There are so many campaigns now to stop stigma and embarrassment - from Davina McCall talking about the menopause to Idris Elba campaigning for black men to get their prostate checked. And when we asked for your stories of how embarrassment impacts your health, our inbox was flooded with stories of incontinence, IBS, genital problems, skin issues, fertility troubles, fatty lumps and more - along with the huge and varied ways these issues are affecting your lives. So, how does embarrassment affect how we behave regarding our health, how can doctors and our health service adapt to alleviate it, and do awareness campaigns really help? To discuss James Gallagher is joined by:Dr Margaret McCartney, GP Dr Vanessa Apea, consultant in sexual health at Barts Health NHS Trust and Medical Director at Preventx Professor Ruth Parry, communications expert who studies clinician-patient interactions about sensitive issues. Plus, James gets some top tips to help alleviate embarrassment when talking to your doctor. Presenter: James Gallagher Producer: Hannah Robins Content Editor: Holly Squire Production Coordinator: Ismael SorianoThis programme was produced in partnership with The Open University.

If you have a rare genetic disorder, new technology that allows your genetic code to be analysed means you could have a diagnosis within weeks. Before, people with rare diseases would often go their entire lives without a diagnosis. It's a revolutionary advancement but does it change how patients are treated or help improve their wellbeing?Presenter James Gallagher meets Lisa whose daughter Jaydi was born with a rare genetic disease that affects her growth, speech, eyesight and a number of other conditions. We hear the story of Lisa and Jaydi's journey to diagnosis through Exeter University's Deciphering Developmental Disorders (DDD) study, and how it changed the course of Jaydi's life.Her clinician, Consulatant Clinical Geneticist Dr Emma Kivuva, tells James how the diagnosis impacted on the care they offered and Dr Caroline Wright, Genetics & Genomics Theme Lead on the DDD study explains how they are measuring the effect of diagnosis on patient treatment and wellbeing.This programme was produced in partnership with The Open University.Presenter: James Gallagher Producer: Tom Bonnett Editor: Holly Squire

Trials of a cancer 'vaccine' have begun and presenter James meets Steve, one of the first patients to trial the new treatment, Steve remembers his shock at being diagnosed with colorectal cancer in his 40s and tells the story of how he became involved in this pioneering research into tackling cancer.The vaccine is based on the same mRNA technology as the Pfizer-BioNTech COVID-19 vaccine and James heads to the University of Cambridge to find out how the early work into cancer vaccines became the foundation for the rapid rollout of the covid vaccine. In the lab, molecular biologist Dr Anne Willis and immunologist Dr James Thaventhiran explain how the vaccine is personalised to target the unique make-up of an individual patients' cancer cells, and how if the trials are successful they could open the door to mRNA treatments being used to treat a wide range of diseases.Also, Imperial College London cyber security researcher Dr Saira Ghafur joins James in the studio to explain why healthcare is a growing target for cyber attackers and how we can prepare for the next one because, as Saira says, it really is a case of "when" not "if".Presented by James Gallagher Produced by Tom Bonnett with Hannah Robins Assistant Producer: Katie Tomsett Editor: Holly Squire

Mpox is spreading and it’s been classified a public health emergency by the World Health Organization. Presenter James Gallagher meets Professor Trudie Lang from the University of Oxford who has been working in the areas affected to discuss what it means for people in the countries it’s already reached and whether its spread can be stopped.James also puts your questions on statins to Professor Naveed Sattar, and we hear the story of Simon who works in the outdoors as a landscape manager. He was having bouts of severe illness and was struggling to understand what was behind it. The answer? He’d had successive bites from ticks and was having symptoms of an allergic reaction when he was eating meat. He had alpha gal syndrome, commonly known as a meat allergy. We hear how it’s caused debilitating changes to his life.We also hear from Consultant Immunologist Dr Rachael O’Brian who has been documenting the first case of alpha gal syndrome her team have been diagnosing at Frimley Park Hospital in Surrey.Presenter: James Gallagher Producer: Tom Bonnett Assistant Producer: Katie Tomsett Editor: Holly Squire

Richard was 10 when he started smoking, and by the age of 35, he had given up on giving up smoking. But thanks to vaping he quit, almost by accident, in just a few months. However, vaping has been in the spotlight recently, with the rise of disposable vapes and awareness of more young people starting to vape. So, is vaping a useful tool to help people get off of cigarettes, or is it a gateway for young people into smoking? We hear from young people about their experiences and thoughts on vaping. In the studio, Dr Sarah Jackson, Principal Research Fellow at UCL Alcohol and Tobacco Research Group, and Hazel Cheeseman, Deputy Chief Executive of ‘Action on Smoking and Health’, are with James to discuss. Plus, podiatrist Dr Ivan Bristow is on hand to advise why James and listener Linda have had a hard time getting rid of their verrucas for years. We find out exactly what the warts are and what options are available to help our body tackle them. Presenter: James Gallagher Producer: Hannah Fisher Assistant producer: Katie Tomsett

The inventor of statins, Akira Endo, died this summer. When he was prescribed statins in older age for high cholesterol he refused, preferring to improve his diet and lifestyle instead. But how far can changes like these really go to reduce our bad cholesterol and our overall risk of cardiovascular disease? Our resident GP Margaret McCartney and Professor of Cardiometabolic Medicine Naveed Sattar discuss. Dermatologist Dr Alexandra Banner gives us the lowdown on how to treat sunburn, including reviewing some of your surprising home remedies. And what is snus and does it enhance sporting performance? Professor Toby Mundel explains. Presenter: James Gallagher Producers: Hannah Robins and Tom Bonnett Assistant producer: Katie Tomsett Editor: Holly Squire

From the Hay Festival, James and a panel of experts explain what we can all do to help ourselves age well. We discover what’s going on in our bodies when we age, the difference between biological and chronological age, as well as getting the audience moving for a physical test. James is joined by gerontologist Sarah Harper from the University of Oxford, biomedical scientist Georgina Ellison-Hughes from King’s College London, and doctor Norman Lazarus to understand how exercise, diet, and mental health all have a part to play in how we age. Presenter: James Gallagher  Producer: Gerry Holt Editor: Holly Squire

As the emotional roller coaster of the Euros comes to a close and the summer Olympics begin, James joins Professor Damian Bailey for an experiment to measure the ups and downs of watching sport. We monitor brains, hearts, lungs and hormones to try to out if watching sport is good or bad for us. But is there an additional risk for sports fans attending the summer Olympics in Paris? As climate change drives the tiger mosquito northwards there are concerns over the potential spread of Dengue in France’s capital. James talks to disease ecologist Dr Jennifer Lord to discover what France are doing to prepare for this mosquito-transmitted virus. Plus, Professor Peter Openshaw joins James to digest the latest Covid-19 inquiry and what lessons we can learn for the next pandemic. Together, they discuss why we are currently experiencing a summer wave of Covid-19. Presenter: James Gallagher Producer: Hannah Robins Assistant producer: Katie Tomsett Editor: Holly Squire

This week James visits a pub in Liverpool where he's joined by a trio of alcohol researchers who’ll watch carefully as he drinks two pints of lager.They’ll give him a few tests and talk through exactly what is going on in the body and brain from the very first sip to the minutes and hours that follow. James finds out we might be more at risk of harm than we may have thought - even if we drink below the recommended guidance of 14 units of alcohol per week. And we’re also going to answer some more of your insomnia questions - from whether exercise can help to why chocolate before bed might be a no-no and whether falling asleep to your favourite health podcast is good for rest…Inside Health is taking a short break for now so we'll see you in the summer. In our next series we're going to be talking about ageing and how to age well. Email your questions or thoughts to [email protected]: James Gallagher Producer: Gerry Holt Editor: Holly Squire Production coordinator: Liz Tuohy Studio manager: Neva Missirian

Last month, Catherine, Princess of Wales shared she’d been diagnosed with cancer. Describing this news as ‘a huge shock’ and at age just 42, the Princess’ disease falls into a category known as “early-onset cancer” – when the disease affects those under 50. While cases in this age group are still rare, diagnosis rates over the past few years have been growing. And scientists are now on a mission to figure out why. Receiving a cancer diagnosis at any age is devastating, but younger people living with the disease face additional challenges. James Gallagher talks to Emma Campbell, a mum of three young children who was diagnosed with bowel cancer at 36. Emma shares not just how her treatment affected her life, but the difficulties in advocating for herself as a younger person trying to get diagnosed. Professor Helen Coleman, cancer epidemiologist for Queens University Belfast, has been studying these diagnostic rates in younger people and explains possible reasons why more people like Emma are finding themselves living with the disease. A series of videos recently went viral on social media from women claiming their weight loss drugs got them pregnant. These drugs – like Ozempic and Wegovy – help people lose weight by suppressing appetite, but could they impact fertility? James speaks to Dr Charlotte Moffett, lecturer in Pharmacology and Molecular Pathology at the University of Ulster, who is studying if these drugs might alter someone's ability to conceive. James is also joined in the studio by GP, Dr Margaret McCartney, who helps him answer some of your questions. Presenter: James Gallagher Producer: Julia Ravey Content Editor: Holly Squire Production Coordinator: Elisabeth Tuohy TikTok credits: @Dkalsolive | @anastasiamalhotra | @coachkatierogers

How did you sleep last night? Perhaps you couldn't drift off, or maybe you woke in the middle of the night and then couldn't nod off again.In this special edition of Inside Health we're talking all about insomnia. It’s an issue that may affect many of us at some point in our lives – but for some it goes beyond a short period of not being able to sleep and becomes something more serious.You’ve been getting in touch with your questions, and James is joined by a trio of experts ready to answer to them: Dr Allie Hare, president of the British Sleep Society and consultant physician in sleep medicine at the Royal Brompton Hospital, Colin Espie, a professor of sleep medicine at Oxford University and Dr Faith Orchard, a lecturer in psychology at Sussex University.We’re going to find out why we get insomnia, when to seek help and how much factors like ageing, menopause, needing the loo or shift work matter. And we'll look at the latest advice and treatments. Can insomnia be fixed? You can keep in touch with the team by emailing [email protected]: James Gallagher Producer: Gerry Holt Researcher: Katie Tomsett Production coordinator: Liz Tuohy Studio managers: Jackie Margerum & Andrew Garratt

Scientists are worried about ticks. They say they’re starting to pose more of a health risk here in the UK, as our climate warms and urban areas spill into green spaces. But what are ticks, what kind of disease can they cause – and how much of a problem are they? We go on a tick hunt in Richmond Park and then head back to the lab to meet the ticks we’ve collected. We find out why new species of ticks and new diseases could be coming our way - and what you can do to keep safe.Also this week, we answer your questions on the impact of noise on our health following our recent programme. And we delve into the fascinating world of measles. It’s the most contagious virus in the world – by a long way. What is it about this virus that makes it so spectacularly good at infecting us?Keep in touch with the Inside Health team at [email protected]: James Gallagher Producer: Gerry Holt Editor: Martin Smith Production coordinator: Liz Tuohy

Have you ever tried intermittent fasting? As the month of Ramadan comes to an end, many Muslims are concluding several weeks of time-restricted eating. But outside of religion, many of us are now choosing to eat this way for health reasons – even UK PM Rishi Sunak does a weekly fast. Claimed benefits of intermittent fasting range from weight loss to improved immune function to maybe even living longer, but do these stack up? James Gallagher gives one of these popular diets a go whilst trying to answer if restricting when we eat our food is good for us. He chats to Colin Selman from the University of Glasgow about the animal studies which inspired these claims, Claudia Langenberg from Queen Mary University on what happens in our bodies when fasting, and Lucy Serpell from UCL on the potential dangers these types of diets can pose. Plus, we visit AFC Wimbledon for an Iftar event to hear if people fasting during Ramadan experience any changes to their health. Presenter: James Gallagher Producer: Julia Ravey Editor: Holly Squire Studio Manager: Giles Aspen

From ear-splitting aircraft noise and the drone of traffic to the hum of an open-plan office, the world around us can feel loud. But is it getting louder? And is this having any effect on our health - and even on how long we live? We find out when living close to a road, railway or airport might go from nuisance to health hazard, with potential effects on our sleep, heart health, mood and concentration. It’ll get loud as we do some tests in a lab to explore how unwanted sound might affect the rest of the body beyond our ears, and we sift through the growing research on the impact of noise. Who might be most at risk and why? We also find out why our reaction to noise might be about more than just volume - and we go in search of some simple tips to help.Keep in touch with the Inside Health team at [email protected]: James Gallagher Producer: Gerry Holt Editor: Martin Smith Production coordinator: Connor Morgans

Ever wondered how much caffeine is too much? Or whether you’d feel better off if you took an afternoon nap? And with the rise in ‘day raving’ we’ll be looking at whether it’s better for your health to have your night out at 2pm rather than 2am. We’ll learn about the amount of caffeine in different drinks, looking at what it does to the body in the short-term and finding out more about what effects it can have when it comes to things like dementia and cardiovascular disease. Then we’ll be following a strict scientifically-approved napping schedule and hearing what impact those bonus sleep sessions can have on brain function – while catching 40 winks in some unusual locations. After that, we’ll take all that energy and party the afternoon (and early evening) away at a daytime rave to find out if that is better for our bodies than pulling an all-nighter.Along the way we’ll be joined by people who know way more about these things than us, from a Spanish sleep whizz in Manchester to a body boffin in Barry Island.Producer: Gerry Holt Presenter: Laura Foster Editor: Holly Squire Production Co-ordinator: Jonathan Harris

BBC health journalist Laura Foster can’t get the first days of the pandemic out of her head; the stunned silence of the newsroom as the first lockdown was announced, the chaos and noise at the supermarket and the empty streets of London.But even though she was a reporter covering every twist and turn of the story, she still can’t remember the first time she heard about long Covid.The world was so engrossed by the immediate threat that few paid attention to what was happening around the edges; the people whose lives didn’t move on after that little red line disappeared from their test and whose symptoms never went away. And that problem was getting bigger and bigger by the day.We visit the UK’s very first long Covid clinic where healthcare workers started learning about this life-shattering disease in the hospital car park - and we find out why recovering from long Covid is a lot like training for the Olympics.What did we know back then – and what do we know now? And are we really any closer to seeing the end of long Covid?Details of organisations offering information and support with long Covid are available at bbc.co.uk/actionline.Presenter: Laura Foster Producer: Gerry Holt Editor: Martin Smith Production co-ordinator: Jonathan Harris

It’s been referred to as puberty in reverse but what actually is the perimenopause? How do you know if you’re in it? What can you do to soften the symptoms and what can men do to help those they care about going through it? Inside Health is talking about the peri-menopossibilities and learning why it’s not as bad as you’ve been led to believe. Endocrinologist Professor Annice Mukherjee and Professor in Reproductive Science at University College London Joyce Harper are alongside Inside Health's resident GP Margaret McCartney and presenter Laura Foster. They're answering your questions to help demystify the perimenopause.Presenter: Laura Foster Producer: Tom Bonnett

In this episode we’re taking a look at emergency medicine outside hospitals and surgeries – and meeting the people who save seriously-ill people in unusual places.Smitha Mundasad goes on a rainy walk in the hills with the Brecon Mountain Rescue Team and meets the flying medics of London’s Air Ambulance. Will she have time for a chat before they get a call-out? We also hear from Sweden where they’re making lifesaving changes before the ambulance even arrives.And from kombucha and kimchi to keffir and sourdough, fermented food and drink is everywhere. But as these foods have exploded in popularity, so have claims of health benefits, from digestion and gut health, to immunity and mood.We start by trying some fermenting with chef Olia Hercules and then Smitha chats to fermented food “nerd” Professor Paul Cotter to sift through the evidence. Next week’s Inside Health is all about the perimenopause – the time leading up to the menopause when oestrogen starts to drop. Why is it all still such a mystery? Send us your questions – and we’ll put them to our panel. It’s [email protected] Presenter: Smitha Mundasad Producer: Gerry Holt Editor: Martin Smith Production co-ordinator: Jonathan HarrisDeclared interests: Professor Paul Cotter: “Research in the Cotter laboratory has been funded by PrecisionBiotics Group, Friesland Campina, Danone and PepsiCo. Paul Cotter has also received funding to travel to or present at meetings by H&H, the National Dairy Council U.S., PepsiCo, Abbott, Arla and Yakult. In addition, he is the co-founder and CTO of SeqBiome Ltd., a provider of sequencing and bioinformatics services for microbiome analysis.”

In 2016, Niall McCann was left with a bruised spinal cord when he crashed his speed glider into the side of a mountain at 50mph. He shares his journey to recovery and some unexpected life lessons he has had to navigate, from soiling himself in inconvenient places and not being able to control his flatulence, to having to re-learn how to have sex again.We also hear from a Brecon Mountain Rescue medic on what looked like an “unsurvivable” situation and Niall’s surgeon on fixing his “exploded” spine. Presenter: Smitha Mundasad Producer: Gerry Holt Editor: Holly Squire

This week we’re exploring our microbial metropolis.Smitha Mundasad heads into the lab to meet the bacteria that live on her skin – and on her family’s dirty laundry – to understand what’s there, and why. She goes antibiotic-hunting around her house to find out whether bacteria on a washing up sponge, a fluffy cushion, the bottom of a shoe – and even some of her kids’ play slime – could hold the key to helping scientists find new medicines. Next, Smitha wants to find out the answer to how often we should wash ourselves – and our clothes – for good health, but, as she finds out, this question is not as simple as it sounds. It turns out there's a big difference between cleanliness and hygiene – and the confusion between these two rather important words could be having an impact on our health…Presenter: Dr Smitha Mundasad Producer: Gerry Holt Editor: Holly Squire

As the nights draw in and the spluttering sounds of coughs and colds seem to be all around us, presenter James Gallagher is getting ahead this year and stocking up his medicine cabinet. He gets some help from Inside Health’s resident GP Margaret McCartney and virologist Lindsay Broadbent from the University of Surrey to take look at a few of the nation’s best-loved remedies and find out what they will actually do to help him when he, inevitably, gets ill. Presenter: James Gallagher Speakers: Dr Margaret McCartney, GP and expert in evidence-based medicine Dr Lindsay Broadbent, Lecturer in Virology at the University of Surrey Reshma Malde, Superintendent Pharmacist, John Bell & Croyden Producer: Tom Bonnett

Exercise in older age is high on the agenda, but the idea that with age comes bags of time and a desire to ‘get out there’ isn’t true for a lot of us. How do you juggle exercise around caring for partners, grandchildren or staying in work? What if you haven’t exercised for years? What can your body take, and how has it changed with age? James Gallagher hears how octogenarian athlete ‘Irongran’ keeps going, he explores the mental and physical barriers that stop us exercising, and he finds out what he might feel like in 40 years as he pulls on an ageing suit. Presenter: James Gallagher Guests: Edwina Brocklesby, athete and founder of SilverFit Dr Dan Gordon, Associate Professor in Cardiorespiratory Exercise Physiology, Anglia Ruskin University Dr Katrina McDonald, judo specialist and Senior Lecturer in Sports and Exercise Sciences at Anglia Ruskin University Dr Josephine Perry, sports psychologist and founder of Performance in Mind Professor Cassandra Phoenix, Department of Sports and Exercise Sciences at the University of Durham Dr Dharani Yerrakalva, GP and NIHR Doctoral Fellow at the University of Cambridge Producer: Tom Bonnett

The issue of sexual assault hasn’t been far from the headlines in recent weeks - but what kind of help is available for people who have been through it? James visits Saint Mary’s Sexual Assault Referral Centre in Manchester where he meets the people who offer invaluable medical and emotional support to patients. He also talks to a young woman who describes her experience of using the service, which she credits with saving her life. And why does Covid-19 seem to be flooring people again? James finds out that the body’s own defences are partly to blame. Lastly, is it safe to flush dog poo down the toilet? We clear up a family debate… Presenter: James Gallagher Producer: Gerry Holt Content editor: Erika Wright Production coordinator: Jonathan Harris Technical producer: Tim Heffer If you have been affected by child or adult sexual abuse or violence, details of help and support are available at bbc.co.uk/actionline, or you can call for free, at any time to hear recorded information on 0800 077 077.

1 in 7 people live with migraines around the world, and the condition costs the UK economy billions each year. Attacks can be debilitating and all-consuming, but a new treatment recently approved by NICE might even help the most stubborn cases find some relief. James Gallagher is joined by neurologist Alex Sinclair from the University of Birmingham, GP Richard Wood from Oxford University Hospitals NHS Trust, and physiotherapist Anne-Marie Logan from St George’s University Hospitals to answer your questions on migraine and headache; from understanding why migraines exist in the first place, to if foods like takeaways could be triggers, and what these new treatments mean for the future of migraine management. Presenter: James Gallagher Producer: Julia Ravey Editor: Erika Wright Production Co-ordinator: Jonathan Harris Technical Producers: Sue Malliot and Donald Macdonald

How many hours do you spend sitting down per day? Six? Maybe eight? Or 10? Between commuting, working and relaxing, sitting can soon add up to hours and hours. In this week’s Inside Health we’re going to delve into the science to find out exactly how much sitting is too much; when does it become worrying for our health? James visits the lab at Leicester University where he meets Professor Charlotte Edwardson to explore what prolonged sitting does to the body and he’ll find out whether there’s anything you can do to offset the effects of sitting a lot. We’ll hear about the origins of sitting research - and just because we like to explore every angle on a topic, we’ll hear all about why standing too much can also be a worry. James visits a school in east London where the children are really focusing on how much time they spend sitting. They’re taking part in the Active Movement programme with the aim of bringing lots of action into the school day - and take it home too. Sounds nice and relaxing doesn’t it? Presenter: James Gallagher Producer: Gerry Holt Editor: Erika Wright Production Co-ordinator: Jonathan Harris Studio Producer: Matthew Chamberlain

When the Government released the latest statistics on STIs in the summer, one in particular stood out. Syphilis. A sexually transmitted infection which might make you think more 1823 than 2023. But figures in England are currently at their highest since 1948, a rise which is reflected across the UK. James Gallagher speaks to people who have first-hand experience with syphilis to work out why we aren't talking about the disease and it's increase more. And James gets on his bike with resident GP Margaret McCartney to find out whether tracking her stats via her many exercise monitors is improving her physical and mental health or making it worse. Dr Brendon Stubbs, Clinical-academic physiotherapist at Kings College London and Dr Eoin Whelan, Professor in Business Analytics & Society at the University of Galway help unpick the evidence. Presenter: James Gallagher Producer: Clare Salisbury Editor: Erika Wright Production Co-ordinator: Jonathan Harris Studio Producer: Sarah Hockley

What happens when a new drug hits the UK’s streets? And how are illicit drugs here changing – and why? James follows the trail of the first case of “zombie drug” xylazine in the UK and hears some powerful personal stories along the way. The story begins in Solihull, in the West Midlands, where 43-year-old Karl Warburton was found dead in May 2022. He had a mix of xylazine, heroin, fentanyl and cocaine in his body. James visits a local addiction clinic where Mark describes the fear and compulsion many addicts face. He tells James about his journey to recovery and we meet Simon who’s on a mission to help people like Mark into a new life. Next, James meets toxicologists at a busy hospital lab in Birmingham where he finds out how xylazine was first detected. Then he travels to London to meet a university academic who first raised the alarm about the drug, and visits a cramped room containing the paper records she keeps detailing every drug death in Britain from the past 25 years. James goes on a surprising and, at times, emotional journey as he gets a rare insight into the world of illegal drugs and the parts of the NHS that treat addiction. Presenter: James Gallagher Producer: Gerry Holt Editor: Erika Wright Production Co-ordinator: Jonathan Harris Technical producer: Andrew Garratt Locations: Solihull Integrated Addiction Services, Birmingham and Solihull Mental Health NHS Foundation Trust Department of Toxicology, Birmingham Heartlands Hospital The National Programme on Substance Abuse Deaths (NPSAD), King’s College London

Until recently, breakthroughs in treating Alzheimer’s disease were non-existent. But two new drugs have shown promise in moderately slowing memory and thinking problems for people with early-stage disease. While welcoming the idea of a ‘new era’ for treating Alzheimer’s disease, how much of a difference could these drugs make for people living with the condition? James Gallagher visits a Memory Café in Doynton to hear about the daily challenges people living with dementia face, and their feelings about the new treatments on the horizon. Lauren Walker, Alzheimer’s disease researcher at Newcastle University, gives an overview of the protein these drugs target in the brain, and Liz Coulthard, Professor of Cognitive Neurology at the University of Bristol, explains how these treatments might impact patient's lives. After listening to our “How hot is too hot for human health?” programme, one of our listeners contacted [email protected] to ask how the heat experienced during a hot flush impacts the body. James asks Clare Eglin, lecturer in applied physiology at the University of Portsmouth, what happens in the body during a hot flush and hears about how many others symptoms are actually caused by the menopause from GP, Margaret McCartney. Presenter: James Gallagher Producer: Julia Ravey Editor: Erika Wright Production Co-ordinator: Johnathan Harris Technical Producer: Tim Heffer

Barely a day goes by without more headlines around new weight-loss drugs, from the issue of global shortages, to investigations into suicide risk, and debate over just how long people will need to be on them. But in this episode of Inside Health we’re going to look at something slightly different - and perhaps unexpected. James Gallagher meets lifelong dieter Cheri who has lost just over three stone on semaglutide but she’s also noticed other effects from her weekly injection; a calmer mind and a complete lack of desire for her much-loved vapes. She wants to know what’s going on – so we seek out some scientists to help us get to the bottom of it. From the evidence gathered so far, are there hints that these drugs could offer potential to treat serious addiction? And have you ever heard of “bed rotting”? It doesn’t sound particularly enticing - but James gives it a go in the name of science and we explain all in the programme with the help of two experts. What health questions do you want us to answer? Email the team at [email protected] Declared interests: Professor Giles Yeo: "I have a PhD student part-funded by Novo Nordisk. I consult for Novo Nordisk and Eli Lilly." Dr Tony Goldstone: "I have previously been a member of Data Safety Monitoring Board for clinical trials of Liraglutide for obesity by Novo Nordisk, and have received an honorarium as a conference speaker from Novo Nordisk." Presenter: James Gallagher Producer: Gerry Holt Editor: Erika Wright Production Coordinator: Jonathan Harris Studio Producer: Duncan Hannant (Photo: Cheri Ferguson with her Ozempic pen. Credit Cheri Ferguson)

One year after the peak of UK infections, can we determine what actions brought mpox cases down? A year ago, mpox – the virus formally known as monkeypox – was spreading in the UK. These infections largely impacted the gay, bisexual and men who have sex with men community, with news cases peaking at 350 per week. One of these individuals was Martin Joseph, who tells James Gallagher how a lack of accessible information and the stigma he observed during his illness inspired him to create a mpox-based podcast so others wouldn’t feel so alone. Thankfully, 2023 so far has told a different story for mpox. Infections in the UK have remained relatively low, and in May, the World Health Organisation declared the mpox global health emergency over. But what helped bring the UK outbreak under control? James is joined by Jake Dunning, infectious diseases doctor and researcher at the University of Oxford, and Claire Dewsnap, sexual health doctor and president of the British Association of Sexual Health and HIV (BASHH), to discuss potential factors, takeaways and whether we are really ‘done’ with mpox. How often should we go to the dentist? Listener Mary emailed [email protected] to query the time needed between check-ups. James hears the evidence from Janet Clarkson, professor of dentistry at the University of Dundee, who explains the unlikely origins of our bi-annual appointments! Presenter: James Gallagher Producer: Julia Ravey Editor: Erika Wright Production Co-ordinator: Jonathan Harris Studio Producer: Donald McDonald (Photo: Monkeypox Credit: Uma Shankar sharma | Getty Images)

Our guinea-pig presenter James Gallagher has been eating either extremely fast or excruciatingly slow to figure out what our eating speed does to our health. Dr Sarah Berry from Kings College London explains it’s not good news if you devour your dinner! And we get to the bottom of the headlines on cancer and the artificial sweetener aspartame. James and Prof David Spiegelhalter discuss why these cancer-scare stories keep on happening. Get in touch with the team (especially if you have any questions about headache or migraine) on [email protected] Presenter: James Gallagher Producer: Julia Ravey Editor: Erika Wright Production Co-ordinator: Jonathan Harris Studio Manager: Giles Aspen

After the hottest June in history and record-breaking temperatures last year, the UK is really feeling the heat. But, we’re not alone. Last week the world experienced the hottest day in history - and forecasters warn this is just a taste of what is to come. Here on Inside Health we love a tricky question - so in the first episode of the new series we’re chasing down the answer to a pretty timely one, how hot is too hot for our health. James heads into the lab to explore exactly what is going on inside our bodies when it gets hotter. He gets wired up and locked inside a heated chamber to find out what factors matter most, from core temperature to humidity, and learns which is more deadly, cold or heat. He also hears about a surprising tip to stay safe in the heat. Do join us on what promises to be a rather hot and sweaty journey… How hot is too hot for you? And what other health issues should we be covering? Do get in touch via email at [email protected] Presenter: James Gallagher Producer: Gerry Holt Editor: Erika Wright Production Coordinator: Jonathan Harris Technical Producer: Tim Heffer Image: James Gallagher in the lab. Credit: Dan Welsh

James Gallagher finds out if we've turned into a nation of grinders after reports from dentists of increased clenching and cracking of teeth. Margaret McCartney answers your feedback about the new weight-loss drug, exercise for your back, sperm counts and then goes for retail therapy with James to discover how useful shopping data could be for understanding our health.

