TASK DEFINITION: Generate an explanation for the given claim using the provided supporting material from the paragraph. Please consider the following points while generating an output. 1) The claim will always have supporting proof in the paragraph, and the paragraph will have a clear point of view supporting the claim. 2) There can be instances where direct correlation to the claim is not available. Make use of the sentences in the paragraph to provide a corresponding output supporting the claim. 3) The explanation should be at least one and at most twelve sentences long.
PROBLEM: Paragraph: Sometime before Oct. 1, the state will start using electronic benefits transfer cards that will allow recipients on the Women, Infants and Children program to buy food at grocery stores and pharmacies Most states are already doing that, and Mississippi is among the few still using a warehouse distribution system, the Commercial Dispatch  reported. WIC provides “nutritious foods to supplement diets, information on healthy eating including breastfeeding promotion and support, and referrals to health care” to low-income pregnant, postpartum and breastfeeding women, infants and children up to age 5 who are considered to be at nutritional risk, according to the U.S. Department of Agriculture. The program serves almost half of all infants born in the United States. WIC foods include “infant cereal, iron-fortified adult cereal, vitamin C-rich fruit or vegetable juice, eggs, milk, cheese, peanut butter, dried and canned beans/peas, and canned fish.” Katie Peterson, a mother of two young children, picked up packages of food recently at the WIC warehouse in Oktibbeha County. “I don’t have a lot of free time, so coming down here can be kind of difficult at times,” Peterson said. “They often run out of stuff too, so when I’m here, I’ll have to skip a couple things that are on my list.” Peterson said picking up WIC-approved food at a grocery store “would be wonderful.” Each state’s health department operates the WIC program, with funding and guidelines from the USDA. The federal agency decided all 50 states must start using electronic cards for WIC recipients by Oct. 1. Each county in Mississippi has at least one WIC warehouse. Liz Sharlot, spokeswoman for the Mississippi State Department of Health, said there will be no need for WIC warehouses once the cards are in place. Oktibbeha County resident Mariam Reynolds, a mother of three, said she got WIC products from grocery stores when she lived in Birmingham, Alabama. “You can go to the grocery store any time to get what you need, and you’ve probably got better options,” Reynolds said. Selection and availability were not a problem for Peterson and her family when they lived in Illinois, which administers its WIC program at grocery stores, she said. “If I need milk and eggs, and they don’t have eggs (at the warehouse), I either have to get the milk and skip the eggs or just get nothing at all,” Peterson said. WIC’s transition from warehouses to grocery stores is still in the early stages of searching for and authorizing grocery stores and pharmacies as vendors, so nothing is final yet, but “the wheels are in motion,” Sharlot said. Claim: Mississippi will phase out warehouses for nutrition program.

SOLUTION: Mississippi will close distribution centers for a federal nutrition program in the coming year and will move to a system that could be simpler to use.

PROBLEM: Paragraph: The story focused on costs, including information about the relative cost comparison between what are called “open” surgeries and those done laparoscopically (with a thin flexible tube.) The release summarized how minimally invasive techniques reduced the length of hospital stay and complication rates for patients. “Researchers also found that, on average, the minimally invasive approach reduced length of hospital stay by approximately two days, and open operations were more than $9,000 more expensive than minimally invasive procedures. The researchers also found that laparoscopic procedures were better for patients in terms of fewer complications. Laparoscopic anti-reflux operations were less likely to result in postoperative blood clots, wound complications, surgical site infection, esophageal perforation (which can be life threatening), bleeding, cardiac failure, and death.” We rate this, but just barely, for citing cost differences between the two types of surgery and the average reduction in the number of days a patient must remain hospitalized. We do wish the release had delved more into the specifics of reduced complications. How common were the surgical complications in each surgical method? The release names complications associated with both types of surgery for GERD, while stating that patients undergoing laparoscopic procedures encountered fewer of them: “postoperative blood clots, wound complications, surgical site infection, esophageal perforation (which can be life threatening), bleeding, cardiac failure, and death.” The news release gave details about how the study examined records of about 75,000 patients from 1,000 hospitals to compare outcomes in the records for open vs. the minimally invasive laparoscopic surgeries. That’s all to the good. However, the news release didn’t mention any of the study’s limitations. The key one is that this is a retrospective, observational review of records that isn’t capable of supporting cause and effect statements such as the minimally invasive approach “reduced length of hospital stay by approximately two days.” Nor should this kind of evidence be used as the basis for statements such as laparoscopic procedures “were better for patients” and “should be the standard of care.” Patients receiving open vs. laparascopic procedures could differ in unknown ways, which is why the superiority of one approach over the other should ideally be established by a prospective, randomized controlled trial. There were other limitations outlined in the journal article that were not mentioned in the release. Because the NIS database doesn’t link to hospital records, researchers weren’t able to track and measure outcomes “including complications, readmission, and mortality, occurring after the initial hospital discharge.” The researchers were also unable to determine which open surgeries were “re-dos” of previous surgeries. The potential for errors in coding which procedures were used was also cited as a possible limitation. There was no disease mongering. The release also provided useful context on the prevalence of GERD and further specified that smaller group of patients, from the many heartburn suffers, might be candidates for the surgery. Well done. The release does not list any funding source for the research and the published study notes that authors had “nothing to disclose.”  We’ll rate this not applicable since this is an examination of existing data, and there may have been no additional outside funding. The news release does a good job here. It compares different surgical methods and it also names alternatives for treating GERD such as medications and changes in the diet. It also states which group of patients the surgery is aimed at: “Anti-reflux surgery should be considered in patients who do not achieve complete control of their symptoms [regurgitation or cough] with medications; who do not want to take medications for the rest of their lives; or who experience complications of medical therapy.” It’s clear from the release that both methods of surgery have been widely available nationally and the outcomes of 75,000 surgeries were tracked by the National Inpatient Sample (NIS) database. The release also notes that “urban academic or teaching hospitals” perform laparoscopic anti-reflux surgery more often than “open” procedures, 54.4 percent versus 45.6 percent. And it recommends that anti-reflux surgery should be performed laparoscopically in specialized centers. The news release was not about a novel procedure and made no claim of novelty. However, this isn’t the first study to examine laparoscopic vs. open surgery. For example, the British Journal of Surgery published results of a randomized trial of the two methods and the Scandinavian Journal of Gastroenterology published research on long-term outcomes following laparoscopic and open procedures for GERD. We did not observe any unjustifiable language. Claim: Laparoscopic anti-reflux operation for GERD linked to fewer postoperative complications

