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: Depression is one of the most common forms of mental illness, affecting more than 350 million people worldwide. It is ranked by the World Health Organization as the leading cause of disability globally. Treatment usually involves either medication, some form of  psychotherapy or a combination of both. Yet many patients fail to get better and suffer recurring bouts of illness. MBCT was developed to help such people by teaching them skills to recognize and respond constructively to thoughts and feelings associated with relapse, aiming to prevent a downward spiral into depression. In the first large study to compare MBCT and anti-depressants, researchers found little difference in outcomes. In terms of cost, mindfulness training — often viewed as more costly because it requires more time with a trained therapist — was not significantly more pricey, particularly when given in group sessions, the study found. Richard Byng, a professor at Britain’s Plymouth University Peninsula Schools of Medicine and Dentistry, said that, while current standard treatment for chronic depression is to keep taking anti-depressants, many people don’t want to take them for long periods and others want to avoid side-effects. In this study, 424 adults with recurrent major depression who were on maintenance anti-depressant drugs were randomly assigned either to come off their anti-depressants slowly and receive MBCT or to stay on their medication. While 212 patients continued taking their anti-depressants, the other 212 attended eight group mindfulness therapy sessions and were given daily home practice as well as an option to have four follow-up sessions over a 12-month period. Study results published in The Lancet medical journal showed that after two years, relapse rates were similar in both groups — at 44 percent in the therapy group versus 47 percent in the anti-depressant drug group. “Whilst this study doesn’t show that mindfulness-based cognitive therapy works any better than maintenance anti-depressant medication in reducing the rate of relapse ... these results suggest a new choice for the millions of people with recurrent depression on repeat prescriptions,” said Willem Kuyken of Oxford University, who worked with Byng on the research. Claim: Mindfulness therapy as good as medication for chronic depression - study.

SOLUTION: Mindfulness-based cognitive therapy (MBCT) may be just as effective as anti-depressants in helping prevent people with chronic depression from relapsing, scientists said on Tuesday.

PROBLEM: Paragraph: The article states that acupuncture costs $45 to $100 per session. It does not say how this compares to other treatments and whether the cost of care is the same, more or less than alternatives. The story states the proportion of patients who successfully responded to each therapy, and clearly explains that “real” acupuncture was no better than sham needling. But it does not define success or otherwise quantify how much people improved clinically in either relative or absolute terms. For a treatment to be considered successful, a patient must have reported either a 33% improvement in pain or as little as a 12% improvement in function during an interview conducted over the telephone 6 months after enrollment. Nonethless we’ll grade this criterion as satisfactory. The story did not mention harms from any of the treatments patients received. Previous research suggests that acupuncture poses few risks when performed with sterile, disposable needles. The article describes the largest randomized controlled trial to date investigating the effectiveness of acupuncture for treating chronic low back pain, and reports its published results. It discusses the three treatment groups studied and potential reasons for the outcomes observed. There are no obvious elements of disease mongering. The story explains that the study participants were people with chronic low back pain. These results wouldn’t apply to other back pain conditions. The article cites one of the study’s coauthors and two physicians who appear to be users and/or proponents of complementary therapies. It would have been interesting to hear from a skeptical observer. The story lists the therapies received by patients assigned to the conventional medicine group. The literature suggests that these treatments generally provide very modest benefits. The article does not mention other therapies that may be effective for managing chronic pain and improving flexibility and strength. These include cognitive therapy alone or in combination with intensive exercise and strengthening. Acupuncture is estimated to be the third most popular complementary therapy for chronic low back pain. Though the article does not say much about its availability, readers are likely to be familiar with it. The story notes that this is the largest study yet of acupuncture for chronic back pain, suggesting that the treatment is not new. There is no obvious use of text from a press release. Claim: Acupuncture, real or fake, called best for lower back pain

