“In a Constant State of Upheaval”: Experiences Caring for Hospitalized Children in State Custody
Bibliographic record
Abstract
INTRODUCTION: Many children in state custody require concurrent hospitalization each year, but little is known about best practices in caring for them. This study explored healthcare providers' experiences working with and perceptions of the needs of hospitalized children in state custody. METHODS: Twenty-five healthcare providers from an urban children's hospital completed semi-structured interviews that were audio-recorded, transcribed, and analyzed using an inductive, thematic coding approach. RESULTS: Two sets of five themes emerged. First: (1) stressors associated with the Department of Children's Services, (2) emotional distress for providers, (3) limited support resources, (4) multidisciplinary care and coordination, and (5) patient-centered care. Second: (1) building relationships and forming attachments, (2) medical and developmental complexity, (3) isolation, (4) extended (sometimes medically unnecessary) hospitalization, and (5) lack of control. CONCLUSIONS: Participants identified the many challenges associated with hospitalization for this population. By prioritizing collaborative care coordination and trauma-informed practices, teams can enhance outcomes for these children.
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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 | 0.021 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.042 | 0.022 |
| Scholarly communication | 0.013 | 0.009 |
| Open science | 0.005 | 0.019 |
| Research integrity | 0.008 | 0.026 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
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".