James meets Ian who has Parkinson's disease and hears how ballet has helped with his symptoms, as a major new review of the evidence shows exercise really does make a difference. And microplastics which can be found in drinking water and food stuffs have now been identified in human vein tissue. James unpicks what this means for our health. Presenter: James Gallagher Producer: Erika Wright and Harry Lewis

James Gallagher asks whether a weight-loss drug on the NHS heralds a new era in tackling obesity? He meets Jan who lost nearly 4 stone after being part of a trial taking a weekly injection of Semaglutide for 15 months alongside advice on meals and exercise. However, when people stop taking the drug the weight starts to go back on. Add to that supply shortages with heightened private demand and some doctors think the drug is as controversial as they come. James unpicks the ethical and societal dilemmas against a backdrop of half the world's population projected to be overweight or obese by 2035. Producer: Erika Wright Declared interests Dr Margaret McCartney: "No conflicts to declare." Prof Sir Stephen O’Rahilly : "in the past has been a remunerated consultant and has had research collaboration with Novo Nordisk." Professor Naveed Sattar: "consulted for and/or received speaker honoraria from Novo Nordisk, Abbott Laboratories, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceuticals, Merck Sharp & Dohme, Novartis, Pfizer, and Sanofi; and grant support paid to his university from AstraZeneca, Boehringer Ingelheim, Novartis, and Roche Diagnostics. He was a co-investigator in lifestyle trials such as DiRECT and co-lead for STANDby."

Lower back pain impacts millions of adults every year and, in many cases, diagnosis can be murky. Non-specific pain is personal and complex, driven by factors such as injury, sensitivity and perception. But are there methods to help manage back pain and live a happier life in the process? James Gallagher is joined at a yoga studio in Stockbridge, Hampshire by Emma Godfrey, psychology researcher at Kings College London, chiropractor David Elliot, physiotherapist Richard Husselbee, and yoga instructor, Alison Trewhela to answer all your back pain questions (and takes to the mat himself to try some gentle healthy lower back poses). Producer: Julia Ravey

James Gallagher investigates whether there is a decline in male sperm including the results of his own sperm count analysis. He meets a couple who conceived after having treatment for a varicocele, enlarged veins in the testes that can heat the sperm up and the leading known cause of male infertility. And James is joined by leading scientists in the field to debate whether sperm counts are falling. Producer: Erika Wright

Can magic mushrooms help your mental health? James Gallagher cuts through the hype and examines the evidence to find out if psychedelics can treat depression. Presenter: James Gallagher Producer: Geraldine Fitzgerald

The cost of everything is soaring, but what toll is that taking on our health? We’re at a food pantry scheme in Coventry meeting mums Danielle and Ellie to find out how hard putting food on the table has become. Dr Megan Blake and Prof Sir Michael Marmot help explain what that does to our bodies now and in the long term. Get in touch: [email protected] Presenter: James Gallagher Producer: Geraldine Fitzgerald

Dawn had a heart attack but 'powered through' making the Christmas dinner before seeking help - because she put her symptoms down to anxiety and backache. Her interventional cardiologist in Newcastle-upon-Tyne, Professor Vijay Kunadian, sees many women like her who aren't seen quickly enough or given the right medication to improve their chances of survival. We hear about research which reveals that women are much more likely to die of a heart attack than men because of delays and lack of treatment. Learning the piano can help to improve the way our brains process audible and visual information - a task we carry out effortlessly when looking and listening as we do things like cross the road safely or chat with friends. Dr Karin Petroni explains how even just a few microseconds in processing speed can make a difference - so she's going to carry on playing drums. James Gallagher's piano version of Giuseppe Verdi's La donna è mobile/When the saints go marching in (trad) arranged by Nancy Litten/Kenneth Bartels (ABRSM)

James Gallagher asks whether the next pandemic might be an invasive fungi? Most people think of athlete's foot or fungal toe nails but the World Health Organisation recently issued the first ever list of life threatening fungi. James hears stories of hospitals being shut down, a ruined honeymoon and fungal infections that consume human tissue leaving terrible disfigurement. Add to that ‘The Last of Us’ a hit video game turned new TV series where a parasitic fungus manipulating the brains of ants has jumped to people. Sounds fanciful but while this particular fungus couldn’t cross from ants to humans, Dr Neil Stone explains why invasive fungal infections are on the rise and a potential pandemic should not be dismissed. Producer, Erika Wright

The rise of antibiotic resistance means that we need alternatives to fight infections - and some healthcare professionals are turning to maggot therapy to help clean up wounds. They might be treating people living with diabetes who can experience a loss of sensation in their feet because of high blood sugar levels. Damage to their blood vessels can also slow down healing. Melanie Rix Taylor from Swansea has type 1 diabetes and had a quarter of her foot amputated because of an infection. When the skin around the wound started to die she was offered maggot therapy. After just a few days the larvae placed on her foot in a small bag - a bit like a teabag - digested the dead skin, helping to promote healing. Her Podiatrist at Morriston hospital Ros Thomas explains how she's used maggots hundreds of times, with great success. The larvae of the greenbottle fly species Lucilia sericata are supplied to the NHS on prescription with an average cost of £200-£300 from BioMonde in Bridgend. James visits their fly room with entomologist Micah Flores, helping him to collect some of the fly eggs which are then thoroughly cleaned and prepared so they can then be used on patients. As well as consuming dead tissue, the larvae also produce anti-microbial secretions and help to promote healing. Professor Yamni Nigam from Swansea University - who's advised television programmes like Casualty about storylines on maggot therapy - is a big fan of the creatures which have a long history of being medically useful, long before scientists found the scientific proof to support their use. She wants to help people to get over their initial disgust so that they can be used more widely, instead of as a last resort. Photo credit: Maggot/BioMonde

Covid and other bugs have ripped through the Inside Health team, so we find out why everyone seems to be getting sick at the moment and if we will be facing a torrent of infections for months or even years to come. We see how easy it is to buy antibiotics online and why scientists are worried about it. And can ketamine and its mind-altering powers can help free people from addiction to alcohol? Get in touch: [email protected].

It’s January. Christmas is a distant memory and nobody feels much like getting off the sofa, but luckily this episode can help. James Gallagher is on a mission to find out what is the least amount of exercise you can do to still stay healthy. James goes on a Ramblers wellbeing walk, uses a treadmill for the first time and takes a hot bath all to find out how lazy he can be. His guide Dr Zoe Saynor at University of Portsmouth explains this is the question everyone asks and offers simple tips about how little you can do. Presenter: James Gallagher Producers: Gerry Holt and Erika Wright

James is in South Wales where he's wired up and locked inside a cryo-lab to discover the impact of cold on the human body. A temperature of 10C seems pretty mild doesn’t it - yet James is shocked at the profound stress it puts on his body. Today we discover why cold is a killer and what you can do about it if you’re struggling to heat your home. Presenter: James Gallagher Producer: Gerry Holt

Do you want to see your GP records at the touch of a button? That’s the plan in England, but doctors warn us freely opening them up to everyone is not safe. And we’ll explore a study that’s transforming our understanding of how cancers develop and bring clarity to the confusion around antidepressants after a study showed low serotonin levels were not the cause of depression. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Can you imagine moving out of the family home and watching your daughter grow up from a distance, all to avoid the threat of Covid? That’s the decision Shannon has taken because the drugs she takes for her lupus leave her immune system weak and vulnerable. She tells us what it’s been like shielding for 951 days (and counting) and we explore whether there are any solutions. Then we see why childhood vaccination rates have been falling for a decade and whether you should follow the health secretary’s example and share your antibiotics. Producer: Fiona Hill and Gerry Holt

I think I might’ve dodged Covid. Like many others, I’m fully vaccinated but have never tested positive despite having had plenty of opportunities to catch it. I used public transport to get to work during the lockdowns and was exposed to the virus when my son came down with it. So what’s going on? Armed with my covid antibody test results, I ask immunologist Prof Mala Maini to clear up the confusion. And a new scale to determine skin colour which could improve how certain health problems are diagnosed and treated. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Maybe listen to this one BEFORE you eat… James is off to meet the sewage scientists trying to stop the next pandemic. He meets the teams that were monitoring 80% of people’s faeces during Covid-19 and finds out how sewage led to hundreds of thousands of children having an emergency polio vaccine. James needs to collect a sample at a water treatment works and then head to the laboratory… just be glad you can’t smell a podcast. Presenter: James Gallagher Producer: Erika Wright

What do sweeteners do to our bodies? We force feed James cups of sweetened tea and find out with nutrition scientist Dr Sarah Berry from King’s College London. We then tackle something stronger - alcohol. Can a new supplement reduce the amount of alcohol getting into the body? And Rohin Francis gets frustrated at the shonky claims being made by health podcasts (not this one, of course, you’re totally in the right place). Presenter: James Gallagher Producer: Beth Eastwood

Should friends and family be trained to give potent medications to those dying at home to relieve their symptoms? We often say that we’d like to die peacefully at home when the inevitable happens. Yet people can be left in pain for hours waiting for a doctor or nurse to be free to visit and administer the medicines that ease our symptoms in our final days. James Gallagher speaks to Mark, who was trained to administer medicines to his mother to help keep her comfortable at the end of her life, and to palliative care doctor Marlise Poolman who is pioneering the programme across North Wales. Presenter: James Gallagher Producer: Beth Eastwood

Smitha Mundasad asks whether we will see waves of Covid – with infections going up and down and then up and down again - forever more. We speak to Elliot whose life has been transformed after a single shot of gene therapy to treat the inherited blood disorder haemophilia B. And Dr Margaret McCartney discusses the accidental discovery of Viagra and how sometimes researchers find new, surprising uses for old medicines. Produced by Geraldine Fitzgerald.

Rashes, a runny nose and weird poos are all common in babies. Parents are sometimes told these symptoms mean their baby is allergic to cows milk and are prescribed low allergy formula or advised to avoid dairy if they are breastfeeding. Marijke Peters cut dairy out of her diet to try and help the gut problems her new baby Eva was having - but it made no difference and she's still trying to find out why she has blood in her poo. Dr Robert Boyle sees babies with allergies in his clinic at St Mary's hospital in London. Those with a cows' milk protein allergy can safely drink low-allergy formula milk - but Dr Boyle thinks that more than the expected 1% of babies are being diagnosed with the allergy. So he looked at the number of prescriptions for these specialised formula milks dispensed in the UK, Norway and Australia. In the UK he says that ten times the number you'd expect to see are prescribed. Professor Paula Moynihan who's Director of Food and Health at the University of Adelaide says these formula milks could pose a risk to children's teeth because they contain different sugars than the type found in milk - which bacteria in the mouth can feed on, making it more acidic and potentially damaging the teeth. She says that any babies given the dairy-free formulas should have their teeth brushed twice a day with a fluoride toothpaste and start seeing a dentist as soon as the first tooth appears. Dr Margaret McCartney explains how long-Covid patients are going to extraordinary lengths to try unproven treatments in the hope that they will alleviate their symptoms. We hear how an investigation by the British Medical Journal uncovered how a special type of blood filtering called apheresis and hyperbaric oxygen therapy - costing thousands of pounds - are offered to long-Covid patients in European clinics but there is no evidence that they will help them. Margaret recommends instead signing up for NHS trials investigating potential treatments in a regulated way. Gout is incredibly painful but many adults diagnosed with the condition aren't taking the recommended medication a year after they were told they had it. Dr Mark Russell from Kings College hospital in London found that only a third of people with gout were taking medication to help lower urate levels in their blood which can turn into crystals in the joints and organs like the kidneys if it is too high.

What do you think bendy joints has to do with the way the brain works? Well you may be in for surprise. Scientists have found a connection with autism, attention deficit and Tourettes. So what does this tell us about how our brain and body work? We’re asking whether we’re stuck with monkeypox forever now or do we still have the chance to stop it spreading? And has the pandemic left a permanent scar on children’s activity levels.

Does medicine have a language problem? We speak to Rachel who was made to feel like a 'naughty schoolgirl' by the terminology used around the birth of her child. We’ll find out how deep-seated blaming and belittling language in healthcare is, and why. We get sticky and sweaty discussing the dangers of heatwaves to the human body. And we take the confusion out of 'chemo brain' or cancer-related cognitive impairment, and explore why we rarely talk about it and how this is now changing. Presenter: James Gallagher Producer: Beth Eastwood

Aaaaaaaaa-choo! If you have hay fever then you know that it can be a right pain in the… nose. This week Inside Health presents a complete guide to hay fever. Are we enduring the worst hay fever season? When was the disgustingly-named “summer catarrh” first identified as a medical condition? And what can we safely plant in the garden without setting off our symptoms? GP Navjoyt Ladher and immunologist Danny Altmann join James Gallagher in the park to talk causes and treatments, and to find out how close we are to having a cure. Presenter: James Gallagher Producer: Anna Buckley

This week James Gallagher finds out if the Power of the Dog is true. No not the movie, but the claim that dogs can make us live longer. He’s also doing press ups in the studio to see if small amounts of muscle building exercise can help boost our health no matter how old we are. Then, inspired by the last episode on long Covid, James goes in search of the lost art of convalescence.

It’s a long Covid reunion on Inside Health. We first met Jo, Neil and John in February 2021 when they were 12 months into the condition. Another year on, we catch up with them to see if they are any closer to making a full recovery. We explore how a virus can cause such prolonged symptoms, with Dr David Strain from the NHS Long Covid Taskforce, and see if we are any closer to treating long Covid. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

We get to the bottom of a medical mystery – what causes multiple sclerosis? A series of studies have compellingly pointed the finger at the virus behind glandular fever. We see if they stack up and assess what it means for the future of preventing and treating MS. Then nearly two years since the World Health Organization described Covid as a pandemic, James chats to Dr Maria van Kerkhove, who is the WHO's technical lead for its response to Covid, about the successes and failures of the past two years and where we’re all heading next? Producer: Andrew Luck-Baker

How often do we need a smear test? It’s become controversial now as a new test means women and people with a cervix need checking less often. But in the future the answer might be only once a lifetime! We hunt for the special blood that's in high demand, yet in short supply, for people with sickle cell disease. And could the disruption from the Covid pandemic be setting the stage for a large outbreak of measles? PRESENTER: James Gallagher PRODUCER: Beth Eastwood Credit Image: NHS Blood & Transplant

James meets a record breaking doctor who is analysing DNA so quickly it is transforming treatment in intensive care and from one of his patients, Matthew, who discovered he needed a new heart. Then James has a disgusting confession as we discuss losing weight by getting more sleep. And can we get better therapies for all of us by copying the revolutionary trial that transformed the pandemic.?

Can you take hormone replacement therapy - HRT - for forever? Three women talk about their different experiences of how they managed the menopause. We balance the risks and the benefits of HRT to see who might be able to take it for the long-term. And do you know how much water should you drink? If you said 2 litres or six-to-eight glasses a day then you may be in for a surprise. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Can “one helluva pig” be the solution to a worldwide shortage of organ donors. People die waiting for replacement hearts, lungs and kidneys. So I meet the teams that have started transplanting pig organs into people. We’ll explore the huge leaps of genetic engineering that are making "xenotransplantation” possible and ask if it’s even ethical to try. Presenter: James Gallagher Producer: Andrew Luck-Baker

Will we need boosters forever? It’s the question you wanted us to tackle so we’re joined by Prof Beate Kampmann, the Director of The Vaccine Centre at the London School of Hygiene and Tropical Medicine, in the search for answers. Then we explore why so few pregnant women are taking up the Covid vaccine even though it is the best option for mother and baby. And can we stop another infection in babies - Group B Strep - which can have devastating consequences. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Jimi Olaghere feels like he’s been reborn after a pioneering new treatment for sickle cell disease. Scientists have engineered his blood to overcome the disease that left him in constant pain. I speak to Jimi about his experience and to his doctors about what this could mean for people with sickle cell around the world. Then we explore the headlines around women being worse off with male surgeons and get quite excited about a study suggesting a bedtime read helps sleep. Presenter: James Gallagher Producer: Andrew Luck-Baker Image Credit: Getty Images

Are you one of the five million people with asthma in the UK? If so, could you be on a different inhaler - one that could control your asthma better while also being kinder to the planet? “Puffers” - or aerosol spray inhalers - contain potent greenhouse gases and can be tricky to use correctly, so not everyone can control their asthma. We speak to Caroline from Cornwall, who has switched inhalers and it’s transformed her life. James talks to the doctors who think far more people could benefit from making the change. We also speak to Nerys from North Wales who has started antiviral treatment for her Covid infection. We explore the new drugs with virologist Dr Elisabetta Groppelli and Prof Chris Butler who is running the clinical trial designed to pinpoint who is likely to benefit from antivirals the most. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Is an Omicron infection inevitable? Which drugs still work? Is this the last hurrah of the pandemic? This week we have three of the country’s greatest scientific minds teasing apart what Omicron means for our lives now and in the future. Prof Eleanor Riley, Prof Azra Ghani and Prof Sir Martin Landray also tackle your, at times controversial questions! And our regular Dr Rohin Francis gives us a first-hand account of the pressures on NHS staff?

Happy New Year. I hope you’re sticking to your New Year’s resolutions! Our resident GP Margaret McCartney has dragged me out for a wintery run to discuss how to stick to a healthier lifestyle. And we’re joined by Dr Giles Yeo, Dr Ian Hamiliton and Prof Russel Foster as we tackle the best diets, giving up booze for Dry January and getting a better night’s sleep. PRESENTER: James Gallagher PRODUCER: Beth Eastwood & Geraldine Fitzgerald

Beat pre-diabetes and get your love life back? We hear from two people who are trying to avoid getting type 2 diabetes. But not everyone thinks the term is helpful so our resident GP Margaret McCartney and Dr Samuel Seidu, from the Leicester Diabetes Centre, join us to discuss. And our cardiologist Rohin Francis gets one step closer to his dream of being an astronaut. Presenter: James Gallagher Producer: Geraldine Fitzgerald

Flying London to New York and back. 244 times every day. For half a year. That’s the size of the carbon footprint of all the personal protective equipment used in health and social care in England during the first six months of the pandemic. So I take a look at how the NHS is going green including efforts to make a reusable facemask. Also, a shortage of vials for blood tests has GP Navjoyt Ladher asking whether we were testing too much anyway. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

The future is here. Gene silencing medicines - which can fine tune how our DNA works - have held promise for decades. Now hundreds of thousands of people will get them in the UK. James speaks to a surgeon whose life and career have been saved by gene-silencing drugs and to researchers who think the field could lead to drugs for diseases we think of as untreatable. Presenter: James Gallagher Producer: Geraldine Fitzgerald

The pandemic has strapped rocket boosters onto vaccine science. So where is it taking us next? What other diseases are we about to take on? Prof Dame Sarah Gilbert, architect of the Oxford vaccine, gives me her view. Also, given teenagers and parents agree about everything and never have any arguments.... we should be able to rapidly resolve any questions about whose decision it is when it comes to the Covid jab in teens. Dr Navjoyt Ladher and Dr Vanessa Apea join some very honest teenagers to help find the answer. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Anyone need a hug? I’m taking a look at this year’s Nobel Prize for Medicine. It helps explain how we experience the physical sensations of touch, heat and cold. Yes it’s the hugs, tea and ice cream Nobel! But it could also have implications for treating pain, so Prof Irene Tracey is here to discuss. And you wait decades for fortification and two come along at once. I explore why the government wants to tweak our flour and water.

We’re going meat-free for this podcast! The supermarket shelves are heaving with faux meats and vegan ultra-processed foods. And if you don’t want to put milk in your coffee or on your cereals there’s a load of plant-based alternatives. So we take a look at how healthy these foods are and what you need to know when you’re doing the weekly shop. Sorry you will have to listen to me eating a sausage roll. PRESENTER: James Gallagher PRODUCERS: Beth Eastwood & Lorna Stewart

Do you know your mons pubis from your labia majora? Few of us can identify the parts of the vulva - that’s the external female genitals. So I go exploring with Dr Fiona Reid from St Mary’s Hospital in Manchester and find out why we all need to be better informed. Also, who should be able to look at your medical records? There are grand plans afoot to collect the data your GP holds on you and make it available to researchers. We discuss the pros and the cons with Prof Martin Landray from Oxford University and GP Dr Margaret McCartney. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

My blood pressure is perfectly normal, but could I benefit from medication to lower it even further? We discuss with Oxford University’s Prof Kazem Rahimi and our resident GP Margaret McCartney. How do you diagnose a new disease that could have 200 symptoms? We explore long Covid in children with our reporter Carolyn Atkinson and Professor Sir Terence Stephenson from the UCL Great Ormond Street Institute for Child Health. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

It’s time to talk about periods and contraception. Different birth control options alter the menstrual cycle. Journalist Nicola Davis tells me about her decade without periods and our resident GP Margaret McCartney and sexual health doctor Julia Bailey discuss the evidence and what you need to know. We’ve also got vaccination expert Adam Finn to discuss the slowdown in young people getting the Covid-19 jab and cardiologist Rohin Francis explores the link between erectile dysfunction and the heart. PRESENTER: James Gallagher PRODUCER: Geraldine Fitzgerald & Beth Eastwood

Time for a sprinkling of happiness with a new exhibition at the Wellcome Collection. Last time we heard how children's A&E is under huge pressure as infections, that disappeared during Covid, make a comeback. But doctors also warn that many of those children shouldn’t actually be there. Damian Roland a paediatrician in emergency medicine at University Hospitals of Leicester NHS Trust busts the myths about fever and gives tips on when to take your child to A&E. And the wonders of ear wax, until it builds up, that is, as it does for me. But it's not just ear wax that nurse Andrew Hill has found in people's ears - cocaine and spiders too. You get it all here on Inside Health. PRESENTER: James Gallagher PRODUCERS: Beth Eastwood & Geraldine Fitzgerald

Here at Team Inside Health we’ve noticed our children are constantly ill. So we find out why. Are all those bugs that were dormant for the pandemic suddenly having a resurgence? Or has a year and a half of being squeaky clean left a lingering impact on our immune system? Plus Medlife Crisis - Rohin Frances asks can you be too fit?

The Inside Health podcast is back with a bang! Find out how having a couple of mates round for the football trapped scientist Alex Crozier inside a Covid experiment. Laura talks us through her remarkable journey, from a fear of needles to having her Covid jab, and Oxford University’s Daniel Freeman has some tips for you too. We’ve unleashed our cardiologist, Rohin Francis, for the first of his “Roving Rohin” (trademark pending) reports on hospital staff who don’t get the vaccine. And GP Navjoyt Ladher shares her insight on where we’re at with the pandemic. Happy listening. PRESENTER: James Gallagher PRODUCERS: Beth Eastwood & Geraldine Fitzgerald

This is the remarkable story of how the UK’s Recovery Trial saved the lives of hundreds of thousands of Covid patients. It was set up in nine days, after a conversation on the number 18 bus. Within 100 days it had found the first life-saving drug. This trial has united thousands of doctors, the NHS and 40,000 patients, at the scariest moments of their lives, changing the pandemic, and possibly medicine, forever. We speak to Oxford professors Martin Landray and Peter Horby who devised the Recovery Trial, and to some of the doctors and patients who helped make it happen. PRESENTER: James Gallagher PRODUCERS: Geraldine Fitzgerald & Beth Eastwood

I was floored for three days with side-effects after having my first Covid jab and many of you have been in touch about your side-effects too. Why do some of us feel awful after the vaccine, while others barely notice anything? What does this say about our immune systems and how protected we will be against covid? We put your questions to Eleanor Riley, a professor of immunology and infectious disease at Edinburgh University. Our resident GP Margaret McCartney has been taking a look at the reports of blood clots after vaccination, and we speak to Victoria Male, a lecturer in reproductive immunology at Imperial College London, about the rules for vaccination in pregnant women. PRESENTER: James Gallagher PRODUCERS: Beth Eastwood & Geraldine Fitzgerald

I have become hooked on playing online chess during this lockdown and after watching the Queen’s Gambit. So we’ll find out if it is actually doing my brain any good and whether it and similar games can ward off dementia. Margaret McCartney takes us on a fascinating tour through the history of deliberately infecting people with diseases, as the first “challenge trials” with coronavirus are about to start. Listeners David and Barbara tell us about a treatable condition called normal pressure hydrocephalus that is often mistaken for dementia. PRESENTER: James Gallagher PRODUCER: Beth Eastwood Clip from the Netflix series 'The Queen's Gambit', directed by Scott Frank. Music copyright: ‘Training with Mr Schaibel’ by Carolos Rafael Rivera from the official soundtrack of The Queens Gambit

What has the pandemic done to our sex lives? We’ll hear if there’s been a baby boom with Dr Margaret McCartney and Dr Rebecca Thomson-Glover has the lowdown on sexually transmitted infections. We’ll also explore changes to contraception and sexual health services. Meanwhile it feels like we’re on the march to normality, but what about the backlog of patients whose treatment has been cancelled. We speak to Charmayne whose surgery has been held up by the pandemic and Nick Arresti from the British Orthopaedic Association to see how such waiting lists can be tackled.

Most people recover rapidly after catching coronavirus. But I chat to three people who were infected almost a year ago and are still feeling the impact, both on their bodies and their minds. Doctors are having to rapidly grapple with how to treat patients with long Covid. We speak to one of them, Dr Manoj Sivan, the Research Lead for the Long Covid Service in Leeds, who warns that long Covid could be a “second pandemic”. We also have GP Dr Navjoyt Ladher answering your questions on the Covid vaccines. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

A fever, cough or loss of smell and taste are criteria for a Covid-19 test, but what if you have different symptoms? James Gallagher discusses whether more symptoms should be added to the UK government's list with resident GP, Margaret McCartney and Dr Thomas Struyf of KU Leuven. Cardiologist Dr Rohin Francis explains what symptoms he sees when patients with coronavirus arrive in hospital. One of the most common symptoms of Covid-19 is the loss of the sense of smell. It returns after a few weeks in most people but a significant minority still can’t smell anything many months later. James Gallagher talks to Prof Carl Philpott of Norwich Medical School who has led an international panel of nose doctors, assessing the evidence for the best therapies to restore the olfactory sense to people who have lost it following respiratory infections. So-called smell training comes out top as the most evidence-based approach. Carl explains how it works and we hear from two people who are trying to regain their sense of smell. And Dr Carly Welch from the British Geriatric Society says that delirium has emerged as another symptom of Covid-19, particularly in the elderly.

One or our listeners, Katharine, asks whether mouthwash can help stop the spread of coronavirus. We hunt down the answer with the help of biochemist Valerie O’Donnell, from the University of Cardiff, and our own Dr Margaret McCartney. Then it’s our turn in the dentist’s chair. Dentistry is up close and personal with a fair amount of splatter, the perfect place for coronavirus to spread. So dentist Paul Woodhouse and University of Newcastle dentist and researcher, Richard Holliday, are on to explain how to make it safe. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

It’s an exercise special on Inside Health. This week Amanda wants to know how quickly she can get back to exercising after Covid. Dr David Salman has drawn up some advice and Dr Navjoyt Ladher explains why this virus means we should be taking it easy, as well as having a shocking confession of her own. We check in on George, Jen and Dr Helen Hawley-Hague to see how they are getting on with their physiotherapy in the height of lockdown. And we explore with Sport England’s Tim Hollingsworth what the pandemic can teach us about improving exercise levels. Oh and I think I nearly broke our resident GP Margaret McCartney talking about 'adaptogens'.

