UNIT 1
Welcome to Insidermedicine In Depth. I'm Dr. Susan Sharma.
Focusing time and energy on the most personally meaningful aspects of their work may help physicians avoid burnout, according to a survey published in the Archives of Internal Medicine. Here are some consequences of physician burnout, published in the Annals of Internal Medicine: •Increased risk for substance abuse
•Damage to personal relationships, and
•Increased risk for developing inappropriate prescribing patterns
Researchers from the Mayo Clinic in Rochester surveyed over 550 physicians in the department of internal medicine at a large academic medical center. The survey included questions about job satisfaction, emotional well-being, and the aspects of the jobs that were the most meaningful.
As many as 34% of respondents met the criteria for burnout, including emotional exhaustion, depersonalization, and a low sense of personal accomplishment. The 88% who said they spent at least 20% of their working time on activities they found to be the most meaningful had about half the burnout r
ate of those who did not.
Today's research highlights the need to optimize career fit among physicians in order to reduce burnout rates.
For Insidermedicine In Depth, I'm Dr. Susan Sharma.
UNIT 2
Emerging economies such as China, India and South Africa are discovering there is a downside to prosperity. As incomes rise, health can decline. On Monday, the U.N. opens a high-level meeting on non-communicable diseases that usually have been associated with western nations.
In recent years, India and China have seen a growing middle class. But with greater affluence has come a surge in diabetes, obesity, cardiovascular disease and cancer. South Africa is on a similar path. The United Nations will debate what can be done about these illnesses.
Project HOPE is calling on the U.N. to take strong action – not only on treatment – but prevention. The health-based NGO has programs in 35 countries on 5 continents, many of them dealing with non-communicable diseases or NCDs.
One of them – the HOPE Center – is located in Johannesburg, South Africa. Stefan Lawson, country director for Project HOPE, welcomes the U.N. meeting.
"It's the first time that we've had non-communicable diseases put on such a high-level forum. The last time a specific disease was done at this sort of level was for HIV and AIDS. And so, being able to push for non-communicable diseases up at that ministerial level I think will do a lot of good," he said.
What's for dinner?
Lawson said a majority of South African men and women are now overweight.
"One of the results of prosperity is a change in lifestyle, which includes a change in diet. So, we see here in a shift to a more western diet – MacDonald's, KFC, fast foods, more processed meat. Things like that that definitely have an impact on a person's lifestyle," he said.
Food prices have risen sharply in recent years, dealing a major blow to the poor. This has a direct effect on diet and health.
"Healthy food – fruits and vegetables, etc. – now becomes more difficult to purchase for someone who lives in a poor township environment. So, they're forced to then buy cheaper, less healthy food," he sai
d.
Footing the bill
As diets change, he said, whether or not by choice, the overall health of a country can decline. That, he says, can place a great burden on budgets.
"South Africa had a well documented problem with HIV and TB. And that really put a strain on the public health system. And (it) has caused a real strain in just the volume of people that are going into the clinics now. So, if you add on top of that now more people going into the clinics with things like diabetes and hypertension related issues, it's just going to increase the burden even more on an already over strained public health system," he said.
He added higher health care costs can be a drag on South Africa's economic growth.
Reaching out
The Hope Center project on the outskirts of Johannesburg provides services to those with non-communicable diseases. It's a partnership with the local community, the South African government and donor Eli Lilly & Company. The services include a diabetes clinic with the latest diagnostic and treatme
nt options.
Project HOPE
The Hope Center offers a variety of health services
The center also has created peer support groups to help people manage their disease and make healthier lifestyle changes. Government health workers are also being trained about NCDs to help raise general awareness.
"Teaching people about healthy meal options, teaching people about portion sizes, teaching people about how to cook their food in a healthier way. Then I think also the second part of that is being able to help people purchase those healthier food options. Because a lot of times some people know that an apple is healthier than a bag of chips, but a bag of chips costs a lot less than an apple," said Lawson.
Lawson hopes the U.N. high-level meeting will issue a strong statement that non-communicable diseases are an emerging threat in the developing world.
In other countries, Project Hope said China has more than 300-million smokers and 30 percent of the
population is overweight with 12 percent considered obese. In India, it says 50 million people have diabetes. It has clinics in both countries to help deal with the NCDs.
UNIT 3editor at large
UNIT 4
You know that old adage that laughter is the best medicine. Well, studies have long shown that laughter can have a positive effect both physically and emotionally. In South Korea, a nation more used to keeping its emotions in check, at least one hospital is encouraging patients to let loose on their regular basis. Here’s our digital reporter Joohee Cho.
