instruction:
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.
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Paragraph: The power crisis is affecting health and sanitation - because sewage treatment plants can’t run, raw sewage is pouring into the Mediterranean - and now the elderly and sick are desperately trying to handle the heat. Plastic trays and scraps of cardboard are doubling as hand-held fans. Precious piped water is hosed over children and work animals. Those trying to sleep have abandoned clammy mattresses, preferring the relative cool of bare tiled floors. Hoping to pressure the Islamist Hamas group to relinquish control of Gaza, Palestinian President Mahmoud Abbas has reduced his administration’s payments to Israel for the electricity it supplies to Gaza. That has left the 2 million Palestinians there with only a few hours of power a day. Hospitals and other emergency facilities have made do with back-up generators. Few ordinary Palestinians have that option. A family excursion to the beach that might elsewhere have been a delight was, for Sabah Joudah, a forced decision, especially when having to put up with the sewage problems. “We came here to entertain the children, even though the sea is polluted,” she told Reuters as the dirty surf lapped close by. “It is summer and there is no electricity; no water and no fans are working in our homes. It is very tough, very tough.”   Environment officials say disruptions at sewage treatment facilities have meant more than 100,000 liters of untreated wastewater is discharged along the coast daily. Around 75 percent of the seawater is polluted. Swimming there frequently leaves children with skin inflammations and abdominal complaints, parents say. In the southern town of Khan Younis, a woman bathed her children in a bucket in the street, while a man doused his horse with water. One Khan Younis couple, the Abu Mehsens, both suffer from high blood pressure and said they were so beleaguered by the heat that simply fanning themselves could be too much effort. “When we get tired we rest for a bit before we start fanning again,” Jihan Abu Mehsen said. “We do so all day long.”    The situation has hurt Gaza’s meager retail sector, with vendors saying that sales of electrical appliances have tanked. One exception has been cheap rechargeable fans, which can be stored, with full batteries, in anticipation of the power cuts. “People have turned to alternative power, using batteries,” said appliance salesman Mahmoud Abu Hamda. “Sometimes they use trays and sometimes even the covers of kettles instead of electric fans. This has impacted us very much.” Claim: As temperatures soar, desperate Gazans try any means to beat heat.
answer:
As Middle East summer temperatures soar above 35 degrees Celsius (95 Fahrenheit), Gazans are struggling to stay cool amid a power crisis, with less than four hours of electricity a day and little chance to run fans and air-conditioners.


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Paragraph: The Office of Inspector General on Friday released two reports that look into the longstanding challenges of the 28 hospitals directly operated by the federal Indian Health Service. The OIG, which acknowledged that reports of inadequate health care services for Native Americans have been of concern to the federal government for almost a century, criticized the agency’s limited oversight regarding compliance with federal regulations and quality of care, detailing how the agency’s regional administrators have few sources of information to assess the services provided at the facilities. The Indian Health Service, commonly referred to as IHS, is responsible for providing health care services to enrolled tribal members as part of the government’s treaty obligations to Native American tribes. But the agency has faced challenges for decades, and within the past year it has been under increased scrutiny from Congress after inspections of hospitals in the Great Plains uncovered severe deficiencies. The OIG says IHS’s eight regional offices conduct activities to monitor the quality of the facilities, but those efforts are minimal in some areas. One of the reports states that the primary source of information that the regional offices use to detect quality problems is a small number of complaints and patient harm reports. “However, according to hospital administrators, most patient complaints relate to customer service and wait times, rather than medical care,” according to the report. “Further, most hospitals (20 of 28) receive fewer than 100 complaints per year for inpatient and outpatient visits combined, averaging about 1 complaint per 1,000 patient visits. ... Considering the quantity and subject matter of complaints and patient harm reports, they are unlikely to provide hospital staff with the breadth of information needed to identify and diagnose systemic quality or compliance breakdowns.” The OIG, which gathered the information for the reports between April and October 2014, also said that only half of the regional offices conducted mock inspection surveys that could provide insight regarding the facilities’ quality practices. The watchdog also faulted the IHS for staggering findings of outdated facilities and the weekslong process that job applicants must follow, even when the physician vacancy rate was 33 percent at the time the information for the reports was gathered. According to the report, in 15 of the 28 hospitals, administrators reported that aging or inadequate physical environments affected their ability to give quality care. Corroded pipes in one hospital caused sewage to leak into the operating room. The IHS has now been under scrutiny for more than a year after inspectors from the Centers for Medicare and Medicaid Services, known as CMS, found several quality-of-care deficiencies at hospitals in South Dakota and Nebraska. At one facility, the alarming conditions of its emergency room led officials to close it for seven months. The OIG on Friday recommended that CMS inspectors survey IHS facilities more frequently. The IHS in a statement Friday concurred with recommendations made by the OIG, including the need for more training for staffers and new ways to monitor hospital quality. The IHS also said it began a mock survey initiative at 26 hospitals in May 2016 to assess compliance with the standards that facilities must meet to be able to participate in the Medicare program. The IHS’s statement also highlighted a team that was formed in February 2016 “to ensure that dependable, quality care is delivered consistently across IHS facilities.” ___ Follow Regina Garcia Cano on Twitter at https://twitter.com/reginagarciakNO ___ Associated Press writer James Nord contributed to this report from Pierre, South Dakota. Claim: Watchdog: Staff issues affect care at reservation hospitals.
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The internal watchdog of the U.S. Department of Health and Human Services says the often-substandard quality of care at hospitals serving Native Americans is the result of outdated equipment and technology, lack of resources and difficulty attracting and keeping skilled staff.


