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© 2017 The Author(s). Background: Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment. The aim of this study was to investigate attitudes of health care professionals (HCP) to the potential implementation of an EBM tool in the workers' compensation setting. Methods: The study has a mixed methods design. The quantitative study consisted of an online questionnaire asking about self-reported knowledge, attitudes and behaviour to EBM in general. The qualitative study consisted of interviews about an EBM tool being applied in the workers' compensation process. Participants were health care practitioners from different clinical specialties. They were recruited through the investigators' clinical networks and the workers' compensation government regulator's website. Results: Participants completing the questionnaire (n = 231) indicated they were knowledgeable about the evidence-base in their field, but perceived some difficulties when applying EBM. General practitioners reported having the greatest obstacles to applying EBM. Participants who were interviewed (n = 15) perceived that an EBM tool in the workers' compensation setting could potentially have some advantages, such as reducing inappropriate treatment, or over-servicing, and providing guidance for clinicians. However, participants expressed substantial concerns that the EBM tool would not adequately reflect the impact of psychosocial factors on recovery. They also highlighted a lack of timeliness in decision making and proper assessment, particularly in pain management. Conclusions: Overall, HCP are supportive of EBM, but have strong concerns about implementation of EBM based decision making in the workers' compensation setting. The participants felt that an EBM tool should not be applied rigidly and should take into account clinical judgement and patient variability and preferences. In general, the treatment approval process in the workers' compensation insurance system is a sensitive area, in which the interaction between HCP and claims managers can be improved.

Background: There is growing evidence that health and social outcomes following motor vehicle crash injury are related to cognitive and emotional responses of the injured individual, as well as relationships between the injured individual and the compensation systems with which they interact. As most of this evidence comes from other states in Australia or overseas, investigation is therefore warranted to identify the key determinants of health and social outcomes following injury in the context of the New South Wales motor accident insurance scheme. Methods/Design. In this inception cohort study, 2400 participants, aged 17 years or more, injured in a motor vehicle crash in New South Wales will be identified though hospital emergency departments, general and physiotherapy practitioners, police records and a government insurance regulator database. Participants will be initially contacted through mail. Baseline interviews will be conducted by telephone within 28 days of the injury and participants will be followed up with interviews at 6, 12 and 24 months post-injury. Health insurance and pharmaceutical prescription data will also be collected. Discussion. The study results will report short and long term health and social outcomes in the study sample. Identification of factors associated with health and social outcomes following injury, including related compensation factors will provide evidence for improved service delivery, post-injury management, and inform policy development and reforms. Trial registration. Australia New Zealand Clinical trial registry identification number - ACTRN12613000889752. Available at: ANZCTR Registered FISH Study. © 2014 Jagnoor et al.; licensee BioMed Central Ltd.

This is the final version. Available on open access from Wiley via the DOI in this record ; Competition among trees is an important driver of community structure and dynamics in tropical forests. Neighboring trees may impact an individual tree's growth rate and probability of mortality, but large-scale geographic and environmental variation in these competitive effects has yet to be evaluated across the tropical forest biome. We quantified effects of competition on tree-level basal area growth and mortality for trees ≥ 10 cm diameter across 151 ~1-ha plots in mature tropical forests in Amazonia and tropical Africa by developing non-linear models that accounted for wood density, tree size and neighborhood crowding. Using these models, we assessed how water availability (i.e., climatic water deficit) and soil fertility influenced the predicted plot-level strength of competition (i.e., the extent to which growth is reduced, or mortality is increased, by competition across all individual trees). On both continents, tree basal area growth decreased with wood density, and increased with tree size. Growth decreased with neighborhood crowding, which suggests that competition is important. Tree mortality decreased with wood density and generally increased with tree size, but was apparently unaffected by neighborhood crowding. Across plots, variation in the plot-level strength of competition was most strongly related to plot basal area (i.e., the sum of the basal area of all trees in a plot), with greater reductions in growth occurring in forests with high basal area, but in Amazonia the strength of competition also varied with plot-level wood density. In Amazonia, the strength of competition increased with water availability because of the greater basal area of wetter forests, but was only weakly related to soil fertility. In Africa, competition was weakly related to soil fertility, and invariant across the shorter water availability gradient. Overall, our results suggest that competition influences the structure and dynamics of tropical forests primarily through effects on individual tree growth rather than mortality, and that the strength of competition largely depends on environment-mediated variation in basal area. ; Gordon and Betty Moore Foundation ; European Union FP7 ; European Research Council (ERC) ; Natural Environment Research Council (NERC) ; Conselho Nacional de Desenvolvimento Científico e Tecnológico of Brazil (CNPq) ; Microsoft Research ; University of Regina ; Royal Society