In Covid, oxygen levels in the body can crash without noticeable symptoms - it’s known as “silent hypoxia”. This week we’ll be discussing whether letting people monitor their oxygen levels at home with a pulse oximeter could save lives. James talks to Chris Harris, who’s been using one, and two pioneers of the project - Dr Matt Inada-Kim, Consultant in Acute Medicine at Hampshire Hospitals NHS Trust, and Dr Caroline O'Keeffe who runs oximetry@home in North Hampshire. And the hotly debated topic of rapid, or lateral flow, testing. Local councils are rolling them out for people who can't work from home, and the hope is that they could help us keep on top of the virus by picking out people with Covid. Could it be a way out of the pandemic or could it cause more harm than good? Prof Irene Petersen and our own Dr Margaret McCartney are on the case. Dr Navjoyt Ladher answers some of the most common questions about vaccines. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Should you take vitamin D pills to ward off coronavirus? Our own Dr Margaret McCartney has been sifting through the evidence in search of answers. Also clinical trials expert Dr David Collier of Queen Mary University London tells us about new treatments for Covid-19 that are in the pipeline. And is the mysterious “nocebo effect” causing most of the side-effects from statins? Janice Richardson from Hebden Bridge shares her experience on the pills and we chat to researcher and Dr James Howard of Imperial College and cardiologist Dr Rohin Francis. Presenter: James Gallagher Producer: Geraldine Fitzgerald

2020 was awful. So what about 2021? I chat with Prof Neil Ferguson to see how this year could play out and when life might return to normal. Cardiologist Dr Rohin Francis and cancer nurse Aly Foyle are both back to share their experiences of coping during Covid. I promise you, it’s not all bad news. And our own Dr Margaret McCartney, alongside Cancer Research UK’s Jodie Moffat, scrutinises a new blood test that promises to find cancer early. It's a good programme, James. PRESENTER: James Gallagher PRODUCER: Beth Eastwood

Saleyha Ahsan reports from Ysbyty Gwynedd, her own hospital in Bangor, North Wales about how the Intensive Care Unit is preparing for winter. Saleyha meets Val and the Critical Care team who have looked after her since the pandemic began. Val was admitted to the unit in March and has become part of the intensive care family. Producer, Erika Wright

Covid-19 damages the lungs, leaving people struggling to get enough oxygen into their body. In the early stages of the pandemic many patients needed a lot of support in intensive care - including artificial ventilation. But there are other ways of boosting oxygen levels in the body - which are being studied in the Recovery-RS trial. Professor Gavin Perkins from the University of Warwick is comparing oxygen delivered by a mask called CPAP with both regular and high-flow oxygen to see which works best. Physiotherapy is one of the hands-on therapies which has been disrupted by the lockdown. Patients who need to do bespoke exercises following a fall or a heart attack might have been offered online sessions instead. But Manchester University researcher Dr Helen Hawley-Hague says these don't suit everyone - including people who don't have access to the internet or a smartphone. We hear from Jennifer and George - both of them have taken part in Helen's studies and have accessed physiotherapy either face-to-face or via a phone app. An Inside Health listener wanted to know if live vaccines like the polio vaccine could protect us against Covid. Oxford University's Andy Pollard explains about the theory behind this idea and how it might help. Dr Margaret McCartney looks at whether it makes a difference if you do a Covid throat and nose yourself - or if it's carried out by a healthcare professional.

Margaret McCartney on National Test and Trace and why households are receiving multiple calls. Beth tells of being contacted many times when her child tested positive and began to think all the family had been separately in contact with different cases, until the penny dropped that the calls were all about the same contact - her daughter. Professor Kate Ardern, director of Public Health in Wigan explains why these calls from the national system aren't joined up. And is there time in a pandemic to do trials for non-drug interventions like pub curfews or social distancing? Professor Paul Glaziou explains that there are currently just 8 such trials globally, while Professor Martin McKee highlights the problems involved. And Margaret hears from Professor Atle Fretheim who is trying to set up a trial in Norway into the impact of school closures on infection control.

The Radio 4 Touch Test included questions about touch in health care. Dr Natalie Bowling who's a psychologist from the University of Greenwich helped to create the test with colleagues at Goldsmith's University. Analysing the data revealed that a positive attitude towards touch in treatment settings increases as we get older. Surprisingly men reported being more likely to feel comfortable with touch in treatment settings - despite women preferring tactile treatments more than men. GPs Margaret McCartney and Ann Robinson agree on the importance of touch in their consulting rooms - both to help tell the difference between constipation and a ruptured appendix - and to place a comforting hand on the shoulder of a distressed patient. Chemotherapy cannot cure 82 year old Anne Townsend who was given a diagnosis of ovarian cancer a year ago - but it's hoped it will help to relieve her symptoms. One side effect has been a loss of her sense of touch - devastating because she loves to sew quilts. She found that reflexology sessions helped - though they stopped because of lockdown and she now uses acupressure techniques which she was taught online by therapists at St Christopher's hospice. Deborah Bowman, Professor of Bioethics at St George's University, also felt calmer and better-prepared for medical procedures when she was having cancer treatment. She explains how she trains medical students to approach their patients in a sensitive way and use touch with care.

The story of one child's recovery from PIMS-TS, the rare new condition that caught doctors by surprise in April. James Gallagher visits specialists at the Evelina London Children's Hospital to hear how they coped with identifying and treating a condition they'd never seen before. Dr Jenni Handforth and Dr Sara Hanna explain how 'they had to reinvent and tweak the rule book' to manage PIMS-TS, where 'the immune system has gone a bit crazy' and treatments worked 'like a fire blanket to dampen down the immune system'. And scientists at the Francis Crick Institute have discovered that children can have Coronavirus-fighting antibodies from before the pandemic started. Dr George Kassiotis explains how kids could have them and what this might mean. And Dr Margaret McCartney unpicks the tricky issue of spotting Covid and cold symptoms in children.

Thromboses - blood clots that form in the circulation - are easily the biggest single killer of British men and women. They affects people of all ages, races and ethnicities. Most strokes and heart attacks are caused by thromboses forming in the arteries supplying the heart or brain. But clots in the veins can be just as lethal, particularly when part of the clot breaks off and travels around the circulation and lodges in the lungs. Recently, the appearance of abnormal micro-clots in the lungs of severely affected Covid patients has highlighted the huge impact even tiny clots can have on our long term health and mortality. What more should be done to protect people from this misunderstood condition? James Gallagher unravels the risks and causes for blood clots, from deep vein thrombosis to clots in the lungs. As he hears from patients, the surprise of a DVT diagnosis and debilitation can be profound. Treating clots is a delicate process with a need to get the balance right between thinning the blood but preventing bleeding. James examines the effectiveness of the latest range of anticoagulants that have a more predictable blood thinning effect, without the need for regular checks to make sure the blood’s not too thick or too thin. The psychological effects of being diagnosed with thrombosis are often under reported. but in up to half the cases severe anxiety, depression and PTSD can arise. We hear of a major new study following the experiences of patients from their diagnosis to follow ups after treatment that explores how effectively they overcame the impact on their mental health of knowing they carried a blood clot. And James Gallagher reports on the newly emerging relationship between Covid and clotting. It was back in April when the alarm was first sounded about abnormal blood clots in severe Covid cases. Research is shedding new light on the causes of the problem - sticky blood. In turn, this knowledge is offering up new ways to treat some of the major complications thrown up by the virus. Presenter: James Gallagher Producer Adrian Washbourne

How will this year's expanded flu vaccine programme be delivered? In addition to usual groups the flu vaccine will be offered to all eleven year olds, any household contacts of vulnerable people told to shield, more health and social care workers and - the biggest change - everyone over 50! Dr Margaret McCartney discusses the difficult logistics for GP practices and pharmacies trying to work out how to immunise around half the population, whilst managing PPE, social distancing and infection control. Dentistry and Covid - Eddie Crouch, Vice Chair of the British Dental Association discusses how practices open since lockdown are coping. And a good news story of how the pandemic has instigated change in the diagnosis of coeliac disease. Dr Hugo Penny, one of the authors of new interim guidance, explains while Radhika tells of her personal experience of coeliac disease. Plus NHS preparations for winter. Trevor Smith, Divisional Director of Medicine at Southampton General Hospital, and Professor Neil Mortensen, President of the Royal College of Surgeons in England, both share their forecasts..

Dr Mark Porter on a new bedside test that differentiates between Covid-19 and other infectious diseases including flu in under an hour. Mark meets Dr Tristan Clark who has already been using the test as part of a trial. And the world's largest study into 'Long Covid' recruiting 10.000 people from 50 different hospitals across the UK who've been hospitalised for Covid to assess their long term recovery. Lead author Professor Chris Brightling discusses the long term symptoms seen in many people recovering from the virus and how research can answer difficult questions such as how long will these continue and what's the best way to help people. And Mark hears from Roz, still recovering from Covid after being admitted to intensive care on May 26th and from physiotherapists Matt and Gemma about how early and long term rehab can help. Plus Professor Sally Singh on the new NHS online rehab service 'Your Covid Recovery'.

As the Government announces GPs should start to prescribe cycling Margaret McCartney examines the evidence for exercise referrals with Harry Rutter, Professor of Global Health at the University of Bath. Temperature checks are popping up in bars, restaurants and receptions but do they work or are they giving false reassurance? Plus while the pandemic progresses Professor Carl Heneghan explains another type of false result, that the chance of false positive tests go up. Navjoyt Ladher, Head of Education at the BMJ, talks us through two highly topical terms - specificity and sensitivity. Amateur choirs have been closed due to Covid-19. Margaret talks to Professor Jackie Cassell who is currently researching what aspect of choirs congregating is particularly dangerous and whether the singing is actually a red herring. Producer: Erika Wright Studio Manager: John Boland

Public health doctors don't dash around hospitals wearing white coats brandishing stethoscopes. The work of this medical specialty is mainly outside of hospitals and it has a very long history. It has a local, national and global reach, an international skeleton charged with the care of populations. And in this pandemic, it is public health which is doing the heavy lifting. In this special edition of Inside Health Dr Margaret McCartney investigates the serious questions being raised about the UK's public health response to trying to stop the spread of the virus, and how tension, over the performance of the government's Test and Trace programme, has spilled out into the open. Margaret hears from Directors of Public Health who feel that their role and expertise in local communities working closely with local Public Health England teams has been overlooked. Instead a new national Test and Trace system has been set up using private companies outside the traditional public health infrastructure. The DPH for Wigan and lead director of public health for the Greater Manchester Combined Authority, Professor Kate Ardern, tells Margaret she believes government didn't understand the role and the experience of local public health teams and so instead of empowering them to oversee test, trace and isolate services, set up a new national system, from scratch, using private companies without public health experience. And the data needed locally to identify and deal with Covid cases, she tells Margaret, just hasn't come through. This is despite the fact that the law is clear; Covid is a notifiable disease and local directors of public health should receive the information. Margaret explores the history of public health with Professor Martin Gorsky from the London School of Hygiene and Tropical Medicine and hears from Professor of Global Health at Queen Mary, University of London, David McCoy, who believes the very structure of public health institutions after the 2012 Health and Social Care fragmented the service, leaving the country vulnerable (as he and 400 other experts warned at the time) to a pandemic. Public Health England's Medical Director, Professor Yvonne Doyle, rejects suggestions that PHE is insufficiently independent from government and insists that both national and local public health teams have pulled together in these unprecedented times. Producer: Fiona Hill

One of the most striking features of the coronavirus pandemic is the disproportionate toll it’s taken on some groups in society. Research by the Office for National Statistics shows black people are nearly twice as likely to have died from coronavirus than white people. And you see a similar pattern of elevated risk in other ethnicities too. Why is this? And to what extent is Covid 19 shedding light on approaches being taken in medicine more generally when assessing and treating people from Black, Asian and Minority ethnic groups? We hear from GP Dr Navjoyt Ladher who’s been navigating the language of race for the British Medical Journal; Dr Rohin Francis, cardiologist and host of the Medlife Crisis podcast, and Prof Kamlish Khunti who’s establishing a detailed Covid risk score to establish exactly who’s at most risk of infection. A major review has found women’s lives have been ruined and babies have been harmed in the womb and yet concerns were dismissed for years as simply “women’s problems”. Those are the findings of the Independent Medicines and Medical Devices Safety Review. It looked at the hormonal pregnancy test Primodos, the epilepsy drug sodium valproate and vaginal mesh implants which are used to treat prolapse and incontinence. Inside Health’s resident GP Margaret McCartney. discusses what needs to change. Presenter: James Gallagher Producer: Adrian Washbourne

Coronavirus has turned the NHS upside down and inside out and by re-organising to treat people with the virus, other potentially fatal diseases like cancer have taken a backseat. At University Hospital Southampton NHS Foundation Trust, which Inside Health visited weekly as the pandemic unfolded, cancer diagnoses fell by half in March and April and of the 50% who were asked to come in for follow up, only 25% actually did. The virus was more frightening than a potential cancer diagnosis. Divisional Director for Medicine at Southampton, Dr Trevor Smith, tells James Gallagher, the BBC's health and science correspondent. that patients are coming back, but it will take a long time to tackle the backlog. For those with cancer caught up in the pandemic, they have experienced disruption, cancellations, altered treatments and they have had to cope with consultations and even surgery by themselves, without loved ones to support them. Charly from Wiltshire was diagnosed with breast cancer in February and her treatment was changed as lockdown happened. Instead of chemotherapy then surgery, she had surgery first. And a mastectomy instead of a lumpectomy. But despite the disruption to her care, she still considers herself one of the lucky ones because she did get treatment. Others weren't so lucky and across the country, lives have been lost. The focus now is on Covid-proofing cancer care and tackling the backlog in screening, diagnosis and treatment. And it's an enormous backlog. Professor Charlie Swanton, chief clinician of Cancer Research UK tells James Gallagher, the BBC's health and science correspondent, that 2.7 million people have missed out on cervical, breast and colorectal screening and 300,000 fewer people than normal have been referred under the urgent 2 week cancer pathway. The creation of Covid-free cancer hubs, he says, safe zones for cancer treatment, are vital, but it will still take a long time to recover and of course there's the spectre of a second wave of coronavirus which would disrupt services all over again. Confidence building includes rapid Covid-19 testing for staff and Dr Trevor Smith from Southampton tells James about the saliva test pilot for key workers in the city. The new test just involves putting saliva in a sample pot, much easier than the normal "have you got it" swab test which involves wiping the back of the throat and deep inside the nose. Dr Navjoyt Ladher, GP and Head of Education at the British Medical Journal gives a simple guide to the "have you got it" tests: PCR, antigen and perhaps if the trial is a success, the new saliva test as well as the "have you had it tests"; the antibody tests. And finally in the week that in England at least, guidance for those who are "clinically vulnerable" and shielding on the advice of the government changes, Inside Health's Dr Margaret McCartney reviews the new advice for those in all four nations of the UK. Producer: Fiona Hill

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 Clips used in programme: Batman theme by Danny Elfman (composer) from Batman (1989) Copyright Warner Bros. Avengers Theme by Alan Sivestri (composer) from The Avengers copyright Disney Clip from Infinity War , Joe Russo, Anthony Russo (Directors) Copyright Disney Clip from Justice League by Zac Snyder and Joss Whedon (Directors) Copyright Warner Bros Clip from Iron Man by Jon Favreau (director) copyright Disney Clip from Avengers Endgame by Joe Russo, Anthony Russo (directors). Copyright Disney

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.

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

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 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

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 hopes 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.

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

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

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

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

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.

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

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

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.

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

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

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.

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 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!

Antidepressants and revised guidance from NICE reflecting that, for some people, they can be difficult drugs to come off; Margaret McCartney explains why this initiative is long over due. Chemotherapy backpacks - a novel way of giving cancer therapy that allows people to stay at home, improves quality of life during treatment and takes pressure off the NHS. Plus dizziness - or vertigo - is a common problem but it can mean different things to different people and occasionally can be a sign of stroke; so what are the clues? And our insider's guide to over the counter treatment: this week anti-inflammatory gels for pain relief.

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.

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.

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.

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.

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.

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?

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

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.

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.

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.

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

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?

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.

Research suggests opioids don't work in long-term chronic pain but dispensing in the UK has risen four-fold since the nineties, and we consume more than any other country in Europe. There is a dearth of good evidence for how best to help people come off these drugs. Mark Porter meets the team trying to change that. And an objective pitch-side test that takes the guesswork out of diagnosing concussion.

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.

Dr Mark Porter investigates the digitisation of the NHS: are online, asynchronous GP consultations the future? He visits a GP surgery in Tower Hamlets to find out how patients are getting in touch online, in their own time. Does it help improve access for patients and manage workload for busy GPs? Manu Vatish, an obstetrician from the University of Oxford, explains that currently every pregnant woman will be tested for pre eclampsia and how a new test could help accurately identify the 4% of women who actually get the condition. And could aspirin help in the treatment of cancer? Mark talks to Professor Peter Elwood from Cardiff University about his recent study into the evidence and to Professor Janusz Jankowski, a gastroenterologist at Morecambe Bay hospital to talk about the implications and risk and benefits.

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.

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.

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?

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.

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.

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.

Clarity behind recent headlines linking cancer to pills for high blood pressure; Margaret McCartney unpicks the numbers. And the aorta is the largest artery in the body so should it burst due to an abdominal aortic aneurysm, results can be catastrophic. Now Surgeons are concerned that restricting the use of the latest keyhole techniques to repair aneurysms would be a backward step and harm patients. Plus how sinks could be causing hospital infections.

Adrenaline auto injectors are used to treat life-threatening allergies, anaphylaxis, but there are severe supply issues with the brand leader, epipen, particularly with junior epipen and many parents are reporting problems when their children's devices need replacing. It's an anxious time for those caring for severely allergic children and Dr Margaret McCartney reviews the reasons for the shortage and the latest advice for worried parents. At the same time, epipen has come under fire from a UK coroner, who concluded during an inquest into the death of 15 year old Natasha Ednan-Laperouse, that epipens aren't fit for purpose because they don't contain enough adrenaline or have a long enough needle to deliver it properly. Consultant paediatric allergist at St Mary's Hospital, London and a researcher in children's allergies at Imperial College, Dr Robert Boyle, tells Mark there is widespread belief that the companies behind adrenaline auto injectors need to innovate and better designs are needed. Meningitis is every parent's nightmare. It can strike anyone at any age but around half of those with the most serious form, Meningitis B, are toddlers and young children. Two years ago, Ezra, who is now three and a half, contracted the disease. His parents, Cosmin and Serena from Carrick Fergus in Northern Ireland, tell Inside Health how this devastating illness spread so rapidly. Ezra's life was saved but septicaemia meant both of his legs, below the knee, were amputated, followed by the fingers on one of his hands. One of the paediatricians who looked after Ezra at the Royal Belfast Hospital for Sick Children was paediatrician Dr Thomas Waterfield. Inspired by Ezra, Tom worked with colleagues at Queen's University in Belfast to develop a rapid bedside test for Meningitis B. The LAMP test - Loop Mediated Isothermal Amplification test - takes just an hour to identify the Meningococcal DNA and it doesn't need specialists to use it. The current lab test for the disease takes a minimum of 48 hours. Age related macular degeneration, AMD, is the leading cause of blindness around the world, with at least half a million people living with this condition in the UK alone. Treatment has hugely improved in recent decades, with regular injections helping to prevent progressive loss of vision. But intensive monitoring is necessary with monthly trips to hospital for patients for vision tests. Researchers at the Centre for Public Health at Queen's University, Belfast, are trialling ways to avoid these regular hospital visits - saving patients the journey and saving the NHS money. The Monarch Study will assess different ways that patients can monitor their own vision at home, using paper tests or more sophisticated ipad-style eye tests. Mark meets Patricia, who has wet AMD in one eye and dry AMD in the other, who's agreed to be part of the trial and talks to research optometrist Lesley Doyle and Chief Investigator, Dr Ruth Hogg, about the study. Producer: Fiona Hill

France delists Alzheimer's drugs, a move that is a world first, after concluding that the dangers of side effects outweigh any benefits. Mark assesses the evidence and hears the arguments from France and the UK including from the head of drug evaluation at the French Health Authority which is behind the decision. Plus a more holistic approach to hip fracture and a visit to a busy clinic in Oxford where research measuring quality of life after surgery aims to improve outcomes that really matter to patients. And Margaret McCartney on prostate cancer and the Stephen Fry effect

Until recently it was assumed that placebo pills would only produce a therapeutic benefit if patients didn't know that's what they had been given. But there are early suggestions that patients can still get symptom relief even when they're told that there is no active ingredient at all in the pills they've been given. So should placebo pills be openly prescribed to patients? Ted Kaptchuk, Professor of Medicine at Harvard University tells Mark he believes open-label placebo could, if evidence continues to accumulate, form part of the physician's therapeutic toolbox. But Inside Health's Dr Margaret McCartney urges caution. She says there is insufficient evidence about the long-term impact on symptoms. Nearly 500 people died on the transplant waiting list last year and if you're one of the 7,000 waiting for a life-saving organ, how would you feel if the organ on offer came from a donor infected with hepatitis C? Such organs are about to be available on the NHS and this radical change has come about because of the revolution in treatment for this potentially-serious blood borne viral infection. Yes recipients of Hepatitis C positive organs will be infected by the virus after transplant, but a short course of treatment, direct acting antivirals, will then cure them. Consultant kidney and transplant specialist Dr Adnan Sharif from Queen Elizabeth Hospital in Birmingham explains why patients on the waiting list should have this option available to them and Professor James Neuberger from the UK government's advisory committee on the Safety of Blood, Tissues and Organs, tells Mark why SaBTO have recommended this policy change and are now keen to see it implemented. Back pain is common but most of us recover in a matter of weeks. For 10-20% of people though, the pain and discomfort doesn't go away and they suffer chronic pain throughout their lives. What many people don't know is the extent to which genes feature in back pain - it runs in families. Frances Williams is Professor of Genomic Epidemiology at Kings' College, London and a consultant rheumatologist at Guy's and St Thomas' NHS Trust. She tells Mark about the genetic clues that emerged from the world's largest ever study of 500,000 individuals with chronic back pain across five countries. Producer: Fiona Hill

When is the best time to clamp a baby's umbilical cord? It is a controversial question that has perplexed maternity units for years but new evidence from Nottingham has changed practice at the hospital's busy labour ward. Mark Porter pays them a visit. Natural Cycles is a much promoted contraception app advertised as an alternative to more conventional methods. But the Advertising Standards Authority has ruled that claims of it being 'highly accurate' were misleading so Margaret McCartney expresses her concerns that the app doesn't live up to the hype. And once the initial enthusiasm of having a pedometer wears off do they keep people walking in the long term?

Four years ago, Peter, a retired engineer from Gloucestershire, suffered a small stroke and lost the ability to speak. He communicated by hand signals and writing notes to his wife, Carol. But this summer, as he tells Dr Mark Porter, he woke up one morning and, much to everybody's amazement, began to talk....and he hasn't stopped since. Later that same day, a second stroke was diagnosed but his newly-returned speech was unaffected. It's a remarkable story and Alex Leff, Professor of Cognitive Neurology at the Queen Square Institute of Neurology in London discusses Peter's experience but describes what usually happens when stroke patients experience aphasia. We're all familiar with devices like FitBits and gym monitors that measure your pulse rate but the latest development in wearable tech is a watch that monitors your heart. The latest Apple watch will offer ECG-like capabilities which can spot potentially worrying disturbances in heart rhythm. But Inside Health's Dr Margaret McCartney has serious concerns about the use of such tech for screening in healthy populations. If you're under 50 you've almost certainly had it. The heel prick test or NHS newborn blood spot screening programme is done during the first week of life and it's designed to detect nine different conditions before they can cause symptoms or irreversible damage in young children. Dr Elaine Murphy is a consultant in inherited metabolic diseases at the Charles Dent Metabolic Unit at the National Hospital for Neurology and Neurosurgery in London and she tells Mark about the history of the heel prick test and describes the original condition, phenylketonuria or PKU, that the 1969 test was designed to detect. Producer: Fiona Hill

Every GP surgery should provide access to a dedicated social prescriber, according to the Royal College of GPs. Supporting peoples' non-medical needs - including housing, finance and social care - will, it is hoped, free up GP time for urgent medical care and at the same time, provide much-needed access to activities in the community. Arabella describes how social prescribing worked for her. A support worker helped her to join a choir, sort out finances and plan how to return to work after a period of serious illness. Dr Marie Polley, senior lecturer in health sciences at the University of Westminster and co-chair of the Social Prescribing Network (with Dr Michael Dixon) tells Dr Mark Porter that social prescribing will be embedded within medical and social care in the next decade as long as the voluntary sector is supported. Steroid cream and ointments - like hydrocortisone, clobetasone and betamethasone - are used to treat a number of skin problems. But for some patients long-term topical steroid use can lead to painful, disfiguring and debilitating skin flare-ups. Some call this condition topical steroid addiction. But consultant dermatologist Dr Tony Bewley from Bart's Health in London tells Mark that health care professionals prefer the term topical steroid withdrawal syndrome. He sees the condition fairly often in his clinic and reassures sufferers that there is treatment available. We're used to having our blood pressure checked using a cuff on our arms but we can also have high blood pressure in our lungs. Pulmonary hypertension tends to put our hearts under strain and causes breathlessness. It can be caused by a range of diseases but in pulmonary arterial hypertension (PAH) the raised pressure is due to constriction of the blood vessels. This narrowing of the arteries makes it difficult for the heart to pump blood through the lungs, leading to breathlessness. Inside Health's Dr Margaret McCartney visits the Scottish national specialist centre for the disease at the Golden Jubilee Hospital in Glasgow's Clydebank. She talks to Lorraine who is living with the disease, to pulmonary vascular consultant Dr Colin Church and watches a team led by Dr Martin Johnson performing right heart catheterisation, the gold standard diagnostic test for the disease. Producer: Fiona Hill.

If you are taking low dose aspirin - typically 75 mg day - to protect against heart attack or stroke and you haven't been weighed then there is a good chance you are on the wrong dose. And from prevention to treatment; a new way of managing the most common form of stroke by grabbing the blockage in the brain and pulling it out. Charlotte Smith tells her story of a remarkable recovery from the procedure whilst she was pregnant with her second child. Plus a continuation of our guide to the help available when people lose the capacity to make decisions about their care. This week Mark Porter explains Best Interest Decisions and Lasting Power of Attorney. And GP Dr Margaret McCartney reflects on the Hadiza Bawa Garba case.

Does running damage your knees? And is cycling any better? Runner, cyclist, GP and Inside Health regular, Dr Margaret McCartney goes to the new Motion Analysis Lab at Glasgow's Jubilee Hospital and asks orthopaedic surgeon and competitive cyclist Jason Roberts about the latest evidence. Around 30,000 people a year suffer cardiac arrest - their heart suddenly stops pumping blood around their body - and fewer than one in ten survive. Paramedics and ambulance crews will give CPR and use a defibrillator to try to restart the heart, and for the past 50 plus years, most patients will be given a shot of adrenaline too. But a landmark new study funded by the government and run by Warwick Medical School reveals that giving adrenaline barely increases survival and almost doubles the risk of severe brain damage. Dr Margaret McCartney discusses likely changes to policy with Dr Mark Porter. It's said that eyes are the windows to the soul - and certainly looking into other peoples' is the key part of human interaction. But what if one of yours isn't real? Sixty thousand people in the UK have an artificial eye and Europe's largest maxillo-facial laboratory at Queen Victoria Hospital in East Grinstead offers a bespoke service where specialists make individual eyes from live sittings. Susan lost one eye as a child and she tells Mark that her latest prosthesis is her favourite. Why? Because it's almost half the weight of eyes she's had fitted before. Dr Emma Worrall, principal prosthetist, has invented a lighter sphere. In a lightbulb moment sitting in a café stirring a sugar cube into her coffee and watching it melt, Emma tells Mark that she realised she could build the plastic sphere around sugar, drill a tiny hole, then melt the sugar out of the middle! Twenty patients at the hospital are now benefiting from lighter eyes (which means less surgery). And there's another plus. The new eyes float in the swimming pool and the sea! Producer: Fiona Hill.

The relationship between when babies are weaned and the amount of time they sleep has hit the headlines after a new study has been published. Now UNICEF has got involved. Margaret McCartney reviews the evidence. Also proof that seeing the same GP saves lives. Mark Porter meets the man behind new research on mortality and continuity of care, Sir Denis Pereira Gray, who also works in the same GP surgery as his father and grandfather did. And a guide to Mental Capacity, an issue that touches many people but is increasingly pressing as more families manage elderly relatives living with dementia. Plus research and the NHS charter.

Copycat biologic drugs, to treat conditions from arthritis and psoriasis to breast cancer and lymphoma, could save hundreds of millions of pounds off the NHS drugs bill. Called biosimilars, these close copies give the same clinical benefit at a fraction of the cost. Up to now the problem has been take-up, but a new initiative led by the specialist UK cancer centre, London's Royal Marsden, run across the NHS Cancer Vanguard, has demonstrated that patients can be switched effectively onto the cheaper drugs. Chief pharmacist at the Royal Marsden, Dr Jatinder Harchowal, who led the national staff education programme, tells Mark that getting clinicians and patients on board was key to achieving an 80% take up for the blood cancer biosimilar, rituximab. This month a biosimilar copy of the breast and stomach cancer drug, Herceptin (generic name trastuzumab) is being introduced to patients too. Imogen had sleep problems for almost 30 years and she admits that at times, her insomnia left her in a desperate state. For years she took sleeping tablets but she ended up increasing the dosage, to no effect. Eventually she found help at Queen Victoria Hospital's Sleep Disorder Clinic in East Grinstead. Mark visits the clinic and finds out from its Clinical Director Dr Peter Venn that sleeping tablets aren't the answer to insomnia and cognitive behaviour therapy, which Imogen used, is the best treatment. Scotland has led the UK nations in allowing early medical abortion at home. Wales in the past 10 days has followed their lead. So where does this leave England? Dr Margaret McCartney reports from Glasgow about the choice now available for Scottish women who opt for a medical termination. Since last autumn the second pill that induces the breakdown of the womb lining can be taken at home, a practice that already happens in Scandinavia and parts of the USA. Dr Audrey Brown, a consultant in sexual and reproductive healthcare, tells Margaret that the impetus for the change in practice in Scotland came directly from women who didn't want to make the second clinic visit for the second set of drugs and risk cramping and bleeding on the way home. A woman who has opted for early medical abortion at home in Scotland shares her experience with Inside Health. Producer: Fiona Hill.