Laughing, for these cancer patients and their families, is a weekly exercise. It’s something that doesn’t come too easy for them, but an hour of laughter is all it takes to fight depression that often follows chemotherapy. Lim Song Li, a therapist at Seoul National University hospital, was once a depression p
atient herself. She now is a laughter therapist and says when you laugh, blood vessels expand, and sugar levels drop, producing an abundance of hormones linked with happiness and pleasure. But in Korean culture, where Confucian tradition dominates social behavior, laughing is not such a natural thing. Korean men are taught not to cry more than thrice in their lifetime. And the sound of a Korean woman’s laughter should not be heard outside the fence of her home.
But inside this hospital, they’re letting it out. By the end of the session, their make-belief laughs somehow become their own.
If laughing requires effort, more natural to Koreans, it’s singing. The sing-song star guru, famous for her therapy sessions to fight housewife depression, Jeong Ji Song says singing is an easier way to express inner feelings, especially for Korean women brought up in a conservative background. For some these classes can be a stress-management tool, but for many more who suffer from depression, learning to sing out their heart can be a healing process.
It not only helped this woman to come out of severe depression, but it also presented her with a new career. She swallowed 90 sleeping pills after her husband cheated on her, she says. But after taking up singing therapy, she found a talent in herself —cheer-leading. And now the new Ying Seung Woo is
taking courses to become a certified therapist. And her dream to be up on that stage with her teacher, helping others once depressed like her may not be too far away.
Joohee Cho, ABC News
UNIT 5
JENNIFER: I’m Jennifer Morris. We’d all like to live a healthier lifestyle, right? Whether that means getting more exercise, or kicking a nasty habit, or losing weight. But how do you get started, you know, what do you do? We’re back here with Trisha Calvo, executive editor of Shape Magazine with some more helpful hints. Hi.
TRISHA: Hi.
JENNIFER: How are you?
TRISHA: Good.
JENNIFER: So you have a half plate rule, can you tell me about what that is?
TRISHA: Yes. I think for health or weight loss one of the most important things you can do is fill half of your plate with fruits or vegetables at every meal. What that does is it helps keep your calories under control. And it also ensures that you are getting plenty of fiber, phytochemicals, vitamins, and minerals in your diet, which help control all your risk factors for diseases like heart disease, cancer, and it can even keep your skin looking wrinkle free and smooth and healthy, and glowing.
JENNIFER: So what about the medical piece. A lot of people don’t go to the doctor enough, or they make appointments and they break it. What do you think about that?
TRISHA: I think that, you pick a day, you know, whether it’s your birthday, and I think that’s a great day for people to sort of take stock of their health now that you’re older, and I think that what you can do is you can sit down and you can say, ok, this week I’m going to make all of my doctor’s appointments. I’m going to schedule a screening with the dermatologist for my skin cancer check-up. I’m going to get a mammogram if I’m a woman. I’m going to schedule my gynecology appointment so I can get my Pap Smear and my check-up. I’m gonna schedule my physical, now you obviously don’t have to go to the doctor on that week. But if you take an hour one day, and you just sit down and you make all the appointments over the next couple of months, you’ll have it in your calendar. And you will make sure that you are getting the preventative care that you need to catch a problem before it becomes a real pr
oblem.
JENNIFER: Uh-huh, uh-huh. And lastly what about down time? I mean, we all live such busy lifestyles, it’s so hard to find down time.
TRISHA: We are so busy and stress increasingly —researches’ve shown that stress has become a factor in a lot of diseases. Everything from catching a cold, to developing cancer, to developing heart disease, even depression. So it’s very important to take time for yourself during the day. And it can be just anything that you enjoy. Uh, you know, it doesn’t have to be, like “oh I need to get a massage, I need to officially relax”. It can just be, you know, I love my dog. I’m gonna play with my dog for ten minutes; I’m just gonna make that my coming home ritual. Or, I love…you know, historical fiction; I’m just gonna carve out fifteen minutes a day to read something that I really really enjoy. I personally, I am not happy if I am not reading a novel that I’m really engrossed in. And I just make sure that I have one in my bag at all times. And whenever I have a couple of minutes I just pull it open and it makes me happy. And it relieves the stress. And I think that everybody has something special like that that they love.
JENNIFER: I mean it’s nice to think of it in small increments because I think we get overwhelmed looking at the whole picture when there are just small things that you can do throughout the day.
TRISHA: Absolutely.
JENNIFER: So what about exercise? Is that…is there similar things?
TRISHA: Walking is one of the best exercises and you can do it anywhere, and it’s easy to do. And it does…you don’t have to be a super athlete to be able to do it. Ten minutes, just take ten minutes.
JENNIFER: How many calories do you burn in ten minutes?
TRISHA:    A hundred forty-five pound woman, if she is walking briskly, about a hundred. JENNIFER: Amazing.
TRISHA: Yeah, so you really, you got to kick it up a little bit to burn that many but brisk

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