Population dynamics and the rise of empires in Inner Asia

Genome-wide analysis spanning 6,000 years in the eastern Eurasian Steppe gives insights to the formation of Mongolia's empires

MAX PLANCK INSTITUTE FOR THE SCIENCE OF HUMAN HISTORY

Research News

 

IMAGE: A LEANING DEER STONE PLACED IN FRONT OF DOZENS OF SMALL STONE MOUNDS CONTAINING RITUALLY-SACRIFICED HORSE BURIALS AT THE BRONZE AGE MONUMENT SITE OF IKH TSAGAANII AM, BAYANKHONGOR PROVINCE, CENTRAL... view more 

CREDIT: WILLIAM TAYLOR

From the late Bronze Age until the Middle Ages, the eastern Eurasian Steppe was home to a series of organized and highly influential nomadic empires. The Xiongnu (209 BCE - 98 CE) and Mongol (916-1125 CE) empires that bookend this period had especially large impacts on the demographics and geopolitics of Eurasia, but due to a lack of large-scale genetic studies, the origins, interactions, and relationships of the people who formed these states remains largely unknown.

To understand the population dynamics that gave rise to the Steppe's historic empires, researchers from the Max Planck Institute for the Science of Human History (MPI-SHH), the National University of Mongolia, and partner institutions in Mongolia, Russia, Korea and the United States generated and analyzed genome-wide data for 214 individuals from 85 Mongolian and 3 Russian sites. Spanning the period of 4600 BCE to 1400 CE, it is among the largest studies of ancient Eastern and Inner Asian genomes to date.

During the mid-Holocene, the eastern Eurasian Steppe was populated by hunter-gatherers of Ancient Northeast Asian (ANA) and Ancient Northern Eurasian (ANE) ancestry, but around 3000 BCE, dairy pastoralism was introduced through the expansion of the Afanasievo culture of the Altai mountains, whose origins can be traced to the Yamnaya steppe herders of the Black Sea region more than 3,000 km to the west. Although these migrants left little genetic impact, they had an outsized cultural effect and by the Mid- to Late Bronze Age, dairy pastoralism was practiced by populations throughout the Eastern Steppe.

In the Late Bronze Age and Early Iron Age, populations in west, north and south-central Mongolia formed three distinct, geographically structured gene pools. These populations remained discrete for more than a millennium, until increased mobility, likely facilitated by the rise of horseback riding, began to break down this structure. The formation of the Xiongnu in north-central Mongolia, the first nomadic empire in Asia, is contemporaneous with this population mixture and with the influx of new gene pools originating from across Eurasia, from the Black Sea to China.

"Rather than a simple genetic turnover or replacement, the rise of the Xiongnu is linked to the sudden mixture of distinct populations that had been genetically separated for millennia. As a result, the Xiongnu of Mongolia show a spectacular level of genetic diversity that reflects much of Eurasia," says Dr. Choongwon Jeong, lead author of the study and a professor of Biological Sciences at Seoul National University.

A thousand years later, individuals from the Mongol Empire, one of largest contiguous empires in history, showed a marked increase in Eastern Eurasian ancestry compared to individuals from the earlier Xiongnu, Turkic and Uyghur periods, accompanied by a near complete loss of the ancient ANE ancestry that had been present since before the Xiongnu Empire. By the end of the Mongol Empire, the genetic makeup of the Eastern Steppe had changed dramatically, ultimately stabilizing into the genetic profile observed among present-day Mongolians.

"Our study of ancient Mongolia reveals not only early genetic contributions from populations on the Western Steppe, but also a marked genetic shift towards eastern Eurasian ancestry during the Mongol Empire. The region has a remarkably dynamic genetic history, and ancient DNA is beginning to reveal the complexity of population events that have shaped the Eurasian Steppe," says Ke Wang, co-first author of the study and a PhD student at the MPI-SHH.

In addition to the impacts of genetic events on political structures, the researchers also investigated the relationship between genetics and subsistence strategies. Despite more than 5,000 years of dairy pastoralism in the region and the continued importance of dairy in the average Mongolian diet today, researchers found no evidence for the selection of lactase persistence, a genetic trait that allows lactose digestion.

"The absence of lactase persistence in Mongolian populations both today and in the past challenges current medical models of lactose intolerance, and suggests a much more complicated prehistory of dairying. We are now turning to the gut microbiome to understand how populations adapt to dairy-based diets," says Dr. Christina Warinner, senior author of the study, a professor of Anthropology at Harvard University and a research group leader at the MPI-SHH.