Tamoxifen, the so called "statin of breast cancer prevention" is recommended for healthy women with a family history of the disease. So why are only 1 in 7 of those eligible taking it? And Mark Porter speaks to Professor Gareth Evans working with his team at the Wythenshawe Hospital in Manchester to reliably identify women at higher risk of breast cancer. They are testing for SNPS, spelling mistakes in the DNA that influence growth and survival of cancer cells and that give a more accurate assessment of a woman's risk.

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.

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.

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.

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.

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.

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 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, Sharlene 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.

Over half of all blood clots are acquired during hospitalisation, particularly for surgery, so prevention is key. Deep vein thromboses - DVTs - typically occur in the veins of the leg and central to prevention is the need to assess individual risk, while taking steps like special stockings, leg massagers and anticoagulant "blood thinning" drugs to mitigate them. But there are concerns in some quarters - particularly among orthopaedic surgeons - that the drive to protect patients against clots has exposed them to risks of bleeding and that the pendulum has swung too far the other way. Three leading specialists discuss the issues. And iron deficiency, a very common problem, but what is the best way to treat it? New research from Switzerland unexpectedly suggests that giving less iron, less frequently, leads to more absorption. Plus, what's in a doctor's bag?

About six thousand people in the UK lose a leg every year from amputations due to vascular problems, trauma and disease. Others are born without limbs. Standard prosthetic knees often meant frequent falls and stumbles as well as the need to use two sticks. But microprocessor power is set to change all that. A new generation of intelligent joints is now available for the first time on the NHS in England - you can already get them in Scotland and Northern Ireland - and they adjust the knee stiffness to match the individual's weight, gait and activity and they even have anti-stumble software. Dr Mark Porter joins Dr Imad Sedki, consultant in rehabilitation medicine at the Royal National Orthopaedic Hospital in Stanmore at a retrofitting clinic, where patients like Naitik Patel are fitted with these new smart knees. Almost a decade ago, researchers in Scotland coined the term "The Glasgow Effect" after they exposed the shocking fact that premature deaths were 30% higher in Scotland's biggest city compared with cities with similar histories like Liverpool and Manchester. Since then studies have highlighted a toxic combination of social, political and economic decisions which adversely affected the health of Glaswegians. Sir Harry Burns, the former Chief Medical Officer for Scotland, now Professor of Global Public Health at the University of Strathclyde, talks to Mark about why the phrase "The Glasgow Effect" has fallen out of favour and what he thinks should be done to address continuing health inequality. Glasgow - in fact the UK as a whole - has one of the highest rates in the world of mesothelioma, a cancer which attacks the lining of the lung and which is directly linked to the breathing in of asbestos fibres. From her home city, Inside Health's Dr Margaret McCartney reports from the Queen Elizabeth Hospital in Glasgow, which is a specialist centre for patients with this cancer. She talks to Robert Henderson, who contracted mesothelioma fifty years after working as an apprentice electrician and to 68 year old Boyd McNicol, who worked as an art teacher in a school full of asbestos when he was in his 20s. Their doctor, Kevin Blyth, is a respiratory consultant who coordinates a mesothelioma service across Western Scotland. He tells Margaret that the 20, 30, 40 and even 50 year time lag between exposure to asbestos and a diagnosis of mesothelioma means that the cancer will still be claiming lives for many years to come and urgent new treatments are needed. Producer: Fiona Hill.

News that the pharmaceutical giant Pfizer has pulled out of research into Alzheimer's and Parkinson's disease is casting doubt over the future of long promised breakthroughs in this area. Mark Porter hears from two leading experts who explain that due to the complexity of the disease the pharmaceutical industry's single agent 'magic bullet' approach needs to change. And while over the last 15 years nearly every trial into new treatments for Alzheimer's has ended in failure, lifestyle and medical prevention are starting to make a difference. Plus clarity on headlines that women who've had the HPV vaccine to prevent cervical cancer will need far fewer smear tests in future. But how will the national screening programme know for sure who has been vaccinated - and who hasn't? And Margaret McCartney's thoughts on other news that women treated for breast cancer who carry the BRCA1 and BRCA2 mutations that dramatically increase the risk of developing the disease, are just as likely to survive their illness as women who don't.

It's fifty years since the first human heart transplant but the number of donor organs - about 200 per year in the UK - remains dwarfed by demand. About 2,000 people under the age of 65 a year will die of heart failure without a transplant. Kevin Fong explores new ways that people with heart failure can be helped. He talks to Dr Doris Taylor, director of the Center for Cell and Organ Biotechnology, at the Texas Heart Institute, in Houston, about her research into growing hearts from stem cells. Kevin discusses the prospect of taking organs from pigs and using them for so-called xenotransplants with cardiothoracic surgeon Prof John Dark, of Newcastle University, who says this approach has not delivered benefits. An alternative to a heart transplant is the left ventricular assist device (LVAD) - an artificial pump that helps the left side of the heart do its job. This has shrunk from a large external piece of kit to a tiny battery-operated device that can be implanted into the chest. For the first year, they are as effective as a transplant, but they have a risk of infection, and they are not always easy to live with. Kevin meets patient Vincenzo Avanzato who had an LVAD that became infected and then a successful transplant. Kevin also talks to surgeon Mr Andre Simon of Harefield Hospital about the future of completely mechanical hearts made of metal and plastic.

What goes into our flu vaccine always has an element of guesswork. Usually the experts get it right but sometimes nature has other ideas and a new strain emerges. Dr John McCauley, Director of the Worldwide Influenza Centre at the Francis Crick Institute in London tells Dr Mark Porter about Aussie flu and how different flu strains pose risks to different groups of people. Cow's milk allergy is the most common food allergy among infants and it affects at least one in 50 babies, toddlers and pre-school children in the UK. It's an allergic reaction to the protein in cow's milk. There are two different types though and one type, called delayed cow's milk allergy, is often missed by health care professionals because it's easily confused with other common conditions. Lucy Wronka tells Inside Health her baby son George was ill for months with reflux, eczema and an upset stomach. It was only a chance meeting with a friend who recognised the symptoms that led to a diagnosis of delayed cow's milk allergy. Twenty four hours after diagnosis and treatment, Lucy says George was a different baby. Dr Adam Fox, paediatric allergist at the Evelina London Children's Hospital explains the difference between the two different types of cow's milk allergy and discusses new guidance for GPs and health visitors which are designed to improve diagnosis. One of Europe's largest robotic pharmacies is housed in Glasgow and this super high-tech hub has replaced fourteen separate pharmacy stores. It handles almost a hundred thousand packs of medicines a week and Inside Health's Dr Margaret McCartney, herself a GP in the city, reports on how this automation has transformed pharmacy services in Greater Glasgow and Clyde.

Can dogs smell cancer? Ever since Hippocrates the odour of disease has been used to aid diagnosis but has this simple technique been forgotten? Dr Mark Porter investigates the evidence for whether canine super noses can be used to accurately detect cancer. There have been plenty of anecdotes reported but what about hard science? Studies since 2004 from the Medical Detection Dogs Centre in Milton Keynes have shown convincing results and they've now teamed up with MIT in the US, specialists in 'e-noses'. Could devices the size of a mobile phone be used to sniff for disease?

The Chief Medical Officer has warned of a "post-antibiotic apocalypse" and "the end of modern medicine". As antibiotic resistance increases, the options to treat potentially deadly infections reduces. Inside Health's Dr Margaret McCartney discusses the latest campaign by Public Health England to remind us all not to take antibiotics when they're not needed. It's been over thirty years since there was a breakthrough in the treatment of pneumonia, but that could soon change....and from an surprising source. Researchers in Birmingham at Queen Elizabeth Hospital have been working with the cholesterol-lowering drugs, statins, and discovered that this medication can turbo-charge our immune systems, helping us to fight infection. Dr Liz Sapey, respiratory consultant and researcher tells Dr Mark Porter about the exciting possibility of tablets that cost just a few pence each, being used to treat potentially deadly lung infections like pneumonia. Epilepsy is normally controlled by anti-seizure medication but for a third of patients, pills don't work, and constant fits can have a devastating impact on the developing brain. Neurosurgery - removal or disconnection of parts of the brain where the seizures originate - is now done at a much younger age in patients with untreatable epilepsy. Operating on children takes advantage of brain plasticity. Mark visits Bristol Children's Hospital, one of four national centres which since 2011 have offered increased access to epilepsy surgery. Paediatric neurosurgeon Mike Carter is part of the national drive to operate on children before they are two years old, all to take advantage of brain plasticity. Mark meets 8 year old Lucy, 20 days after she had major surgery to remove a finger-nail sized portion deep in her brain. Lucy's father, Mark Nettle, describes how, before surgery, his daughter had suffered from multiple daily seizures with increasing weakness down the left side of her body. The possibility of ending these debilitating attacks made surgery an attractive option. Producer: Fiona Hill.

GPs have been told to ask about their patients' sexual orientation as NHS England plans to record this data for everyone using the service over the age of 16. Dr Google - are doctors' noses really being put out of joint by patients searching their symptoms on the internet to come up with their own diagnoses? Hypermobility is being double jointed and flexible and is often perceived as an asset, but for around 1 in 30 of the population it can be a problem that is often missed - and mismanaged. Plus a counterintuitive approach to help people with Chronic Obstructive Pulmonary Disease. You might think the last thing someone with breathing difficulties needs is smaller lungs, but lung reduction surgery is exactly what's being offered some people with COPD.

Vaginal mesh, used for the treatment of prolapse and incontinence, has hit the news recently as women pursue litigation after suffering serious complications. But there have been concerns ever since the first type of vaginal mesh was launched in the mid-nineties, only to be withdrawn a few years later. Carl Heneghan, Professor of Evidence Based Medicine at the University of Oxford, explains the 'shambolic' regulation of medical devices, Consultant gynaecologist Swati Jha, who has been collecting data on mesh for over a decade, believes media coverage has been muddled. Women speak of living with surgery, while Inside Health's Dr Margaret McCartney calls for a registry to collect effective data. Plus, new guidance in Scotland challenges the so called 'J-shaped curve' - evidence that moderate drinking is good for the heart. Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow and part of the committee that produced the updated guidance, talks to Mark Porter about the changes.

Mention arthritis and most people think of older people with osteoarthritic hips or knees. But children get arthritis too, although it's an inflammatory condition where the child's immune system attacks the lining of the joints causing pain, swelling and stiffness. But the joints aren't the only part of the body affected. Around one in six of the 12,000 children in the UK with juvenile idiopathic arthritis also develop worrying inflammation in their eyes, uveitis. This is a silent, symptomless condition which can result in significant visual impairment and even blindness. But a new drug treatment, tested in the UK, has proved to be so successful for this group of children that it has revolutionised treatment both in this country and around the world. The benefits were so large that the trial was stopped early and the new therapy adopted as frontline treatment. Dr Mark Porter visits the Bristol Eye Hospital and meets paediatric rheumatology consultant, Professor Athimalaipet Ramanan to find out more. Bigger babies can get stuck in the final stages of labour - a condition called shoulder dystocia. Most are delivered safely but there are both enormous risks to the baby through lack of oxygen and a traumatic experience for the mother. Professor of Obstetrics at Warwick Medical School, Siobhan Quenby, tells Mark that a nationwide trial of big baby births aims to find out whether delivering the child two weeks early, at 38 weeks, reduces shoulder dystocia and makes the birth safer for mother and child. A report by NHS England highlights cost savings of around £100,000 for GP practices that use telephone triage for patients. But the first independent evaluation of this system, where everyone speaks to a doctor on the phone before they get a face to face appointment suggests that policy makers should reconsider their unequivocal support. Inside Health contributor Dr Margaret McCartney, herself a GP, reviews the findings. Several thousand people a year, many of them children, are admitted to hospital every year with serious burns. One of the country's leading centres for burns victims is at the Queen Elizabeth Hospital in Birmingham. As well as serving 13 million people in the local area, the Healing Foundation UK Burns Research Centre treats injured service personnel, airlifted from conflict zones in Iraq and Afghanistan. Mark gets a tour of the unit from director Naiem Moieman and finds out about the newest research on burns treatment which uses some of the oldest remedies.

After Simon Cowell paid for a Britain's Got talent contestant to have surgery in the US for her curved spine we examine the state of therapy for scoliosis here in the UK. Recent headlines claimed that 1 in 4 teenage girls are depressed but were they accurate? And pets in hospital: the Royal College of Nursing has called for patients to have better access to animals, including their own. Plus Eustachian tubes: tips for what to do if you have blocked ears after your summer holiday.

Inside Health reveals the poor state of addiction services in England with heroin and morphine related deaths the highest on record. Professor Colin Drummond raises concerns about a split in care between the NHS and Local Authorities since the 2012 Health and Social Care Act. And personal testimony is heard from Alison Bedford Russell whose son George died of a heroin overdose last year. The Care Quality Commission, who is responsible for inspections, has found that 2/3 residential drug and alcohol treatment services failed to meet the required standard. Dr Paul Lelliott, Deputy Chief Investigator of hospitals at the CQC, explains what was discovered. The correct use of medical language is a topic close to Inside Health so Margaret McCartney was naturally drawn to discuss news this week about the misuse of the term Schizophrenia. And as London hosts the first ever Cardio-Oncology Summit in Europe, specialists from both fields discuss how to treat and prevent heart problems in people undergoing therapy for cancer.

Breast Density - the major risk factor for breast cancer that you may have never heard of. Health Education - a long term approach to changing attitudes to illness by encouraging children to be less dependent on doctors and pills. Switching Outcomes - one reason why so few clinical trials result in real changes in practice that benefit patients.

Margaret McCartney unpicks recent headlines suggesting its okay not to finish your antibiotics; Lung Cancer screening in the high risk; Can you die a broken heart? Evidence suggests this is a real condition called Takotsubo syndrome and is much more common than previously thought. And gender bias in trials.

There are growing concerns about the widespread use of PPIs, the acid suppressing family of drugs used to treat indigestion and the most prescribed in the world. They are recommended to be used for weeks in typical cases of heartburn, but most people including Mark, take them for months or years. But one reason why PPIs are being used so widely is to protect the lining of the gut from aspirin and combining these two drugs may also have benefits against cancer. Mark hears preliminary findings on the so called chemo-protective effects of aspirin. And radiotherapy is a crucial part of modern cancer treatment so why does it get so little attention compared to drugs? Plus why radiation and smoking are particularly poor bedfellows.

The Hepatitis B vaccine has been added to the childhood national programme joining the 5 vaccines already given to all young babies at 8, 12 and 16 weeks. Andrew Pollard, Professor of Paediatric Infection & Immunity at the University of Oxford, and Chair of the Joint Committee on Vaccination and Immunisation, explains why. Margaret McCartney and Mark Porter visit men in north London looking for the physical and mental benefits of community sheds. The obesity paradox - can being overweight sometimes be beneficial? Gavin Murphy, British Heart Foundation Professor of Cardiac Surgery at the University of Leicester and Naveed Sattar, Professor of Metabolic Medicine at the University of Glasgow, debate the latest research suggesting that obese people are more likely to survive heart surgery than their slimmer peers. Are clinical trials good for you? We examine the evidence behind conventional wisdom that people taking part in research tend to fare better - whatever their illness.

Are we on the cusp of a new era where computers rather than doctors will be doing the diagnosing. Ali Parsa, founder of Babylon Health, believes we are and is developing an online tool using artificial intelligence that diagnoses quicker and more accurately than a doctor. He debates the issues with resident sceptic Dr Margaret McCartney. Mark Porter visits the world's first national tissue bank for pancreatic cancer, set up to aid research into a disease that has seen no outcome improvement for over 40 years. Plus statins and muscle aches; could the drugs' bad press in the media actually increase the odds of people experiencing side effects - the so called nocebo effect?

Price rises of everyday medicines due to some manufacturers utilising monopolies; Can a simple routine blood test help identify cancer; A definitive guide on undescended testes with evidence for the best time to intervene if a baby boy's testes do not drop and the downsides of delay; Aspirin and the risk of stomach bleeds in the elderly.

Statins have dominated the cholesterol-lowering field for some years but last week the results of an international trial of Evolocumab, one a new breed of medicines for reducing cholesterol, was hailed as a breakthrough. Professor Peter Sever, one of the leaders of the trial, explains how Evolocumab differs from statins and Dr Margaret McCartney takes a look at the trial. You may have noticed them in work places, gyms, and other public spaces but do you know how and when to use a defibrillator? Every time someone has a cardiac arrest and CPR is performed we should also be running for the nearest defibrillator. But currently this only happens in 2-3% of cardiac arrests, putting thousands of lives at risk every year. Mark speaks to teacher Erica Melsom and the pupil, Alex Cowes, whose life she saved by using the school defibrillator. Professor Gavin Perkins explains why and when we should run and get one. And Mark demonstrates just how simple they are to use, even if you've never touched one before. Posttraumatic Stress Disorder, a psychological condition which can begin after a traumatic event and last for many years, is the equivalent for your cardiovascular system of smoking 10 cigarettes a day. Dr Donald Edmondson explains how extreme stress takes a toll on our arteries. More than 80% of pregnant women take at least one prescribed medication and yet very few of these drugs are actually licensed for use in pregnancy. Mark talks to Professor Anna David about why there has been a reluctance to license medications for use in pregnancy, what impact that has for pregnant women, and what needs to change. Producer: Lorna Stewart.

Clarification of new evidence that Bisphosphonates for osteoporosis may actually weaken bones if people are left on them for too long ; Dietary change using FODMAPS to treat Irritable bowel syndrome when medicines have not worked; CRP testing for chest infections to identify which need antibiotics; And Mark eats humble pie for getting clinical terminology mixed up.

More than 6500 people are currently on the national transplant waiting list, hoping for an organ to be donated which might save their lives. Many of them will wait for years and, sadly, hundreds will die before a suitable organ becomes available. The low supply of organs remains the main restriction on performing lifesaving transplant surgery. The British Medical Association believes that moving to an opt-out donation system - where people who die without expressing whether or not they wish to donate their organs will be presumed to be willing to donate - would increase donation rates and save lives. The system has been in place in Wales since December 2015 and now the BMA says it's time the rest of the UK followed the Welsh model. Dr Margaret McCartney discusses with Dr Phil Banfield, chair of the British Medical Association Welsh Council. An area of medicine not often discussed on Inside Health is pathology. Mark visits the morgue at St Mary's Hospital in London to speak to pathologist Mike Osborn. What happens to your body after death? What is rigor mortis? And how much do crime dramas on TV get right? Finally, what time of day should you be taking your blood pressure medication? Millions of people take drugs to control their blood pressure and reduce their risk of heart attacks and strokes. Most people will take their medications in the morning but with many heart attacks and strokes happening during nighttime hours, just when the medication might be wearing off, should we be considering evening dosing instead? A new online trial has enrolled 21,000 people and aims to find out what time of day is best to take blood pressure medications. Mark speaks to Dr Amy Rogers from the University of Dundee who is in charge of the trial. Producer: Lorna Stewart.

New moves to test pregnant women for smoking by measuring carbon monoxide on their breath. How helpful are lifestyle targets like 10 portions of fruit and veg or 10, 000 steps a day? The incidence of thyroid cancer has tripled in 40 years, but many of the tumours picked up are on scans for something else and may never have caused harm. Mark Porter debates the issues. Plus this week's uncertainty question for Margaret McCartney and Carl Heneghan, to floss or not to floss?

Vitamin D , the sunshine vitamin, has been in the news again with claims that supplements could help ward off coughs , colds and flu. Dr Margaret McCartney takes a look at the study that generated the headlines. Whether or not a severely injured person will receive blood products at the scene of an accident depends on which air ambulance service they are attended by: some air ambulances replace lost blood with red blood cells, but others replace only with saline solution. Evidence from military casualties in Afghanistan suggests giving blood before patients reach hospital leads to better survival rates, but evidence from civilian populations in the UK is less clear. A new randomised controlled trial, being conducted by six air ambulance services, will investigate which course of action has the best outcomes for patients. Mark visits the Midlands Air Ambulance to hear more from lead investigator and trauma anaesthetist Dr Nick Crombie and critical care paramedic Jim Hancox. Phantom limb pain - pain in an amputated limb - is a common complaint among amputees. Pain medication rarely solves the problem and there is is no known cure. But now a trial in Sweden is using augmented reality to help patients relearn how to move their missing limb, and showing that chronic pain can be reduced. Mark talks to lead researcher Dr Max Ortiz. And Margaret McCartney takes a look at the evidence for that dinner party favourite - the sitting-rising test - which proponents have claimed can predict how long you might live.

A special debate on the current state of the NHS. Recorded in front of an audience at the BBC Radio Theatre London. The last few months have seen the service creaking under unprecedented demand, and there is likely to be worse to come. Something needs to give. Is it simply a matter of more resources, or do we also need to change our expectations of what the NHS provides? Is rationalisation and rationing the way forward? Dr Mark Porter discusses the issues with a panel including Clare Marx, president of the Royal College of Surgeons, Chris Hopson, chief executive of NHS Providers, David Haslam, chair of NICE, Prof Sir Nick Black, London School of Hygiene and Tropical Medicine and regular contributor Margaret McCartney GP. Issues discussed include whether the NHS should continue to be free at the point of use. Is there too much bureaucracy with too many bosses? Was the internal market evidence based, has it worked and was it fair? Rationing of treatments. And can the NHS be taken out of politics? Inside Health listeners set the agenda by emailing the programme - some of whom joined the audience - so thank you for all your input. Margaret McCartney writes: The NHS is never far from the headlines, but the last few months have depicted a service in crisis. It's been made clear that there will be no more money from central government - so what needs to give? Clare Marx, explained the angst of her members who wanted to operate on people but had been forbidden to. Nick Black, discussed the types of surgery that were now being placed off limits - like hip replacement surgery - even though they were very cost effective. Because of the way hospitals are funded, it is these useful operations that are being stopped rather than the much less cost effective prescription of some very expensive cancer drugs. Chris Hopson described tensions between the expectations being placed on the NHS to provide excellent care despite the funding gap to actually provide it. And David Haslam, chief executive of NICE, expressed his disquiet that patients could no longer expect a consistent service across the NHS. Instead, different Clinical Commissioning Groups decided themselves how many rounds of IVF to fund, for example. The result was a patchwork of provision, and was inherently unfair. Is rationing therefore the way forward? Some listeners had emailed in suggesting that the NHS shouldn't fund treatments for 'smokers, drinkers and the obese'. Others that people should pay for hospital meals, or there should be a charge made for GP consultations. We already have charges for some things - for example, prescriptions in England, or dental check ups for many people - but as Clare Marx pointed out, removal of teeth is the commonest childhood operation, so can we really say this policy has been successful? I don't believe that we have the evidence to show this is safe: the bureaucracy would be sizeable - I had to sign 12 bits of paper for a routine check when my kids and I last went to the dentist - and then there are unintended consequences. Paying for appointments turns us in to consumers - would doctors feel obliged to give us treatments that people want, even when they don't work well, aren't cost effective or do net harm? Listeners wanted to know if the NHS was over managed - and had strong opinions on how much could be saved if we got rid of middle managers in particular. But Chris Hopson pointed out that we spend less than the very efficient Germany on hospital managers, and Clare Marx said that hospitals are highly complex places needing a huge amount of organisation to run smoothly. For me it is a question of what managers are doing - is it of value to patients, or is it a waste of time? Nick Black argued that there was a great deal of waste still in the NHS - and suggested that the internal NHS market may have had some advantages to start off with, but now, the 4.5 billion a year estimated to be spent on it could be better used elsewhere. There is no doubt that the process of bidding and judging for commissioning costs time and money, but how to stop the problem of bad and wasteful policy in the first place? Could politics be taken out of the NHS? I was on my own, arguing that party politics had done avoidable harm to the NHS and that cross party working - as we see in the Health Select Committee and the National Audit Office - was possible. My fellow panellists argued that since the budget of the NHS was such a large amount of money it would be impossible to disentangle it from politics: but Chris Hopson pointed out that defence spending, for example, was ring fenced. The audience overwhelmingly voted to be taxed more to pay for the NHS. If we were sure that extra money would go on human level care, and not wasteful, non evidence based policy making, I would support it completely. But we are not, as a population, being given that option.

Prescriptions for over-the-counter items cost the NHS millions each year; in 2015 paracetamol prescriptions alone cost £87.6 million. Mark talks to Paula Cowen, medical director at Wirral CCG, one of a growing number of Clinical Commissioning Groups that are asking GPs to restrict prescribing of these items, and to Andrew Green, a GP and the prescribing policy lead at the BMA, who has reservations. Virtual Reality is being harnessed to help people recover from serious brain injury following accidents or strokes, and in conditions like Parkinson's disease and dementia. Mark visits a clinic in Salford where they're using virtual reality in neuro-rehabilitation. And treating sore throats with antibiotics. Sore throats are common accounting for 1.2 million GP consultations every year in England alone - and they affect many millions more who don't see their doctor. Most are viral and self-limiting, but around 1 in 10 are caused by a bacteria and may benefit from antibiotics. The tricky bit is telling the difference between the two but a new pharmacy-based test and treat initiative may help. Mark speaks to Peter Wilson, one of the authors of the pilot study, and Margaret McCartney is on hand to examine the evidence.

Hernias, hands and varicose veins might not be treated on the NHS as such interventions are now on the 'not normally funded' list. This list is where local commissioners show what they are not prepared to pay for, unless circumstances are exceptional. Such prioritising is also known as rationing. Dr Mark Porter investigates if this new layer of bureaucracy is a cost effective use of resources or just delaying inevitable operations with the possible risk of creating emergencies that could cause harm.

Are preventable deaths in hospitals a good measure of the quality of care being offered to patients? It's estimated that there are 12,000 deaths a year in hospitals which could have been avoided, but what does that mean and should we be worried that that number could rise with the NHS under pressure? Mark Porter visits a 'poo bank' in Portsmouth where donated faecal matter is being frozen and stored for later use in patients with Clostridium difficile or C. diff. And midwife Mervi Jokinen and our own Margaret McCartney take a look at the evidence for waterbirths. Is giving birth in water less painful? And is it safe? Producer: Lorna Stewart.

Do funding requests hinder surgery on the NHS? GP referrals to specialists for common complaints are checked by a panel to make sure they're appropriate, but can the admin for funding requests be more costly and time consuming than the operation itself? Mark Porter meets an eye specialist in Reading who argues that it can. Plus a new genetic test that has been developed to identify women at risk of breast cancer more accurately. And lactose intolerance: there's a burgeoning number of lactose-free ads and products in the shops, but is need driving the market - or marketing driving the need?

Evidence suggests Paracetamol is neither as effective or safe as previously thought for chronic pain; Prostate cancer and new targeted treatments with fewer side effects plus feedback following last week's special edition; And is giving oxygen in heart attacks a help or hindrance? Margaret McCartney and Carl Heneghan debate the first in a new mini-series investigating uncertainty in medicine.

One in 8 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 reports 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.

Most of us say we'd like to die at home but few of us actually achieve this wish - something the NHS is keen to change. An award-winning GP surgery in Lancaster, The King Street and University Medical Practice, has transformed the way they care for patients reaching the end of their life, twice winning the Gold Standards Framework Quality Hallmark Award. Dr Nour Ghazal tells Dr Mark Porter what they've done to ensure their patients have a say in how and where they would like to die and Inside Health's Dr Margaret McCartney describes how important it is to broach that most difficult of subjects. Familial Hypercholesterolaemia, also known as FH means that you have inherited high cholesterol levels and the consequences of this, if you don't know about it, can be deadly. Over half of men with FH will have a heart attack before they are 55, a third of women with FH before they're 60. But a simple genetic test can identify the condition and with a good diet, exercise and lipid lowering drugs like statins, people can live long and healthy lives. Steve Humphries, Professor of Cardiovascular Genetics at University College London tells Mark that only 15,000 people in the UK have a diagnosis of FH but it's thought that almost a quarter of a million people could in fact have the condition. So the race is on to identify and diagnose the thousands who don't know that they're carrying the suspect genes. Lorraine Priestley-Barnham, an FH clinical nurse specialist at Harefield Hospital in Middlesex describes the cascade testing being rolled out across the country in a programme supported by the British Heart Foundation. And three generations of the same family, father Chris, daughter Joanne and grandson, six year old Alfie, tell Inside Health how they found out they have FH. Delirium - an acute confused state with hallucinations and psychosis - is incredibly common in hospitals. One in five patients can experience it, many more in intensive care. Fiona tells Mark about her own experience in ICU after major surgery last year, when she believed she was being held prisoner and experimented on. She tried to escape from the ward and her daughter, Catherine, describes how distressing it was to witness her mother in such a terrified state. Julie Darbyshire, Critical Care Research Manager at the University of Oxford has done some of the first research into patients' experience of delirium and ICU consultant pharmacist, Mark Borthwick, who has a special interest in the condition, tells Mark about the different types of delirium.

