Reference: World Economic Forum

Reference: CTV News, Oct. 27, 2017

RCMP가 잘 못된 정보를 제공한 탓체 시리아에 억류되어 고문 당한 세명에게 300억이 넘는 보상금을 지급하도록 판결이 났군요. 인권을 중요시 하긴 하지만 과도 금액이 지급되고 있다고 생각하는 견해도 있군요. 캐나다는 좋은 나라입니다. 얼마전 북한에 억류되었다 풀려난 목사님도 캐나다 시민권자였기 때문에 살아 돌아올 수 있었다고 하니 말입니다.

미국에서 JFK 암살 관련된 비밀 문서들을 공개하도록 트럼프 대통령이 승인을 했군요. 그렇지만 여전히 상당 수 예민한 자료들은 공개할 수 없다는 군요.

Two new studies have some surprising findings on the prevalence of food allergies among both adults and children. Plus, we have an update to CTV News' report on the settlement paid to three men wrongfully accused of links to terrorism and tortured in a Syrian prison.

Plus, CTV News contributor Richard Crouse lays out the films you should check out at theatres this weekend.

1. $31.3M in settlements: As CTV News first reported, the federal government has paid a total of $31.3 million in settlements to three men wrongfully accused of links to terrorism and tortured in a Syrian prison. Public Safety Minister Ralph Goodale's office said in a statement on Thursday that this settlement is 'consistent' with the findings of the 2008 federal inquiry into the detentions of the three men.

2. Allergy research: Two studies have found that food allergies are on the rise in the United States amongst both adults and children. One study found that almost half of all adults with food allergies report that they don't develop their allergies until reaching adulthood.

3. JFK files: U.S. President Donald Trump okayed the release of roughly 2,800 documents on Thursday concerning the assassination of John F. Kennedy, but did cave to pressure from intelligence agencies by holding back some. 

4. Pension concerns: The Conflict of Interest and Ethics Commissioner says she has 'concerns' about Finance Minister Bill Morneau's sponsorship of Bill C-27, which proposes changes to private pensions.

5. Top 40 under 40: Four Canadian police officers and a crime analyst have made the list of top 40 law enforcement professionals in the world under the age of 40.

And one more thing… "Suburbicon" is a beautifully nasty film, nicely made but marching to the beat of a very dark heart, says film critic Richard Crouse.

Reference: Linkedin

Attacking the Opioid Crisis on a Budget: 8 Innovative Ideas

• Published on Published onOctober 26, 2017

Political talk is cheap, substance abuse programs are expensive, and the nature of the crisis demands fast action. Sadly, while an official ‘public health emergency’ declaration helps, it doesn’t give a quick infusion of cash to help embattled front line substance abuse workers. To allocate funds, the Health and Human Services (HHS) budget (that currently cuts $4B in funding) must be revised so that Congress has funds to allocate. As it looks like the crisis will continue to be fought on a shoestring, in addition to immediate definitional changes to access existing funds, it’s time to get the biggest bang for addiction intervention bucks: prevention innovation.

Addiction is heartbreakingly difficult to combat, with high failure rates and costs to society. The substance abuse programs that need money are obvious: the acting HHS secretary can allow Medicaid to reimburse opioid abuse treatment at mental health centers, negotiate reduced costs for naloxone, and mandate Medicaid reimbursement of proven addiction medications. (This actually saves systems money - mean health care costs with addiction medication treatment = $13,578; vs. with no addiction treatment = $31,055) . Waiving the requirement for naloxone prescriptions will save lives. But since resources are scarce, focus on increasing community health access for addicted pregnant mothers. Addressing addiction before birth saves $55,000 in treatment costs for neonatal dependence, with lifelong savings in education and law enforcement costs.

Since the era of “Oxycontin doesn’t cause addiction”, between 40 and 80% of opioid abuse has been attributed to initial medical use for pain. These studies underestimate the medicine cabinet availability for experimental teens - they weren't in pain, but someone was. As part of an opioid legislative package in Georgia, pharmacist Rep. Buddy Carter sought help from pharmaceutical companies, noting “Once you get past Tramadol and a couple of others, there is nothing else for us to use [for pain], there is nothing else for us to prescribe.” This perspective is exactly why we have an opioid problem – we’re focusing on drugs, not the problem of pain that got us there. Want fewer addictions? Put fewer pills in circulation. Here are some obvious and some less-intuitive ideas:

• Lower the quantity of pain medications per prescription

Pain is personal, but there is some generalizability of duration of pain for normal recovery. Tier pain management clinical scenarios, and limit scrips for 24, 72 hour, and (rarely) 7 day home recovery.

