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Health Check

Author: BBC World Service

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Health issues and medical breakthroughs from around the world.
15 Episodes
BBC global health correspondent Naomi Grimley joins Claudia Hammond for a round-up of the latest developments in Covid vaccines and their rollouts – including the World Health Organisation’s Director General who has admonished richer countries and pharma companies for undermining the chances of access to vaccines for all countries. Plus a controversial vaccine rollout in India and the Iranian leader wants to ban US and UK vaccines. Claudia’s guest of the week is family doctor Ann Robinson who has perspectives on some of the latest Covid treatment news. Early results suggests a place for two monoclonal antibodies in treating patients who are sick enough to be in intensive care, although the drugs are expensive. And there are some encouraging results from a small trial in Argentina of convalescent plasma therapy in older mildly ill patients. The pandemic has disrupted the training of the next generation of health professionals. From Chile, Jane Chambers reports on how a leading dental college in Santiago is innovating to keep the practical tuition of its students up to standard. Ann Robinson tells Claudia about new research measuring the role of air pollution in miscarriages and stillbirths in India, Pakistan and Bangladesh. Should only doctors do surgery? Claudia talks to Sierra Leonian surgeon Thomas Ashley and Jenny Lofgren of the Karolinska about training more junior health care workers to perform relatively simple surgical procedures such as hernia repair, in the hope of addressing the enormous unmet need for this operation across sub-Saharan Africa. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Image: Pfizer-BioNTech Covid-19 vaccines pictured in January 2021 in Liege, Belgium. Photo credit: Vincent Kalut/Photonews/Getty Images.)
Claudia Hammond talks to Guardian health editor Sarah Boseley exactly one year after she and Claudia first talked on Health Check about a mysterious respiratory disease that had appeared in Wuhan in China – with 59 cases reported at that point. What have been the highs and lows of the world’s response to the coronavirus so far? Alison van Diggelen reports from the USA on research which has found that on average the mental wellbeing of older people has held up better during the pandemic than that of younger generations, despite the mortality risk being much higher for the elderly. Researchers in California and Georgia have also looked at why. For listeners living under strict lockdowns, psychologist Virginia Frum recommends awe walks. Walks during which you deliberately look out for things to be amazed by can boost your emotional wellbeing. You don’t have to travel to spectacular scenery: awe walks can work just as well in a city as out in nature. Boston University’s global health epidemiologist Matthew Fox is Claudia’s guest of the week. They discuss the United States’ troubled Covid vaccine rollout, the long term health problems of conflict refugees, and how smartphones can improve a low-tech method of cervical cancer screening. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: Medical staff members wearing protective clothing accompanying a patient in Wuhan, China in January 2020. Photo credit: STR/AFP/Getty Images.)
Claudia Hammond explores how children think with two psychologists; Dr Victoria Simms from Ulster University who researches how children’s understanding of maths develops and Professor Teresa McCormack from Queens University Belfast who researches how children understand time. The discussion was recorded in front of an audience at the Northern Ireland Science Festival in February 2020. Presenter: Claudia Hammond Producer: Caroline Steel (Picture: A group of preschool students sitting on the floor with their legs crossed and their arms raised in the air. Photo credit: FatCamera/Getty Images.)
Have you lost a loved one who is still a part of your life in some way? Did it leave you feeling confused or frozen about how to continue with life? Claudia Hammond examines the distressing phenomenon known as ambiguous loss – the enormous challenge of dealing with a loss when you aren’t sure what has happened, leaving you searching for answers, unable to move on. What has the pandemic done to our memories? Anecdotally many people report that they keep forgetting things which they are sure they would have remembered before. Psychologist Catherine Loveday of the University of Westminster examines the new emerging evidence. Our brain is formed of two hemispheres and in most of us, the two halves are interconnected by millions of nerve fibres that form a large bridging structure called the corpus callosum. But some babies are born without a corpus callosum, linking the two sides. A quarter of these babies grow up with serious developmental difficulties and half have mild to moderate cognitive problems. But a quarter have no problems at all suggesting that somehow the brain is compensating for the low level of connectivity between the two hemispheres. New brain scanning research at the University of Geneva by Dr Vanessa Sifreddi has revealed how the brain does this. Are you more open, less conscientious or more neurotic than you used to be? It used to be thought that personality was fixed in adulthood but it can and does change. Psychologist Eileen Graham has studied data from thousands of people and explains how and which traits are likely to increase or decrease. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: Vintage orange velvet armchair in a stylish, minimal domestic room. Photo credit: Catherine Falls Commercial/Getty Images.)
