness arising from conditions like Chronic Obstructive Pulmonary Disease. He hears from the choir based at Charing Cross Hospital in London and talks to respiratory physiologist, Adam Lound, to find out how the breathing and singing techniques being taught there, as well as the camaraderie, improve people's quality of life and confidence. Does exercise increase the risk of worsening an aortic aneurysm? Consultant vascular surgeon, Rachel Bell talks about the benefits of cardio vascular exercise for people with aneurysms. Dr Margaret McCartney reviews the evidence on sunscreens. Also in the programme, Saiju Jacob discusses myasthenia gravis, an auto-immune condition that causes muscle weakening. He explains what causes it and how it's treated.
Bats+and+Rabies%3B+Hip+Dysplasia+in+babies%3B+Online+health+tips%3B+Clinical+Law
access_time10 months ago
What is the risk of catching rabies from bats in the UK? We answer this question prompted by a case at Mark Porter's surgery last week when a bat flew straight into a person in broad daylight. Hip dysplasia in babies is a condition where the ball and socket of the joint don't form properly in early life. Every baby is examined as part of the National Screening Programme but new research suggests hundreds are being missed. Plus tips from Margaret McCartney and Carl Heneghan on finding reliable health information online. And what is clinical law?
Anti-inflammatories+and+ovulation%3B+Probiotics+and+Parkinson%27s%3B+Blood+interval+and+patient+forums+online
access_time11 months ago
Dr Mark Porter finds out why non-steroidal anti-inflammatory painkillers can affect female fertility by preventing ovulation. Prof Richard Anderson from Edinburgh explains. And the link between gut bacteria and Parkinson's disease and why a new trial that is finding out if a particular probiotic can improve symptoms of the disease. Prof Ray Chaudhuri from King's College London explains. Also the latest evidence on the optimum intervals between blood donations and in the latest look at health and the internet Dr Margaret McCartney and Carl Heneghan unpick the pros and cons of patient groups and online forums
Declining+male+fertility%2C+Diagnosing+urinary+tract+infections+in+the+elderly%2C+Guide+to+health+websites
access_time11 months ago
Decline in Male Fertility and evidence sperm counts have dropped dramatically over the last 40 years but despite this, research into the understanding of male fertility problems have fallen behind. Two leading specialists in the filed explain the issues. Plus diagnosing Urinary Tract Infections in the Elderly and risks of over treatment leading to antibiotic resistance. And tips from Margaret McCartney and Carl Heneghan on identifying health websites to trust.
Obesity+and+Cancer+campaign%3B+Intelligent+liver+function+tests%3B+Getting+reliable+information+from+websites
access_time11 months ago
The new Cancer Research UK campaign that compares obesity to smoking as a risk factor for cancer has come under criticism; Margaret McCartney debates the issues with Professor Linda Bauld. And how healthy is your liver? Do you know? Does your doctor know? Liver Function blood tests are notoriously difficult to interpret and early disease is often missed. Hence a new initiative - Intelligent liver function tests devised by a team from the University of Dundee. And a new mini series on which websites to trust and whether the health information you've found is reliable. Top tips on how to navigate the internet.
