Given a paragraph, generate a claim that is supported by the given paragraph. 1) The claim must contain information from within the paragraph. 2) A sentence within the paragraph can be used as a claim. 3) The claim should not have contradictions within the paragraph. 4) The claim should be at most one sentence long.

Q: The story doesn’t address costs for any of the treatment options discussed. Is MBSR comparable to CBT? Does insurance cover either treatment option? The story tells readers what percentage of study participants who got MBSR treatment reported improvement in pain, as well as what percentage of MBSR participants “reported improvement in the activities they could do.” It also offered the same numbers for participants who received CBT and for the control group, which received typical medical care for this condition. These details deserve a Satisfactory rating. But: The story notes: “The study did caution that 30 of the 103, or about one-third, of the participants in the meditation group reported an ‘adverse event,’ most often an increase in pain due to yoga.” It’s good to see that included. Since the story is effectively comparing MBSR to CBT and conventional treatment, it would also have been worth noting “adverse events” for those groups in the study. According to the study, 10 percent of the CBT group also experienced “adverse events,” and no adverse events were mentioned for the control group. Defining “adverse events” would also have been good, since it’s not clear whether they mean momentary pain or a debilitating flare-up of long-term pain. According to the study, the pain–for both MBSR and CBT groups–was “mostly temporary” and no “serious” adverse events were reported. Those things are worth mentioning. (It’s also worth finding out what “mostly” and “serious” mean.) The story describes the study in detail, explicitly stating the study size and the absolute percentages in each arm that had benefit. It also acknowledged the study was randomized. We’ll count this as sufficient for Satisfactory, keeping in mind the following: As explained in the summary above, the story doesn’t make clear MBSR and CBT were used in addition to conventional medical treatment, rather than instead of medical treatment. The story didn’t mention that the study excluded participants with what the study authors term “a specific diagnosis (eg, spinal stenosis).” In other words, the study did not address treatments for back pain caused by issues like a herniated disc or rheumatoid arthritis. Many readers have these conditions, and should be informed that these study results may not be applicable to their situation. Lastly, we would have welcomed a discussion of the high rates of success within the control group. Forty-four percent in that group experienced a gain in functionality, for example. That seems pretty good! What do the researchers have to say about that? No disease mongering here. However, we did want to point out that the story “fear mongers” in a sense, by stating back pain is “one reason why more and more people are addicted to painkillers.” The story insinuates that these other treatment methods–especially meditation–could help with that. And maybe they could. But the study itself says “No overall differences in treatment effects were observed for…self-reported use of medications for back pain.” So why the mention of painkiller addiction? Conflicts of interest don’t appear to be an issue here, and the story includes statements from an accompanying editorial in JAMA, which was written by experts unaffiliated with the research. This squeaks by as Satisfactory, though it should be noted that most of this material was available via news releases (see below). The story is effectively all about comparing alternatives, though–again–it should have made clear that MBSR and CBT were used in conjunction with conventional medical treatment, and it left out discussion of other well-known non-medication treatment methods, such as exercise. It’s not clear from the story whether MBSR is widely available, is available in mainly metropolitan areas, or is a relatively new field that is still uncommon. The story does quote from a separate editorial in JAMA that says health care systems “should provide access to affordable mind-body therapies,” implying that it’s not widely available. Is this the case, or can it be easily accessed? Given the constraints of a brief news story, the piece does a nice job of articulating the differences between MBSR and CBT. It would have been even more helpful for the story to mention previous studies on the impact of MBSR and CBT on low back pain, to help us understand how novel this new study is. There is little in the story that is not found in the two news releases issued on this study. (Those releases can be found here and here.)

