PP518 Topic: AS23–Rehabilitation: Early Mobilization/Interdisciplinary Care/Developmental Care/Other: IMPLEMENTING PAEDIATRIC EARLY REHABILITATION AND MOBILISATION DURING INTENSIVE CARE (PERMIT) PROGRAMME: A UNITED KINGDOM FEASIBILITY TRIAL.
Bibliographic record
Abstract
Aims & Objectives: Early Rehabilitation and Mobilisation (ERM) may improve outcomes for critically unwell or injured children. We aimed to assess 1) feasibility and acceptability of implementing a multidisciplinary designed and delivered, complex ERM programme named PERMIT, 2) recruitment and safe delivery of the programme to PICU patients. This was phase 3 of a multi-stage National Institute for Health and Care Research (NIHR) funded feasibility study. Methods: United Kingdom PICU (n=3) non-randomised, un-blinded trial for patients aged 0-15 years with anticipated PICU length of stay greater than three days, with mixed-method process evaluation (June to Dec 2021). Programme implementation followed six key steps (see Figure 1). Outcomes: acuity assessment, ERM planning/delivery, adverse events and patient outcomes (validated tools). Process evaluation included qualitative (weekly progress meetings, interviews- health care professionals, parents/carers) and quantitative (staff survey) to assess feasibility and acceptability of the consent model and trial design.Results: All three sites implemented PERMIT and successfully recruited the 10-patient target. All patients had an acuity level scored, appropriate ERM activities planned and delivered. There were no severe adverse events. Through debriefs (n=48), survey responses (n=118) and interviews with health care professionals (n=13) and parents/carers (n=15) PERMIT purpose, tools and processes evaluated positively; however, all felt that it was challenging to deliver ERM on current resources. Conclusions: The PERMIT programme was successfully implemented and safely delivered in three diverse UK PICUs. Additional resource requirements are essential for wider evaluation and sustained implementation. Keywords: implementation science, Early Rehabilitation, Mobilisation, Paediatric Intensive Care
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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 | 0.006 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.040 | 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".