"Reconstructing a 6,000-year genetic history of Mongolia has had a transformative effect on our understanding of the archaeology of the region. While answering some long-standing questions, it has also generated new questions and revealed several surprises. We hope that this research will energize future work on the rich and complex relationships between ancestry, culture, technology, and politics in the rise of Asia's nomadic empires," adds Dr. Erdene Myagmar, co-senior author of the study and professor of Anthropology and Archaeology at the National University of Mongolia.

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Present-day home in the Mongolian countryside, known as a ger (Mongolian) or yurt (Russian)

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A horse-hair banner adorns a hillside monument in central Bayankhongor province, Mongolia.

NYCHA secondhand smoke policy needs more time and effort to show how well it works

NYU LANGONE HEALTH / NYU SCHOOL OF MEDICINE

Research News

 

One year into a smoking ban in buildings run by the nation's largest public housing authority, tenant exposure to secondhand smoke in hallways, stairwells, and apartments has not declined, a new study shows.

Among the explanations for this, investigators say, are delays in promotion and enforcement, including putting up signage and training building managers, and reluctance among nonsmokers to report violations. They also cite lack of smoking cessation services as a possible factor.

The findings proceed from the move in July 2018 by the New York City Housing Authority (NYCHA) to implement a ban on smoking in public housing authorities issued by the U.S. Department of Housing and Urban Development (HUD). NYCHA's goal was to quell secondhand smoke exposure in its more than 165,000 low-income apartments. Similar policies had successfully reduced smoking in public places like bars and restaurants, and policymakers were hoping they would work in large apartment buildings.

Led by researchers at NYU Grossman School of Medicine, the new study found that so far, little change has occurred. Investigators tracked indoor air quality samples before and after the policy was enacted. They compared the results in 10 high-rise NYCHA buildings (in the homes of about 150 families) with those in 11 so-called Section 8 housing (about 110 families). The latter is a group of privately run apartment buildings that were not subject to the policy but whose resident makeup was similar in terms of how many received subsidized housing, how many smoked, and racial mix.

"Our findings show that more intensive efforts to support and enforce NYCHA's smoke-free housing policy are needed to really change resident smoking behaviors," says study lead author Lorna Thorpe, PhD, MPH. "Managers need to be given sufficient tools to ensure that both tenants and staff understand what the rules are, where they can report violations, and why buildings free of secondhand smoke will improve the health of all the families that are living under the same roof."

Publishing online Nov. 5 in the journal JAMA Network Open, the new study showed that in the 12 months since the policy was enacted, nicotine concentration in stairwells or inside households for either building type dipped by just an average of 0.04 micrograms per cubic meter in apartments and just 0.03 micrograms per cubic meter in stairwells. A microgram is one millionth of a gram. By comparison, a smaller study in 2017 in Philadelphia found more than a 0.20 microgram per cubic meter reduction in nicotine levels in stairwells nine months after the introduction of a smoke-free policy.

In pursuit of the policy's success, NYCHA has already taken steps recommended in the study, the researchers say. These include developing a streamlined system for tracking complaints, assigning responsibility for enforcement, and communicating the consequences of policy violations. In addition, it has added new signage in most buildings and launched the Smoke-Free NYCHA Housing Liaison program to help residents get the help they need to quit smoking.

At the same time, tenants must be empowered to speak to their neighbors and given places for people to smoke without impacting others, adds Thorpe, a professor in the Department of Population Health at NYU Langone Health. She also serves as the department's vice chair of strategy and planning and director of its Division of Epidemiology.

Involuntary exposure to secondhand smoke kills about 41,000 American adults annually, according to the U.S. Centers for Disease Control, and increases risk of cancer, heart disease, and asthma, among other ailments. Today, owing to state and federal bans on smoking in public venues, most people are exposed to cigarette smoke in the home, particularly in multi-unit housing, the study authors say.

For the investigation, the researchers used air filters to measure nicotine levels in the homes of non-smoking residents and in common areas like stairwells and hallways. They also surveyed the tenants to identify any changes in the number of people seen smoking in public spaces.

"Although the initial reductions in secondhand smoke exposure were disappointing, it does not mean that the policy has failed," says study senior author Donna Shelley, MD, MPH, a professor at the NYU School of Global Public Health. "Instead, our findings tell us that NYCHA, HUD, and other institutions need to work together to do more for real change to occur."

"Getting residents to fully comply with the policy is a serious challenge; it is going to take time," says Shelley, also affiliated with the Department of Population Health at NYU Langone. "We will reevaluate the policy impact in another year," she continues.

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Funding for the study was provided by National Cancer Institute grant R01 CA220591.