SOLUTION: This article reports on the largest randomized controlled trial to date investigating the effectiveness of acupuncture for treating chronic low back pain. It explains that both acupuncture and sham needling are more effective than conventional medical therapies, but that “fake acupuncture works nearly as well as the real thing.”       In addition to describing the quality of the evidence, the story mentions several other treatment options, tells the reader the cost of acupuncture, and hints at its novelty. The story neglects to mention harms. (A recent systematic review reinforces the study’s finding that acupuncture poses few risks; see Spine 2005;30:944-63). And it also provides an incomplete picture of the treatment’s apparent benefits. Although it notes the proportion of patients who improved with each therapy, it does not define success or otherwise quantify how much people improved clinically–in either relative or absolute terms. For a treatment to be considered successful, for example, a patient could have reported as little as a 12% improvement in function during an interview conducted over the telephone 6 months after enrollment. This is important information if people are to weigh the apparent benefit of a therapy against its cost. The article cites one of the study’s coauthors and two physicians who appear to be users and/or proponents of complementary therapies. They attempt to explain why needling seems to work. To provide some balance, the study’s coauthor suggests that the apparent benefit could merely be the result of patients’ expectations of improvement from acupuncture, on the one hand, and of poor results from conventional medicine on the other. (Unfortunately, the researchers did not measure patients’ expectations.) It would have been interesting to hear from others. Some might point out that the new study shows that acupuncture and sham needling are only more effective than treatments that are not themselves very effective. Others might make the case that acupuncture provides no specific treatment effect and is unethical to use—because it could be construed as prescribing a placebo. People with chronic low back pain are desperate for anything that will help. When a large new study provides apparently strong evidence to buttress a therapy that previously had little high-quality evidence to support it, readers might also benefit from more context. A major systematic review that analyzed 35 randomized trials involving 2861 patients recently concluded that acupuncture appears to confer modest, short-term pain relief, but that the quality of the studies was not very good. The reviewers were careful not to overstate the benefits of acupuncture (Spine 2005;30:944-63). Overall, this was a good article that would have been helped by some more context.