The Meningitis ACWY Vaccine was introduced last year to protect teenagers from year 9 in school to those starting university or college. But there seems to be confusion about how to get the jab and many parents remain unaware of the threat posed by Meningitis W. Inside Health's resident GP, Dr Margaret McCartney takes a closer look at headlines reporting that women should be given testosterone for low sex drive. Plus, half of all people with heart failure also have iron deficiency so might iron be a clue to a new type of treatment? And Mark Porter visits his local patch in Gloucestershire where doctors are offering allotments on prescription.

Several decades ago, if you had a mini stroke or a transient ischaemic attack, it wasn't unusual for your doctor to tell you to rest in bed with the reassuring words that you'd been lucky. Follow up was casual to say the least, because it was thought that your chances of having a major stroke within the month was negligible. Dr Mark Porter talks to Peter Rothwell, Professor of Clinical Neurology at the University of Oxford, whose research transformed the way mini strokes are treated. TIAs are now seen as medical emergencies requiring urgent treatment. Taking aspirin straight after a TIA, his team's research also showed, could reduce the chance of a major stroke over the next few days by a staggering 80%. Headlines this week from a New Zealand study suggested midwife-led births mean worse outcomes for babies compared with doctor-led care - contradicting other research in the area. Inside Health's Dr Margaret McCartney assesses the new study and concludes the evidence still points to midwife-led care providing reassuringly good outcomes for low risk pregnancies. Imagine being sick for hours, days at a time, recovering for a few weeks, only for the whole cycle to start again as regular as clockwork. Roger McCleery has Cyclic Vomiting Syndrome and every couple of months he's so sick he ends up in hospital, from where he told Mark about the life-changing nature of this unpleasant condition. Consultant paediatric gastroenterologist, Sonny Chong from St Helier Hospital in Surrey who has a special interest in CVS, outlines the possible causes and treatments. Hospitals are getting noisier but in intensive and critical care, 24 hour operations, the noise can be intense, as loud as a busy restaurant with peaks of sound as loud as a pneumatic drill. Researcher Julie Darbyshire, critical care research programme manager at the Kadoorie Centre for Critical Care at the Nuffield Department of Clinical Neurosciences, has been involved in efforts at intensive care units across the Thames Valley to identify excess noise and take steps to muffle it. Peter Edmonds tells Mark how much sleep he missed being in ICU when he was a patient and Matron and Clinical Director at Oxford University Hospitals NHS Foundation Trust, Matt Holdaway, outlines how staff have embraced efforts to cut noise levels.

Breast Cancer and Bisphosphonates; an old drug for treating weak bones can reduce the risk of breast cancer spreading, but many post menopausal women are missing out. Why? Alcoholism and Baclofen; another old drug with a new use, this time a muscle relaxant to help people with an alcohol problem and news of three new trials recently presented in Germany. Complex Regional Pain Syndrome, a rare condition that often occurs after an injury or surgery and results in life changing pain. And why are some generic, non-branded medicines so expensive?

A new medical movement in Wales is urging patients to take more control of the decisions about the care and treatment they receive. Called Choosing Wisely, it calls for a more equal doctor-patient relationship, an end to "doctor knows best". Dr Paul Myers, chair of the Academy of Medical Royal Colleges in Wales discusses the initiative with Dr Mark Porter and with Inside Health contributor, Dr Margaret McCartney. A new way of tracking cancer, through the blood, not from a biopsy of the tumour, is exciting oncologists worldwide. A liquid biopsy, a simple blood test, is proving to be a hugely promising development in cancer treatment. Circulating tumour DNA is measured in the blood, giving doctors the chance to target new treatments for the particular type of cancer. Dr Mark Porter talks to one of the pioneers in this field, Dr Nick Turner at The Royal Marsden Hospital and team leader at the Institute of Cancer Research about what liquid biopsies could, in the future, mean for cancer care. Traditional advice to parents has been to delay the introduction of foods like peanuts and eggs when they wean their babies onto solid food, in order to reduce the risk of food allergies later in life. But conventional wisdom has been turned on its head with a new body of evidence suggesting the opposite is true. In a new survey of the latest data, the Director of Imperial College's Paediatric Research Unit, Dr Robert Boyle, tells Mark that the two most common childhood food allergies, to peanuts and eggs, may be prevented by introducing them early. How accurate are parents when they're measuring out liquid medicine for their children? Not at all, according to a new study. Dr Margaret McCartney discusses the findings that 84% of the 2,000 or so volunteer parents made at least one error, and 20% made a big error. Scary stuff. But there's advice on how to avoid giving your sick child the wrong dose.

Is it useful as a public health message to compare obesity and smoking? Controversy in Rome behind a new trial that suggested Blood Pressure targets should get lower. And after a rise of medicating for ADHD over 25 years, the numbers of prescriptions for children has now plateaued. Is this a good news story or is there something more complicated behind the change in trend?

Kevin Fong explores how doctors cope when things go wrong

The real lives of junior doctors today.

Was there ever a golden age in which to train to be a doctor?

Vivienne Parry asks if the NHS can deliver the benefits of genomic medicine for all

With over 50 confirmed cases of people in the UK with the Zika, Dr Margaret McCartney reviews the latest advice for people worried about the virus. Keyhole surgery for the hip. Dr Mark Porter finds out how hip arthroscopy is increasingly being used to treat problems caused by hip impingement. Sion Glyn Jones, Professor of Orthopaedic Surgery at the University of Oxford and consultant orthopaedic surgeon at the Nuffield Orthopaedic Centre describes which groups appear to benefit most from hip arthroscopy, and Amanda, who had to wait 8 years before keyhole surgery on one of her painful hips, tells Mark about the transformation the operation made to her life. Mark and Margaret discuss the benefits of the "yellow card" system, which allows patients and health professionals to report side effects of drugs. And, as more and more people in the UK are surviving, or living with cancer, thanks to recent advances in treatment, choosing the best approach when faced with a life-limiting disease can be difficult. When cure rates approach 100% for early bowel cancer, advising a patient to have surgery is much easier than recommending aggressive chemotherapy for a hard-to-treat tumour when there's only a slim chance of a cure. Consultant oncologist Sam Guglani, from Cheltenham General Hospital, discusses with Mark the different factors that can influence and impact on the unique relationship between doctor and patient when faced with such choices.

Has media coverage of statins caused people to come off the drugs? An unusual neurological itch on the arms or back that is often misdiagnosed. Plus Ghrelin, the hormone that makes your tummy rumble and an unexpected surgical side effect that may help in the quest for people to lose weight. And the story of how Viagra was discovered.

Every three minutes somebody in the UK develops dementia, so when it's claimed that tailored computer brain training can reduce cases of dementia and cognitive decline by a third over a decade, people sit up and take notice. The research claiming the 33% reduction for the group of people whose "processing function" was targeted for brain training, hasn't yet been published - so isn't peer-reviewed - but the preliminary data by a US team was presented to the Alzheimer's Association International Conference in Toronto this week. Dr Doug Brown, Director of R&D at the UK's Alzheimer's Society speaks from the Canadian conference to Dr Mark Porter and says there's widespread excitement about the potential of brain training to protect against dementia. Dr Margaret McCartney urges caution, warning it's too early to make claims before the full data is available. James is a young man with a high pressure sales job, but every year in the summer months he is crippled by agonising headaches. He's one of the 100,000 people in the UK who suffers from cluster headaches, so called because they come in disabling bouts, lasting for 4-6 weeks at a time. Inside Health visits a new one-stop multidisciplinary rapid-access headache clinic at St Thomas's Hospital in London, where James is getting treatment. Dr Giorgio Lambru, who heads the new service, tells Mark why it's so vital that patients with cluster headaches have to be seen, diagnosed and treated quickly. Years after cardiac rehabilitation became a standard part of therapy for heart attacks, the same post-treatment care still isn't routinely available for people who've had cancer, despite decade-old guidance from NICE suggesting that it should be. The UK's first clinical trial to measure holistic cancer care is hoping to provide the evidence that will demonstrate the type of support and rehabilitation that really works. Professor of Nursing Annie Young from Warwick Medical School and University Hospitals Coventry and Warwickshire NHS Trust tells Mark that after treatment, patients can feel abandoned and vulnerable. #hellomynameis is a hugely successful social media campaign which highlights the importance of healthcare staff introducing themselves to patients. It was launched by Dr Kate Granger after her experience of being in hospital. Kate died at the weekend from cancer, aged just 34. Dr Margaret McCartney describes the enormous impact of Kate's campaign throughout the NHS.

What is Papilloedema? The condition has been in the headlines as an optometrist was found guilty of manslaughter after missing abnormalities in the eyes of an eight year old child. Plus, Margaret McCartney debates the accuracy of screening young people for Sudden Cardiac Death in Sport. How to diagnose early miscarriage in women who are bleeding in early pregnancy? And the serendipitous story of how the anti-clotting agent warfarin was first discovered.

Care.data, the scheme to build an enormous database containing the medical records of all English patients has been scrapped. Dr Mark Porter investigates the fall-out following the cancellation of this expensive programme, which foundered on concerns about confidentiality and public and professional trust. Chair of the national EMIS user group and Sheffield GP Dr Geoff Schrecker and GP Dr Margaret McCartney discuss the scale of the failure of the care.data programme and outline what needs to happen in the future if valuable patient data is to be used for the public good. Twelve hundred adults and children die every year in the UK from asthma attacks, and these grim statistics have remained stubbornly consistent for decades. But there is light on the horizon as researchers in the field begin to stratify the disease; identifying patients with different types of asthma and treating them accordingly. Mark visits the Churchill Hospital in Oxford where some pioneering work has taken place to develop new diagnostic tests and new treatments. Ian Pavord, Professor of Respiratory Medicine at the Nuffield Department of Medicine, shows Mark the new FENO breath test for nitric oxide to test inflammation - soon to be available for use in general practice. Acne Rosacea is a debilitating and painful condition. It's characterised by redness, spots and inflammation on the face and affects both sexes but mainly women. Dr Bav Shergill of the British Association of Dermatologists discusses latest treatments. And the first in a new series dedicated to happy accidents that have altered modern medicine. First off, the pacemaker. Dr Margaret McCartney and Carl Heneghan, Professor of Evidence Based Medicine at the University of Oxford, tell the remarkable story of the serendipitous discovery of this life-saving device.

David Haslam, chair of NICE, discusses with Mark Porter how doctors should treat patients with 'multi-morbidity', the millions of people receiving many different drugs for many different conditions. There's plenty of trial data for starting treatments, but a dearth of evidence for stopping them! And one-shot radiotherapy during surgery for breast cancer may help 20,000 women in the UK. Rather than daily hospital visits for radiotherapy over 5 weeks, a dose is given straight to the open wound during the operation. It is quicker, cheaper and much more convenient, so why isn't it more widely available?

NHS health checks or 'mid-life MOTs' have hit the headlines as new research claims they are a success. The aim is prevention - of diabetes, heart attacks and strokes - but their introduction has been controversial amid criticism they are not evidence based or cost effective. Resident sceptic Dr Margaret McCartney debates the issues with National Clinical Advisor Dr Matt Kearney. And putting the family back into planning. As more couples leave it later before starting a family there is growing concern from fertility experts that many people don't know enough about when female fertility starts to decline. Professor Adam Balen and Professor Joyce Harper discuss the issues. And how accurate is the perception, often reported in the media, that fertility 'drops off a cliff' in the mid to late thirties? Professor Richard Anderson reviews the so called 'broken stick' study, a mathematical model which first defined the sharp drop off of female fertility. And another instalment of Inside Language where Dr Margaret McCartney and Professor Carl Heneghan examine the terms used in evidence based medicine and why they matter. This week, adjustment and how researchers allow for factors that might skew their findings.

The average five-year-old consumes their own body weight in sugar every year in this country - a scary illustration of the scale of the sugar problem. The new sugar tax is supposed to tackle this, but what's the evidence that a tax on sugary drinks alone will make a difference? Dr Margaret McCartney reviews the evidence from other countries, which have also used fiscal measures to nudge their populations into eating a healthy diet. PrEP - pre-exposure prophylaxis - is the latest advance in the ongoing battle against HIV. Studies show this preventive HIV therapy can reduce the risk of HIV infection by 86%. So the announcement by NHS England that it wasn't its responsibility to commission the drug has been met by shock and disappointment. Sexual Health and HIV consultant, Dr Jake Bayley, tells Mark that PrEP is a game changer in preventing HIV in high risk groups and the news that it won't be rolled out nationally, as expected, means the UK is falling behind in HIV prevention. "We don't like to talk about our bottoms", Maureen Williams tells Inside Health is one reason why take up of bowel cancer screening across the country is so patchy. Maureen was one of the first people to receive the faecal occult blood test ten years ago as part of the roll out of the bowel cancer screening programme and despite having no symptoms, they found early stage bowel cancer. Ten years later Maureen campaigns for people to complete and return the potentially life-saving test. The clinical head of the Scottish Bowel Cancer Screening Programme talks to Mark about the new, simpler screening test called FIT, the Faecal Immunochemical Test, due to be rolled out in Scotland, and perhaps soon in the rest of the UK as well. Researchers in Taiwan have concluded that most patients who undergo surgery can start showering 48 hours after an operation - a finding that flies in the face of traditional thinking that scars need to be kept dry and under a dressing for a week or more, before getting wet. Consultant Surgeon Nicholas Markham from North Devon District Hospital details the dramatic changes for patients undergoing surgery, including keyhole surgery, changes in the use of anaesthetic, access to food and water and bed rest.

Why asthma is both over diagnosed and undertreated. Professor Mike Thomas and GP Dr Margaret McCartney discuss this apparent contradiction and look behind recent headlines that half a million children in the UK could be taking asthma medicines they don't need. A new study finds that putting doctors under pressure or being a difficult patient may backfire, inducing them to make diagnostic errors. With scarlet fever and measles in the news, Margaret McCartney gives a quick guide on the key symptoms as both diseases have a characteristic rash. A listener has emailed to ask about visual snow, a condition where your vision is like an untuned TV set. World expert, Professor Peter Goadsby explains the latest understanding of visual snow, and says that even 15 years ago it hadn't been universally accepted as a condition. Plus the first in the latest Inside Language series with Margaret and Dr Carl Heneghan of Oxford University. This week, they discuss confounding factors and why they matter to your health.

Millions of anti-depressants are prescribed every year and more than half of people taking them have been doing so for two years or more. But how do you know when you're better and how can you tell that the time is right to stop taking them? Withdrawal symptoms are often confused with a return of the original depression so careful tapering of medication is crucial. Tony Kendrick, Professor of Primary Care at the University of Southampton gives Dr Mark Porter a run down of what to do, and what not to do, when it comes to coming off medication. If you're 40 or above you're to receive dementia awareness as part of the latest Prime Minister's Challenge on Dementia 2020, just announced. The plans to include dementia education for middle aged people in future NHS Health Checks are aimed at making England - no plans as yet to replicate this in Scotland, Wales or Northern Ireland - the best country in the world for dementia care. Dr Margaret McCartney reviews the new proposals. Seven thousand people in the UK are currently waiting for life saving organ transplants - and every year 1200 die because there's a critical shortage of donor organs. It's meant that the transplant community has had to consider using organs that aren't quite as perfect as they would like. Poorer quality, older or damaged organs are now being considered when they would have been rejected in the past. Mark visits Rutger Ploeg, Professor of Transplant Biology at the University of Oxford at the Oxford Transplant Centre to find out about the pioneering work to treat, heal and re-condition organs using normothermic perfusion devices - essentially mini-life support machines that work at body temperature. Frederique Rattue was the first woman at her local hospital to use "vaginal seeding" when her fourth child was born by caesarean section a year ago. It's a practice that involves taking a swab from the mother's vagina and rubbing it over the baby's mouth, face and skin after birth and the theory is that vaginal seeding will restore the microbiota of infants born by caesarean section, boosting their gut bacteria and reducing the risk of allergies or obesity. Dr Margaret McCartney discusses the theory of vaginal seeding and the evidence that the practice leads to health benefits for the baby.

The use of talc and its potential connection with ovarian cancer has hit the headlines after a court ruling in America. Given that nearly half the UK population uses talc to some degree GP Dr Margaret McCartney looks at the evidence and puts any link in perspective. PBC is an often missed condition that causes severe itching and fatigue with the resulting liver damage mistakenly associated with drinking too much. Laura Gilmore lived with the symptoms for many years - scratching herself raw and falling asleep during the day but still not waking refreshed - before getting a diagnosis. Professor James Neuberger explains the science behind PBC. Plus treating severe head injury and why a commonly used intervention used in intensive care units across the country is being questioned. Professor Peter Andrews is the man behind a new trial looking at the evidence for hypothermia, or cooling people with head trauma to prevent damage. The trial was stopped because early evidence suggested harms from this commonly used practice. Dr Mark Porter discusses the implications for critical care medicine across the world with Peter Andrews and Professor John Myburgh who is at the University of New South Wales in Sydney.

Up to half a million people in the UK could have it, but it's a condition that hardly anybody has heard about: Charles Bonnet Syndrome. It happens to people who are losing their sight through age-related macular degeneration, cataracts, diabetic eye problems or glaucoma. They see vivid and often frightening visual hallucinations and these images are soundless. Judith Potts' mother Esme was in her 90's when she eventually admitted to her daughter that she was seeing frightening images of goblins and Victorian children all around her. Judith had never heard of the condition and as she tells Dr Mark Porter, neither had any of the health professionals taking care of her mother. Shocked that there was so little awareness about something that is so common, she set up an awareness group, Esme's Umbrella. Dr Dominic Ffytche, Clinical Senior Lecturer at King's College London's Institute of Psychiatry and an expert in visual hallucinations, tells Mark that a key area of research is why some people have Charles Bonnet Syndrome and others don't. Co-proxamol, or Distalgesic as it's better known, was a common drug for mild to moderate pain in the 1990's. But a decade ago, a review by the Medicines and Healthcare Products Regulatory Agency (MHRA) decided that it wasn't a good painkiller and it had very worrying side effects. Its licence was withdrawn and doctors were urged to switch patients onto different medication (although it could still be prescribed on a "named patient" basis). Dr Andrew Green, Chair of the Clinical and Prescribing arm of the GP committee of the British Medical Association tells Mark he's disturbed that nearly ten years after the licence was withdrawn, thousands of patients are still being prescribed co-proxamol at a high cost to the NHS while Bedfordshire GP Dr John Lockley defends continued and careful prescribing for a tiny number of patients who can't get relief from other medication. In a week in which hundreds of thousands of people have signed a petition calling for more children to receive the Meningitis B vaccine, Dr Margaret McCartney talks to Mark about the tricky decisions involved in planning immunisation programmes. Traditional bedside paper charts, which record and monitor patients' vital signs, have been replaced in Oxford hospitals with smart PC tablets. Clinical staff enter patients' blood pressure, heart rate and temperature on the tablet and the new "smart" system provides an early warning traffic light system, alerting them if there's a deterioration in the patient's condition. This means clinicians can prioritise care and another major bonus is that the same information is available, at the touch of a button, to medical staff across Oxford's hospitals. The project is called SEND - System for Electronic Notification and Documentation - and it's a collaboration between the University of Oxford and Oxford University Hospitals NHS Foundation Trust. Mark goes to Oxford and with intensive care consultant and SEND Project Leader Dr Peter Watkinson, sees how the new paperless system is working.

The UK's first licensed e-cig, owned by a tobacco company, is now classed as a medicine paving the way for it to be prescribed on the NHS to help people quit. Robert West, Professor of Psychology at University College London and one of the world's leading experts on smoking cessation, and GP Margaret McCartney debate the issues. Asherman's Syndrome, a little known complication of surgery that is often missed but can cause infertility. Obstetrician Virginia Beckett explains how Asherman's Syndrome occurs and how it is treated. Rugby is growing in popularity, particularly among children, with 1.2 million of them now playing at schools and clubs in England alone. But at what cost? Rugby is rough and injuries are more common than most parents think. After her son and other young people were hurt repeatedly on the rugby field, Allyson Pollock, Professor of Public Health Research and Policy at Queen Mary, University of London, explored the incidence of injuries. From her research she is now recommending an end to the contact element of rugby in young people. Rugby Football Union's community medical director Dr Mike England responds.

Dr Margaret McCartney reviews advice to pregnant women concerned about the Zika virus while Andrew Shennan, Professor of Obstetrics at King's College and St Thomas' Hospital in London tells Dr Mark Porter about the risks of infection closer to home - chicken pox. One in every one thousand babies born in the UK has congenital talipes, or club foot. This is where the foot points inwards and downwards, the sole facing backwards. But thanks to the late Ignatio Ponseti, an orthopaedic surgeon from Iowa in the USA, 95% of children born with club foot will make a complete recovery. Dr Ponseti was concerned about the low success rate of surgical treatment, which often resulted in life-long pain and stiffness and a 50% chance of recurrence. He developed a new technique in the 1960's that involves stretching the foot, holding it in plaster casts and eventually braces. The problem was that nobody believed him and it wasn't until the early 2000's that his technique became the new gold standard for club foot treatment - the news spread by his patients and their parents using the internet. Mark visits the club foot clinic at The Royal London Hospital, which sent a team, led by consultant paediatric orthopaedic surgeon, Manoj Ramachandran to study with Dr Ponseti at his Iowan clinic. Mark meets Hannah, whose 8 week old baby, Penelope, is just beginning treatment and hears from Claire, whose son, Lucas, now four years old, has, post-treatment, two perfect feet. Professor of Endocrine Hypertension at Queen Mary University London, Morris Brown, gives more details about the test for Conn's Syndrome - which could account for as many as one in ten cases of high blood pressure. And Inside Health listener Howard, calls on Mark to settle a teeth cleaning dispute between him and his wife. Should you brush before or after breakfast? The British Dental Association's Chief Scientific Officer, Professor Damian Walmsley adjudicates.

How low should you go when treating blood pressure? Mark Porter talks to the author of landmark study that was stopped early because the benefits of aggressive treatment were so convincing. This looks set to change the management of high blood pressure and millions more people in the UK will be taking extra medication. Dr Margaret McCartney debates the issues with Professor Tony Heagerty. Imagine if your high blood pressure could be cured by an operation that meant no pills at all? That's possible if it's due to a condition called Conn's syndrome, now thought to be much more common than previously thought. Mark Porter hears from leading specialist, Professor Morris Brown, plus a school teacher who spent 10 years on pills before being diagnosed and is now cured. And an Inside Health listener asks: why is palm oil in everything?

Scotland is considering whether to add folic acid to staple foods like flour to protect babies against conditions like spina bifida. Frustrated at the lack of action by the UK government on the issue - despite government advisers recommending for 16 years that flour should be fortified with folic acid - the Scottish government is preparing to go it alone. Spina bifida is one of a group of severe congenital abnormalities known as neural tube defects that affect around 5000 developing babies in Europe every year. It's long been known that taking folic acid supplements, before and after pregnancy, can reduce the likelihood of these defects, as Helen Dolk, Professor of Epidemiology at the University of Ulster explains to Dr Mark Porter. Professional footballers are vulnerable to hip and groin injuries and much more likely to get arthritis as they get older. Southampton Football Club has introduced a new hip stretch and flexibility programme for all their players and the result is a dramatic reduction in injuries. Mark visits the club and meets Olufela Olomola, who, before his transfer to The Saints, spent a season on the bench with hip and groin injury at Arsenal. Just a season later he's recovered and now captains The Saints under 18 team. Mo Gimpel, Director of Medical and Science Performance Support at Southampton FC says the decision to focus on hip flexibility came several years ago, after serious hip and groin injury was keeping key players off the pitch, and the club was losing matches. The new pre-activation sessions have transformed the club's injury rates and research teams are partnering the club to find out how hip impingement develops in the first place. Professor Sion Glyn-Jones from the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences is leading a group tracking 110 young players from The Saints' Footballing Academy, a league two club, a cricket club and pupils from local schools. Detailed mechanical and imaging studies of these young players' hips will help to show exactly when hip injury, or femoroacetabular impingement, first appears, what causes it and most importantly, how to prevent it in the first place. Private medical helplines providing 24/7 advice are the latest development in private medicine. New companies are popping up, attracting millions in private finance. They offer people access by e-mail, phone or online visual link to a GP consultation, for a fee. Dr Karen Morton, founder of DrMortons.co.uk tells Mark why she believes pressure on primary care will result in an inevitable rise in demand for such services. People who want reassurance and advice, she says, can use such helplines and avoid clogging up GP waiting rooms with relatively minor complaints. But Dr Margaret McCartney disagrees and says phone-only consultations risk fragmenting medical records and undermining the relationship between a GP and their patient.

Dr Mark Porter unpicks the science behind the so called 'weekend effect'. Politicians have quoted research claiming that people are 20% more likely to die of a stroke at the weekend, while another much cited study finds 11,000 more deaths in people admitted at the weekend. But how valid are these figures and the research that generated them? Dr Margaret McCartney reviews the stroke data that has been criticised by experts as being out of date. While Mark Porter talks to Editor of the BMJ, Fiona Godlee, who published the 11,000 figure but is concerned about the political use of the findings. And discusses the study with lead author Nick Freemantle, plus Consultant Surgeon Sam Nashef who is sceptical about the results.

Inside Health listener and keep fit enthusiast, David Heathcote, wanted advice on how far he should safely push himself when he's training in the gym. In this special programme about the health benefits of keeping active, Dr Mark Porter helps David to find the answer to his question about the exercise "sweet spot". If you struggle to screw the top off a jar, or use your arms to push yourself out of your chair, that's a sure fire sign, according to Dr Philip Conaghan, consultant rheumatologist and Professor of Musculoskeletal Medicine at the University of Leeds, that your muscles are weak. And the good news is that building muscle strength will protect your joints, not damage them. Dr Conaghan tells Mark that there's a worrying lack of understanding about the impact of muscle weakness on arthritic joints. Over the last decade there's been a growing interest in the relationship between activity and the risk of developing cancer. Studies have demonstrated that exercise appears to have a protective effect against at least four different cancers (breast cancer, colon cancer, endometrial cancer and some upper gastrointestinal cancers) and that being fit helps recovery from cancer too. Dr Denny Levett, a consultant in peri-operative medicine and critical care at University Hospital, Southampton who has a special interest in the relationship between exercise and health, says the reason for the apparent protective effect of fitness is still being researched but the evidence that the effect exists is now widely accepted. Professor of Clinical Cardiology, Sanjay Sharma from St George's University of London outlines the benefits to our hearts of keeping active and Park Run fan and regular Inside Health contributor, Dr Margaret McCartney, admits how running has become something of an obsession and promises that the evidence shows that when it comes to getting fitter, it's never too late to start.

Prescriptions for nerve drugs pregabalin and gabapentin have risen dramatically in recent years and at the same time, concerns about abuse. Former prisoner and addict "Patrick" tells Dr Mark Porter that "gabbies" or "pregabs" are drugs of choice in jail and Dr Iain Brew, a GP who works in prisons, says misuse is a growing problem and there are examples of doctors being pressurised into prescribing them. Dr Cathy Stannard, consultant in pain medicine at Southmead Hospital in Bristol, chaired an expert group that drew up new prescribing guidelines for pregabalin and gabapentin and she tells Mark that more attention needs to be paid to emerging evidence of misuse. Many women say that if they've had one caesarean section, they feel pressurised to have another one and Sara describes how her medical team planted "a seed of doubt" about the potential risks to her baby which she says for her meant another C-Section was inevitable. But new guidelines from the Royal College of Obstetricians and Gynaecologists spell out that vaginal birth after a previous caesarean is a clinically safe choice, with a 75% success rate, the same as for first-time mothers. Inside Health's Dr Margaret McCartney discusses the history of changing attitudes to natural birth after caesarean and says why the new guidelines should give future mothers the confidence to discuss, well in advance of their birth, the best option for them. How do you fill in health check forms that ask for family history if you don't know who your family was? Inside Health listener Jessica is adopted and her heart health check suggested a very low risk of a stroke or heart attack when she couldn't answer the family history question. Mark and Margaret discuss how common this is, and what difference family knowledge would make to Jessica's risk (not much). Adrenaline auto injectors were first used in the 1960s when they were developed for soldiers to use during nerve gas attacks allowing them to self administer the antidote. But is a device designed to be used by fit, trained soldiers just as suitable for use in children and adults of widely varying size and weight? These concerns were raised by a coroner conducting the inquest into the death of a 19 year old student who died of anaphylactic shock caused by a nut allergy, despite her using her auto injector. The Medicine and Healthcare Products Regulatory Authority and also the European Medicines Agency have been looking into issue and Dr Robert Boyle, allergy specialist at St Mary's Hospital, Paddington and Director of the Paediatric Research Unit at Imperial College, London provided expert advice. He talks to Mark about the limitations of auto injector design and urges everybody who might use the devices to ensure they are confident about exactly how to use them.