Deprescribing
access_time11 months ago
In a new series of Inside Health Dr Mark Porter explores the growing initiative to 'deprescribe'. The last two decades have seen a dramatic increase in prescriptions and over the counter medication use with one third of people aged over 75 taking at least six medicines. Evidence suggests a person taking ten or more medicines is 3 times more likely to be admitted to hospital. Yet this is not just an issue in the elderly. Inside Health visits a children's ward with a new drug optimising service leading the way in appropriate prescribing for kids. Mark Porter investigates why such a huge number of people are on multiple medications and discusses the barriers to change with tips from leading experts trying to achieve a new approach.
Moving+the+goalposts+in+research%2C+Involving+parents+in+the+care+of+premature+babies%2C+Feedback
access_time1 year ago
Fiddling figures in research and why it matters that outcomes aren't switched or goal posts moved; involving parents in the care of premature babies to improve recovery; feedback on the current series
E-cigs%2C+Prehabilitation+before+surgery%2C+Hospital+safety
access_time1 year ago
Why vaping is dividing public health experts causing a polarised split; prehabilitation before cancer surgery and the benefits of preparing for an operation; plus can hospital safety be compared to lessons learnt from the aviation industry?
CBD+oil%2C+Dental+phobia%2C+Gout
access_time1 year ago
Cannabidiol or CBD oil has had a recent surge in popularity but is there any evidence for it having any health benefits? Dr Margaret McCartney reviews the research. Mark visits the Dental psychology service at Guy's Hospital in London and talks to Tim Newton about dental phobia, the treatment available and how successful it is at treating a phobia which affects 1 in 10 people in the UK. Also what causes gout and why has advice changed on the best way to treat it? Mark talks to rheumatologist, Dr Tim Tait at United Lincolnshire hospitals.
05%2F03%2F2019
access_time1 year ago
Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us.
Home+fetal+heart+monitoring%2C+Deconditioning+in+hospital%2C+Alcohol+harm+paradox%2C+Pre-eclampsia+feedback
access_time1 year ago
Regulation of Home Fetal Heart Monitors prompted by concerns that the burgeoning use of these devices could be harmful. Deconditioning - there is a popular adage that spending 10 days in hospital can age people 10 years, but is this backed by evidence and could it actually be worse? Mark Porter visits Warwick Hospital to meet the team working to combat deconditioning in the elderly. Plus the Alcohol Harm Paradox - why do less affluent drinkers tend to develop more problems than their better off peers even if they drink exactly the same amount.
19%2F02%2F2019
access_time1 year ago
Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us.
Migraine%2C+Iron+overload%2C+Redefining+low-risk+cancers
access_time1 year ago
A new handheld device for migraine is being pioneered at Guys and St Thomas's Hospital in London. Using single pulses of transcranial magnetic stimulation the device is helping prevent and treat migraines in people who haven't responded well to other treatments. Dr Anna Andreou, director of headache research, and nurse specialist, Bethany Hill talk Mark through how it works.