A: Mindful meditation may be the answer to relieving chronic back pain, study suggests
****
Q: "The release of a video showing NFL running back Ray Rice striking his now-wife in an Atlantic City, N.J., casino elevator revived conversations about domestic violence on the Sunday shows. On the Sept. 14, 2014, edition of CNN’s State of the Union, Sen. Amy Klobuchar, D-Minn., shared an anecdote from her time as a prosecutor to illustrate the ills of domestic violence. ""We had a poster outside the door so everyone would see it when they came in. It was a picture of a woman beaten up with a Band-Aid over her nose, holding a little baby boy,"" Klobuchar said. ""And the words read, ‘Beat your wife, and it’s your son that goes to jail.’ "" ""Kids … that have seen it happen,"" Klobuchar said, are ""twice as likely to commit it themselves."" Klobuchar concluded that because the NFL puts ""out their players as role models,"" they have ""to set a different culture."" We were interested in checking Klobuchar’s claim that kids who witness domestic violence are ""twice as likely to commit it themselves."" 90's kids We want to be clear upfront that witnessing domestic violence means witnessing it in a child’s household -- not watching the TMZ.com Rice video. That said, the ""twice as likely"" talking point is fairly popular among advocates against domestic abuse, and suffice to say has been around for a while. The domestic violence literature we’ve seen often cited that claim with a 1990 book called ""Physical Violence in American Families: Risk Factors and Adaptations to Violence in 8,145 Families."" This book compiled the results of the landmark National Family Violence Surveys of 1975 and 1985, which constituted 60-minute face-to-face interviews and 30-minute phone interviews, respectively, with thousands of American families. Based on those interviews, the book’s authors illustrated how a variety of factors influenced the incidence of domestic violence. Most of the book is about gender differences and roles in domestic violence, but the section on the effects on children crunches the surveys’ numbers on whether abusers said they witnessed abuse as children. That produced the ""twice as likely"" estimate. The experts we talked to told us there hasn’t been any study as definitive or comprehensive since, although other studies have taken stabs at the issue of intergenerational transmission of domestic violence. ""We’ve known for such a long time that the biggest risk factor for being abusive against wives and children is witnessing domestic violence at home or being abused,"" said Jacquelyn Campbell, a professor at the Johns Hopkins School of Nursing who studies domestic violence. So ""people haven’t repeated the research for a while,"" Campbell said, and ""a lot of stuff is old and mostly cross-sectional."" What the existing literature says Campbell pointed us to a 2010 study about intimate partner violence -- a subset of domestic violence -- which found that children who witnessed any intimate partner violence were 2.6 times as likely to perpetrate it themselves. Children who witnessed any violence were 1.6 times as likely, according to the study, to become abusers as adults. Klobuchar’s claim, then, has grounds in literature both old and new. There are literally dozens of studies on this issue, though, and different studies tell different stories. A 2000 meta-analysis of 39 different studies on this issue found a ""small-to-medium"" correlation between witnessing and perpetrating. The studies in that survey, while a couple decades old, ranged from showing a causal relationship between witnessing and perpetrating to showing no relationship at all. That corroborates Klobuchar’s larger point that parents’ domestic violence has negative outcomes for their children, but that’s not the same as these kids being ""twice as likely to commit it themselves."" Difficulties with measurements Putting numbers on domestic violence is particularly hard, and perhaps even inappropriate, said Ruth Glenn, executive director of the National Coalition Against Domestic Violence. ""I wouldn’t say twice as likely,"" said Glenn. ""So I would say that it is an additional risk factor. I get nervous when we start to assign data, because there’s not enough data to support it. Domestic violence happens in families, and each of those families are individual units."" In other words, there’s enough out there to suggest that children who witness domestic violence are more likely to perpetrate it, but saying something as precise as ""twice as likely"" is difficult. Domestic violence is ""hard to measure for various and sundry reasons,"" said Glenn, from the lack of ""good data"" on who’s charged and convicted of domestic violence to confidentiality issues with its victims. And even when researchers can get affirmative data, there are methodological concerns. The studies about children who witness domestic violence often surveyed clinical populations -- meaning those with family issues, so a non-representative sample -- and ask respondents to self-report and to retroactively report. Extricating domestic violence from other family issues -- like mental health and substance abuse -- is also difficult, according to the studies Campbell referred us to. Our ruling Klobuchar, arguing that the NFL has a responsibility to hold its ""role models"" accountable to a ""different culture,"" said that kids who witness domestic violence in their households are ""twice as likely to commit it themselves."" There are legitimate, peer-reviewed studies that bear Klobuchar’s claim out. But overall, even though there’s a consensus that witnessing domestic violence puts kids at a greater risk for perpetrating it themselves, the precise figures differ. Measuring domestic violence is very difficult for a variety of reasons, and there hasn’t been a recent, comprehensive study. So saying these kids are ""twice as likely to commit"" domestic violence is a little too precise."

A: "Children who witness domestic violence are ""twice as likely to commit it themselves."
