The Reflective Fostering Programme fidelity rating scale: development and inter-rater reliability

Purpose: The purpose of this study is to describe the development of the 14-item reflective fostering fidelity rating (RFFR), an observational rating system to evaluate model fidelity of group facilitators in the Reflective Fostering Programme (RFP), a mentalisation-based psychoeducation programme to support foster carers. The authors assess usability, dimensionality, inter-rater reliability and discriminative ability of the RFFR. Design/methodology/approach: Eighty video clip extracts documenting 20 RFP sessions were independently rated by four raters using the RFFR. The dimensionality of the RFFR was assessed using principal components analysis. Inter-rater agreement was assessed using the intra-class correlation coefficient. Findings: The proportion of missing ratings was low at 2.8%. A single principal component summarised over 90% of the variation in ratings for each rater. The inter-rater reliability of individual item ratings was poor-to-moderate, but a summary score had acceptable inter-rater reliability. The authors present evidence that the RFFR can distinguish RFP sessions that differ in treatment fidelity. Originality/value: To the best of the authors’ knowledge, this is the first investigation and report of the RFFR’s validity in assessing the programme fidelity of the RFP. The paper concludes that the RFFR is an appropriate rating measure for treatment fidelity of the RFP and useful for the purposes of both quality control and supervision

Measuring patients' experience with renal services in the UK: development and validation of the Kidney PREM

© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Non Commercial License (https://creativecommons.org/licenses/by-nc/4.0/).Background Patient experience is a recognised aspect of quality of care for people with chronic kidney disease (CKD), but current patient-reported experience measures (PREMs) only focus on dialysis care. We developed and validated the Kidney PREM to assess patients’ experience with renal services in secondary care for any CKD stage or treatment (transplant, haemodialysis, peritoneal dialysis). Methods We developed the Kidney PREM in two phases, informed by a multidisciplinary expert group to ensure face validity. We organised three national data collections (2016 to 2018) to investigate item response profiles and to conduct exploratory and confirmatory analyses to assess internal consistency. We also explored content validity in cognitive interviews and evaluated test-retest reliability. Finally, we developed the Kidney PREM Short Form for more frequent measurement of patient experience to inform local service improvements. Results We analysed 32,959 responses across data collections, the 2018 collection covering all 71 UK renal centres. The Kidney PREM final version consisted of 38 items grouped in 13 themes, all pertaining to one underlying dimension reflecting the construct of ‘patient experience’ with high internal consistency (Cronbach’s α, .94). The Kidney PREM Short Form consisted of 15 items across the same 13 themes. Conclusions The Kidney PREM supports collection of reliable information on patient experience that people with CKD consider relevant, regardless of CKD stage or treatment modality. Kidney PREM data has the potential to guide local and national initiatives to improve patients’ experience with renal services in the UK and other countries.Peer reviewedFinal Published versio

The Least Luminous Galaxy: Spectroscopy of the Milky Way Satellite Segue 1

We present Keck/DEIMOS spectroscopy of Segue 1, an ultra-low luminosity (M_V = -1.5) Milky Way satellite companion. While the combined size and luminosity of Segue 1 are consistent with either a globular cluster or a dwarf galaxy, we present spectroscopic evidence that this object is a dark matter-dominated dwarf galaxy. We identify 24 stars as members of Segue 1 with a mean heliocentric recession velocity of 206 +/- 1.3 kms. We measure an internal velocity dispersion of 4.3+/-1.2 kms. Under the assumption that these stars are in dynamical equilibrium, we infer a total mass of 4.5^{+4.7}_{-2.5} x 10^5 Msun in the case where mass-follow-light; using a two-component maximum likelihood model, we determine a similar mass within the stellar radius of 50 pc. This implies a mass-to-light ratio of ln(M/L_V) = 7.2^{+1.1}_{-1.2} or M/L_V = 1320^{+2680}_{-940}. The error distribution of the mass-to-light ratio is nearly log-normal, thus Segue 1 is dark matter-dominated at a high significance. Using spectral synthesis modeling, we derive a metallicity for the single red giant branch star in our sample of [Fe/H]=-3.3 +/- 0.2 dex. Finally, we discuss the prospects for detecting gamma-rays from annihilation of dark matter particles and show that Segue 1 is the most promising satellite for indirect dark matter detection. We conclude that Segue 1 is the least luminous of the ultra-faint galaxies recently discovered around the Milky Way, and is thus the least luminous known galaxy.Comment: 12 pages, 6 figures, ApJ accepte

The Star Formation History and Extended Structure of the Hercules Milky Way Satellite

