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: On 21 January 2019, Slate published a article headlined “The Trump Administration Quietly Changed the Definition of Domestic Violence and We Have No Idea What For.” That story highlighted significant changes to the definition of domestic violence appearing on website of the Department of Justice’s (DOJ) Office of Violence Against Women office. An archived version of that website from April 2018 previously defined domestic violence as:  A pattern of abusive behavior in any relationship that is used by one partner to gain or maintain power and control over another intimate partner. Domestic violence can be physical, sexual, emotional, economic, or psychological actions or threats of actions that influence another person. This includes any behaviors that intimidate, manipulate, humiliate, isolate, frighten, terrorize, coerce, threaten, blame, hurt, injure, or wound someone. By contrast, the current version of that same website encompasses only acts of physical violence under the definition of domestic violence:  The term “domestic violence” includes felony or misdemeanor crimes of violence committed by a current or former spouse or intimate partner of the victim, by a person with whom the victim shares a child in common, by a person who is cohabitating with or has cohabitated with the victim as a spouse or intimate partner, by a person similarly situated to a spouse of the victim under the domestic or family violence laws of the jurisdiction receiving grant monies, or by any other person against an adult or youth victim who is protected from that person’s acts under the domestic or family violence laws of the jurisdiction. We reached out to the Office of Violence Against Women (OVW) for an explanation on what motivated the change in the definition and whether that change was spurred by an actual change in law or policy. We received a response from Allison Randall, Chief of Staff for the OVW, that did not adequately answer either question. Her response is reproduced in full below:  The Department is strongly committed to enforcing the Violence Against Women Act (VAWA) and combating domestic violence, dating violence, sexual assault, stalking, and sex trafficking, and to do so in a manner that is consistent with the law enacted by Congress. Domestic violence is clearly defined in VAWA, and OVW has always used the statutory definition in carrying out its mission. By following the statute, the Department ensures the funds made available by Congress are employed in the most effective manner possible to reduce violence and to assist crime victims. In fiscal year 2018, OVW awarded a record $467 million under VAWA. President Trump’s request for fiscal year 2019 OVW funding was the largest ever requested. OVW discretionary grantees serve an average of 125,000 victims every six months and formula subgrantees serve over 400,000 victims each year. VAWA funding supports victim advocates who answer over a million hotline calls and provides over 2 million housing and shelter bed-nights for victims and their children annually. Every year, VAWA-funded professionals assist victims in securing more than 200,000 protection orders. The narrower definition employed in the current version of the OVW website stems from the definition provided in the Violence Against Women Act (VAWA) as it relates to disbursing funds for VAWA grant programs. While it is true this narrow definition has not changed as it relates to the VAWA, it is unclear why the DOJ found it necessary to remove information about non-physical intimate partner violence. Writing in Slate, Natalie Nanasi, a Professor of Law and the Director of the Judge Elmo B. Hunter Legal Center for Victims of Crimes Against Women at Southern Methodist University, argued that:  A domestic violence relationship rarely begins with physical violence, much less violence that rises to the level of a crime. If you were punched on a first date, odds are there wouldn’t be a second. Intimate partner abuse is insidious: Emotional and psychological abuse escalates to physical violence as an abuser’s need and/or ability to exert power and control increases. In the United States today, more than half of female homicide victims are killed by an intimate partner. If we do not acknowledge the “small” things — yelling or screaming, name-calling, and controlling or monitoring communication and social media — victims may not realize they are in danger until it is too late. In our response to the statement from OVW, we suggested that they had not provided any explanation for the change to their website and requested further clarification; if we receive such clarification, we will update our story. Claim: The DOJ changed the definition of domestic violence on their website without explanation.
answer:
The Violence Against Women Act, which was extended by President Obama in 2013, expired at midnight on 22 December 2018 as a result of the 2018-19 federal government shutdown over funding for President Trump’s proposed border wall.