Iran was one of the first countries to be hit hard by the coronavirus. In the first population wide survey of infection rates in a Middle Eastern country, Iranian medical researchers now estimate that about one in five people on average were infected during its first wave in 18 cities in the country. But the rate varies enormously from city to city. In the city of Rasht, they estimate more than 70% of the population caught the virus. Claudia Hammond talks to Iranian infectious disease researcher Maryam Darvishian about the findings and what they mean for Iran’s attempts to control the virus today. We look at the sleep hygiene plight of international students whose study and sleep cycles have been thrown into chaos because of Covid travel restrictions. We hear the experiences of a student in Singapore studying remotely at Columbia University in New York. Her classes are usually in the dead of night Singapore time. Harvard sleep researcher Jeanne Duffy advises on the best ways for students to plan their work/sleep patterns. When surgical patients are under general anaesthetic, playing them soothing music and comforting messages may reduce the pain that they experience and the need for opioid pain relief in the 24 hours after their operations. This is the conclusion of a randomised study of about 400 patients undergoing surgery in five German hospitals. Claudia talks to anaesthesiologist Ernil Hansen of Regensberg University who explains how this might be working to make post-operative recovery more comfortable and less reliant on strong analgesic drugs. Claudia’s studio guest this week is BBC Medicine and Science correspondent James Gallagher, talking about Covid-19 vaccines, how our genes influence the severity of Covid illness and how ear wax might improve blood sugar monitoring for diabetes. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: People wearing protective masks walk through a street in Tehran in July 2020. Photo credit: Fatemeh Bahrami/Anadolu Agency/Getty Images.)
Are genetic therapies for sickle cell disease beginning to come of age? Claudia Hammond talks to David Williams and Erica Esrick of Boston Children’s Hospital about their promising results with a gene therapy for the disease in a pilot trial involving six young patients. Their report appears in the latest edition of the New England Journal of Medicine alongside encouraging results of a CRISPR gene editing therapy for sickle cell disease. Both approaches target the same gene – the result of which is to make bone marrow cells to produce foetal haemoglobin to compensate for people’s faulty adult haemoglobin. BBC Global health correspondent Naomi Grimley has a coronavirus global round up for us, and we report on the discovery of a pair of salivary glands new to medical science – the first new set of organs to be discovered for centuries. Dutch researchers detected them with a sophisticated form of body scanning, hiding where the back of the nasal cavity meets the top of the throat. It’s an anatomical revelation which may have implications for kinder radiotherapy for head and neck cancer. Claudia’s studio guest is Tabitha Mwangi, who is a lecturer in public health at Anglia Ruskin University and has also been a malaria researcher in Kenya. Tabitha talks about the great benefits of giving children four months of malaria prophylaxis tablets during the rainy season in West and Central sub-Sahelian Africa. A study involving millions of children and tens of thousands of health workers halved the number of children dying from malaria. Tabitha also tells Claudia about a simple strategy for improving the success rate in getting people onto TB treatment quickly, and whether schemes in low income countries to encourage mothers to grow their own vegetables to improve their children’s nutrition actually work. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: Dr. Erica Esrick and Manny Johnson, the first patient to participate in the Boston Children’s Hospital sickle cell disease clinical trial. Credit: Boston’s Children’s Hospital.)