SOLUTION: A new study by the American College of Surgeons, a professional organization, compared records for 75,000 patients who underwent surgery for GERD, or gastrointestinal esophageal reflux disease. The study looked at two different surgical procedures and found the less invasive one seemed equally effective, but kept patients in the hospital a shorter time with fewer complications. The news release did a good job of discussing surgical alternatives and costs, which were estimated to be $9,000 lower for the less invasive laparoscopic procedure. The release would have been better had it spelled out some of the study limitations, the key one being that a retrospective, observational review of hospital records — as this study was — isn’t capable of supporting the cause and effect statements sprinkled throughout the release. Millions of Americans complain of occasional heartburn, sometimes called a burning sensation in the throat from food coming back up from the stomach. But some estimates are that about 20 percent of US adults fit the definition of GERD, which means they suffer symptoms at least every week. If patients consider a surgical fix, this study shows that a less-invasive procedure could reduce their complications and shorten their hospital stay. It’s hard to pin down stats on GERD prevalence. A 2014 review of 16 epidemiological studies of GERD prevalence published in the journal Gut suggest GERD prevalence ranges from “18.1%-27.8% in North America, 8.8%-25.9% in Europe, 2.5%-7.8% in East Asia, 8.7%-33.1% in the Middle East, 11.6% in Australia and 23.0% in South America.”

PROBLEM: Paragraph: A man does chin-ups at a city park in Kiev, March 19, 2012. REUTERS/Anatolii Stepanov Experts say often a professional tweak can go a long way towards firming up your workout. “People usually injure themselves on basic exercises, like a squat or a bench press,” said New York-based personal trainer Tiffany Boucher. But Boucher, who works for the national chain of fitness centers Equinox, said form is relatively easy to fix. “Something is being overused, usually in tandem with some type of muscle imbalance,” she said. “So it’s often about getting people to put their shoulders in a certain place, find their center of gravity, engage their abdominals, or tilt their pelvis in a certain direction.”   She said even a small adjustment can be transformative. Knees are the most common focus of client complaint, according to Boucher. Once form is corrected, relief often comes within weeks. “People don’t have that continued inflammation,” she said. Dr. Daniel Solomon, a spokesperson for the American Academy of Orthopaedic Surgeons, believes in getting the help of a professional trainer before embarking on a new routine. “Most of what we see are strains and really preventable muscle-type injuries,” said Solomon, a California-based physician specializing in sports medicine. “People just do things their bodies aren’t ready to do or capable of sustaining for long.”   Another big mistake is skipping the warm up. “They jump right in instead of spending 15 minutes to do a good cardio warm up and stretching before grabbing the weight,” he said. He said some workouts just require more expertise than others. “I’m a proponent of using free weights,” he said. “But you’ve got to make sure you have the technique correct.”   Jessica Matthews, an exercise physiologist for the American Council on Exercise, said many highly effective workouts, such as kettle bells, medicine balls, and plyometric (jumping) moves, can be dangerous if done incorrectly. “Some workouts are trickier,” said Matthews, who is based in San Diego, California. “I’ve seen a lot of people use free weights incorrectly. There is a much greater margin of error than with machines, which move on a fixed path.”   Before going all-out on the plyometric training that characterizes so many home DVD workouts, she said it’s important to learn to land safely, which means softly and on the mid-foot. “The body is one big kinetic chain. Dysfunction in one area will create dysfunction in another,” she said. “So suddenly your hip is bothering you because of instability in your ankle.”   Before tackling the latest high-intensity, technique-based workout, Matthews advises strengthening your stability and mobility through back-to-basic exercises such as plank, side plank, lunges and squats. “Build that solid foundation first,” she said. “Then progress to more explosive workouts that take more advanced skills.”   If don’t have your own personal trainer, Boucher said, don’t hesitate to ask a fitness professional at your gym to observe your form for a few seconds. Then be open to the feedback. “Do you hunch your shoulders? Hunch your back? “ she said. “Maybe one side of your body is tighter than the other. Or the left hip is more rotated than the right.”   “Sometimes it’s that little thing that you can’t catch on your own,” she said. Claim: Checking up on your fitness form.

SOLUTION:
From jumping rope to swinging a kettle bell to pounding a treadmill, a finely-tuned form can spell the difference between a sound body and a sore knee.