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Paragraph: Whimpering and badly malnourished, they are among the most vulnerable in a country that remains one of the poorest in the world. Now an expected United States-Taliban agreement to end nearly 18 years of fighting raises questions about whether the foreign aid largely propping up the country will drop as troops withdraw. Much depends on the Taliban, who have indicated they want that aid to continue even as they call for armed “invaders” to leave. But if the insurgent group that already controls roughly half of Afghanistan tries to assert a harsh form of Islamic law across the country or continues its attacks, some donors could walk away. The urgency of aid is seen in Jebul Siraj, a mountainside community north of the capital, Kabul, where a burqa-clad woman held a gaunt, startled-looking boy named Abdullah, just 7 months old. Days ago, he was at an emergency ward. Now he sipped curiously at a supplement as part of a new nutrition monitoring program at a clinic in Parwan province supported by the United Nations children’s agency. Mothers and children lined up outside. Some 2 million children in Afghanistan face acute malnutrition, according to UNICEF, about 600,000 of them so severely malnourished that without urgent treatment they could die. The hospital in nearby Charikar city treats more than 1,000 children a month for malnutrition and the problem is growing, nurse Fariba Hashimi said. “It’s mostly an economic issue, for mothers as well,” she said. “They can’t breastfeed because they don’t have enough income to feed themselves.” Aid has dropped in recent years, with supplemental biscuits and wheat flour that was once provided for patients now unavailable. Health care and other basic services are precarious in a country where the World Bank says grants finance some 75% of total public expenditures. This year it warned against the dire consequences of “any rapid decline in international aid flows.” Afghanistan has been the largest single recipient of American aid since the U.S.-led invasion to oust the Taliban in 2001, but despite billions of dollars in assistance more than half of its people still live in poverty. Much of the aid has gone to security efforts, and frustrated Afghans assert that untold amounts have been lost in corruption and mismanagement. U.S. aid to the country was cut in half in 2014, the year that U.S. and NATO forces formally ended their combat mission. About 20,000 forces remain, largely to train and support Afghan counterparts. If a U.S.-Taliban agreement on ending America’s longest war brings badly needed peace, Afghanistan could see an increase in aid, said Alex Thier, who once directed assistance for the country with the U.S. Agency for International Development. But if the peace process drags out or fails, that could “depress enthusiasm for giving,” he warned after a visit to Kabul this month. Some donors could be reluctant to fund a government in which the Taliban wield power and don’t respect the rights of women and others. The Taliban have indicated they want international aid to continue, and understanding how to keep it flowing is part of talks with the U.S., Thier said, citing what he has heard from diplomats, Taliban proxies and people who met with Taliban leaders in intra-Afghan dialogues in Moscow and Qatar this year. “Part of the Taliban motivation in the peace process is, they clearly want to avoid being a pariah state as before,” he said. But no one knows what they will give up to keep receiving support. The local U.N. humanitarian coordinator, Toby Lanzer, who has spoken with “all of the authorities across Afghanistan,” said he believes aid won’t drop, calling the country’s case so compelling that efforts must continue, whatever happens. He has spoken with the United States and other “particularly generous” countries and believes donors are in Afghanistan for the long haul. Asked how the interest of President Donald Trump’s administration in cutting overall foreign aid complicates the situation, Lanzer paused for more than 10 seconds before saying that “when it comes to a strategic location such as Afghanistan, everybody has to chip in, and everybody has been chipping in. And I would very much count on the continued generosity of the people of the United States of America, of institutions such as USAID, to stay the course.” Next year could be Afghanistan’s most pivotal, he said, as the latest round of international aid pledges ends. He expects another pledging conference in 2020 for “the new government, whichever government that might be.” At the Indira Gandhi children’s hospital in Kabul, which treats 70 to 80 malnourished children a month, director Dr. Mohammad Bashir Qurishi worried about how doctors will be paid and medicine purchased if aid follows troops out of the country. Everyone is afraid of losing the progress made since 2001, he said, as the U.S. and the Taliban negotiate the country’s future while excluding the Afghan government. “If Trump wants to take us back to Stone Age time, then it is their policy,” he said. In the ward for malnourished children, decorated with aid stickers from UNICEF and Japan, a nurse pointed out fragile toddlers. One 2-year-old, her face covered in tape to keep a nasal feeding tube in place, breathed with discomfort, a Barbie-like doll next to her on her pillow. Nearby was Bibi Warai. Her 2-year-old granddaughter had just died at home outside the eastern city of Jalalabad, and now the girl’s 3-year-old sister, Humaira, was undergoing treatment. After their hours-long journey to the capital she wished for more such wards so that all Afghans can reach help in time. “My son told me, ’How can you leave us at this time of mourning?”″ she said. “I told him, ‘I can’t stay, I have to take my child for treatment.’ Maybe God will help us, and she will survive.” She placed her hand gently on the girl’s forehead and began to cry. ___ Associated Press video journalist Ahmad Seir in Kabul contributed to this report. Claim: As troops prepare to leave Afghanistan, will aid stream out?.
answer:
The children will inherit any peace that comes to Afghanistan, if only they can live to see it.