• Redefine chronic pain

"Chronic" has been defined as pain lasting 3-6 months. Opioids are poor choices for most patients with chronic pain, but by three months of treatment, addiction already exists. We need a new treatment category for pain lasting over 7 days, and must change our focus from treating chronic pain to promoting movement and function.

• Cover initial visits for pain to physical therapists

Pain is usually physical – physical problems require physical solutions. We need to cover visits to physical therapists prior to physician authorization, paying for longer treatments to rehabilitate misused muscles, strengthen, and change movement habits. PTs won't prescribe Percocet.

• Require non-pharmacologic recommendations with every prescription

Prescribing medications is a physician’s super power – we study long and hard for the ability to help people in pain with a prescription. To change addiction, we have to change physician behavior by teaching alternate evidence-based options for pain. This will take a while, so for now, teach pain patients they have options. When patients have a list of nonpharmacologic interventions, the ability to choose gives control, reduces fear, and helps diminish the incorrect perception that drugs are first line pain relievers.

• Cover pain relief devices and office education

The Centers for Medicaid and Medicare pays for pills, but won’t pay for low cost home devices, even when used to reduce opioid intake. BakBalls, VibraCool, NeckRest, Posture Pals, soft tissue rollers, all are over the counter and used by clinicians for patients' pain. To avoid covering a device that a patient finds too cold, or an electrostim unit when a patient hates the feel of electricity, reimburse therapists for office trials.

• Create non-pill pain management lists

Doctors don’t have time to cover exhaustive options, but there are evidence-based nonpharmacologic treatments NOW to address chronic and post-surgical pain. University of Michigan offers a “Poke Plan” for needle pain, University of Iowa has a laminated list from creams to Buzzy – offering treatment option menus to patients is not just good service, it’s good science. Menu-selected treatments benefit from belief bias, choice-supportive bias, confirmation bias, selective perception, and even the “IKEA effect”– you like a pain plan more if you made it yourself. 

• Give injury, chronic pain and post-surgical patients a $200 budget for pain services and products

Pain relief options aren’t useful if they’re unaffordable while opioids are free. If a patient hates stretching but loves massage, don’t waste time and money prescribing a yoga class. Massage, thermal treatments, yoga classes and chiropractor visits topped Consumer reports lists of effective pain management treatments. Pay for them.

• Use available pharmacogenomics testing to predict de novo abuse

Opioids in particular have variable metabolism. Caucasians with variations of the CYP2D6 enzyme metabolize opioids poorly – they may get poor relief from opioids, but more importantly are less likely to become addicted. In contrast, ultra-rapid metabolizers have greater risk of overdosing, and likely addiction. The genetic test is currently available, and the cost and clinical benefits are being tested by Indiana University. Funding to make a rapid bedside test available could help both pain treatment and prevent susceptible patients from getting opioids at all.

• Don’t even think of putting more money toward the drug war. Aggressive law enforcement keeps illicit drug users and pregnant mothers from treatment, and has not been proven to reduce use. A 2012 article in The Lancet argues international drug conventions may have increased availability. No additional funds here.

Treating addiction is astronomically expensive. Drastically curtailing opioids in circulation can save money as well as lives at a fraction of the cost. Declare a national emergency, yes, and PLEASE pay for addiction medications, but let’s use this ‘public health emergency’ opportunity to change how we think about and pay for pain.

Talking about cities, Seoul and Tokyo.

find the mean between the two extremes.

prudish

eclectic fashion

elaborate

throw up

finishing religious

forbidden city

The signage is pronounced.

clear-cut

segues

flashy

Frank Llyod Wright - architect of minimalism

seismic proof

tremors

Larry David Pissed Off - Curb Your Enthusiasm Season 6

morally aggressive  being nice in a nasty way

stand behind Larry  support Larry

pipe down be quiet

turn off ~  I don't feel interested, don't have any desire to do something.

freak of nature  somebody behaves strangely, strange behavior 

lyme disease  caused by being bitten by Tick

everything goes  everything goes wrong

skin cancer  Melanoma

Wait till you see that. You gonna die.  You'll really love it.

They make a mountain out of a mole.  exaggerate

It's not my (quite) cup of tea.  I am not interested.  I'm not really into it.

