Litigants in person in private family law cases

This study was designed to develop the evidence base on litigants in person in private family law cases, including their behavioural drivers, experiences and support needs, and impact on the court prior to the implementation of legal aid reforms in April 2013. Fieldwork was conducted between January and March 2013. The study delivered primarily qualitative evidence. The researchers sampled 151 private law family cases where a hearing was observed, the court file examined and parties and professionals interviewed. To provide wider context, focus groups were also held with judges, court staff and lawyers

A cluster randomised controlled trial in primary dental care based intervention to improve professional performance on routine oral examinations and the management of asymptomatic impacted third molars: study protocol

BACKGROUND: Routine oral examination (ROE) refers to periodic monitoring of the general and oral health status of patients. In most developed Western countries a decreasing prevalence of oral diseases underpins the need for a more individualised approach in assigning individualised recall intervals for regular attendees instead of systematic fixed intervals. From a quality-of-care perspective, the effectiveness of the widespread prophylactic removal of mandibular impacted asymptomatic third molars (MIM) in adolescents and adults is also questionable. Data on the effectiveness of appropriate interventions to tackle such problems, and for promoting continuing professional development in oral health care are rare. METHODS/DESIGN: This study is a cluster randomised controlled trial with groups of GDPs as the unit of randomisation. The aim is to determine the effectiveness and efficiency of small group quality improvement on professional decision-making of general dental practitioners (GDPs) in daily practice. Six peer groups ('IQual-groups') shall be randomised either to the intervention arm I or arm II. Groups of GDPs allocated to either of these arms act as each other's control group. An IQual peer group consists of eight to ten GDPs who meet in monthly structured sessions scheduled for discussion on practice-related topics. GDPs in both trial arms receive recently developed evidence-based clinical practice guidelines (CPG) on ROE or MIM. The implementation strategy consists of one interactive IQual group meeting of two to three hours. In addition, both groups of GDPs receive feedback on personal and group characteristics, and are invited to make use of web-based patient risk vignettes for further individual training on risk assessment policy. Reminders (flow charts) will be sent by mail several weeks after the meeting. The main outcome measure for the ROE intervention arm is the use and appropriateness of individualised risk assessment in assigning recall intervals, and for the MIM-intervention group the use and appropriateness of individualised mandibular impacted third molar risk management. Both groups act as each other's control. Pre-intervention data will be collected in study months one through three. Post-intervention data collection will be performed after nine months

The atmospheric response to three decades of observed arctic sea ice loss

© Copyright 2013 American Meteorological Society (AMS). Permission to use figures, tables, and brief excerpts from this work in scientific and educational works is hereby granted provided that the source is acknowledged. Any use of material in this work that is determined to be “fair use” under Section 107 of the U.S. Copyright Act September 2010 Page 2 or that satisfies the conditions specified in Section 108 of the U.S. Copyright Act (17 USC §108, as revised by P.L. 94-553) does not require the AMS’s permission. Republication, systematic reproduction, posting in electronic form, such as on a web site or in a searchable database, or other uses of this material, except as exempted by the above statement, requires written permission or a license from the AMS. Additional details are provided in the AMS Copyright Policy, available on the AMS Web site located at (http://www.ametsoc.org/) or from the AMS at 617-227-2425 or [email protected] sea ice is declining at an increasing rate with potentially important repercussions. To understand better the atmospheric changes that may have occurred in response to Arctic sea ice loss, this study presents results from atmospheric general circulation model (AGCM) experiments in which the only time-varying forcings prescribed were observed variations in Arctic sea ice and accompanying changes in Arctic sea surface temperatures from 1979 to 2009. Two independent AGCMs are utilized in order to assess the robustness of the response across different models. The results suggest that the atmospheric impacts of Arctic sea ice loss have been manifested most strongly within the maritime and coastal Arctic and in the lowermost atmosphere. Sea ice loss has driven increased energy transfer from the ocean to the atmosphere, enhanced warming and moistening of the lower troposphere, decreased the strength of the surface temperature inversion, and increased lower-tropospheric thickness; all of these changes are most pronounced in autumn and early winter (September–December). The early winter (November–December) atmospheric circulation response resembles the negative phase of the North Atlantic Oscillation (NAO); however, the NAO-type response is quite weak and is often masked by intrinsic (unforced) atmospheric variability. Some evidence of a late winter (March–April) polar stratospheric cooling response to sea ice loss is also found, which may have important implications for polar stratospheric ozone concentrations. The attribution and quantification of other aspects of the possible atmospheric response are hindered by model sensitivities and large intrinsic variability. The potential remote responses to Arctic sea ice change are currently hard to confirm and remain uncertain