177: Rehabilitation of Feeding-Tube Dependent and Feeding-Disordered Children – A Community Paediatric Experience
Bibliographic record
Abstract
Feeding rehabilitation of feeding-tube dependent and feeding-disordered infants and children can be a protracted challenge. Standard outpatient approaches rely on behavioural and sensory interventions based on largely anecdotal data. Effective stimulus-based intervention has until now required prolonged admission to the few specialized centers that offer this approach. To assess effectiveness of a community hospital or clinic stimulus-based intervention for feeding-tube dependent and feeding-disordered children. Uncontrolled non-randomized prospective clinical study. Children were either managed as inpatients (17) or outpatients (3) with immediate discontinuation of all tube feeds and implementation of a standard “picky eater” behavioural management program. Supplemental fluids were provided by tube during sleep if the child was noted to have significant ketosis, weight loss and lethargy. A total of 20 children (17 in-patient and three out-patient) were enrolled. Successful progression to full or partial oral feeding was seen within one week of admission in 17 of 19 (89%) of inpatient managed children and three of three (100%) of children managed as outpatients. Three children subsequently required re-initiation of tube feeding due to parental or medical concern with adequacy of intake (74% long-term successful feeding outcome). Two children with severe behavioral or developmental challenges were resistant to this intervention. Selected tube-dependent and feeding disordered children can be successfully managed in a community-based setting without multidisciplinary support using a naturalized non-coercive hunger and thirst-stimulated approach. Parent satisfaction was extremely high.
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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 | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".