Some people, particular of North European and Irish ancestry have the faulty genes that mean they are unable to get rid of excess iron in the body. This can lead to symptoms ranging from tiredness, joint pain, and diabetes to skin discolouring and liver disease. New research has shown the condition is far more common than has been previously thought and is often missed as a diagnosis. Haematologist at Gartnavel Hospital in Glasgow, Ted Fitzsimons and epidemiologist, David Melzer of the University of Exeter, talk testing and treatment for iron overload, or haemochromatosis.

Cancer is an umbrella term which covers a spectrum of disease. Some cancers, like lung cancer grow and spread rapidly. But others like some forms of breast, thyroid and prostate cancer have a less than 5% chance of progressing over twenty years. So should we redefine low risk cancers? GP Margaret McCartney and consultant histopathologist, Murali Varma of University Hospital of Wales in Cardiff discuss this question.
Genes+and+confidentiality%3B+sore+throats+and+cancer%3B+diet+for+epilepsy%3B+shaving+for+hospital+drips
access_time1 year ago
Genetics and confidentiality; a fascinating legal case where a woman is suing the hospital trust that looked after her father with Huntington's disease for not warning that she too could be affected. And a well established use of very low carb diets that isn't so well known - to treat complex childhood epilepsy. Plus cancer of the voice box and persistent sore throat. And should hairy arms be shaved for a hospital drip? This question has prompted a transatlantic spat when Sir Andy Murray posted a photograph after his recent hip operation.
Unproven+IVF+add-ons%3B+Running+injuries%3B+DNA+analysis+on+the+NHS
access_time1 year ago
Warnings that expensive, unproven 'add-ons' are being offered by IVF clinics ; Keen jogger Margaret McCartney asks whether rest helps running problems such as stitch, shin splints and plantar fasciitis. Plus DNA testing on the NHS to anyone prepared to pay for it with the results contributing to research. But what exactly is the aim of such testing and are there hidden implications?
Conflict+of+interest%2C+Living+with+a+stoma%2C+Diet+books
access_time1 year ago
Concerns about conflict of Interest and reputational damage. Should policy making organisations in the public health arena form partnerships with charities funded by industry? And living with a Stoma. Mark goes to Addenbrookes hospital in Cambridge to meet Michael, who explains what life is like after having his large colon removed. 1 in 500 people in the UK - children and adults - live with some form of bowel stoma, where part of their gut has been brought out through their abdominal wall to empty into a bag. But how does it all work, and what it’s like living with one? Plus Margaret McCartney on diet books and why they are rarely discussed on Inside Health.
Drug+shortages%2C+Eye+drops+for+myopia%2C+Is+muscle+more+dense+than+fat%3F+Sarcopenia
access_time1 year ago
An unprecedented number of medicines are in short supply, according to NHS England. Doctors, pharmacists and patients all over the UK are finding common drugs like naproxen are more difficult to get hold of. Why is there such a problem with supply of medicines that are normally cheap and easy to get hold of? And why a 'severe shortage protocol' due in the next few weeks should give pharmacists more power help ease the situation. Mark talks to Ash Soni, president of the Royal Pharmaceutical Society and pharmacist, Ben Merriman to find out more.
The number of children with short-sightedness, myopia has doubled in the last 50 years. Mark finds out why atropine eye drops, which are widely used in China and Singapore, are being trialled on children in the UK to help prevent the progression of myopia. Professor Augusto Azuara-Blanco from Queens University Belfast explains.
And is muscle more dense than fat? Jason Gill, professor of cardio metabolic health at the University of Glasgow discusses how even a small amount of fat loss can have hugely significant health benefits. Elaine Dennison, professor of Musculoskeletal Epidemiology at the University of Southampton explains why muscle is an under researched part of the body and how we lose muscle mass and strength in middle age and what we can do to prevent it.
08%2F01%2F2019
access_time1 year ago
Dr Mark Porter discusses High Blood Pressure, a silent threat that isn’t well managed, with only a third of those affected being diagnosed and treated as advised in the latest guidelines. Dr Margaret McCartney and Professor of Medicine, Bryan Williams help unpick areas of confusion including lifestyle and treatment with the latest thinking in the UK, on who should be offered what and when.
Acid+Attacks+and+Corneal+Grafts%2C+Bowel+Cancer+Screening%2C+Sports+Prosthesis+for+Children
access_time2 years ago
The UK has one of the highest recorded rates of acid attacks in the world, nearly 500 cases in 2016. Most of the victims are men and most have corrosive liquid, typically acid or bleach, squirted into their faces while they are being mugged for their phone, bag or car. Andrew Keene was attacked in London last year while he sat in his car, and blinded by a robber who then drove off in his car. He's had five operations, including two corneal grafts, to try to restore the sight in his right eye. Dr Mark Porter talks to Andrew at Queen Victoria Hospital in East Grinstead, where sight-saving eye surgery was pioneered over sixty years ago. This hospital set up the UK's first Eye Bank for donor eyes and it is from these donations that eyes, damaged like Andrew's, are repaired using grafts. Mark hears about the shortage of donated corneas which mean long waiting lists for eye surgery and Eye Bank head Dr Nigel Jordan tells him they're having to import donor eyes from the USA to meet demand.

BBC News anchor George Alagiah has gone public with the news that his bowel cancer has come back three years after it was diagnosed at an advanced stage. He has questioned why screening starts at different ages in different parts of the UK. If he lived in Scotland where the bowel cancer screening programme starts at 50, up to 10 years before the rest of the country, he would have been screened earlier and his cancer might have been picked up earlier, making it easier to treat. Inside Health's Dr Margaret McCartney discusses the complexities involved in rolling out national screening programmes and tells Mark why there's a difference in Scotland and the rest of the UK about the starting age for bowel screening.