As cars were banned from central Paris this weekend and the health risks of pollution hit the headlines, Mark Porter examines the statistic that pollution kills 29,000 people a year in the UK. And he visits a pioneering clinic at Southampton General Hospital where falls in the elderly are seen as a risk factor for underlying health problems; 'Having a hip fracture is like having a heart attack or stroke' explains Dr Mark Baxter. 50% of people who have a hip fracture will have previously presented with a fall, but once they go on to break a hip, 1 in 10 elderly people may not be alive at the end of the month and up to 25% by the end of the year. Many elderly people are found to be on multiple treatments - blood pressure pills or bladder pills for example - that make people fall over. In recent years there has been much more attention paid to the cumulative burden of the side effects of medicines in the elderly - particularly the group of commonly used drugs known as Anticholinergics. And according to new research by a team at the University of East Anglia, taking Anticholinergics increases the risk of falls too - particularly in men. Following news of the Meningitis B vaccine in children, an Inside Health listener got in touch to ask why it wasn't being given to teenagers in light of data showing that there is a second peak in incidence in the disease among 15 - 19 year olds? Mark talks to Professor Andrew Pollard, Chair of the Joint Committee on Vaccination and Immunisation. And Inside Language: Dr Margaret McCartney and Professor Carl Heneghan demystify the terminology of medicine and research. This week, false positives and false negatives; when is something not what it seems, and when does it seem what it's not?

For five years the Cancer Drugs Fund has supplied seventy five thousand patients in England with cancer drugs, but its days are numbered. Spiralling costs have led to a reduction in the number of drugs the CDF will pay for, meaning newly-diagnosed patients may miss out. Dr Mark Porter talks to Vicky Rockingham about the anxiety that reform of the CDF is causing. Vicky is a mother of two, working full time, and receiving regorafenib paid for by the CDF for her rare type of gastrointestinal stromal tumour, or GIST. She tells Mark that the drugs from the CDF are giving her extra time with her family and enabling her to carry on working. And Jonathan Pearce, Chair of Cancer 52, an alliance of organisations that represent people with less common and rarer cancers like Vicky's, tells Mark why any new-model CDF must take into account individual patient needs. Regular Inside Health contributor, Dr Margaret McCartney, describes how patients access cancer drugs in Scotland, Wales and Northern Ireland and discusses with Mark the difficult decisions that access to expensive and innovative new cancer medicines present for the NHS. Last season's winter flu vaccine provided only limited protection to those who received it. An exceptional year where there was a mismatch between the flu virus that eventually circulated, and the vaccine that had been developed by international teams. The result was just 30% protection (down from its usual 70-80%). Dr Mark Porter asks the chair of the Joint Committee on Vaccination and Immunisation (JCVI), Professor Andrew Pollard, whether confidence in this year's vaccine could be dented. Babies, toddlers and pre-school children often seem to have bow legs and knock-knees and parents frequently turn up at their doctor's surgery asking for reassurance about the way their children walk. Manoj Ramachandran, consultant children's orthopaedic and trauma surgeon based at The Royal London and Bart's Hospital tells Mark that up to a quarter of the children referred to his clinics have normal, developmental lower limb variants. Children are naturally bow legged when they first walk and by the age of three, there's another natural re-alignment which tends to lead to knock knees. At both these ages his clinic receives a peak in referrals but by the age of seven, he says, most childrens' legs straighten up naturally. Inside Language: Carl Heneghan, Professor of Evidence Based Medicine at the University of Oxford and Dr Margaret McCartney continue to demystify the scientific language of medicine. This week, peer review. Producer: Fiona Hill.

Are league tables listing surgical outcomes the best way to assess your surgeon or are high risk patients being turned away as surgeons keep an eye on their figures? New data published this week list the clinical outcomes for heart surgery - cardiac surgeons are just one speciality from an ever expanding list of doctors whose performance is now published in league tables and subject to public scrutiny. But what impact has their introduction had on patient care? Sam Nashef, a consultant cardiac surgeon at Papworth Hopsital, discusses this issue with Mark Porter. Recent research in schools in Wales suggest that as many as one in 12 primary school children get them at this time of year - and that compares favourably with Australian research, which suggests the figure's much higher - closer to one in five. Resident sceptic Dr Margaret McCartney explains which treatments are supported by evidence. Lyn e-mailed Inside Health to understand why she often feels colder than other people. How, she asked, do we regulate our body temperature and are some people better at it than others? George Havenith is Professor of Environmental Physiology and Ergonomics at Loughborough University, and Mike Tipton, Professor of Human and Applied Physiology at the University of Portsmouth, provide answers. And in the next of our special series demystifying the language of research and statistics Carl Heneghan, Professor of Evidence Based Medicine at the University of Oxford and Dr Margaret McCartney unpack the concept of surrogate markers. These feature increasingly in medical research and can involve everything from blood test results, to the pattern on your heart trace or ECG.

Dr Mark Porter presents a programme devoted to questions from the listeners. Dr Mike Knapton from the British Heart Foundation answers a question about whether aspirin can protect against a second heart attack. A number of people asked about the treatment of vertigo. Vertigo is a symptom of a variety of conditions ranging from migraine and Meniere's, to strokes and tumours, but by far the most common is a condition called BPPV - benign paroxysmal positional vertigo. It is caused by debris floating around in the fluid in the balance sensors of the inner ear and typically affects people over 40. And there is a relatively simple way to treat it called the Epley movement, which is much underused. Dr Louisa Murdin, consultant in vestibular and balance disorders at Guy's and St Thomas's hospitals in London, explained how she uses the technique. Dr Margaret McCartney and Mark discuss why doctors sometimes use patronising language when talking to patients. Carpal tunnel syndrome - which normally eventually affects both hands - is caused by pressure on the median nerve as it passes under the flexor retinaculum ligament at the wrist - close to where the clasp or buckle on your watch would sit. The classic story is pins and needles affecting the thumb side of the hand and sparing the little finger, and often worse during the early hours of the morning. Dr Jeremy Bland, consultant in clinical neurophysiology at King's College Hospital London, and Kent and Canterbury Hospital, where he runs one of the few NHS clinics dedicated solely to carpal tunnel syndrome, explains why people wake up with symptoms and why wearing a splint can be helpful. Osteoporosis features regularly in our in-box - particularly concerns about bisphosphonates, the gold standard treatment for the bone thinning condition. Every year in the UK around 300,000 people break a bone - such as a hip or wrist - following a relatively trivial injury because their bones are weaker than they should be. Most are middle aged and elderly. Drugs like alendronate and etidronate are prescribed to make bones stronger after a fracture. Peter Selby, Professor of metabolic bone disease at the University of Manchester and a consultant at the Manchester Royal Infirmary, answers queries about how long these drugs should be taken.

From this week all UK babies will be vaccinated against that most feared disease, meningitis B, the first country in the world to take this step. But the decision to include Men B in the national immunisation programme has come too late for parents, Freya and Ross. A year ago their baby daughter, Harmonie, nearly died after contracting the infection. Her arms and legs as well as the tip of her nose had to be amputated because of the resulting sepsis. Sue Davie, Chief Executive of Meningitis Now tells Mark that the vaccine is great news and will save many lives. But she hopes in the future that it will be offered to older babies and young children, as well as another at risk group, adolescents. Mental health problems have long been linked to fluctuating hormone levels, at times of menstruation, childbirth and menopause. Dr Michael Craig who runs the Female Hormone Clinic at the Maudsley Hospital in London discusses the role of hormone replacement treatments. Statins are the most commonly prescribed medicines in the UK. They work to lower the level of cholesterol in your blood. There's been considerable debate about when doctors should start prescribing statins and NICE, the National Institute for Health and Care Excellence, had been keen for GPs to be paid to put more patients on the cholesterol-reducing drugs. Dr Margaret McCartney outlines the controversy and NICE Deputy Chief Executive, Professor Gillian Leng, tells Mark that the health advisory body has listened to concerns and why their new statins targets are now to be tested in the field. Young, healthy, sporty people don't get heart attacks. Except when they do. Dr Stuart Miller, Clinical Director of Sport and Exercise Medicine at the University of Bath admits that he was shocked when he had a heart attack, even though he cycles, swims and eats a healthy diet. Sanjay Sharma is professor of cardiology at St George's Hospital in London and he tells Mark how common unexpected heart attacks are. Producer: Fiona Hill.

Why more than 1 in 10 people having emergency abdominal surgery die within 30 days of their operation. Which thermometers parents should use and which they should not. Vitamins and dementia - a controversy dividing scientists. Could taking B vitamins lower the levels of the amino acid homocysteine and slow the onset of Alzheimer's disease? Absolute risk v relative risk.

The Off-Patent Drugs Bill aims to prevent people missing out on life-saving treatments, but doctors can already prescribe drugs off-licence so why do we need a new law? Pre-diabetes - a new label that could apply to as many as 1 in 3 British adults, but is it a useful to know this? The importance of diagnosing sepsis early and how to recognise the key signs. Plus Dr Margaret McCartney and Dr Carl Heneghan explain the meaning of the phrase 'all cause mortality'. Presented by Dr Mark Porter.

Elite athletes are far more likely to use asthma inhalers than the general population. Do the stresses and strains of competition bring on asthma-type symptoms or does an inhaler give a performance advantage to individual sportsmen and women? Dr Mark Porter talks to sports physician Dr Babette Pluim about her review of the use of inhalers in sport. One hundred and fifty thousand knee arthroscopies are performed every year in the NHS with most of them involving surgery to smooth, remove or repair damaged cartilage, the meniscus. But there are concerns that we do too many arthroscopies in the light of evidence that intervention isn't always required. Andrew Price, Professor of Orthopaedic Surgery at the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences at the University of Oxford, tells Mark when surgery is useful and Inside Health's Dr Margaret McCartney reviews the mounting body of evidence that has called into question some knee surgery. Dr Annabel Bentley, former Medical Director of Insurance at the private health insurers, BUPA, describes how, back in 2011, there was an instant (and subsequently sustained) reduction of 9% in knee arthroscopy claims. The drop came weeks before a new checking process, to confirm the surgery was in line with best practice, was introduced. Pelvic Girdle Pain is a condition that affects one in five pregnant women. It causes discomfort in the pubic region, the hips and lower back and gets worse as the pregnancy progresses. Some cases can be mild but more severe forms can leave a woman needing crutches, or even a wheelchair, to get around. But there is help out there and official advice is for women to get help early and not to suffer in silence. Mark visits the Rosie Maternity Hospital in Cambridge, and speaks to new mum Joanna Welham and Women's and Men's Health Physiotherapist, Claire Brown, about what treatment is available. Medically unexplained symptoms, sometimes known as MUS, cause problems for both patient and doctor, and they're common, up to a fifth of a GP's workload, and around half of all specialist referrals, costing the NHS more than £3 billion a year. Rona Moss Morris is Professor of Psychology as Applied to Medicine at King's College London and she believes the NHS fails such patients. She tells Mark what she thinks needs to change, starting with the name, MUS. Producer: Fiona Hill.

What is the evidence that taxing sugary drinks will help to tackle obesity? Low libido in women - what is Hypoactive Sexual Desire Disorder and where did the diagnosis originally come from? Is it a label that will liberate millions of women or a construct to market new drugs? Plus Mark visits Europe's largest robotic pharmacy at a brand new hospital in Bristol.

Diabetes in pregnancy, gestational diabetes, is on the increase, and the risks to mother and baby if this condition is untreated, are very serious. Around one in fourteen pregnant women will develop GD, but the risk is much greater according to age and weight of the mother, whether there's a history of diabetes in the family and in certain ethnic groups. Dr Mark Porter visits The Rosie Maternity Hospital in Cambridge, where Dr Helen Murphy introduces him to the specialist teams that enable 70% of the women diagnosed there to manage their diabetes through diet and exercise, rather than medication. The UK's National Institute for Health and Care Excellence, NICE, has introduced new guidelines for diagnosing gestational diabetes which differ from international thresholds backed by the World Health Organisation. Mark talks to researcher Dr Claire Meek from The Rosie, one of the authors of research published in the journal Diabetologia, which found that up to 4,000 women, at risk of serious birth complications, would be missed under the new UK criteria. The teams at The Rosie are shunning the new NICE guidelines and continuing to follow the WHO thresholds. Professor Rudy Bilous, who runs the Diabetes in Pregnancy Service at the James Cook University Hospital in Middlesbrough and chaired the development group at NICE that produced the new diagnostic guidelines, tells Mark that he's confident that the thresholds, which were drawn up using the latest available evidence, are set at the right level. Weight loss properties and low carbohydrate diets: listener Mark Robins from Southampton describes his success following a low carb diet (he lost nearly four stone in a year) and Inside Health's Dr Margaret McCartney and Susan Jebb, Professor of Diet and Population Health at the University of Oxford discuss the evidence behind weight loss and low carb diets. The number of children who say they are afraid of injections is increasing and Dr Amy Baxter, a paediatric emergency doctor from Atlanta, Georgia and an expert in needle pain, has shown a link between the number of jabs and fear of needles. UK children have up to 15 vaccinations, with the new Meningitis B on the horizon, so managing that fear is important. Dr Baxter tells Mark what parents and health care professionals can do to help, and saying "Sit still, don't move, this will only hurt a bit", isn't recommended! Producer: Fiona Hill.

Across England, selected GP surgeries are trialling 7-day working, but there are reports that take-up has been so low in some areas, particularly on Sundays, that pilots have been abandoned. Dr Margaret McCartney and Dr Mark Porter investigate where the pressure for extended opening hours is coming from. Mark visits Herefordshire where Taurus Healthcare, a federation of local GPs, is running a late night/weekend service. Managing Director Graeme Cleland describes the high take-up of the service after an initial slow start, and says new patients have been treated, showing previously latent demand in the system. Mike Dando is a wheelchair user with spina bifida and diabetes, and before the pilot started a year ago, he would have to wait in all day for a district nurse to dress his ulcerated legs. Now he just makes an appointment at a time convenient for him. But at the end of this year the seed money provided by the Prime Minister's Challenge Fund runs out, so what will happen to the Herefordshire pilot? Chair of the local Clinical Commissioning Group, Dr Andy Watts, says without extra funding, the pilot service is unlikely to continue and deputy chair of the BMA's GP Committee, Dr Richard Vautrey, calls for investment in current GP practices rather than expensive additional services. Doctors in the UK have been warned by public health officials to be on the lookout for people who become ill after travelling to South Korea. Middle East Respiratory Syndrome (MERS) has killed 27 people in the region and there are 174 confirmed cases of the disease. Nearly five hundred people have died worldwide after the virus first emerged three years ago, in Saudia Arabia. Jonathan Ball, Professor of Molecular Virology at the University of Nottingham, describes how coronaviruses like MERS (and SARS) jump to humans via an intermediary animal. In the case of MERS, that's via the Dromedary camel. Nitrous Oxide or laughing gas has a long history of recreational use but in recent years, there's been an exponential growth in use among teenagers and young people. Founder of the Psychedelic Society, Stephen Reid, describes the physical effects of laughing gas and tells Mark why he believes the gas shouldn't form part of the government's planned clampdown on legal highs. But Dr Paul Seddon, respiratory paediatrician from Queen Alexandra Children's Hospital in Brighton, warns that increased use could mean increased health problems, like the case of the teenager girl with a collapsed lung admitted to his hospital after inhaling the gas. Producer: Fiona Hill.

Cervical screening in older women has hit the headlines, but reports have not explained whether these women being diagnosed after 65 have attended screening. Concerns about an outbreak of Hepatitis E in Nepal that could kill pregnant women; A new technique being trialled in the UK to treat enlarged prostate; and Dr Margaret McCartney on statistical significance.

Treating low sex drive in women. Expert panels in the USA have voted in favour of a drug that has been dubbed 'Pink Viagra', but there are serious reservations. Outdoor swimming is the new trend for 2015, but should you take the plunge or go in slowly? Strokes in the under 55's have recently been reported to be on the increase: Dr Margaret McCartney takes a closer look at the evidence. And unpicking tricky terms to understand your health - causation versus association. Presented by Dr Mark Porter.

In the last of the current series Mark Porter answers your feedback on sex education, off licence use of drugs and drinking smoothies instead of eating fruit. Plus hospital bed numbers have been halved over 25 years, while admissions have rocketed - up by 3 million in the last decade alone; Inside Health discusses how hospitals have been coping. Plus calls for frailty to be an official diagnosis rather than simply a general description - Mark Porter examines the implications.

Mark Porter visits a very smelly laboratory to find out how your gut bacteria could be influencing your weight - and more besides. Doctors have written to the authorities asking for permission to use the drug Avastin instead of the more expensive alternative, Lucentis, to treat patients with age related macular degeneration (AMD) - the commonest cause of blindness in older people. Inside Health investigates. And new research into peanut allergy, turning conventional wisdom on its head, that every parent should know.

The big news in public health this week with the parliamentary vote on the introduction of standardised cigarette packets. A move the tobacco industry has resisted fiercely. Inside Health discusses the evidence for the sort of impact the policy might have on the nation's smoking habits? The difficult issue of when and how to tell children about sex. Schools throughout England are to be offered new guidance to help them with sex education in PHSE classes for KS3 and KS4 pupils. But, the classes are still not going to be made a statutory part of the curriculum. Inside Health's Margaret McCartney examines the evidence. And a listener has asked about gallstones after a recent scan had shown debris or sludge in the gallbladder. Plus news from Las Vegas, New York and the UK on trends in plastic surgery.

Recent research was widely reported as concluding that 30 year old guidance to limit saturated fats had been overturned and should never have been introduced - and that we can now eat as much butter, cheese, sausages and pies as we like. But, as ever, the real story is a bit different. Inside Health debates the real evidence and hears from Sweden that rumours of change in its guidance have also been misreported. As big companies try to attract female employees by offering 'egg freezing' as a corporate carrot, Dr Mark Porter examines the success rates and implications for women wanting to start a family. And checking your moles - how to tell the difference between the sinister and the innocent.

New drug-driving legislation which comes into force next week applies to some medicines too. Particularly morphine based painkillers taken by hundreds of thousands of people in the UK, many of whom could inadvertently find themselves on the wrong side of the law. And planning for a good death - an Inside Health listener says he believes it's better to die earlier from heart disease than go on to develop cancer later in life. Is he right? Plus as many as 1 in 10 university students in the UK are now thought to be dabbling with smart drugs to help them revise and boost exam performance. Inside Health talks to leading experts about cognitive enhancers.

After recent headlines that running too much can be bad for your heart, Mark Porter talks to the Medical Director for the London Marathon to get an insider's perspective. A novel psychological approach to weight loss that asks why people are eating too much rather than just giving dietary advice. Plus new treatments for Hepatitis C and statistics showing a reduction in binge drinking in young adults.

With the NHS facing significant and enduring financial pressures, as people's need for services continues to grow faster than funding, what impact is all this having on NHS staff? New advice about flying if pregnant and new research that links drinking one can a day of a sugary drink to an earlier onset of puberty. Plus the sensitive issue of FGM.

Diagnosing Cancer - why does the UK still lag behind much of Europe and what is being done about it? The American dream - personalised medicine based on your genes. Plus do headphones damage hearing?

With widespread reports of a link between dementia and commonly used medicines, Inside Health assesses the risks. Why women are more likely to die from heart disease than men with cardiologist, Dr Laura Corr. With more and more people choosing to adopt a gluten free diet, Mark explores the possible health benefits for people who don't have coeliac disease. Is the real problem wheat intolerance, irritable bowel syndrome, or too much hype? Boilers on prescription: a new idea being investigated by one Clinical Commissioning Group. And new research that links having a weekend lie-in with an increased risk of obesity-related diseases, like diabetes.

Mark investigates reports that the UK faces an epidemic of "mutant flu". Just a month after NICE calls for more weight loss operations to be done, there are proposals to slash the amount hospitals are paid to do the procedures - a move that could see many hospitals stop offering the operation. Six packs and big guns - there is growing concern about steroid abuse by young men on a quest for the perfect body. And Dry January - Mark looks at the science behind going on the wagon for a month.

Dr Mark Porter talks to leading experts about treating alcohol dependence with a pill and whether the required counselling services are available to make it work. And Mark finds out the state of his arteries when he has a new blood test to predict his risk of heart attack. Plus what does the evidence tell us about how often to visit the dentist?

Should fruit juice be dropped from the 5 a day fruit and vegetable recommendations? A&E in a mild winter - why has the NHS been stretched to near breaking point over the festive period? Dr Mark Porter visits a busy pain clinic to find out why prescribed opioid painkillers for long term non-cancer pain often do more harm than good. And resident sceptic and GP Dr Margaret McCartney outlines her New Year resolutions.

Financial incentives for GPs - do they work? Mark Porter learns there are parallels between the latest £55 to diagnose dementia and an incentive to diagnose depression which didn't work and was dropped. Are walk-in CT Scans a good idea - two experts who authored recent reports address concerns about people arranging their own scans. Hot Flushes feedback; plus the new generation of anti-coagulants offering an alternative to warfarin.

As more NHS operations are done in the private sector, how much do we know about patient safety in private hospitals? Kits to self-monitor warfarin have been recommended by NICE, so why is the uptake so poor? Hyperbaric medicine - using high doses of oxygen to accelerate healing; And sick day rules - the medicines you should stop taking while you are unwell to reduce kidney damage.

Inside Health examines advice for when parents should and shouldn't send their sick children to school. Is this another example of the nanny state, or a useful guide? Hip replacements and knee replacements are well known treatments but now a new trial is looking into the effectiveness of ankle surgery for arthritis. Margaret McCartney reveals the origin of the word hypochondria. Plus, how effective is HRT for the commonest symptom of the menopause, hot flushes? And Inside Health answers listeners' questions on Guillain-Barré syndrome, what are the causes and treatments.

Ebola - how do they predict how it's going to spread, and why estimates have risen so rapidly. In the UK there are 22 million prescriptions a year for morphine type painkillers, costing over 300 million pounds - but do they actually work in non-cancer pain? And a simple blood test that can tell if your recurrent chest infections might be due to an immune problem. Plus thyroid problems and pregnancy.

Dr Mark Porter reports on sleep apps, can they help with common sleep problems such as sleep apnoea? A new study reveals the failure of antibiotics for simple infections. Margaret McCartney reviews the evidence and asks is it worth having a flu jab? Plus who is eligible for NHS continuing health care.

Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us.

Dr Mark Porter examines how powerful lobbying groups like the food and alcohol industries steer public health policy in the direction that suits them most.

Dr Mark Porter examines the hidden conflicts of interest that may affect how your GP or specialist treats you. He discovers that the advice patient groups give you is also not immune to the influences of organisations such as pharmaceutical companies.

Are conflicts of interest in medicine out of control and undermining public trust, or an over-hyped concern? Dr Mark Porter investigates the hidden influences affecting your health.

Dr Mark Porter finds out about the latest research investigating why people with HIV very rarely get multiple sclerosis. What does it mean for the cause of MS and possible future treatments? Also in the programme how much is black skin at reduced risk of skin cancer from exposure to the sun? Why iron overload can often go undiagnosed and the training for the nose that can help recover a lost sense of smell.

Mark Porter investigates a new research trial which shows that paracetamol doesn't help back pain. And why are blood thinning drugs being overused in NHS hospitals? New laws on limits for driving on prescribed drugs come into force in March 2015. Which prescription drugs are included and what does it mean for people taking them? Also in the programme, can any medications help get rid of kidney stones?

Some media coverage has suggested that there is a link between eating junk food and the rise of conditions like Crohn's disease and ulcerative colitis which involve inflammation of the digestive system. Mark Porter questions the evidence. As school's out for summer Mark finds out why teachers' voices need a rest. He also examines whether cholesterol lowering spreads and drinks do what they suggest. Also in the programme: is frying with olive oil harmful or the healthy choice?

Switzerland looks set to be the first country in Europe to halt routine breast screening; yet in the UK a review of the same evidence came to the opposite conclusion. Dr Mark Porter asks how two groups of experts can arrive at such different decisions, and examines the harms and benefits of screening for breast cancer.

Public Health authorities have written to doctors in the UK to ask them to look out for cases of Ebola following the recent outbreak in West Africa which has killed nearly 500 people. Dr Mark Porter talks to David Heymann, professor of infectious disease epidemiology at the London School of Hygiene and Tropical Medicine about the risks of Ebola cases coming to the UK. He is joined by Dr Margaret McCartney to discuss why some types of bike saddles can cause erectile dysfunction. He also talks to Glyn Elwyn about the pros and cons of recording consultations with your doctor Also, insect bites, why do some people get bitten more than others, what's the best repellent and what's the best treatment if you do get bitten?

Dr Mark Porter returns with a new series to address confusion about statins for healthy people rather than patients. Statins have hit the headlines as doctors debate the draft recommendation from NICE to lower the threshold for offering statins, which could mean millions more will be taking them. And Mark Porter turns patient when he is investigated for persistent heartburn. Plus should GPs who miss cancers be named and shamed and why drugs can't be recycled.

Headlines this week claim that 'thousands of patients die in hospital of thirst' but did the authors of the study actually analyse hydration? Mark Porter investigates the evidence for using Baclofen to treat alcoholism and hears how it helped a listener to stop drinking 6-8 bottles of wine a day. Why did NICE question the use of Paracetamol - the UK's favourite painkiller - in the treatment of osteoarthritis? And are saturated fats really bad for us?

Dr Mark Porter investigates the dramatic increase in testosterone prescribing; low fibre diets - why the traditional advice to eat high fibre is not always recommended. And having a consultation with your GP via a video service such as Skype from your computer - is there any evidence to back up the government's latest answer to increasing access to your doctor.

Tamiflu - the controversial drug - has been stockpiled by the government for use in a flu pandemic and endorsed by regulatory bodies including the WHO. With a new review of the evidence due this week, Inside Health's Margaret McCartney and James Cave, Editor of the Drug and Therapeutics Bulletin have been following the story. Mark Porter gets his body fat checked and finds out how much is hiding inside. And how should doctors raise concerns about a person's weight? Plus, why you might want to think twice before paying for a total body scan.

With a replacement of the controversial Liverpool Care Pathway expected over the next few months Professor Keri Thomas, National Clinical Lead at the GSF Centre for End of Life Care, debates the need for change and calls for a more personalised care for the dying. And Inside Health examines differences in sex development, when it is unclear if a new born baby is a boy or a girl. Plus, does the environment of your GP's surgery increase or alleviate anxiety?

Dr Mark Porter finds out why insomnia can often go untreated by the NHS despite there being a treatment that not only works but also doesn't involve drugs. There are nearly 11 million prescriptions for sleeping tablets in the UK every year but their effect isn't long lasting and people can find it hard to come off the tablets. Cognitive behavioural therapy has consistently been shown to be very effective at improving sleep in the long term but few people have access to it. Mark is joined by Colin Espie, professor of Sleep Medicine at the University of Oxford, and by professor Kevin Morgan, director of the Clinical Sleep Research Unit at Loughborough University, to discuss why insomnia is so neglected, and to talk about the success of methods to deliver CBT online using mobile and web technology. Also in the programme, Mark talks to Peter Goadsby, professor of neurology at King's College Hospital London, to find out what cluster headaches are, why they're so painful and why they can occur when the clocks change. He also meets Ann McNeil, professor of tobacco addiction at the Institute of Psychiatry, to bust the myth that smoking helps bust stress.

A committee advising the Food and Drug Administration in the US has voted to change the way it tests women for cervical cancer by solely using a test that detects Human Papilloma Virus (HPV) rather than also using a standard smear test which looks for abnormal cell changes. The test is likely to become more widely used in the NHS than it is now. What advantages does it offer over smear tests and what difference will it make for women? Dr Mark Porter talks to Jack Cuzick, director of the Wolfson Institute of Preventive Medicine and GP Dr Margaret McCartney about the pros and cons. The HPV virus is responsible for a big increase in the number of oral cancers. Some researchers have even gone so far as to call it an epidemic. Mark talks to head and neck cancer surgeon Andrew Schache from the University of Liverpool to find out more about the reason for the rise in numbers. Also in the programme. You are when you eat. According to some diets, not eating in the evening can help you lose weight. But does the timing of when you eat really make a difference? Susan Jebb, professor of diet and population health at the University of Oxford, explains why the time you eat doesn't make a difference to whether you put on weight. Scar free surgery. Mark talks to Mikael Sodergren from Imperial College London, about the latest surgical innovation - natural orifice surgery. Surgery via natural orifices like the stomach and vagina can dramatically improve people's recovery after an operation reducing their pain and time in hospital. Currently only used in women, in the future it could be available for everyone with a robotic surgical device going in through the mouth and then being used to perform operations like an appendectomy via the stomach.