PROBLEM: Paragraph: Social and religious conservatives praise the administration for promoting “a culture of life.” But women’s-rights activists and some medical experts view the multi-pronged changes as a dangerous ideological shift that could increase unintended pregnancies and abortions. “When I ran for office, I pledged to stand for life,” President Donald Trump said in a recent speech to the Susan B. Anthony List, which backs political candidates who oppose abortion. “And as president, that’s exactly what I’ve done. And I have kept my promise, and I think everybody here understands that fully.” Most of the changes involve rules and regulations under the administration’s direct control, such as a proposal to forbid federally funded family planning clinics from referring women for abortions and separately allowing more employers who cite moral or religious reasons to opt out of no-cost birth control for women workers. Trump also is appointing numerous new federal judges endorsed by anti-abortion groups. Justice Neil Gorsuch, the president’s only appointment to the Supreme Court so far, has a sparse record on abortion, but has drawn praise from anti-abortion groups and criticism from abortion rights supporters. Unlike regulatory changes, judicial appointments cannot be reversed by a future president. Democrats say Trump is changing policy in ways that could disrupt access to family planning for some women. A recently proposed rule would make major changes to Title X, the family-planning program, including banning clinics from sharing physical space and financial resources with abortion providers. Providers like Planned Parenthood could be forced out. “It’s across the spectrum of women’s health services,” said Rep. Diana DeGette, D-Col. “They’re proposing abstinence-only sex education —which study after study has shown doesn’t work— restrictions to family planning, and more and more restrictions to abortion.” Title X serves about 4 million low-income people, mainly women. Disruptions could affect women’s access to long-acting contraceptives, such as implants and IUDs. Those are more effective than daily pills that can be forgotten but also much more expensive up-front. Eight professional groups representing doctors, nurses, midwives and physician assistants say the administration’s Title X proposal “dangerously intrudes” on the patient-provider relationship. “The strange thing about this is that people who want to decrease the number of abortions are taking away access to the very services that help prevent them,” said Dr. Hal Lawrence, CEO of the American College of Obstetricians and Gynecologists, one of the eight groups. Among the others are the American College of Nurse-Midwives and the American Academy of Pediatrics. Speaking at a recent rally organized by women’s health advocates in Phoenix, Karina Romero recalled how she had no health insurance and about $20 in her bank account when she sought birth control at a Planned Parenthood clinic in the city’s suburbs. The federal program enabled her to get a long-lasting contraceptive implant. “They have allowed me to pursue a higher education without having to worry about how I’m going to pay for my birth control, or how I’m going to pay for just a regular check up every year,” said Romero, who studies online at Northern Arizona University. The administration says it supports family planning and isn’t cutting funding — merely drawing a “bright line” between birth control and abortion. Officials say the doctor-patient relationship is protected because if a woman asks for an abortion referral, Title X doctors could offer a list of pregnancy services providers, including some who perform abortions. Abortion is legal, but under longstanding law and regulations, taxpayer money cannot be used to pay for abortions. Planned Parenthood, a major provider of both kinds of services, can receive federal family-planning grants while separately providing abortions. Trump’s changes come at a time when U.S. rates of births overall, births to teens, and abortions are low. “If we were seeing skyrocketing abortion rates and wildly high numbers on teen births, you could say we have a crisis, but this is just the opposite,” said Kathleen Sebelius, secretary of Health and Human Services under President Barack Obama, and a supporter of abortion rights. “This is playing politics and putting people in a very precarious situation.” In addition to the proposed changes to Title X, other regulatory actions include: — Proposing a shift in the Teen Pregnancy Prevention Program to emphasize an abstinence-only approach. — Proposing new criteria for federal family-planning grants that would favor applicants who promote “natural family planning” and abstinence. — Expanding a ban on U.S. funding to foreign organizations that promote or provide abortions. Professor Michael New, who teaches economics at Ave Maria University in Florida, agrees there’s a major policy shift. But New, who opposes abortion, dismisses claims of dire consequences as “false and frankly absurd.” “President Trump is decidedly pro-life and it is his administration’s prerogative to use federal funding rules to incrementally build a culture of life,” said New. “The administration is seeking to redirect tax dollars away from entities like Planned Parenthood that treat abortion as a method of family planning and toward entities that affirm life and provide more holistic health care services.” Planned Parenthood, which survived attempts by congressional Republicans to deny it funding, says the administration’s proposed changes to Title X could be another way of achieving the same goal. Planned Parenthood serves 41 percent of program clients, and operates 13 percent of the clinics. Such facilities have become a specialized niche. Research from Texas after that state moved to oust Planned Parenthood showed that other local providers like community health centers were not able to easily fill the gap. Dr. Stephanie Ho works for Planned Parenthood at a clinic in Arkansas that will have to stop offering medication abortions because of a state law that the Supreme Court this week allowed to take effect. The combination of state restrictions and administration actions worries her. “They’re pushing their views on everyone,” she said. “They’re ignoring scientific evidence and expert medical opinion.” Top Planned Parenthood officials say they will fight to remain in Title X, and will consider litigation if necessary to challenge new rules. HHS is expected to announce funding awards for the $260-million program this fall. At a time when social mores on human reproduction continue changing across the world, some see the U.S. in a time warp. “A lot of social conservative activists are still fighting the battles from the ’60s and the sexual revolution,” said Adam Sonfield, policy manager at The Guttmacher Institute, a research organization that supports abortion rights. “That’s their ultimate goal — that some people will just give up and stop having sex.” But Kristi Hamrick, spokeswoman for Students for Life of America, said one result of the policy changes “may be that American women will find that life goes on without Planned Parenthood.” ___ Crary reported from New York. Melissa Daniels in Phoenix also contributed to this story. Claim: Trump remaking federal policy on women’s reproductive health.

SOLUTION:
Step by methodical step, the Trump administration is remaking government policy on reproductive health — moving to limit access to birth control and abortion and bolstering abstinence-only sex education.