In addition to Thorpe and Shelley, other NYU Langone researchers include Elle Anastasiou, MPH; Albert Tovar; Emily Gil, MPH; Brian Elbel, PhD; Sue Kaplan, JD; Nan Jian, PhD; and Terry Gordon, PhD. Other research support was provided by Katarzyna Wyka, PhD, at the City University of New York in New York City and Ana Rule, PhD, at Johns Hopkins University in Baltimore, Md.

Prejudice, poverty, gender - illustrations show the reality of living with disease

Community-based research programme leads to innovative 'cartoons'

SIGHTSAVERS

Research News

 

IMAGE: LONG DISTANCES AND POOR ROADS HINDER MANY WITH NTDS FROM ACCESSING HEALTHCARE, ESPECIALLY THOSE WITH POOR MOBILITY. view more 

CREDIT: SIGHTSAVERS

Illustrations by a local artist in Nigeria are helping health workers and policy makers understand what it's really like to live with a neglected tropical disease (NTD).

The twelve illustrations have been drawn as part of a research project to improve services for those living with long term impacts of conditions such as lymphatic filariasis, buruli ulcer and leprosy. They include depictions of some of the social and mental health impacts of these conditions - including stigmatisation, loneliness and depression - and will be used in new areas later this month.

When the images, created by Nigerian artist, Christian Okwananke, were shown to NTD health professionals including programme implementers, healthcare workers and policy makers in the Nigerian capital Abuja, it was clear that they had an impact.

"The illustrations kickstarted conversations in a sensitive, non-confrontational way. The health professionals clearly related to the images and were able to understand more effectively the challenges faced by their patients," said Martins Imhansoloeva, research coordinator at Sightsavers.

"We rightly spend a lot of time working to eliminate NTDs, but sometimes at the expense of considering the people behind the numbers and providing services which reflect the realities experienced by people living with an NTD," he added.

The illustrations were drawn following a community-based participatory research programme looking into morbidity management and disability prevention (MMDP) services. These services rarely have input from the people who have been directly affected, which is why research like this is critical.

NTDs affect more than a billion people around the world - often in the poorest and most rural communities - and can cause severe and lifelong physical impairments.

Community stigma and discrimination is often based on misinformation, cultural or traditional beliefs, and further pressures come from fear of surgery, difficulties accessing transport to take up services, worry over the cost of treatment and overstretched health workers.

Large scale mass drug administration programmes to combat NTDs are well established, whilst services for those living with an NTD remain generally underfunded and poorly accessed.

Sightsavers works with partners and ministries of health to eliminate and treat five neglected tropical diseases in over 30 countries: The five NTDs it treats are: trachoma, river blindness (onchocerciasis), elephantiasis (lymphatic filariasis), schistosomiasis and intestinal worms (soil transmitted helminths).

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The illustrations are based on findings from participatory research carried out in Kebbi and Benue states. The researchers from Sightsavers, the Liverpool School of Tropical Medicine (LSTM), and the Nigerian Ministry of Health trained up frontline health care workers and people living with NTDs to be co-researchers who were involved at all levels of the research, analysis and recommendations from the findings. Funding for the project came from the Taskforce for Global Health.

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Often people with NTDs feel ashamed to attend health facilities for fear it will expose their condition, resulting in discrimination.

NOTES:

Please contact us for Jpeg copies of the illustrations. There is also an explanatory video here:
https://www.youtube.com/watch?v=Ju-7c2SYllc

About Sightsavers:

1. Sightsavers is an international organisation that works in more than 30 developing countries to prevent avoidable blindness, treat and eliminate neglected tropical disease, and promote the rights of people with disabilities. It is a registered UK charity (Registered charity numbers 207544 and SC038110)
   http://www.sightsavers.org
2. In the seven decades since its foundation, Sightsavers has:
   • Supported more than 1.2 BILLION treatments for neglected tropical diseases
   • Carried out more than 7.7 million cataract operations to restore sight
   • Carried out more than 196 million eye examinations
   • Dispensed more than 4.6 million glasses
3. Sightsavers holds Independent Research Organisation (IRO) status, making us one of the only international non-governmental organisations to hold this status in the UK. We conduct high quality research to address global gaps in knowledge and put research findings into practice by feeding them back into the design of our programmes.

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Health worker attitudes are important in encouraging people with NTDs to access care. The burden and pressure on health workers should also be considered.

 

Human intelligence just got less mysterious says Leicester neuroscientist

UNIVERSITY OF LEICESTER

Research News

 

NEUROSCIENCE EXPERTS from the University of Leicester have released research that breaks with the past fifty years of neuroscientific opinion, arguing that the way we store memories is key to making human intelligence superior to that of animals.