Tropical forests are global centres of biodiversity and carbon storage. Many tropical countries aspire to protect forest to fulfil biodiversity and climate mitigation policy targets, but the conservation strategies needed to achieve these two functions depend critically on the tropical forest tree diversity-carbon storage relationship. Assessing this relationship is challenging due to the scarcity of inventories where carbon stocks in aboveground biomass and species identifications have been simultaneously and robustly quantified. Here, we compile a unique pan-tropical dataset of 360 plots located in structurally intact old-growth closed-canopy forest, surveyed using standardised methods, allowing a multi-scale evaluation of diversity-carbon relationships in tropical forests. Diversity-carbon relationships among all plots at 1 ha scale across the tropics are absent, and within continents are either weak (Asia) or absent (Amazonia, Africa). A weak positive relationship is detectable within 1 ha plots, indicating that diversity effects in tropical forests may be scale dependent. The absence of clear diversity-carbon relationships at scales relevant to conservation planning means that carbon-centred conservation strategies will inevitably miss many high diversity ecosystems. As tropical forests can have any combination of tree diversity and carbon stocks both require explicit consideration when optimising policies to manage tropical carbon and biodiversity. ; This paper is a product of the RAINFOR, AfriTRON and T-FORCES networks, for which we are hugely indebted to hundreds of institutions, field assistants and local communities across many countries that have hosted fieldwork. The three networks have been supported by a European Research Council (ERC) grant ("T-FORCES" - Tropical Forests in the Changing Earth System), the Gordon and Betty Moore Foundation, the David and Lucile Packard Foundation, the European Union's Seventh Framework Programme (283080, 'GEOCARBON'; 282664, 'AMAZALERT'), and Natural Environment Research Council (NERC) Urgency Grants and NERC Consortium Grants 'AMAZONICA' (NE/F005806/1) and 'TROBIT' (NE/D005590/1), 'BIO-RED' (NE/N012542/1) and a NERC New Investigators Grant, the Royal Society, the Centre for International Forestry (CIFOR) and Gabon's National Parks Agency (ANPN). Additional data were included from the Tropical Ecology Assessment and Monitoring (TEAM) Network, a collaboration between Conservation International, the Missouri Botanical Garden, the Smithsonian Institution and the Wildlife Conservation Society, and partly funded by these institutions, the Gordon and Betty Moore Foundation, and other donors. J.T. was supported by a NERC PhD Studentship with CASE sponsorship from UNEP-WCMC. R.J.W.B. is funded by a NERC research fellowship (grant ref: NE/I021160/1). S.L.L. was supported by a Royal Society University Research Fellowship, ERC Advanced Grant (T-FORCES) and a Phillip Leverhulme Prize. O.L.P. is supported by an ERC Advanced Grant (T-FORCES) and a Royal Society Wolfson Research Merit Award. L.F.B. was supported by a NERC studentship and RGS-IBG Henrietta Hutton Grant. We thank the National Council for Science and Technology Development of Brazil (CNPq) for support to Project Cerrado/Amazonia Transition (PELD/403725/2012-7), Project Phytogeography of Amazonia/Cerrado Transition (CNPq/PPBio/457602/2012-0) and Productivity Grant to B.S.M and B.H.M-J. Funding for plots in the Udzungwa Mountains (Tanzania) was obtained from the Leverhulme Trust under the Valuing the Arc project. We thank the ANPN (Gabon), WCS-Congo and WCS-DR Congo, Marien Ngouabi University and the University of Kisangani for logistical support in Africa, and the Tropenbos Kalimantan project (ITCI plots) and WWF (KUB plots) for providing data from Asia. This study is contribution number 706 to the Technical Series (TS) of the BDFFP – (INPA-STRI). For assistance with access to datasets we thank Adriana Prieto, Agustín Rudas, Alejandro Araujo-Murakami, Alexander G. Parada Gutierrez, Anand Roopsind, Atila Alves de Oliveira, Claudinei Oliveira dos Santos, C. E. Timothy Paine, David Neill, Eliana Jimenez-Rojas, Freddy Ramirez Arevalo, Hannsjoerg Woell, Iêda Leão do Amaral, Irina Mendoza Polo, Isau Huamantupa-Chuquimaco, Julien Engel, Kathryn Jeffery, Luzmila Arroyo, Michael D. Swaine, Nallaret Davila Cardozo, Natalino Silva, Nigel C. A. Pitman, Niro Higuchi, Raquel Thomas, Renske van Ek, Richard Condit, Rodolfo Vasquez Martinez, Timothy J. Killeen, Walter A. Palacios, Wendeson Castro. We thank Georgina Mace and Jon Lloyd for comments on the manuscript. We thank our deceased colleagues, Samuel Almeida, Kwaku Duah, Alwyn Gentry, and Sandra Patiño, for their invaluable contributions to this work and our wider understanding of tropical forest ecology.