We present imaging of the recently discovered Hercules Milky Way satellite and its surrounding regions to study its structure, star formation history and to thoroughly search for signs of disruption. We robustly determine the distance, luminosity, size and morphology of Hercules utilizing a bootstrap approach to characterize our uncertainties. We derive a distance to Hercules of $133 \pm 6$ kpc via a comparison to empirical and theoretical isochrones. As previous studies have found, Hercules is very elongated, with $\epsilon=0.67\pm0.03$ and a half light radius of $r_{h} \simeq 230$ pc. Using the color magnitude fitting package StarFISH, we determine that Hercules is old ($>12$ Gyr) and metal poor ($[Fe/H]\sim-2.0$), with a spread in metallicity, in agreement with previous spectroscopic work. We infer a total absolute magnitude of $M_V=-5.3\pm0.4$. Our innovative search for external Hercules structure both in the plane of the sky and along the line of sight yields some evidence that Hercules is embedded in a larger stream of stars. A clear stellar extension is seen to the Northwest with several additional candidate stellar overdensities along the position angle of Hercules out to $\sim$35' ($\sim$1.3 kpc). While the association of any of the individual stellar overdensities with Hercules is difficult to determine, we do show that the summed color magnitude diagram of all three is consistent with Hercules' stellar population. Finally, we estimate that any change in the distance to Hercules across its face is at most $\sim$6 kpc; and the data are consistent with Hercules being at the same distance throughout.Comment: 50 pages, 15 figures, submitted to the Astrophysical Journa

The Reflective Fostering Programme—improving the wellbeing of children in care through a group intervention for foster carers: a randomised controlled trial

Background: The needs of children in care are a government priority, yet the evidence base for effective interventions to support the emotional wellbeing of children in care is lacking. Research suggests that supporting the carer-child relationship, by promoting the carer’s reflective parenting, may be an effective approach to improving the wellbeing of these children. Methods: The study comprises a definitive, superiority, two-armed, parallel, pragmatic, randomised controlled trial, with embedded process evaluation and economic evaluation, and an internal pilot, to evaluate the effectiveness, and cost-effectiveness, of the Reflective Fostering Programme. Randomisation is at the individual level using a 1:1 allocation ratio. The study is being conducted in local authority sites across England, and is targeted at foster carers (including kinship carers) looking after children aged 4 to 13. Consenting participants are randomly allocated to the Reflective Fostering Programme (intervention arm) in addition to usual support or usual support alone (control arm). The primary outcome is behavioural and emotional wellbeing of the child 12 months post-baseline, and secondary outcomes include the following: foster carer’s level of stress, quality of life, reflective capacity, compassion fatigue and burnout, placement stability, the quality of the child-carer relationship, child’s capacity for emotional regulation, and achievement of personalised goals set by the carer. Discussion: A feasibility study has indicated effectiveness of the Programme in improving the child-carer relationship and emotional and behavioural wellbeing of children in care. This study will test the effectiveness and cost-effectiveness of implementing the Reflective Fostering Programme as an additional aid to the support already available to local authority foster carers. Trial registration: ISRCTN 70832140

Plasma Dynamics

Contains table of contents for Section 2 and reports on three research projects.National Science Foundation Grant ECS 89-02990U.S. Air Force - Office of Scientific Research Grant F49620-93-1-0108U.S. Army - Harry Diamond Laboratories Contract DAAL02-92-K-0037U.S. Department of Energy Grant DE-FG02-91-ER-40648U.S. Navy - Office of Naval Research Grant N00014-90-J-4130National Aeronautics and Space Administration Grant NAGW-2048National Science Foundation Grant ECS 88-22475U.S. Department of Energy Grant DE-FG02-91-ER-54109Magnetic Fusion Science Fellowship Progra

Understanding the Day to Day Experience of Managing; A Qualitive Analysis of 27 Renal Patients on Haemodialysis

© 2021 The Authors. This is an open access work distributed under the terms of the Creative Commons Attribution Licence (https://creativecommons.org/licenses/by/4.0/).Peer reviewe

Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: A national cross-sectional study

Funding Information: This project was funded internally by the University of Hertfordshire with a cross-school collaboration research grant. Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.OBJECTIVES: To examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD). DESIGN: Analysis of data from a cross sectional national survey; the UK Renal Registry (UKRR) national Kidney patient-reported experience measure (PREM) survey (2018). Centre-level data were obtained from the UKRR report (2018). SETTING: National survey of patients with advanced kidney disease receiving treatment with maintenance HD in UK renal centres in 2018. PARTICIPANTS: The Kidney PREM was distributed to all UK renal centres by the UKRR in May 2018. Each centre invited patients receiving outpatient treatment for kidney disease to complete the PREM. These included patients with chronic kidney disease, those receiving dialysis-both HD and peritoneal dialysis, and those with a functioning kidney transplant. There were no formal inclusion/exclusion criteria. MAIN OUTCOME MEASURES: The Kidney PREM has 38 questions in 13 subscales. Responses were captured using a 7-point Likert scale ( never 1, always 7). The primary outcome of interest was the mean PREM score calculated across all questions. Multilevel modelling was used to determine the proportion of variation of the mean PREM score across centres due to patient-related and centre-related factors. RESULTS: There were records for 8253 HD patients (61% men, 77% white) from 69 renal centres (9-710 patients per centre). There was significant variation in mean PREM score across centres (5.35-6.53). In the multivariable analysis there was some variation in relation to both patient- and centre-level factors but these contributed little to explaining the overall variation. However, multilevel modelling showed that the overwhelming proportion of the explained variance (45%) was explained by variation between centres (40%), only a small proportion of which is identified by measured factors. Only 5% of the variation was related to patient-level factors. CONCLUSIONS: Centre rather than patient characteristics determine the experience of care of patients receiving HD. Further work is required to define the characteristics of the treating centre which determine patient experience.Peer reviewe