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Paragraph: The Food and Drug Administration approved Medtronic’s CoreValve system based on U.S. clinical trials in which it was shown to be safe and effective while demonstrating low rates of stroke and valve leakage, the company said. Medtronic and Wall Street analysts had not expected the approval decision until April, giving the company a head start on efforts to seize market share from a similar rival product sold by Edwards Lifesciences Corp. News of the early CoreValve approval sent Edwards shares down nearly 5 percent. More than 100,000 people in the U.S. have severe aortic stenosis with about one-third too ill or frail for open-heart valve replacement surgery, making them candidates for CoreValve or the rival Edwards Sapien system. The systems, in which the replacement valve is threaded into place through an artery using a catheter - known as transcatheter aortic valve replacement, or TAVR - spares patient’s chest-cracking surgery, cutting down on recovery time. CoreValve has been available since 2007 in Europe, where it is not uncommon for medical devices to win approval several years ahead of the United States. “We estimate the U.S. TAVR market will be approximately $450 million in 2014,” said Glenn Novarro, an analyst with RBC Capital Markets. “With approval earlier than expected, share loss for Edwards will likely occur sooner than expected,” added Novarro, who sees Medtronic grabbing 20 percent of the U.S. TAVR market this year, rising to more than 30 percent by 2016. But CoreValve’s U.S. sales prospects may hinge on further legal proceedings after a U.S. jury earlier this week found that the Medtronic system infringes a patent held by Edwards and awarded Edwards more than $390 million in damages. Medtronic vowed to appeal the decision and oppose any request for an injunction. Edwards, meanwhile, said the patent infringement ruling entitled it to seek increased damages of up to three times the value of the award. The FDA approved CoreValve without first requiring an expert advisory panel to review the device and make recommendations to the agency. “The low rates of stroke and valve leakage with the CoreValve System - two of the most concerning complications of valve replacement because they increase the risk of death and have a dramatic impact on quality of life - set a new standard for transcatheter valves,” Dr. Jeffrey Popma, director of Interventional Cardiology at the Beth Israel Deaconess Medical Center in Boston and one of the lead investigators of the pivotal clinical trial, said in a statement. The CoreValve uses a smaller catheter than the currently approved Sapien, giving it a potential but temporary competitive edge. Edwards is awaiting U.S. approval of a next generation Sapien with a similarly smaller catheter. Both companies are also testing their systems in less high risk patients in hopes of broadening the potential patient population and market for the devices. Medtronic shares were up 18 cents at $59.29 in afternoon trading, while Edwards shares were off $3.49, or 4.8 percent, at $69.18, both on the New York Stock Exchange. Claim: U.S. FDA approves Medtronic heart valve system early.
answer:

Medtronic Inc’s minimally invasive system for replacing diseased heart valves won U.S. approval for use in patients deemed too frail to endure traditional open heart surgery, the U.S. medical device maker said on Friday.