****
Q: The sun has glowed an eerie red behind a brown shrouded sky for weeks over Australian metropolitan areas that usually rank high in the world’s most livable cities indexes. It’s an unprecedented dilemma for Australians accustomed to blue skies and sunny days that has raised fears for the long-term health consequences if prolonged exposure to choking smoke becomes the new summer norm. Similar concerns over smoke are emerging in other regions of the globe being impacted by more fires tied to climate change, including the Western U.S. “I’m going to give birth any day now, literally, and I’m going to have a newborn baby that I’m going to protect from all this,” said Emma Mauch, a pregnant Canberra mother. Her friend, Sonia Connor, described the struggle of keeping her own energetic 3-year-old daughter contained inside their Canberra house with windows and doors sealed by tape as the outside temperature exceeded 42 degrees Celsius (108 degrees Fahrenheit). It’s a choice between air flow in stifling heat or keeping potentially toxic smoke out. “My daughter hasn’t shown any sort of symptoms, let’s say. For me, I can feel it in my lungs, my throat has felt weird,” Connor said. “It doesn’t seem to be stopping her, but the long-term effects? Who knows? She’s 3. Who knows what’s going to happen?” she added. Slovenian tennis player Dalila Jakupovic fell to her knees in a coughing fit on Wednesday while competing in a qualifying match for the Australian Open in Melbourne. “I’ve never experienced something like this,” Jakupovic told Nine Network television. “We are used to pollution — like, we play in China and more polluted countries — but this smoke is something different that for sure we’re not used to.”  Canberra as well as Australia’s two largest cities, Sydney and Melbourne, have at various times in recent weeks rated as the most polluted cities in the world, although some argue the industrial pollutants in places such as New Delhi are more dangerous than wood smoke. The fires have claimed at least 28 l ives since September, destroyed more than 2,600 homes and razed more than 10.3 million hectares (25.5 million acres), mostly in New South Wales state. The area burned is larger than the U.S. state of Indiana. Victoria state increased its official fire death toll by one to five on Wednesday when it reclassified the death of a fire management contractor in a traffic accident in November as a victim of the current wildfire crisis. Hospital admissions have increased in the smoke-affected cities, with some patients suffering asthma for the first time in their lives. The government has responded by distributing 3.5 million free particle-excluding masks. Acting Australian Chief Medical Officer Paul Kelly said he was discussing with the government launching a study of the long-term health implications of the wildfire smoke. Bruce Thompson, president of the Thoracic Society of Australia and New Zealand, is among the respiratory disease experts who predict increases in heart and lung diseases as well as some cancers if climate change makes prolonged exposure to wildfire smoke an annual phenomenon. “We’re breathing in stuff that the lungs don’t like that leads to significant changes, especially people who are predisposed to respiratory conditions,” Thompson said. Thompson, who suffers itchy eyes and a running nose from smoke at home in Melbourne, said comparisons could be drawn between the current crisis and a wildfire that ignited coal in the open-cut Hazelwood mine near the town of Morwell in Victoria state in 2014. The fire burned for 45 days, blanketing Morwell and its 14,000 residents in thick smoke and coal dust. That exposure was still taking tolls on the health of the Morwell community and the wider Latrobe Valley, particularly the young, Thompson said. Brian Oliver, head of the Respiratory Molecular Pathogenesis at University of Technology Sydney, likened prolonged and repeated exposure to such wildfire smoke to smoking cigarettes. Oliver predicted increases in smoker diseases across Australia if the wildfire smoke became more common in a drier and hotter future. NASA says the unprecedented masses of Australian smoke that have drifted east across the Pacific Ocean have returned after circumnavigating the globe. In the U.S., an estimated 20,000 premature deaths now occur annually due to chronic wildfire smoke exposure. That’s expected to double by the end of the century, according to scientists funded by NASA, as tens of millions of people get exposed to massive “smoke waves” emanating from blazes in Western states. Experts say an increase in serious health problems in California may be almost inevitable for vulnerable residents as the disasters become more commonplace. Research suggests children, the elderly and those with existing health problems are most at risk. Short-term exposure to wildfire smoke can worsen existing asthma and lung disease, leading to emergency room treatment or hospitalization, studies have shown. Increases in doctor visits or hospital treatment for respiratory infections, bronchitis and pneumonia in otherwise healthy people also have been found during and after wildfires. Some studies also have found increases in ER visits for heart attacks and strokes in people with existing heart disease on heavy smoke days during previous California wildfires, echoing research on potential risks from urban air pollution. For most healthy people, exposure to wildfire smoke is just an annoyance, causing burning eyes, scratchy throats or chest discomfort that all disappear when the smoke clears. Wood smoke contains some of the same toxic chemicals as urban air pollution, along with tiny particles of vapor and soot 30 times thinner than a human hair. These can infiltrate the bloodstream, potentially causing inflammation and blood vessel damage even in healthy people, research on urban air pollution has shown. Studies have linked heart attacks and cancer with long-term exposure to air pollution. Whether exposure to wildfire smoke carries the same risks is uncertain, and determining harm from smog versus wildfire smoke can be tricky. There is little known about the long-term effects of wildfire smoke because of difficulties in studying populations years after a wildfire. Michael Abramson, professor of epidemiology and preventive medicine at Melbourne’s Monash University, is a co-author of a report on the ongoing investigation of the health impacts of the Hazelwood blaze. Abramson urges a national study of the health impacts of the latest wildfires, saying his research focused on a much smaller population of 74,000 people in the Latrobe Valley. “We’re now seeing substantial exposure extending over weeks to cities that have millions of inhabitants, so I think it’s very likely that there might be more subtle effects that we haven’t been able to detect,” Abramson said.

A:
Australian wildfire smoke stokes health fears in cities.
****