Until a couple of years ago, children who were born without a limb, or those who lost a limb after illness or injury, could get a traditional prosthesis, or artificial limb fitted, but it was a limb of the most basic kind which would enable them to walk, but not to run or do sports. But thanks to money released into a special fund by the Department of Health in England, for the last 18 months these children have been fitted with the high-tech futuristic-looking prostheses - racing blades - that allow them to run, jump and compete in all sorts of activities and sports. Mark visits a paediatric rehabilitation clinic at the Royal National Orthopaedic Hospital in Stanmore and meets the children who are benefiting from these new activity blades.
Ageing+brain%2C+Fish+Oils%2C+Adaptive+Trials%2C+Yoga
access_time2 years ago
Deciding between healthy ageing and early dementia; how useful are modern imaging techniques in deciphering this difficult question that many families are grappling with. Margaret McCartney tries to make sense of conflicting research on the impact of fish oils on children's reading ability and memory - how can the same research group, in the same university run two trials and get completely opposite results? And recently Baroness Tessa Jowell called for more access to adaptive trials but what does this type of research actually mean for patients taking part? Plus the evidence for the health benefits of yoga.
Cardiac+Rehab%2C+Withdrawing+from+Antidepressants%2C+Middle+Ear+Implant
access_time2 years ago
There are many myths about recovery from a heart attack. The most dangerous is that exercise is too risky. The truth is that for most people, they should be doing much more exercise, not less. Patrick Doherty, Professor of Cardiovascular Health at York University and lead author for the National Audit of Cardiac Rehab tells Dr Mark Porter that 70,000 people who should be accessing life saving cardiac rehabilitation therapy are missing out. The answer? Don't blame the patients but improve the design of rehab packages, he says. Inside Health visits a rehab session at Charing Cross Hospital in London and hears from cardiac patients about the impact of supported exercise programmes on their health.

A group of psychiatrists, psychologists and patients have complained to the Royal College of Psychiatrists about the withdrawal effects of antidepressants. They say claims that side effects are resolved, for the majority of patients, within a few weeks of stopping treatment are false and in fact, many people suffer unpleasant, frightening symptoms for much longer. Inside Health's Dr Margaret McCartney looks at the evidence.

We're all familiar with hearing aids, amplifiers which boost volume in a failing ear. And you might have heard of cochlear implants which, in people too deaf for aids, can be used to send signals directly to the inner part of the ear, and on to the brain. But in the future we're likely to hear more about middle ear implants, devices implanted because the outer ear hasn't developed properly. ENT surgeons at Guy's and St Thomas' Hospital in London, Professor Dan Jiang and Harry Powell, have performed a middle ear implant on the UK's youngest ever patient, Charlotte Wright was just three years old when she had this pioneering treatment.

Producer: Fiona Hill.
Prostate+Cancer
access_time2 years ago
This week it has been hard to miss news on prostate cancer. The papers were full of a 'one stop shop' service for the diagnosis of the disease being rolled out in three hospitals in England. Plus celebrities have described their diagnosis and encouraged men to see their doctor for a PSA test. But just published today, the largest every study of prostate cancer over 10 years confirms that a single screening test of PSA does not save lives. With all these headlines this week is an ideal time to repeat Inside Health's prostate special. One in eight men in the UK will develop prostate cancer at some stage, but deciding who needs treatment - and when - is still far from clear. Mark Porter and Margaret McCartney report on two landmark trials that could provide some clarity, and hears from men and their doctors, faced with the dilemma of choosing the right course of action.
Diabetes+Tech%2C+Antidepressants%2C+Stem+Cell+Therapy+and+knees
access_time2 years ago
First urine testing then finger pricking and now high-tech scanning. The monitoring of glucose levels is undergoing a revolution for patients with Type 1 Diabetes. Dr Margaret McCartney reports from Glasgow on the new sensing devices which allow for endless glucose scanning without the need for multiple finger prick blood tests. She talks to parents like Ben, who's paying for a continuous glucose monitor because the fingers of his young son George, were so sore from constant finger prick testing that he couldn't even play with his lego. And to 18 year old Matthew and his mum, Barbara, about the flash glucose monitor which they say has transformed the control and management of his diabetes. Dr Kenneth Robertson, who's led NHS Greater Glasgow and Clyde's Children's Diabetes Service for the past 25 years tells Margaret that the new technology is a game changer for diabetes, but urges a cautious, evidence-based roll-out of the best devices.