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Paragraph: The question of cost is cited in the final line of the story, which suggests that the scoring system can “address escalating health care cost issues.” But we didn’t think that was specific enough to warrant a Satisfactory score. The story doesn’t clue readers in to the fact that the financial burden can be measured in billions of dollars — a single screening test recommended for millions of Americans can cost thousands of dollars apiece. The other cost issue specific to this test is that it takes valuable time for providers to retrieve a reputable risk calculator when sitting with a patient and enter in the specific data points, including in this case waist circumference, which clinicians often do not measure as a ‘vital sign’ per se. The story cites a study that credits colonoscopy with reducing the risk of death from colon cancer by about 50 percent, by removing polyps. It would have been helpful for the story to explain what that relative reduction in risk means in absolute terms (e.g. did the rate of cancer death go from 50% to 25% or from 2% to around 1%?) The story also notes that the study found that patients with a low to intermediate risk score “still have a risk between of between 1.9 percent to 9.9 percent of harboring a polyp that can develop into cancer.” We’ll give credit here for the story’s provision of these key statistics, which do give a sense as how well the test accurately identifies truly low-risk individuals. However, we’d note that the benefit here should ideally refer to the ability of the algorithm to classify people at all risk levels (including high-risk), and therefore target the highest-risk patients for colonoscopy. The story doesn’t really get into discussion of the predictive power of the test, referred to as a likelihood ratio, which is in the study manuscript. However, this is a difficult concept for most health care providers and patients, and we think it’s understandable that the story did not include a full discussion of this topic. The harm of a screening test such as this really is “getting it wrong” in terms of predicting someone to be at low risk and finding them to have a higher risk polyp or malignancy. As noted above, the story cautions that “low- to intermediate-risk patients still have a risk between of between 1.9 percent to 9.9 percent of harboring a polyp that can develop into cancer.” This story accurately explains that the research was about predictive modeling, and explains the components of the risk score as well as the study design. There are some cautionary notes in the text, including a statement from outside expert that “the data from this study is not strong enough to spur any changes in current screening recommendations,” an opinion shared by an editorialist on the study. We think this is sufficient for a Satisfactory rating. The story does not hype the incidence or seriousness of the disease. The prevalence statistics cited are consistent with these National Cancer Institute figures. The story contains two independent voices. The perspective they provide is a particular strength of the article. We wish that more stories would reach out to experts not affiliated with the studies being reported on for context. The story notes that a variety of screening tests exist, but the relevant alternative here is actually other risk calculators, which the authors of the study describe and cite but are not routinely used. The story doesn’t mention these other calculators and why they are seldom used — context that would have deepened reader understanding of the issue. Although availability isn’t explicitly addressed, this risk calculator is now available (implicitly) by virtue of publication of the paper. It is a simple scoring system that can be implemented based on the information in the paper, and the story makes this clear. We’ll rate this Satisfactory. The story makes it sound as if this is a first-of-its-kind tool. However, risk calculation tools for colon cancer have been in circulation for many years. We could not find a news release related to this study. But in any case, the comments from two independent experts assure us that the story wasn’t based on a news release. Claim: 'Scoring System' May Spot Those in Greatest Need of Colonoscopy; But one expert cautions that even 'low risk' patients can still develop suspicious polyps
answer:

Can a new scoring system help some people avoid a colonoscopy?This is an important story that touches on all sorts of issues involved in public health, including how to best to screen for a disease that takes a terrible toll, how to determine who is at highest risk and how to get the best use out of a test (colonoscopy) that is both expensive and invasive. The story does a good job summarizing the study authors’ efforts to devise a scoring algorithm that might answer some of those questions, but makes only perfunctory references to cost and doesn’t acknowledge the long history of similar calculators that have been developed and never widely used. That’s pertinent context for this new effort. Despite leaving some room for improvement, the story makes a strong effort at interpreting a relatively simple algorithm with complex ramifications, and draws on two outside experts for perspective — something we wish more stories would take the time to do. The concept of “risk stratification” — which is what this story and the related research paper address — is difficult for physicians and patients alike. Risk prediction tools are often created and then not used by physicians because they are cumbersome or their use historically has not been incorporated into guidelines because they have important limitations, including that even low-risk people still sometimes develop the cancer or condition. Since this new tool appears to suffer from these same limitations, it’s not clear if it will fare any differently than previous efforts, but the issue is worth exploring.