Coupling carbon allocation with leaf and root phenology predicts tree-grass partitioning along a savanna rainfall gradient

The relative complexity of the mechanisms underlying savanna ecosystem dynamics, in comparison to other biomes such as temperate and tropical forests, challenges the representation of such dynamics in ecosystem and Earth system models. A realistic representation of processes governing carbon allocation and phenology for the two defining elements of savanna vegetation (namely trees and grasses) may be a key to understanding variations in tree–grass partitioning in time and space across the savanna biome worldwide. Here we present a new approach for modelling coupled phenology and carbon allocation, applied to competing tree and grass plant functional types. The approach accounts for a temporal shift between assimilation and growth, mediated by a labile carbohydrate store. This is combined with a method to maximize long-term net primary production (NPP) by optimally partitioning plant growth between fine roots and (leaves + stem). The computational efficiency of the analytic method used here allows it to be uniquely and readily applied at regional scale, as required, for example, within the framework of a global biogeochemical model. We demonstrate the approach by encoding it in a new simple carbon–water cycle model that we call HAVANA (Hydrology and Vegetation-dynamics Algorithm for Northern Australia), coupled to the existing POP (Population Orders Physiology) model for tree demography and disturbance-mediated heterogeneity. HAVANA-POP is calibrated using monthly remotely sensed fraction of absorbed photosynthetically active radiation (fPAR) and eddy-covariance-based estimates of carbon and water fluxes at five tower sites along the North Australian Tropical Transect (NATT), which is characterized by large gradients in rainfall and wildfire disturbance. The calibrated model replicates observed gradients of fPAR, tree leaf area index, basal area, and foliage projective cover along the NATT. The model behaviour emerges from complex feedbacks between the plant physiology and vegetation dynamics, mediated by shifting above- versus below-ground resources, and not from imposed hypotheses about the controls on tree–grass co-existence. Results support the hypothesis that resource limitation is a stronger determinant of tree cover than disturbance in Australian savannas.The contributions of V. Haverd and P. Briggs were made possible by the support of the Australian Climate Change Science Program. B. Smith acknowledges funding as an OCE Distinguished Visiting Scientist to the CSIRO Oceans & Atmosphere Flagship, Canberr

Multi-decadal increase of forest burned area in Australia is linked to climate change

Fire activity in Australia is strongly affected by high inter-annual climate variability and extremes. Through changes in the climate, anthropogenic climate change has the potential to alter fire dynamics. Here we compile satellite (19 and 32 years) and ground-based (90 years) burned area datasets, climate and weather observations, and simulated fuel loads for Australian forests. Burned area in Australia’s forests shows a linear positive annual trend but an exponential increase during autumn and winter. The mean number of years since the last fire has decreased consecutively in each of the past four decades, while the frequency of forest megafire years (>1 Mha burned) has markedly increased since 2000. The increase in forest burned area is consistent with increasingly more dangerous fire weather conditions, increased risk factors associated with pyroconvection, including fire-generated thunderstorms, and increased ignitions from dry lightning, all associated to varying degrees with anthropogenic climate change

A stand-alone tree demography and landscape structure module for Earth system models

We propose and demonstrate a new approach for the simulation of woody ecosystem stand dynamics, demography, and disturbance-mediated heterogeneity suitable for continental to global applications and designed for coupling to the terrestrial ecosystem component of any earth system model. The approach is encoded in a model called Populations-Order-Physiology (POP). We demonstrate the behavior and performance of POP coupled to the Community Atmosphere Biosphere Land Exchange model (CABLE) applied along the Northern Australian Tropical Transect, featuring gradients in rainfall and fire disturbance. The model is able to simultaneously reproduce observation-based estimates of key functional and structural variables along the transect, namely gross primary production, tree foliage projective cover, basal area, and maximum tree height. Prospects for the use of POP to address current vegetation dynamic deficiencies in earth system modeling are discussed

Pilot to policy: statewide dissemination and implementation of evidence-based treatment for traumatized youth

Abstract Background A model for statewide dissemination of evidence-based treatment (EBT) for traumatized youth was piloted and taken to scale across North Carolina (NC). This article describes the implementation platform developed, piloted, and evaluated by the NC Child Treatment Program to train agency providers in Trauma-Focused Cognitive Behavioral Therapy using the National Center for Child Traumatic Stress Learning Collaborative (LC) Model on Adoption & Implementation of EBTs. This type of LC incorporates adult learning principles to enhance clinical skills development as part of training and many key implementation science strategies while working with agencies and clinicians to implement and sustain the new practice. Methods Clinicians (n = 124) from northeastern NC were enrolled in one of two TF-CBT LCs that lasted 12 months each. During the LC clinicians were expected to take at least two clients through TF-CBT treatment with fidelity and outcomes monitoring by trainers who offered consultation by phone and during trainings. Participating clinicians initiated treatment with 281 clients. The relationship of clinician and client characteristics to treatment fidelity and outcomes was examined using hierarchical linear regression. Results One hundred eleven clinicians completed general training on trauma assessment batteries and TF-CBT. Sixty-five clinicians met all mastery and fidelity requirements to meet roster criteria. One hundred fifty-six (55%) clients had fidelity-monitored assessment and TF-CBT. Child externalizing, internalizing, and post-traumatic stress symptoms, as well as parent distress levels, decreased significantly with treatment fidelity moderating child PTSD outcomes. Since this pilot, 11 additional cohorts of TF-CBT providers have been trained to these roster criteria. Conclusion Scaling up or outcomes-oriented implementation appears best accomplished when training incorporates: 1) practice-based learning, 2) fidelity coaching, 3) clinical assessment and outcomes-oriented treatment, 4) organizational skill-building to address barriers for agencies, and 5) linking clients to trained clinicians via an online provider roster. Demonstrating clinician performance and client outcomes in this pilot and subsequent cohorts led to legislative support for dissemination of a service array of EBTs by the NC Child Treatment Program

Abstracts from the NIHR INVOLVE Conference 2017

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BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management