It's my cup of tea. I like it

He has taste.  He knows that it is a good fashion. 안목이 있다.

tooth fairy  어린이의 젖니가 빠졌을 때 이것을 베개 밑에 넣어두면 요정이 가져가는 대신에 돈을 두고 간다고 함.

wiggle out  비틀어서 빼다

old factory nightmare It's a mess.

The coast's clear. You're safe. Nobody's here.

bum homeless person, strange person, 

the unwritten rule agreed social rule

She put her gun to my head. to force you to do something

No one's gonna put your gun to your head. 

No one's going to force you.

No can do. I can't do it.

she uses obscenities. Cursing

The movie is too obscene for kids.

Sometimes, we get to hear this phrase in many situations.

I love apples. That being said, I almost never eat them.

= I love apples. Even though I said that, I almost never eat them.

That being said (or that having been said) is used as a transition from something you have just said to something different, often something that contradicts the first thing. It is close in meaning to however.

Disabled Restroom Stall 

ADA Compliance Americans with Disabilities Act(ADA) published in September 2010 by the Department of Justice

Stall  칸막이

Archaic  old

disabled physically disabled not handicapped

able-bodied having a strong healthy body

douche bag  Jerk

dibs claim of rights

I would have given you dibs.

Larry Mocks Hotelguy

being petty  concerning small things

bellhop bellboy

Don't be Dubious

Larry respects wood

Has it ever occurred to use your coaster? 

a covering (plate or mat) that protects the surface of a table

We'll just sand it off.

Ring around the toilet.

flare

demeaning 

All in the family, Edith finds an old man, S-4, E-3

Edith befriends a nursing home runaway, but Archie is not too happy having a reminder of his own advancing years hanging around the house.

You just made it in the nick of time. at the last possible moment

Do I have to pay out of pocket? deductible money

The rest comes out of my pocket.

Get off my back. Don't bother me and I am taking care of this. cohabitate live together 동거하다 Out of the wedlock child out of a wedding 사생아 Domestic Partnership Policy insurance company's rule 동거관계에 대한 보험회사의 정책 Get with it Be up to date, time's going. 시대에 뒤지지 않도록 열심히 하다. He lives in a box. Anything unconventional is foreign to him. 상자에 갇혀 살다. kleptomaniac someone with an irrational urge to steal 도벽이 있는 사람 getting deported handed over to the authorities 경찰 등에 인계되다 tuna chicken of the sea One good turn, deserves another. pay it forward. "Pay it forward" is when people pay for the price made by a car right behind them.

해외에서 가장 먼저 숙지하고 있어야 할 것이 응급 상황에 대처하는 방법입니다. 911에 전화를 했을 때의 상황을 머리 속에 그리고 있어야 합니다. 

The first thing that you have to know when you are abroad is to make a phone call to 911 in an emergency. You have to be prepared for those emergencies.

Reference: English The American Way, Sheila MacMechnie Murtha

If you own a television, you've seen them: amazing rescues from the burning buildings, victims rescued from the bad guys and lives saved in hospital ERs. From the comfort of your couch, you've seen the TV versions of real-life drama. The downside of these TV dramas is that they make the emergencies seem very simple. Unlike in real life, TV problems are resolved in just an hour. But the upside of emergency shows is that people see what they have to do to get help. 

  The most important information to know in an emergency is a very simple phone number: 911. Even schools teach this number to small children at an early age. There are plenty of stories of kids as young as three years old making a 911 phone call that has saved a life. 

  The phone number is the same for fire, medical and police emergencies: 911.

  The phone number is the same from both landlines and cell phones: 911.

  When a landline call comes in, the emergency dispatcher may able to see the phone number and the exact location, but not always. Calls from a cell phone may not display the same information. The most critical thing to remember when making an emergency call is to remain calm. It's a matter of life and death. You must be understood when making this call. Because everyone tends to speak very quickly or excitedly when they are nervous or afraid, it can be even more difficult to understand second language speakers in an emergency. For this reason, it's vital to remember the following instructions:

• Stay calm.

• Speak slowly and clearly.

• Know what information the operator needs.

The operator will ask many questions so that she can get a good picture of the problem and send exactly the right kind of help. She will ask for essential information like: Who? What? Where? When? It's important to answer all the questions slowly and clearly. Don't worry; she is not wasting time. Even while you're answering her questions, the operator is contacting the right emergency system. You must stay on the line with the operator until help arrives. Don't hang up! 

  The 911 dispatchers are specially trained to ask very clear questions about the emergency. The dialogues below are examples of the kinds of conversations you may have. Remember, the operator will ask different questions as he or she learns about your emergency.