Many patients, as Margaret hears, are paying for the devices out of their own pockets and the charity UK Diabetes is keeping tabs on which areas of the NHS are funding flash glucose monitors after they came on NHS license four months ago. Policy Manager Nikki Joule tells Mark that they'll lobby hard on behalf of patients denied access to this life-changing technology. Meanwhile Dr Partha Kar, Associate National Clinical Director for Diabetes at NHS England urges clinical commissioning groups to review national guidance and where patients are multiple testing or at risk of the life-threatening high sugar level condition, ketoacidosis, allow access.

Enthusiastic headlines following the recent Lancet study of antidepressants claimed the drugs work, that they're better than placebo and that more should be prescribed. Inside Health's Dr Margaret McCartney takes a closer look at the large meta-analysis of over 500 clinical trials.

Every year in the UK almost 200,000 hip and knees get replaced, mainly because of osteoarthritis. But if the damaged cartilage could be repaired in younger people, would this prevent arthritis and a replacement joint later in life? Researchers have been using stem cell therapy to re-line damaged joints but it's an expensive and complex process, which up to now has involved two stages, one to harvest the stem cells and another, weeks later, to put the tissue back into the injured joint. But now a team at the Royal National Orthopaedic Hospital at Stanmore has developed a one stop operation. Stem cells are harvested from the pelvis and then in the same operation, put back into injured knees to "seed" new cartilage . George Bentley, emeritus Professor of Orthopaedics, orthopaedic surgeon James Donaldson and patient, Nick Brown, talk to Inside Health about this pioneering new treatment.

Producer: Fiona Hill.
Medical+Cannabis%3B+Hidden+Blood+in+the+Urine%3B+Ageing+and+Immunity
access_time2 years ago
There are questions in Parliament following the story of 6 year old Alfie Dingley who was refused medical cannabis to help relieve his epileptic seizures. But what is the body of evidence for medical cannabis and does the reality live up to the hype? And age, immunity and the poor performance of this season's flu vaccine. Why do our defences decline as we get older and what can be done to improve vaccines that aim to protect the elderly against flu? Plus blood in your urine - pee the colour of Ribena is hopefully enough to drive anyone to their doctor - but what about tiny traces invisible to the naked eye frequently picked up by sensitive dipstick tests? If that has happened to you listen to our comprehensive guide.
Rickets%2C+Drug+addiction+recovery%2C+Defibrillator+support
access_time2 years ago
Rickets was eradicated from the UK after World War Two but "The English Disease", as rickets has long been known, is back. Two children have died of this completely preventable disease in the past two years. Dr Mark Porter talks to paediatrician Dr Benjamin Jacobs at the Royal Orthopaedic Hospital in Stanmore about the importance of Vitamin D supplementation and calcium for proper bone growth. He meets Zana, whose toddler son was diagnosed with rickets six months ago and talks to Dr Priscilla Julies, paediatrician from the Royal Free Hospital in London about the forthcoming British Paediatric Surveillance Unit survey of the disease. Consultant Paediatric Endocrinologist Dr Wolfgang Hogler from Birmingham Children's Hospital tells Mark that the UK's record of vital Vitamin D supplementation is woeful compared to our European neighbours and warns that unless rickets is given a higher priority, more lives will be lost.

The number of drug related deaths has soared in recent years and this is against a background of growing concern about the misuse of prescription medicines - particularly morphine type painkillers - and the burgeoning popularity of novel psychoactive substances like spice and mamba. But this changing drugs scene has been accompanied by changing attitudes and approaches to what helps addicts recover. A new European survey - in England, Scotland, Belgium and the Netherlands - led by David Best, Professor of Criminology at Sheffield Hallam University aims to map what has helped people out of their drug addiction and he tells Mark this will better shape policy and services.

Advances in pacemaker technology mean that many people who are prone to life-threatening heart rhythm disturbances, will have, inside their chests, their own internal defibrillators, known as implantable cardioverter defibrillators, or ICDs. These tiny devices, not much bigger than a matchbox, sit in the upper chest and monitor the heart. When they detect a problem they automatically deliver a shock, direct to the organ. This is life-saving technology but arrhythmia specialist nurse, Charlene Hogan from St Thomas' Hospital in London six years ago set up a support group for patients with ICDs, because she realised that there was enormous anxiety about when the device might fire. The group meets three to four times a year and Inside Health reports from their most recent get together.

Producer: Fiona Hill.
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