Is sugar really addictive? As the Chief Medical Officer for England suggests that it is and a 'sugar tax' may have to be introduced, leading experts debate whether the white stuff on our table is really habit forming. How 40 year old research hidden away in a book has thrown new light on a link between iron deficiency and stroke. And why the clue to solving recurrent thrush maybe getting the diagnosis right in the first place. Plus concern about the increase in prescription charges just announced by the government.

Dr Mark Porter investigates a pioneering research project designed to reduce the psychological trauma experienced by more than half of critically ill patients after a stay in intensive care. Why do treatments on ICU cause hallucinations and post traumatic stress disorder in patients months after they leave hospital? Mark talks to the doctor who believes people over the age of eighty are being overtreated to protect them against heart attack and stroke. He finds out why some of the drugs used could increase their risk of falls. Also in the programme, how lens replacement surgery for cataracts is also being used to correct vision. And why are cases of scarlet fever on the rise?

Selenium supplements have hit the headlines with reports that men taking them can increase their risk of developing aggressive prostate cancer. Dr Mark Porter talks to leading expert on selenium, Margaret Rayman, Professor of Nutritional Medicine at the University of Surrey, to find the truth behind the story. Idiopathic pulmonary fibrosis is a disease that kills more people in the UK than breast cancer. It's caused by the thickening and scarring of the part of the lung that forms the barrier between blood and air and can make your chest sound like it's full of Velcro. Mark talks to Luca Richeldi, Professor of Respiratory Medicine at the University of Southampton, about why it can be mistaken for asthma or Chronic Obstructive Pulmonary Disease - what used to be called emphysema and bronchitis. Also in the programme, as many as 1 in 20 children will experience long term constipation with no underlying cause and which doesn't get better with dietary changes. Mark visits a specialist clinic at Addenbrooke's hospital in Cambridge to meet families managing the problem.

Dr Mark Porter investigates the health effects of loneliness and why some researchers believe being lonely is worse for your health than obesity. Also in the programme, as proposed new UK guidelines mean as many as 5 million more people could be prescribed statins to lower their cholesterol how do you work out if you are in this new category of being at risk? Are the current calculators that work out your risk up to the job? Mark also investigates coughs. Does it really make a difference if your cough is viral or bacterial, and why eighty percent of people won't benefit from taking antibiotics for their cough. A recent study has found that long term, repeated exposure to air pollution increases the risk of heart attacks. What does this mean for people who live near busy roads, and who is most at risk? Mark Porter talks to Frank Kelly, professor of environmental health at King's College London about why the microscopic particles in air pollution cause problems for the heart and why he believes cycle routes shouldn't be on busy, main roads.

As NICE issues its latest guidelines for treating osteoarthritis, Inside Health looks at the use of paracetamol to relieve pain and is glucosamine a recommended supplement? Also in the programme, Dr Mark Porter investigates how the latest drug treatments for problem drinking work. And how much do doctors use their gut instinct when it comes to diagnosing patients?

Why testosterone prescriptions are on the increase in the UK and growing concern amongst some doctors that these supplements may be linked to heart attack. Do the hours spent on laptops or tablets before bedtime disrupt your sleep? Dr Margaret McCartney reviews the evidence for later school start times for teenagers to match their natural bodyclocks. And a listener's concern about antidepressants in pregancy - 1 in 30 women take medication for depression whilst expecting a baby, but does the science suggest these drugs are harmful?

As the government calls for a ban on the sale of e cigarettes to under 18s, Dr Mark Porter is joined by Martin McKee, Gerard Hastings and Robert West to discuss who is using them and how they are being advertised. The chairman of NICE, David Haslam has suggested patients should demand more NICE approved drugs from their GP. Mark is joined by David and by GP Margaret McCartney to discuss whether patients really should be more pushy. Also in the programme Mark talks to Mark Emberton at University College London Hospital in London about the PROMIS trial into the benefits of using MRI to scan men's prostate gland to detect cancer.

Recent reports say that as many as 2 million people in England could be eligible for bariatric surgery. Dr Mark Porter investigates if a new gastric balloon swallowed in a capsule could be a valuable new tool for weight loss. Targeted for people whose BMI is lower than those who would be eligible for weight loss surgery, Inside Health finds out what the new balloon involves and asks two NHS bariatric surgeons - Sally Norton in Bristol and Guy Slater in Chichester - is this a boon to the arsenal of weight loss surgeons or is it a just slimming aid? Proton pump inhibitors are a family of drugs which reduce stomach acids to stop the symptoms of heartburn and ulcers. But they are being widely overused according to many gastroenterologists and doctors. Mark talks to gastroenterologist, Anton Emmanuel about the scale of the overuse, the potential side effects of being on them for too long as well as what people can do if they think they should come off the drug. Margaret McCartney and Mark Porter ask whether the anonymity of patient records on a new NHS database can be guaranteed? And using botox to treat vocal dysphonia, a kind of writer's cramp for the voice.

As Germany becomes the first country in Europe to pass a law allowing newborn babies to be registered as being of indeterminate sex - neither male nor female - should the UK follow suit? The incapacitating facial pain that feels like an electric shock - a world expert explains Trigeminal Neuralgia. And recurrent indigestion - should more be done to investigate the millions of people troubled with heartburn? Plus a new test for diagnosing diabetes that's causing some confusion.

Current recommendations advise that parents should give children under five Vitamin D supplements, but most parents do not follow this, and Vitamin D deficiency is now widespread, leading to a resurgence of rickets. To combat this, England's Chief Medical Officer Professor Dame Sally Davies is now recommending that free supplements be available to all children under five. Following the publication of a new Cochrane review into the evidence behind advocating exercise for people who are depressed, there were very different conclusions in the medical press; ranging from suggesting exercise was as good as antidepressants, to the other extreme that there was not much evidence that it helped at all. But is exercise an effective treatment or not? Gillian Mead, Professor of Stroke and Elderly Care Medicine at the University of Edinburgh, was lead author of the review. Fungi occur naturally on our bodies but thrive in warm, damp dark places like shoes. If you have healthy nails and a normal immune system, it is hard for the fungi to get a foothold. But if your nails are damaged, creating a portal of entry for the fungus, or your immune system is compromised because of some underlying health issue, then infection becomes more likely. But how are they best treated? Ina Farrelly is a senior podiatrist at Mile End Hospital in London. We often hear how difficult it is to get a GP appointment. It is an issue that has been picked up recently in the debate about pressure on A + E departments. So how can access be improved? In North Manchester, a group of GPs are trialling web based solutions that blur the boundary between hospital and community and out-of-hours GP clinics and normal surgeries. Dr Frederic Thomason is working on the pilot.

With news that actor Tom Hanks has been diagnosed with Type 2 Diabetes, how far in advance can doctors predict the onset of the condition and what can be done to delay it. And is obesity a disease? It has been classified as such in America, so what are the implications and should the UK follow suit? Plus the first ever conference on Lyme Disease - the tick borne infection that can cause serious complications.

How would you feel if your child's immunisations were linked to benefits or child care? In Australia, a full set of vaccinations is now a requirement for accessing most types of child care and claiming family tax credit worth around £500 a year. The only exception is if parents ask to be registered as conscientious objectors. Dr Steve Hambleton is President of the Australian Medical Association and explains how well these measures have been received. University of Sydney researchers have just published a new study adding to a body of evidence that pregnant women who see the same midwife require less intervention, have safer outcomes and are more likely to breastfeed their babies. They also save the healthcare system over £300. Professor Cathy Warwick, chief executive of the Royal College of Midwives, tells Inside Health that adoption of this "caseload" model in the UK has been slow. Around half a million people in the UK have some form of leg ulcer, and up until recently many would have them dressed in the community for years, without the underlying cause ever being diagnosed and treated. But this now looks set to change, as new guidance published by NICE recommends that if ulcers last more than two weeks, patients should be referred to a specialist vascular clinic. Like the one at Addenbrooke's Hospital in Cambridge, run by consultant vascular surgeon Mr Paul Hayes. Last year the NHS spent around £800 million on asthma medicines, but research suggests that at least half of people given the most common type of inhaler do not use them properly. This means their asthma remains poorly controlled and the NHS is wasting hundreds of millions of pounds. Mike Thomas is Chief Medical Advisor to Asthma UK.

Margaret McCartney reports on confusion around the new Shingles Vaccine - including how old you have to be to qualify and why there's a lack of supply in some GP surgeries.Why readymade drinks combining caffeine and alcohol have been banned in America.Are the tests GP's use to screen for liver damage falsely reassuring?And a leading authority dispels myths surrounding the causes of anorexia.

New research has found an association between Pandemrix, a swine flu vaccine, and a rare sleep disorder in children. Fears about a pandemic of H1N1 flu, so called "swine flu", over the winter of 2009/2010 led to millions of vulnerable people across the UK, including every child under five, being offered a new vaccine. There has since been a dramatic rise in the number of children diagnosed with narcolepsy. Paul Gringras, Professor of Children's sleep medicine and neurodisability at the Evelina Children's Hospital in London, is one of the researchers investigating this link. October 1st marks the start of a mass stop smoking campaign called Stoptober. Last year, 160,000 people gave up for the month, saving themselves £25 million from not buying cigarettes. Inside Health spoke to two of them, Adrian Osborne and Donna Horton. The Traditional Herbal Medicines Registration Scheme was brought in by the Medicines Healthcare Products Regulatory Agency (MHRA) in 2005. But there are concerns that the threshold for this type of licensing is set too low, and is misleading consumers. To debate the issue, Mark Porter is joined by resident sceptic Margaret McCartney and Dr Linda Anderson from the licensing division at the MHRA. It is thought that around five million people in the UK, most of them women, take some form of high dose calcium supplement to keep their bones healthy. But there have been a number of reports linking them to heart attacks and stroke. So what is the latest thinking on their use? Juliet Compston is Emeritus Professor of Bone Medicine at the University of Cambridge School of Clinical Medicine.

Following Billy Connolly's announcement that he has signs of Parkinson's Disease, Inside Health reports from the World Congress of Neurology in Vienna where early diagnosis is top of the agenda. Suncreams and Cancer. After a long hot summer an evidence based look at whether sunscreens really protect against the lethal forms of skin cancer - melanoma. And slimming pills - why have two regulatory bodies on different sides of the Atlantic made different decisions about two diet drugs? As a new NHS information leaflet 'Helping You Decide' is given to women invited for breast screening, Dr Margaret McCartney - who has criticised previous versions - gives her verdict. And a definitive guide to the only true dental emergency - what to do if you or your child knocks out a front tooth.

As last year's increase in Whooping Cough looks likely to continue judging from data coming out of America and Europe, Mark Porter finds out why it's on the rise and who should be concerned. Fish oils and Prostate Cancer - Inside Health responds to listeners' worried by this recent study and scrutinises the findings that hit the headlines. And weighing up the risks and benefits of screening for Aortic Aneurysms.

Dr Mark Porter reports on NHS Health Checks which are available to everyone between 40 and 74. Public Health England's Professor Kevin Fenton says this could save at least 650 lives, prevent 1600 heart attacks and 4000 cases of diabetes. Inside Health's resident sceptic Dr Margaret McCartney isn't convinced. We examine the truth behind rumours of a blood service sell off. Inside Health visits Addenbrooke's Hospital to answer a listener's query about Crohn's disease. Diabetes in pregnancy is a growing problem with potentially serious consequences for both the mother and baby. Mark meets a team which has developed an app to help women manage their diabetes.

Tailor made artificial hips - why we should learn more from failed joint replacements. The headache that really can be blinding and can cost you your vision unless treated promptly. Plus - why Elton John is waiting two weeks for his appendix operation that has caused him to cancel his European tour.

Prostate cancer and Sir Michael Parkinson's comments this week that the test 'is if you can pee against the wall from 2 foot' - Inside Health brings you the verdict. And stiff painful joints are usually associated with getting old, but imagine being told your toddler has arthritis - Mark Porter investigates. And why the change in doctors' dress code may be doing more for Private Medicine than infection control.

Should private clinics be offering out dated injections for hay fever? Cheese Molars - why do up to 1 in 7 British children have soft yellow teeth? And generics versus branded medicines - why pay more for the same thing?

Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us.

Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us.

As High Intensity Exercise regimes hit the news headlines, Inside Health sceptic Dr Margaret McCartney reviews the evidence for short sharp workouts. With new legislation restricting the use of teeth whitening products, Dr MArk Porter examines the science behind a brighter smile. And misconceptions around so called 'Voice Lifts'. They are not designed to cosmetically rejuvenate the ageing voice, but to help people with real conditions that cause paralysis of the vocal chords. Plus an update on the measles outbreak in Swansea.

What's the story behind the headlines about the links between red meat and heart disease? Researchers have reported that the way meat eaters' gut bacteria process a substance in red meat, carnitine, could be the trigger for heart disease. As the numbers of measles cases in Swansea rise, where else might be at risk of an outbreak and as the age of vaccination in Swansea has been lowered to 6 months, why do we vaccinate babies and young children when we do? Around a million people in the UK every year have some form of head injury. Most make a full recovery but there is growing concern that doctors are missing a common complication of head injury. Dr Mark Porter investigates a condition called post traumatic hypopituitarism - the result of a damaged pituitary gland- a small vulnerable structure which sits at the base of the brain. It regulates the actions of hormones controlling everything from immunity and the thyroid gland, to normal growth, sex drive and fertility.

Dr Mark Porter reports on NHS 111 - the new 24 hour urgent care number designed for the public to access urgent medical care. It was meant to go live across the whole of England this week but has been plagued by problems. And Inside Health's resident sceptic Margaret McCartney turns her beady eye to the latest fashion in the diet industry - fasting and so called 2 day diets. Popular - but what about the evidence? And obesity and cancer - there's growing understanding that being overweight is an important risk factor for a number of common cancers, but the relationship is never realy explained - Mark Porter turns his attention to one of the factors that might explain the link.

As part of NHS reforms doctors will be holding the purse strings from April 1st. In a special edition of the programme Dr Mark Porter finds out what the changes actually mean in practice. He meets GPs who have already been piloting some of the ways in which health services are commissioned to find out what they will mean for services on the ground. He also hears from GPs and hospital doctors about their concerns. One doctor says implementing GP commissioning is like flying a plane while it's being built. Why are GPs concerned and what could the changes mean for the future of our health services?

The evidence behind minimum pricing of alcoholic drinks in England and Wales - putting the political debate aside, does it actually work? Could harnessing the power of phages - naturally occurring viruses that prey on bacteria - help fight the threat posed by growing resistance to antibiotics? Plus a follow up on last week's item about Cervical smears - if women in their late 60s are among those most likely to develop cancer of the cervix, why aren't they included in the national screening programme? And babies' hips - concerns that the resurgence of swaddling is leading to abnormal hip development.

Following the chief medical officer, Professor Dame Sally Davies apocalyptic report comparing the threat of antibiotic resistance to terrorism, Dr Mark Porter looks at the overuse of antibiotics. He asks is it even useful to ask if an infection is viral or bacterial - are antibiotics the right thing even in a bad, bacterial infection? 60,000 pregnant women will go into premature labour every year in the UK. Mark visits a pioneering clinic at St Thomas's hospital in London to prevent premature labour. He also asks do all women need smear tests even if they're in long term monogamous relationships, have always had clear tests or are in a lesbian relationship? And aspirin to prevent the risk of stroke after hip replacements.

Dr Mark Porter questions Lord Howe, Minister for Health, as the government announces a U-turn to the NHS reforms following widespread concern that they would lead to privatisation by the back door, and the end of the NHS as we know it. Why women with epilepsy need to take extra care with their contraception, and the importance of managing their medication when they do get pregnant. And what sort of thermometer should you use when monitoring your child's temperature?

Dr Mark Porter puts the Pharmaceutical Industry in the spotlight as some clinical trials are criticised for testing new drugs against a weaker rival so that the results appear much better than they really are. Kamran Abbasi takes on Dr Bina Rawal from the Association of British Pharmaceutical Industry to discuss if the hurdles are being set too low, so that a new therapy comes out on top. And what if sustained periods of adversity in childhood are associated with permanent structural changes in brain development? So suggests new research into adolescents with Conduct Disorder - a controversial diagnosis given to 1 in 20 teenagers in the UK with aggressive or anti-social behaviour. Many of these children will have been exposed to severe abuse, but do these findings have implications for common family discord that lasts months or years? Mark Porter investigates.

Is it safe to drink urine, or even sea water in a survival situation? Mark Porter examines calls to withdraw one of the most widely used anti inflammatory drugs, diclofenac, because it increases the risk of heart attacks. And what kinds of health problems can result from living with a parrot, cockatiel or a loft full of pigeons? As guidelines to improve hospital meals are introduced, how will the idea of food as medicine improve patients' experience?

Dr Mark Porter investigates a new shingles vaccine for the over 70s. Is a chicken pox vaccine for children an alternative? And contraception for the over 35s: can you take the pill until the menopause? Mark Porter finds out why we're so poor at First Aid. And if you're switching to cheaper drugs, does the size and colour influence how you take your medicine. Could changing to a cheaper brand have a hidden cost? And early clues to Parkinson's disease.

Why the reporting of drug side effects has dropped by a third in a decade - it's the responsibility of GP's and the general public to notifiy through the yellow card system - but it's on the wane - does that mean drug safety is slipping through the net? Mark Porter finds out how the medical technology that identified why King Richard 111 died could be used to help the rest of us. And answers a listener's question about so called 'chemo brain'. Does chemotherapy really effect memory and the ability to concentrate? Plus a family history of cancer - is it always as worrying as it sounds?

Following the latest figures on deaths from alcohol, Dr Mark Porter talks to liver transplant expert Dr Varuna Aluvihare from King's College London, the largest liver transplant centre in Europe. Targeted cancer therapies - thousands of people with cancer are to have their genes mapped as part of a new drive towards treatment tailored to the individual. But what's in it for the patient? Mark discusses with Prof Peter Johnson, chief clinician for Cancer Research UK. Mark talks to Dr Paul Farrant about caffeine - is there a benefit to having it in your shampoo? Halitophobia - fear of bad breath and what can be done to help. Tim Hodgson and Claire Daniel from the Eastman Dental Hospital in London explain.

New research suggesting that the ban on smoking in public places has led to a sharp fall in the number of children admitted to hospital with asthma. Sunbeds and cancer Dr Mark Porter examines claims by some tanning salons that their machines do not increase the risk of developing skin cancer despite UV tanning devices being classified as carcinogenic to humans. Plus we visit a leading expert to answer a listener's query about why she is waking up with a very dry mouth. And why your body mass index may not be the best way to work out if you are overweight.

Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us.

Dr Mark Porter explores Dementia Challenge - the Department of Health's much publicised campaign to improve dementia care, including a new scheme to test everyone over 75 who's admitted to hospital for signs of the condition. Will this lead to overdiagnosis or will it get people treated early? And prescribing sleeping tablets for those unable to rest on a noisy hospital ward may seem like a quick fix but there is strong evidence that they are linked to side effects including an increase in falls. Mark Porter investigates and finds some simple solutions to getting a good night's kip in hospital. Plus a leading expert on the thyroid gland answers a listener's concerns about the use of the hormone thyroxine.

Dr Mark Porter discovers that three quarters of people with diabetes who are likely to benefit from an insulin pump are not on one. He talks about the cancer that no one talks about - cancer of the penis. And he learns why you shouldn't wake your child during a night terror. GP and regular contributor Margaret McCartney investigates the growing incidence of self harming amongst the young as a new report on it is published.

Felix Baumgartner's record-breaking freefall from the edge of space was witnessed online by 8 million people around the world this week. The jump was well-planned and included equipment to enable him to breathe at high altitude and low pressure. Dr Kevin Fong is the Wellcome Trust Public Engagement Fellow, and Associate Director of the Centre for Altitude, Space and Extreme Environment Medicine at University College London. He says that a pressurised suit would prevent his blood from "boiling" at the so-called Armstrong line - where pressure in the atmosphere means that boiling point of water is the same as body temperature. A previous attempt in the 1960s almost failed - when the pressurised suit leaked, causing swelling in one hand. The chances of surviving a common type of emergency abdominal surgery are lower if you have the operation at night or over the weekend. The first report produced by the UK Emergency Laparotomy Network shows that the odds of survival vary tremendously between hospitals too - from a 96% chance of pulling through in the best units, to just 58% in the worst. The study involved 2,000 patients who had undergone the surgery at 35 different NHS hospitals. The patients who need this operation are often very sick - with a blocked bowel or suspected bleeding in the abdomen. Mike Grocott, who's Professor of Anaesthesia and Critical Care Medicine at the University of Southampton believes that this type of case should be given the best care possible - by a consultant surgeon and consultant anaesthetist. The published results are anonymised - but Dr Dave Murray who's a Consultant Anaesthetist at James Cook University Hospital in Middlesbrough, says data will be collected nationally and published in 2015, including the names of the hospitals. One listener - a former artist and puppeteer - emailed Inside Health about his recent diagnosis of essential tremor. He's finding the shaking of his hands embarrassing and wonders what can be done about it. Professor Leslie Findley, who's Consultant Neurologist at the Essex Neurosciences Unit at Queens' Hospital in Romford, describes the options - from beta blockers to deep brain stimulation. If you've ever spent time in hospital you may have worn an open-backed hospital gown - which often gapes in an undignified manner. But if you are a man on the urology wards at Solihull hospital in the West Midlands then you are in for a treat - pyjamas designed by the staff to preserve dignity and reduce the likelihood of complications. Consultant urological surgeon Mr Dev Sarmah is one of the team who came up with new design in response to a spate of blocked catheters in patients wearing conventional pyjamas.

As the Nobel Prize for Medicine announced this week recognises stem cell research, Dr Mark Porter asks if it's already making a difference to patients. And imagine waking up with numbness in your face, by the end of the day with paralysis in your leg, all tests are normal and there's no apparent cause - Margaret McCartney reports from Edinburgh on a burgeoning field of medicine - functional disorders. Plus an Inside Health listener who has been taking epilepsy treatment for 35 years asks when is it safe to stop taking her medication? And do 'stop-smoking' campaigns really work? Kamran Abbasi looks at the evidence.

The latest addition to the burgeoning ranks of health magazines on the newsagent's shelves is called What Doctors Don't Tell You. The headlines on the front of this month's edition promise to help you sunbathe your diabetes away, end your child's wheezing without drugs, reverse bone loss for good, and avoid hysterectomy by changing your diet. Lynne McTaggart who edits the magazine with her husband responds to the views of Inside Health's resident GP, Dr Margaret McCartney. The commonest cause of hepatitis in the UK isn't A,B or even C - it's Hepatitis E. Although it may not have the profile of the better known strains it is causing more than its fair share of problems. Dr Harry Dalton who's a consultant gastroenterologist at The Royal Cornwall Hospital is a senior lecturer at the European Centre for Environment and Human Health and a world authority on Hepatitis E. He says we still don't fully understand what the long term effects of hepatitis E may be, particularly on the brain and nervous system. A listener contacted Inside Health about unpleasant dizziness that happens when she turns over in bed or straightens up after bending down. She wanted to know whether it was likely to be low blood pressure, or a problem with her ears. Dr Mike Jeffreys, a Consultant physician in the Department of Healthcare for Older People at the Royal Devon and Exeter Hospital explains how benign paroxysmal positional vertigo, or BPPV could be behind her symptoms. And how it can be effectively treated with a simple series of movements to the head called the Epley manoeuvre.

In Inside Health this week Dr Mark Porter asks whether headlines identifying a 'SARS Like' virus may cause unnecessary alarm. While this new virus and SARS are both members of the same family, virologist John Oxford explains that they are more like cousins that behave differently. And should you be worried about the shape of your baby's head? Lots of parents are. Margaret McCartney questions the growing trend for corrective helmets to treat so called 'flat head syndrome'. Plus Mark Porter visits the first NHS hospital to offer a new approach to treating heartburn.

Ovarian cancer is known as the silent killer - because its symptoms can often be vague - bloating, abdominal discomfort and feeling full after eating. An American medical body says that screening all women for this cancer does not save lives - and may cause more harm than good. The US Preventive Services Task Force were responding to the latest results from the PLCO study - which included 80,000 women over 55. There was no difference in outcome between the women who were offered screening and those who just carried on as normal. Around a thousand of the women who were screened had surgery after testing positive - only to find they didn't have cancer. And 1 in 7 of them had at least one serious complication following their unnecessary surgery. Professor Usha Menon from University College London says that screening could be used in women with abdominal symptoms to help spot the cancer. One Inside Health listener got in touch about his risk of developing cardiovascular disease - after his GP based his risk on his very high blood pressure reading - despite the fact that he's managed to reduce it by taking medication and exercising more. Dr Margaret McCartney says that charts in the the British National Formulary's charts are often used to assess these risks - but that other resources like QRISK can be used instead. A niggling dry cough or a constant feeling like you need to clear your throat may have been diagnosed as a post-nasal drip. But cough expert Professor Alyn Morice says many people plagued by these symptoms are in fact affected by a "leaky" valve at the top of their stomach - creating a mist of partly-digested food which triggers the cough reflex. The benefits of a vegetarian diet are often publicised - but how much does not eating meat improve your health? Dr Kamran Abbassi searches the medical literature and finds that there are modest benefits to cardiovascular risk, blood pressure and Body Mass Index. For parents who may be anxious when their children announce they want to turn veggie - one Vietnamese study found no difference between the growth rates of vegetarian and meat-eating children. Another listener Georgina Abrahams emailed to ask about treating gallstones. Does the gallbladder need to be removed surgically or can dietary changes help to alleviate symptoms? At least 1 in 10 of us will develop gallstones at some stage. Professor Hugh Barr is an upper gastrointestinal specialist in Gloucester. He explains how a low fat diet can help to prevent gallstones - which are usually deposits of cholesterol - but that once they're causing symptoms surgery is the most effective solution.

Dr Mark Porter dispels myths about osteoarthritis. It is usually put down to ageing and the result of wear and tear with people told that the condition inevitably leads to surgery. Mark Porter investigates the latest research on the condition and discovers that a third of patients will get better through the natural repair process.

HIV testing The first over-the-counter DIY testing kit for HIV is expected to go on sale in America in the next month. It's said to allow people to screen potential sexual partners for HIV before deciding to have sex them - all in the comfort of their own home. But sexual health consultant from London's Chelsea and Westminster hospital Ann Sullivan believes that the idea is flawed as someone could be recently infected and still show a negative result. Her hospital offers an HIV test to all patients who are admitted to the Emergency Department. A positive result is picked up in around 4 people in every thousand tested. Glasgow GP Dr Margaret McCartney analyses the latest HIV figures for the UK - which are on the rise. She advises that safe sex should be practised even with a negative result to help protect people from all sexually transmitted infections. Vitamin D and TB As much of the UK enjoys the last of the summer sun, Vitamin D is back in the headlines. The body makes its own Vitamin D with sun exposure - but supplements in tablet form can be taken by anyone who's deficient. A dose of the Vitamin D was given to patients with tuberculosis - along with the regular antibiotics - and it helped to speed up their recovery. Dr Adrian Martineau, who's a Senior Lecturer in Respiratory Infection and Immunity at Queen Mary University, London, says that the Victorian idea of giving "consumptive" patients of sunshine was spot on. Vitamin B12 A growing number of people believe they're deficient in another Vitamin - B12. Sources of the vitamin include meat, fish and dairy products - so strict vegans can be at risk of deficiency. The vitamin is crucial in the production of red blood red cells and for the normal functioning of the brain and nervous tissue. Symptoms of low levels can include anaemia, tiredness, pins and needles, memory loss and confusion. If it's not addressed promptly the damage can be irreversible. John Hunter who's Professor of Medicine at Cranfield University sees many patients who can't absorb the vitamin because of problems with their gut like Crohn's or Coeliac disease. Another condition - pernicious anaemia - is caused by the lack of a protein required to make absorption possible. As many as 1 in 30 adults have B12 deficiency - rising to 1 in 16 in the over 65s. A blood test which is used to check levels is thought by many doctors and patients to be inaccurate. The top-up injections of B12 are usually given every 2 or 3 months, in spite of many patients saying that their symptoms return well before their next one is due. Martyn Hooper from the Pernicious Anaemia Society says that testing and treatments need to be improved - to stop patients resorting to their own drastic solutions outside mainstream medicine. Mouth Ulcers One in 5 of the UK population will get mouth ulcers at some stage of their lives. For some, they can recur every month or so - in painful crops that can take a fortnight to heal. Some are associated with underlying problems such as inflammatory bowel disease, or vitamin and mineral deficiencies, but in many cases no cause is found. Patients like Ruth have to avoid certain foods - like chocolate and fruit - to reduce the risk of recurrence. She's had ulcers since her teens and now takes immunosuppressant drugs to reduce their impact on her life. Tim Hodgson who's a consultant in oral medicine at the Eastman Dental Institute in London has had some success treating them with drugs like thalidomide. He says that some patients fear that their recurrent ulcers could develop into oral cancer - but that simply isn't the case.

