Air Pollution; Infectious Disease and Healthcare Staff; Hymenoplasty
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; Breakfast; Women and Heart Attacks; Personal digital assistants
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.
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
Coronavirus; Probiotics and Babies' gut health; Pill Organisers; Haemophilia therapy
James Gallagher, BBC health and science correspondent, and Dr Margaret McCartney talk about the new coronavirus and how GPs have been advised to manage a patient at risk. He meets listeners 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. What is the evidence for the potential impact on long term health and can probiotics help? Dr Trevor Lawley at the Sanger Centre and Dr Lindsay Hall of the Quadram Institute provide the answers. Debi Bhattacharya of the University of East Anglia and James discuss pill organisers and whether arranging medicines into one single packet is always a good idea. And Prof John Pasi explains the results of trials on a 'Holy Grail' treatment for Haemophilia A and Shaun, who took part in the trial at Guy's and St Thomas in London, reveals how it has changed his life.
Remote and Rural Healthcare
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