In the week of World AIDS Day, Health Check looks at what's being described as a milestone in the prevention of HIV infection in women. It is a form of pre-exposure prophylaxis (PrEP) - an injection every 8 weeks of a drug called cabotegravir. A clinical trial has been comparing it to a daily PrEP pill which is already known to be effective at preventing HIV infection. The injection regimen was about 90% more effective at shielding women from the virus than the daily tablet. The trial involves more than 3,000 women in seven Southern and East African countries. Claudia talks to study co-leader Sinead Delany-Moretlwe of the University of Witwatersrand about why this form of PrEP seems to be so effective and whether it will be affordable for low and middle income countries. Chhavi Sachdev reports on informal health workers known as ‘chhota doctors’ who are the backbone of primary health care for the hundreds of millions of rural people in India. They are not formally recognised as health care providers by the authorities and lack medical degrees, but they are the first port of call for many when people feel ill, particularly during India’s coronavirus lockdown. At a time when so many people are stuck indoors working at home, World Health Organisation has published new recommendations on how much physical activity we should be doing for the sake of our health. We talk to Fiona Bull, head of the WHO’s physical activity unit. James Gallagher is the Health Check guest this week talking about Covid-19 vaccines, vitamin D and a step towards a blood test to predict Alzheimer’s disease. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: Female doctor giving a young female patient an injection in her consultation room. Photo credit: Henk Badenhorst/Getty Images.)
Oxford University and Astrazeneca announced interim results from the phase 3 trial of their coronavirus vaccine. The results are promising with efficacy scores ranging from 70% to possibly 90%, depending on the dose of the first of the two inoculations. This vaccine also remains viable when stored at refrigerator temperatures – a logistical advantage compared to the Pfizer and Moderna vaccines. Claudia consults Charlie Wheeler, head of vaccines at the Wellcome Trust, about how this vaccine may advance the ambition of protecting the world from Covid-19. The pandemic has disrupted routine health services in many countries. Maternity services for pregnant women and women in labour have not escaped restrictions. In the UK this has included banning partners from clinics and wards, often for most of labour. Dr Samara Linton reports. High levels of lead exposure in childhood result in smaller, less robust-looking brains in middle age. This is the conclusion of a long-running study of hundreds of people who grew up in the town of Dunedin in New Zealand. They have been followed since their childhoods in the early 1970s, during the era of leaded petrol. At the age of 45, more than 550 of them have had MRI brain scans. This part of the research has been led by Aaron Reuben and Maxwell Elliot at Duke University in the United States. Although leaded petrol is banned in all but one country today, hundreds of millions of children are still exposed to environmental lead levels well above what’s regarded as safe. Epidemiologist Matthew Fox of Boston University also joins Claudia to talk about the disappointing covid antiviral drug remdesivir, coronavirus rapid tests and a flu vaccine grown in plants. Presenter: Claudia Hammond Producer: Producer: Andrew Luck-Baker (Picture: Laboratory technicians in Italy handle capped vials as part of filling and packaging tests for the large-scale production and supply of the University of Oxford’s Covid-19 vaccine. Photo credit: Vincenzo Pinto/AFP/Getty Images.)
Global measles deaths were already at a 23 year high in 2019 after several years of inadequate immunisation levels in a number of countries around the world. The coronavirus pandemic looks set to make matters worse. The World Health Organisation is worried that disruptions to measles vaccination programmes this year in Africa have substantially raised the risk of large outbreaks in many countries. Immunisation coverage needs to be maintained at 95% or more to keep measles suppressed. Too many babies have missed routine measles vaccination at 9 months and planned special immunisation campaigns in areas where the coverage was already too low pre-Covid had to be cancelled. We talk to paediatrician Ifedayo Adetifa at the Kemri Wellcome research programme in Kenya who’s been modelling outbreak scenarios in Kenya of this situation. The risk of large outbreaks of measles in Kenya is now much greater, and likely to be worse in other countries in the region. But mounting vaccination campaigns as soon as possible would reduce the risk to zero. Sian Griffiths reports from a Canadian school in Quebec which is in the middle of a Covid-19 red zone. The school’s principal decided to move classes outdoors to reduce the infection risk to pupils and staff. Many lessons are happening in three big wedding marquees erected in the school grounds, and the principal plans to keep this going through the Canadian winter. A new study in BMJ Global Health identifies a widely unrecognised danger to the hundreds of millions of people (mainly women) who have to leave their homes to fetch water for their households. This is physical injury. A survey of more than 6,000 households in 24 countries in Africa, the Middle East, Asia and Latin America found that about 15% of them have been injured while fetching water for the family. The researchers were shocked by this. Injuries include broken limbs, dislocations, lacerations and burns. Northwestern University’s Sera Young says the causes range from falling over while carrying the water, falling into wells, physical assault, animal attacks and road accidents between the home and communal water sources. Family doctor Ann Robinson is Claudia’s guest this week to talk about measles, the Moderna Covid vaccine and the latest results from trials of polypills. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: Children outside a field clinic during a vaccination program against measles in Bangui in 2014. Photo credit: Miguel Medina/AFP/Getty Images.)
