Palliative and Hospice Care Needed for Children With Life-Threatening Conditions
Bibliographic record
Abstract
WHEN CHILDREN IN THE UNITED States are stricken with a serious illness or injury, few question the medical community’s focus on aggressive intervention aimed at curing or extending young lives. But what is all too often overlooked, say experts, is that children who die—along with many others who ultimately triumph over life-threatening conditions— often suffer needlessly because of lack of palliative and hospice care. Such care not only addresses the physical needs of the child, such as managing pain and other symptoms, but also brings together a team of physicians, nurses, social workers, therapists, clergy, volunteers, and others to provide psychological, social, and spiritual support for children and their families. Although pediatric palliative care is more generally accepted in some industrialized countries, seriously ill children in the United States often are not offered this kind of help. The United Kingdom, Australia, and Canada have done a better job in providing such services, says Marcia Levetown, MD, of the University of Texas Medical Branch, Galveston. But there are encouraging signs that the issue is gaining new prominence in the United States. A few months ago, the American Academy of Pediatrics (AAP) issued care guidelines for children with lifethreatening and terminal conditions (Pediatrics. 2000;106:351-357) that include a number of recommendations to help make palliative care and respite programs more widely available to children and families who need them. And earlier this year, for the first time, Congress allocated $1 million to develop children’s hospice care demonstration programs in Florida, Kentucky, New York, Utah, and Virginia.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.002 | 0.004 |
| Open science | 0.001 | 0.005 |
| Research integrity | 0.005 | 0.009 |
| Insufficient payload (model declined to judge) | 0.019 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".