O-24: A Transition and Independence Pathway Designed for Children and Young People with Intestinal Failure
Bibliographic record
Abstract
Aims: To improve the experience of Transition for children and Young People (CYP) with Intestinal Failure (IF) Background: All health care professionals have access to documents describing transition and what it should look like in theory. Putting this theory into actual practice is challenging, heightened by the complexities of the CYPs medical, nursing and psycho/social needs. Advances in management techniques and science have resulted in many more children and young people receiving HPN surviving into adulthood and therefore requiring a transition pathway. A UK review of transition practices for CYP and IF in 2014 highlighted that this cohort were complex in nature and that transition service standards for young people on HPN were lacking and required practical elements of transition such as independence and training. Methodology: Working with a PINNT we developed documents for the main stakeholders of Transition (the young person, parent/carer and health care professional) providing support, assessment and readiness tools for transition. Incorporated into this is an instrumental annual transition clinic for all children in secondary education, including independence training which is planned and secured in a partnership with the tertiary centre, home care company and young person. Results: Eight young adults are currently enrolled in the annual transition clinic; four have completed the independence programme designed for them according to physical and emotional maturity and readiness. 100% of CYP and parents attending the transition clinic report positive experiences and conclude rounded involvement and participation positively prepares all parties for transition. The health care professionals in attendance (consultants, clinical nurse specialists, dietitians and pharmacists) all reported a feel good factor and increased job satisfaction that can only enhance the fresh new forming relationships as the young person transitions and bids slowly good bye to these long extensive relationships in paediatrics. Conclusion: All CYP with IF require a robust transition pathway. The complex nature of IF including the psycho-social and educational influences, requires tools to assess need and readiness in order to construct individually tailored plans that can be incorporated into the transition pathway.
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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 | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.002 | 0.008 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.014 | 0.003 |
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".