Health Check examines the excitement around the preliminary announcement of 90% effectiveness of BioNTech and Pfizer’s Covid-19 vaccine in its phase 3 clinical trial. Claudia Hammond talks to Professor Gregory Poland, head of vaccine research at the Mayo Clinic in the United States about what we do and don’t know about the vaccine at this stage, and how the vaccine may be approved and deployed in the coming months. She consults Kalipso Chalkidou, Professor of Global Health Practice at Imperial College London, about the challenges of getting this vaccine to people in low and middle income countries. One logistical problem is that the vaccine has to be stored at minus 80 degrees Celsuis. BBC medical and science correspondent James Gallagher also joins Claudia to explain the innovative nature of the vaccine and how its interim success bodes well for the development of other coronavirus vaccines. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: Medications in sealed vials with a disposable plastic medical syringe. Photo credit: GIPhotoStock/Getty Images.)
Some of the first large scale trials of Covid-19 vaccines may report results to regulators in the next few weeks. These first results will reveal how effective these vaccines are at preventing mild Covid illness but they’re unlikely to tell us how good they are at preventing serious disease and death. Should governments permit wide scale vaccination of populations based on that level of data when this may compromise learning more about their efficacy? And might widespread deployment of first generation Covid-19 vaccines make it harder to properly trial vaccines at earlier stages of development but which may have the potential to be more effective? Claudia Hammond discusses the dilemmas with Dr Gregory Poland, director of the Mayo Vaccine Research Group. People who are double-jointed are much more prone to suffering from anxiety and panics attacks. Reporter Madeleine Finlay investigates the link. Claudia consults mental health experts for tips to help people get through the coming months of uncertainty and anxiety. Boston University epidemiologist Matthew Fox joins Claudia with insights on vaccine hesitancy, how Namibia is maintaining its HIV treatment services under Covid-19 restrictions and whether antibiotics can prevent surgery for appendicitis. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: A doctor preparing a coronavirus vaccine. Photo credit: Filippo Bacci/Getty Images.)
For months now, many people hospitalised with Covid-19 have been given convalescent plasma – donated blood serum from people who’ve already had the illness. The hope has been that transfusing donated antibodies against the coronavirus will help to prevent deaths and serious illness. Convalescent plasma therapy received a high profile boost in the USA in August when the Trump administration announced emergency use authorisation for the treatment, despite the lack of robust evidence for its efficacy against the coronavirus. Now the results of the first completed randomised clinical trial of the therapy have been published in the British Medical Journal. The findings are not particularly encouraging. In this Indian study, there was no difference in the death rate or the progression from moderate to severe disease between patients given the therapy and those receiving only standard care. Claudia Hammond talks to Dr Aparna Mukherjee of the India Council of Medical Research and the BBC’s medicine and science correspondent James Gallagher about the prospects now for convalescent plasma therapy. Health Check also asks whether vaccines against other diseases might provide some protection against the coronavirus, and features a report from California where a lot of mental health counselling has gone online or on the phone since the pandemic took hold. Reporter Alison Van Diggelen asks people with mental health problems and their therapists how they feel about the loss of face-to-face sessions. Presenter: Claudia Hammond Producer: Andrew Luck-Baker (Picture: An Iraqi phlebotomist holds a bag of plasma donated by a recovered Covid-19 patient. Photo credit: Asaad Niazi/AFP/Getty Images.)