As many as 2 million people in the UK may have been misdiagnosed with high blood pressure - getting treatment they don't need. But how many of them have so-called "white coat hypertension" - where their blood pressure shoots up at the very sight of their doctor or nurse? For patients with high readings in the surgery doctors can offer "ambulatory" machines for them to take home, which monitor blood pressure round-the-clock. Bryan Williams who's professor of medicine at University College, London, led the team which drew up the latest blood pressure guidelines for the National Institute for Health and Clinical Excellence, or NICE. He says that anyone considering monitoring their own blood pressure at home should take measurements both in the morning and evening whilst sitting down - and work out the average over four days. The British Hypertension Society has a list of approved home blood pressure monitors on their website. NICE has also just approved the use of Botox injections to help people with chronic migraine that hasn't responded to other treatments. But it's been a controversial decision - Botox is expensive, and no miracle cure. It was initially rejected and is still not endorsed by NICE's equivalent in Scotland. Consultant neurologist Dr Fayyaz Ahmad has had some success with patients at his private clinic outside Hull. One of them is Dawn Cook, who's just had her third round of injections. She's suffered from headaches since she was 7 years old. Would you like to read your medical notes? The Government has pledged that everyone will have online access to NHS records by October 2015. So will this change the way doctors write about their patients? Professor Steve Field - who's Chair of the NHS Future Forum and one of the driving forces behind the plan - hopes that it will mean more plain English that's easy to understand. His own surgery will give patients online access early next year. One in 4 women develop fibroids at some time - benign, non cancerous growths in the wall of the uterus which can cause heavy painful periods. Surgery might be suggested to help wtih the discomfort - using keyhole techniques via the abdomen or vagina - a procedure known as myomectomy. But in recent years some less invasive techniques have become available to help relieve symptoms.

Dr Mark Porter asks whether doctors can try too hard in the early detection of disease and investigates the overdiagnosis of hypertension. This week he discovers that as many as 3 million people who have been told they have high blood pressure may not actually have it - could you be one of them?

Dr Mark Porter finds out that some medical conditions are over-diagnosed and therefore over-treated, because of the results of certain tests.

Apart from a few cases that hit the headlines, the use of anabolic steroids is rare among the athletes in the Olympic village. But in the wider society abuse has exploded, according to an expert from Liverpool John Moores University. Jim McVeigh - who's Deputy Director at the Centre for Public Health - says that anabolic steroid abusers are the largest group using needle exchanges. Anabolic steroids are naturally occurring hormones, like testosterone, which influence growth, physical development and the workings of the reproductive system. Abuse allows athletes to train harder for longer so they become bigger, stronger and faster. But those effects will not be seen if you don't exercise or fail to eat and sleep properly. The injected steroids are often combined with tablets. There are a number of side effects like a growth in breast tissue, acne, baldness and shrinking testes - as well as longer-term health concerns for the heart and kidneys. Although they share the same umbrella term - steroids - anabolic steroids are not the same as drugs from the corticosteroid family - found in cortisone joint injections and some types of creams for eczema, sprays for hayfever and inhalers for asthma. For the best chance of good recovery from strokes patients need to be treated within a few hours. In the Lake District new technology is giving suspected stroke patients access to specialists - using high speed broadband and video cameras. Dr Paul Davies is Consultant Stroke physician at the Cumberland Infirmary in Carlisle. He can assess a patient's scans and other tests over a video connection - with the help of nurses and doctors treating them locally. Thrombolytic - or clotbusting treatment - can be given if the stroke is one of the 80% caused by a clot. It's important to get this diagnosis right as the other 20% are the result of a bleed - which could be potentially fatal if thrombolysis is given. It's has been dubbed the Killing Season by some sections of the media - but Dr Margaret McCartney believes that August isn't as risky a time to be in hospital as the headlines claim. One study compared the number of deaths at the end of July and the beginning of August - but the difference wasn't statistically significant and could have been down to chance rather than a real harmful effect of new doctors. Inside Health listener and keen pianist Roger emailed the programme about Dupuytren's contracture - where the fingers curve into the hand and can't be straightened. A new treatment is becoming available on the NHS for this common problem which affects 1 in 10 people's hands. The only option used to be surgery but Mike Hayton, who's a Consultant Orthopaedic Hand Surgeon at Wrightington Hospital in Lancashire, is now carrying out collagenase injections on some of his patients. Up to 60% of Dupuytrens patients can benefit from the treatment - which helps to break down the collagen-rich cords so they can then be snapped a day or two later.

If you believe recent headlines the growing increase in deaths from liver disease is entirely down to excessive alcohol consumption, but it's estimated that two thirds of liver related deaths are caused by other conditions. Dr Mark Porter investigates two liver conditions that do not hit the headlines but could be silently creeping up on millions of people in the UK.

Do you have trouble getting an appointment to see your GP? If so, you are not alone. A Department of Health review from 2009 suggested that as many as 200,000 patients a day struggle to get a consultation with their doctor. And a quarter of those who want to book an appointment in advance simply can't. One Inside Health listener emailed us to ask why some surgeries seem to only release appointments on the day - a bit of a telephone lottery - and others do allow for some advance booking. Chair of the the Royal College of General Practitioners Dr Clare Gerada offers some insight. Monitoring patients in their own homes - telehealth - is one of the latest developments in general practice. The government hopes that the technology will help at least 2 million people over the next 5 years, saving the NHS more than a billion pounds. The £2,000 black boxes measure blood pressure, blood sugar levels and blood oxygen - information that's then sent over the internet to a medical professional. But the project to monitor patients with long term conditions like diabetes, heart failure and breathing difficulties hasn't got off to a good start and GP Margaret McCartney questions whether it will ever live up to the hype. The most seriously ill patients in hospital are looked after in Intensive Care - where they are given life-saving treatment and support with vital bodily functions like breathing. To help staff relieve anxiety - and enable staff to carry out procedures like inserting breathing tubes - patients are often sedated. Dr Chris Danbury from the Royal Berkshire hospital in Reading says it's important to get the level of sedation right - not too little and not too much. One consequence of the drugs and environment can be hallucinations and flashbacks - with some patients reporting dreams of being abducted by alien space ships. Specialist outreach nurses in Reading - like Sister Melanie Gager - are skilled at offering strategies to overcome this - including follow-up visits to the ICU for both patients and their families. Now that summer has finally arrived for most parts of the UK, if you are planning an outdoor swim then there may be hazards lurking in the water. Heavy downpours result in the release of sewage into the sea from overflow pipes - which can affect water quality for a couple of days. Inside Health reporter Anna Lacey met Pollution Control Manager Dr Robert Kierle on the banks of the river Axe in Weston-Super-Mare - and Surfers Against Sewage who are offering a free text service to alert would-be bathers about local measurements of any pollutants.

Whooping cough is on the rise - but the official figures could be the tip of the iceberg, according to one doctor. Retired GP from Nottinghamshire Dr Doug Jenkinson has spent most of his professional life researching the condition which is also known as pertussis. He says that instead of around 1,700 cases every year, there could be tens of thousands. He personally has seen around 700 cases and a blood test available for the last few years has helped to confirm cases. The key to diagnosis is a cough which almost causes choking - sometimes with the characteristic whooping sound - which then subsides for a few hours. The cough can last up to 3 months. The cough can be dangerous for infants under the age of one - who can catch it from parents and grandparents. Dr Jenkinson suggests a vaccine booster could be offered to parents-to-be. Following the recent high profile cases of elite sportspeople collapsing with undiagnosed heart conditions should screening be made available to amateurs? Since the collapse of footballer Fabrice Muamba on the pitch earlier this year the profile of so-called silent heart conditions has risen. Sanjay Sharma is Professor of Cardiology at St George's Hospital - he works closely with the charity Cardiac Risk in the Young or CRY - and supports screening. CRY believes that screening will pick up an abnormality in as many as 1 in 300 youngsters - although it freely admits that the vast majority of these would never have gone on to develop a serious problem. And it is the resulting disruption to these children's lives that puts some people off screening, not least because they far outnumber those likely to be saved by the tests. Dr Anne Mackie is the Director of Programmes for the UK National Screening Committee. She says that she wouldn't even opt for screening for her own children Following last week's feature on unfounded rumours that toys were to be banned from GP waiting rooms to reduce the risk of cross infection, an Inside Health listener emailed the programme to ask about the evidence behind products marketed as killing germs on the various surfaces we touch at home. So what's the science behind adding antibacterial agents to household products? Dr Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine reveals that there is no evidence to show that products labelled 'antibacterial' reduce the number of infections in the home any more than 'regular' cleaning products. GP Margaret McCartney explains why she thinks the latest campaign to encourage more self-care for minor ailments is wrong to imply that people who consult their doctor about dandruff are wasting NHS resources. The NHS 'Choose Well Summer' campaign says 'self care is the best option if you have a summer health complaint' and it's supported by the National Association for Patient Participation, who say it's all about 'empowering individuals'. The campaign was launched with headlines about the 40,000 visits in a year to GPs which were for dandruff. But what was really behind those consultations? And how good are we at looking after our own health? Computer games are being used to help people recover from strokes and brain injury, thanks to experts in Reading. Products like Microsoft's Xbox Kinect - which can recognise a player's movements - are being adapted by Professor Malcolm Sperrin at the Royal Berkshire Hospital. The technology allows patients to select an activity - from dancing to golf or ten pin bowling - and monitor their progress as part of their recovery. The charity Headway - which supports people with brain injury - is using the technology in the community to help people to recover at home.

Dr Mark Porter debates whether the recent lung cancer awareness campaign on TV, radio and the internet, hits the spot or is scaremongering. He discovers new research suggesting some people with exercise induced asthma are being given the wrong diagnosis and treatment. And GP Margaret McCartney investigates rumours this week that children's toys are to be thrown out of the doctors surgery in the on going battle against infection. Producer: Erika Wright.

50,000 people end up in hospital every year in the UK because of bleeding from the top end of the gut - an upper gastrointestinal bleed. Around 1 in 10 of them will die. Gastrointestinal or GI bleeds are often due to ulcers - a side effect of taking aspirin and other non-steroidal anti-inflammatory drugs like ibuprofen and diclofenac. The bleeding can occur in the gullet, stomach or the first part of the intestine, the duodenum. Other causes include cancers and liver disease. The location of the bleed can be pinpointed by using an endoscope - a camera to look inside the gut - and treatments include stopping the bleeding with clips, heat or injections of adrenalin. The National Institute for Health and Clinical Excellence hopes to change that with new guidelines on managing GI bleeds - guidelines which, as of last month, hospitals in England, Wales and Northern Ireland will be expected to follow. Scotland has had similar guidance in place for the last few years. David Patch is a Consultant Hepatologist at the Royal Free Hospital in London and has a special interest in this type of bleeding. He says that patients whose needs cannot be met at smaller hospitals should be transferred to specialist units where they can be treated promptly. Tariq Iqbal who's a consultant gastroenterologist at the University of Birmingham is evaluating a new kind of treatment called Hemospray. This is a powder that can sprayed over the bleeding area to stop or slow any bleeding by accelerating the natural clotting process. New research appears to show that standing at work for long periods in pregnancy can affect the unborn child. Research in the journal Occupational and Environmental Medicine, followed 4,680 mothers throughout their pregnancies. Some of the women had jobs where they were on their feet a lot - such as hairdressing, sales and working with toddlers. Women who stood for a long time had babies with smaller heads. It's thought that standing for long periods of time causes blood to "pool" in the legs, limiting the blood supply to the rest of the body including the uterus and therefore the developing foetus. The study also showed that working up to 36 weeks of pregnancy had no impact on birth weight, size or prematurity. Previous studies have shown that heavy lifting increased the risk of babies being born early - but this study showed no such link. Many people with pain and stiffness in the shoulder are told they have a frozen shoulder. But the label is often incorrect as a truly frozen shoulder means restricted movement in all directions, accompanied by pain. It's not known what causes it but it is commoner in people with diabetes. During the very painful initial phase it's best to rest the shoulder and use analgesia to help relieve the pain, especially at night time when it can be at its worst. TENS and acupuncture can help sometimes. The tissues in the shoulder "capsule" appear to be thickened and rubbery - and some relief can be gained from surgery, to let the shoulder move more freely. If left alone about half of patients still have discomfort after 7 years - so the common belief that it lasts 2 years is a myth. As the pain starts to recede physiotherapy can be helpful and if there is inflammation - eg with calcified tendonitis - then steroid injections can relieve pain. Producer: Paula McGrath.

In Inside Health, Mark Porter clarifies recent headlines claiming that researchers have found a "Blood test that identifies depression". It certainly isn't that simple. GP Margaret McCartney reports from Paisley Abbey in Glasgow on the health benefits of joining a choir. And do special muscle building drinks live up to the marketing hype? Max Pemberton looks at the science behind the recent explosion in sales of high protein sports drinks. Plus a new treatment for helping people with fluid retention due to heart failure, that can transform a puffy face to a chiselled jaw bone overnight. Producer: Erika Wright.

Whooping cough is making a comeback - the latest figures show that there were more confirmed cases in the first 3 months of this year than there were in the whole of 2010. But the condition can only be monitored properly if GPs test for it - and it's estimated that up to 40% of persistent coughs in children could actually be down to whooping cough. Kamran Abassi who's Editor of the Journal of the Royal Society of Medicine, explains how immunity wears off as we get older. The coughing can last for up to 3 months and is most serious in small babies. Up to 10 deaths are reported each year in the UK and antibiotics can be used to treat it. In the UK all deaths in pregnancy and childbirth are recorded. Just 1 in 10,000 British women currently die - on average one woman every week. The information is held by the Maternal and Newborn Clinical Outcomes Review Programme - known as the Confidential Enquiry. Last year this clinical audit was effectively suspended after the process was put out to tender. Susan Bewley who's Professor of Complex Obstetrics at King's College, London explains why it's so important to keep such detailed information. Blushing can become a vicious cycle - with those severely affected finding it impossible to lead a normal life. Some turn to psychological therapies. Dr Jennifer Wild from the Centre for Anxiety Disorders and Trauma in Oxford says she sees a success rate of 90% in patients who opt for cognitive behavioural therapy. An operation called a sympathectomy - where the nerves are cut - can be carried out by surgeons like Alan Cameron, who works in Ipswich. He sees mixed results - with many experiencing side effects like increased sweating and sensitivity to light and sound. Dr Margaret McCartney doesn't like it when doctors use euphemisms for our genitals. Children often use words like "twinkle" or "pee pee" instead of the correct anatomical terms. But whose blushes are they sparing - theirs or their parents? An Inside Health listener emailed the programme to find out about what happens to the food he he eats - specifically how quickly peas pass through his gut into the loo. Neuro-gastroenterologist Anton Emmanuel from University College Hospital, London, demystifies gut transit times.

Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us. Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, discusses with Mark new research that suggests that giving heart attack victims drugs to ease their chest pain could hamper the heart's ability to heal itself. The standard approach to appendicitis is to remove the inflamed organ. But a new review argues that antibiotics could be an alternative to surgery in some cases. Dileep Lobo, Professor of Gastrointestinal Surgery at the University of Nottingham, explains his team's findings. GP Margaret McCartney is on her soapbox about sick notes, following regulatory pressure from Europe that could allow people who fall ill on holiday getting compensatory time off work. Dr Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine, looks into the evidence that the change from sick notes to fit notes two years ago has had an impact on people returning to work. Mark visits the pathology laboratories at St Thomas' Hospital in London to find out from Senior Biomedical Scientist Diane Murley how blood is analysed. And Dr Andrew Moore from the Pain Research Unit at the Churchill Hospital in Oxford talks about which over the counter painkillers are likely to work best for acute pain. Producer: Deborah Cohen.

Should prescriptions be free for everyone? They already are in Wales, Northern Ireland and Scotland - so why aren't they in England? The BMA says the current list of exemptions is unfair and outdated - but there are no government plans to scrap the charges for the 10% of people who have to pay for them. And as the vaccination campaign for young girls against the virus which causes cervical cancer and genital warts gains momentum - are boys losing out? Uptake of the vaccine among teenage girls in the UK is high - but there are no plans to extend the programme to boys - despite plans to do so in Australia and the United States. There are confusing statistics surrounding the debate over the use of bicycle helmets for both adults and children. Some research points to helmets encouraging car drivers to give cyclists less space in traffic. Up to a third of children in another study said wearing a helmet would put them off cycling in the first place - bad news for parents concerned about childhood obesity. GP Margaret McCartney uses her own risk analysis to work out how to keep herself safe and fit. Producer: Paula McGrath.

Aspirin is over 100 years old, but doctors still can't agree whether the benefits of taking it to prevent heart conditions or cancer outweigh the risks.Dr Mark Porter investigates. And - you've worked flat out to get on holiday, then come down with a stinking cold - is there any science behind why so many of us get sick on vacation. Plus ADHD - not in children, but ADULTS - why is it so hard for grown-ups to get a diagnosis. Producer: Erika Wright.

Dr Mark Porter demystifies discusses polycystic ovary syndrome, the health benefits of garlic, the PSA test for prostate cancer, and concerns over patients' dignity.

A new study shows that a diet rich in red meat increases the risk of developing bowel cancer - so how much is too much? Professor Tom Sanders from Kings College, London, explains how a rise in obesity and an inactive lifestyle could be as much to blame as your favourite steak. This week 17 people - including 2 ambulance crew - were treated for suspected carbon monoxide poisoning at a food plant in Cornwall. The medical adviser to the charity CO Awareness explains how to protect everyone in your home from the accidental poisoning which can have catastrophic effects. NHS screening programmes are based on evidence - so that they target the right groups of people who are most at risk of developing a condition. But more and more private companies are offering tests like CT and ultrasound scans. Abdominal aortic aneurysm is a potentially lethal condition - where the main artery in the abdomen balloons and could burst. Many private companies offer screening for it - but vascular surgeon Hany Hafez from St Richard's hospital in Chichester believes that it's a waste of time and money for women and for men who are under 65 years of age. And Dr Mark Porter gets on a treadmill to answer a listener's question about whether running is truly good for his health - or will end up ruining his knees. Dr Kamran Abassi - the editor of the Journal of the Royal Society of Medicine - casts his expert eye over the evidence behind supplements which are supposed to help keep our joints healthy.

In Inside Health tonight, Dr Mark Porter tackles the confusion and prejudice that surrounds the skin condition Vitiligo - famously said to have been the reason why Michael Jackson skin looked so light. Max Pemberton discovers why surgeons may be wearing masks for their benefit rather than their patients. And Margaret McCartney reminds doctors who tweet to proceed with caution - posting photographs of the first patient you've anaesthetised is likely to get you into trouble!

10 million prescriptions for sleeping pills are written every year in England. So how alarmed should we be over new American research suggesting that people who take them are more likely to die than those who don't? Dr Mark Porter speaks to a leading British sleep expert about the findings and asks what the alternatives are. An Inside Health listener asked us to investigate how safe "electronic" cigarettes are. So Dr Max Pemberton, who uses them himself, talked to Professor John Britton from the UK Centre for Tobacco Control Studies at the University of Nottingham about these currently unregulated products. Rumours abound that a tobacco manufacturer is about to launch the world's first so-called "safe" cigarette. But smokers' reactions are mixed and some prefer other products like nicotine gum. GP Margaret McCartney's column is about whether your doctor's dietary preferences and habits influence your well being. Half of all pregnancies in the UK are unplanned, so women and their babies lose out on important supplements like folic acid to help prevent spina bifida. But for women with an underactive thyroid gland it's even more important that they do their best for their baby by increasing their thyroxine dose as soon as they know they're pregnant. But research from Leicester shows that women often fall through the gaps when seeking care - as GPs, midwives and consultants often think someone else is helping these women. Producer: Paula McGrath.

Dr Mark Porter demystifies the health issues that perplex us and separates the facts from the fiction. He brings clarity to conflicting health advice, explores new medical research and tackles the big health issue of the moment revealing the inner workings of the medical profession and the daily dilemmas doctors face. As new figures published show that 1 in 7 women in England continue to smoke during pregnancy, Inside Health investigates a pilot incentive scheme - which gives women just over £750 worth of vouchers if they give up, and stay off cigarettes for at least 6 months after they give birth. What is the evidence that these incentive schemes work? And what about incentives encouraging doctors to ask whether a patient smokes, or check their blood pressure and cholesterol levels. Dr Margaret McCartney explains why she is one of many GPs who are uncomfortable with the way incentives can influence practice Plus if you've been plagued by a recurring dry tickly cough, it could be caused by a widely used family of blood pressure drug - the ACE inhibitors. Mark Porter investigates. And although it's been slightly warmer that's likely to be cold comfort for 10 million people in the UK with Raynaud's disease where the fingers turn ghostly white after exposure to temperature changes . Presenter: Dr Mark Porter Producer: Erika Wright.

As the Prime Minister announces his efforts to reduce compensation claims for whiplash, Dr Mark Porter asks are doctors having the wool pulled over their eyes? Or are drivers and passengers making mountains out of molehills? Our resident sceptic Kamran Abbasi looks behind recent headlines that suggested weaning your baby on finger foods may be a healthier option than spoon feeding. And in response to our listeners, cholesterol tests - what do they mean, and what should we do about them? Statins are the main mode of prevention for those at greatest risk of heart attack and stroke. But how do you balance the risk of side effects with the protection they provide? We explore the latest research. And how many times have you been to a hospital appointment only to find that the doctor seeing you doesn't have your notes or test results? By 2015, the Department of Health hopes to give us all access to our notes via a centralised electronic record. We examine an alternative approach being tried at various hospitals including Great Ormond Street Hospital. Called Patients Know Best, it works a bit like Facebook and puts the patient in charge. Producer: Beth Eastwood.

Dr Mark Porter demystifies the health issues that perplex us and separates the facts from the fiction. He brings clarity to conflicting health advice, explores new medical research and tackles the big health issue of the moment revealing the inner workings of the medical profession and the daily dilemmas doctors face. This week Mark examines the protocols for visitors to hospitals and asks whether there's any evidence that they help control the spread of infection - is there any science behind using the hand gels provided? Why do some hospitals ban flowers - and should you be able to sit on the hospital bed of your loved one? Martin Kiernan - Nurse Consultant in prevention and control of infection - helps to clear up the confusion. Inside Health discovers that gout - a condition associated with older portly men caricatured in cartoons and literature - is on the increase and striking much younger. And while it has been the butt of many a joke, it has never been a laughing matter - at least for those afflicted. And after the longest grand slam final in history just over a week ago, Mark Porter investigates a new treatment for Tennis Elbow that is used by the top players, Olympic athletes, and is available to mere mortals on the NHS in a handful of places. Plus Dr Max Pemberton investigates whether the explosion in the use of tablets, such as the i-Pad, has caused a similar elbow injury. An Margaret McCartney scrutinises new research suggesting that people with coeliac disease are not the only ones who can develop symptoms if they eat gluten containing foods. Gluten is a component of wheat, barley and rye, and responsible for triggering coeliac disease in around 1% of the UK population, causing problems that include bloating, diarrhoea, weight loss and fatigue. But there now appears to be another group of people with milder symptoms caused by gluten sensitivity - or gluten intolerance - the terms are interchangeable - but how do you identify them? Well certainly not with fancy High Street tests. Producer: Erika Wright.

On Inside Health this week, the bacteria Pseudomonas that's been responsible for a number of deaths in special care baby units in Northern Ireland. Mark Porter asks Prof Richard James, Director of Healthcare Associated Infection at the University of Nottingham, why the outbreak occurred and how the Department of Health is likely to try to prevent future occurrence.. We look at a new class of drugs that could transform the lives of tens of thousands of people on warfarin. Recently approved by NICE, the National Institute for Health and Clinical Excellence, these drugs overcome many of the drawbacks of taking warfarin. Mark Porter explores just who is likely to benefit if the drug gets its final endorsement from NICE next week. Mark also explores which prescription drugs are addictive, and how wearing high heels can damage your calves but might improve your sex life. Presenter: Dr Mark Porter Producer: Beth Eastwood.

Inside Health covers the ongoing debate about proposed reforms to the NHS in England. This week Colleges representing nurses, midwives and physios have joined sceptical GPs and hospital specialists by announcing their opposition to the reforms. And, just out, a report by a cross party select committee on health questions whether current financial pressures make it too risky to implement the most radical changes in the Service's history. Health Minister Lord Howe talks to Dr Mark Porter in response to the criticisms from Professor Martin McKee and Dr Clare Gerada in last week's programme.. And an Inside Health listener emailed to ask why Tinnitus confuses patients as well as doctors. Dr Max Pemberton investigates. Plus why are teenagers - the most internet savvy generation of all - finding it difficult to access good health information in the internet? Psychologist Ellen Henderson at the University of Bath is one of the authors behind a new study looking at websites aimed at young people and offering advice on treating pain like headaches and period cramps. Vitamin D supplementation is currently recommended for all groups at particular risk of deficiency - such as pregnant and breastfeeding women and young children - but three quarters of parents, and more than half of doctors, midwives and health visitors are not up to speed with the latest guidance, so don't follow it. As Chief Medical Officer for England, Dame Sally Davies, writes to healthcare professionals highlighting the importance of vitamin D supplements Inside Health talks to Nick Bishop Professor of Paediatric bone disease at The University of Sheffield. Finally, our resident sceptic Dr Margaret McCartney explains why she doesn't rate over the counter cough mixtures. Producer: Erika Wright.

The programme that uncovers the real stories behind the health headlines, providing clarity where there's confusion. First, a subject that looks set to be in the headlines this week - growing disquiet about the Health and Social Care Bill and changes to the NHS which include the transfer of responsibility and resources to GPs. Many health experts simply don't understand the reforms, including international public health expert Professor Martin McKee who confesses in this week's British Medical Journal that he doesn't get it either. So what chance is there for the rest of us? It's not just bewilderment that's likely to hinder the implementation of the new Bill. There's active resistance from both hospital consultants and GPs. But what are the reforms going to mean for you? Dr Clare Gerada, the Chair of the Royal College of GPs, discusses this question with Mark. Mark Porter puts his mental agility to the test at the Research Institute for the Care of the Elderly in Bath to find out whether there's any truth behind recent headlines suggesting that our cognitive abilities start to decline from forty five. Professor Roy Jones tells Mark the results of his memory test. And GP Margaret McCartney explores the thinking behind Do No Resuscitate Orders, the record put in a patient's notes when staff feel that attempts to resuscitate them in the event of cardiac arrest are likely to do more harm than good. Finally, the holy grail to combat all flu viruses - a universal vaccine. Mark Porter visits the world's only Flu Camp where new versions of the vaccine are being trialled in volunteers. Professor David Salisbury, Head of Immunisation at the Department of Health, and Dr Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine, join Mark to discuss the use of the current flu vaccine. Producer: Beth Eastwood.

New Series: Dr Mark Porter demystifies the health issues that perplex us and separates the facts from the fiction. He brings clarity to conflicting health advice, explores new medical research and tackles the big health issue of the moment revealing the inner workings of the medical profession and the daily dilemmas doctors face. This week Mark Porter looks at the regulation covering medical devices and implants - everything from artificial joints, to pacemakers and heart valves - and explains why more needs to be done to protect the general public who are often unwitting guinea pigs for untried technology. He asks why is it so much easier to get approval for devices like new hip or breast implants compared with the strict protocols observed for drugs? All you need for most devices is the equivalent of the CE mark - the sort of approval you would expect to find on a toy or a kitchen appliance, not a pacemaker - which may explain why some have unacceptably high failure rates. Inside Health's psychiatrist Dr Max Pemberton investigates a question tweeted to the programme - what's the role of testosterone supplements in men. And following the Prime Minister's comment about Tourette's syndrome Max tells Mark what the condition really involves. Mark talks to Prof Tony Heagerty from the University of Manchester and Professor Tom McDonald from the University of Dundee about new research suggesting that taking pills at night rather than in the morning reduces the risk of complications like stroke and heart attack. And there's a column from GP Margaret McCartney about what goes on in her head when she's making a diagnosis. If there is an issue that confuses you - that you've read or heard about - then please get in touch. Contact us on twitter @BBCRadio 4 using the hash tag #InsideHealth or email the programme via the Radio 4 website. Producer: Erika Wright.