Coronavirus update

Coronavirus update


As South Africa goes into lockdown what measures are they taking? Plus big data in Taiwan and a round-up of drug trials, antibody testing and low cost ventilators. Presenter: Claudia Hammond Producer: Geraldine Fitzgerald (Image: Microscopic view of influenza virus cells. Photo credit: Panorama Images/Getty Images.)
Many people with autistic spectrum disorder learn techniques to overcome their difficulties interacting with others. The first study that has looked at the consequences of these compensatory strategies reveals some benefits but also significant downsides. The consequences can be stress, low self-esteem, mental illness and misdiagnosis. Claudia talks to lead researcher Professor Francesca Happé from King’s College London and Eloise Stark, a woman with autism. A new research programme at Imperial College London is investigating the link between obesity and infertility in men. Madeleine Finlay explores why weight gain and other factors of modern life might be influencing men’s sperm health. Tick-borne Lyme disease is on the rise in the northern hemisphere. Lyme disease can develop into a serious illness. It is hard to diagnosis early and delayed diagnosis means lengthy treatment and recovery. Dr Mollie Jewett at the University of Central Florida is working on a much faster means of diagnosis, and a more effective treatment. Deborah Cohen meets Dr Jewett and her ticks. Graham Easton is in the Health Check studio to talk about links between hearing loss and dementia, and the worrying spread of bacteria resistant to carbapenems, one of the most important kinds of antibiotic drugs. (Photo caption: A young woman standing in the middle of a crowded street – credit: Getty Images) Health Check was presented by Claudia Hammond with comments from Dr Graham Easton. Producer: Andrew Luck-Baker
Claudia Hammond visits the Royal Society Summer Science Exhibition. Every year a minority of births goes wrong and the baby is deprived of oxygen, which can lead to long-term brain damage and conditions such as cerebral palsy. Early treatment can reduce the likelihood of permanent disability or even death, so a team at University College London have now developed a new portable device which uses harmless infra-red to detect signs of brain injury in newborn babies, minutes after birth. It is called Cyril and consultant neurologist Subhabrata Mitra and Dr Ilias Tachtsidis, Reader in Biomedical Engineering, demonstrate it to Claudia. Antibiotic-resistant bacteria are a well-known problem, with one insidious thriving place being medical implants, where they form impenetrable biofilms. But there could be a solution from scientists at Nottingham University. Kim Hardie, a molecular microbiologist, is part of a team that has developed special slippery coatings for biomedical devices, such as catheters, that stop bacteria attaching and sticking in the first place. It is hoped these super biomaterials will help in the fight against super bugs, which has huge implications for infection rates in hospitals globally. It is estimated that one in nine people experience some form of breathlessness, which is most common in conditions such as heart failure, lung disease, panic disorder and Parkinson’s. But there are also significant numbers of people who suffer from breathlessness which cannot be explained. A team at Oxford University hypothesise this might be driven by networks in the brain. So using brain scans and computational modelling, Breathe Oxford has examined breathlessness in athletes, healthy people and those with chronic lung disease, seeking clues as to why some individuals become disabled by their breathlessness, while others with the same lung function live normal healthy lives. Claudia discusses this relationship between breathlessness and brain perception with lead researcher and anaesthetist Professor Kyle Pattinson and research scientist Sarah Finnegan. They also, using a ‘Steppatron’, demonstrate what it is like to live with a chronic lung condition. Mirror-touch synaesthesia is a rare type of synaesthesia where people can actually feel something that they can see being done to someone else. For example they might seem to feel a brush on their hand whilst watching someone else having their hand stroked. Dr Natalie Bowling from the University of Sussex researches this condition. It is estimated that 30% of the population could experience some form of synaesthesia and Claudia also meets Kaitlyn Hova, a violinist with visual-auditory synaesthesia. She demonstrates her violin, which lights up with different colours according to how she sees the notes. (Photo caption: Members of the MetaboLight team working together to develop novel light technologies to assess brain injury severity in newborns within hours after birth - credit: MetaboLight) Producer: Helena Selby
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