It has previously been thought and copiously published that it is 'pattern separation' in the hippocampus, an area of the brain critical for memory, that enables memories to be stored by separate groups of neurons, so that memories don't get mixed up.

Now, after fifteen years of research, Leicester University's Director of Systems Neuroscience believes that in fact the opposite to pattern separation is present in the human hippocampus. He argues that, contrary to what has been described in animals, the same group of neurons store all memories. The consequences of this are far reaching, as such neuronal representation, devoid of specific contextual details, explains the abstract thinking that characterizes human intelligence.

Leicester University's Director of Systems Neuroscience Professor Rodrigo Quian Quiroga explains,

"In contrast to what everybody expects, when recording the activity of individual neurons we have found that there is an alternative model to pattern separation storing our memories.

"Pattern separation is a basic principle of neuronal coding that precludes memory interference in the hippocampus. Its existence is supported by numerous theoretical, computational and experimental findings in different animal species but these findings have never been directly replicated in humans. Previous human studies have been mostly obtained using Functional Magnetic Resource Imagining (fMRI), which doesn't allow recording the activity of individual neurons. Shockingly, when we directly recorded the activity of individual neurons, we found something completely different to what has been described in other animals. This could well be a cornerstone of human's intelligence."

The study, 'No pattern sepaeration in the human hippocampus', argues that the lack of pattern separation in memory coding is a key difference compared to other species, which has profound implications that could explain cognitive abilities uniquely developed in humans, such as our power of generalization and of creative thought.

Professor Quian Quiroga believes we should go beyond behavioural comparisons between humans and animals and seek for more mechanistic insights, asking what in our brain gives rise to human's unique and vast repertoire of cognitive functions. In particular, he argues that brain size or number of neurons cannot solely explain the difference, since there is, for example, a comparable number and type of neurons in the chimp and the human brain, and both species have more or less the same anatomical structures. Therefore, our neurons, or at least some of them, must be doing something completely different, and one such difference is given by how they store our memories.

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The biggest trees capture the most carbon: Large trees dominate carbon storage in forests

Large-diameter trees make up 3% of total stems, but account for 42% of total carbon storage in Pacific Northwest forest ecosystems

FRONTIERS

Research News

 

IMAGE: A RECENT STUDY EXAMINING CARBON STORAGE IN PACIFIC NORTHWEST FORESTS DEMONSTRATED THAT ALTHOUGH LARGE-DIAMETER TREES (21 INCHES) ONLY COMPRISED 3% OF TOTAL STEMS, THEY ACCOUNTED FOR 42% OF THE TOTAL... view more 

CREDIT: THE AUTHORS

Older, large-diameter trees have been shown to store disproportionally massive amounts of carbon compared to smaller trees, highlighting their importance in mitigating climate change, according to a new study in Frontiers in Forests and Global Change. Researchers examined the aboveground carbon storage of large-diameter trees (>21 inches or >53.3 cm) on National Forest lands within Oregon and Washington. They found that despite only accounting for 3% of the total number of trees on the studied plots, large trees stored 42% of the total above-ground carbon within these forest ecosystems. This study is among the first of its kind to report how a proposed policy could affect carbon storage in forest ecosystems, potentially weakening protections for large-diameter trees and contributing to huge releases of carbon dioxide to the atmosphere in the face of a changing climate.

In the Pacific Northwest region of the US, a 21-inch diameter rule was enacted in 1994 to slow the loss of large, older trees in national forests. However, proposed amendments to this limit would potentially allow widespread harvesting of large trees up to 30 inches in diameter with major implications for carbon dynamics and forest ecology. Dr David Mildrexler, who led the study, highlights:

"Large trees represent a small proportion of trees in the forest, but they play an exceptionally important role in the entire forest community -- the many unique functions they provide would take hundreds of years to replace."

To examine the relationship between tree diameter and aboveground carbon storage in forests east of the Cascades Crest, the researchers used species-specific equations to relate tree diameter and height to the aboveground biomass in the stem and branches, taking into account that half this biomass in a tree is comprised of carbon. They also examined what proportion large trees made up of the total forest stand, their total calculated aboveground carbon storage and therefore what the potential consequence of removing these large trees could have within future forest management practices.

The study also revealed that trees >30 inches (>76.2 cm) in diameter only constituted 0.6% of the total stems, but these giants accounted for over 16% of the total aboveground carbon across the forests examined. Once trees reached a large size, each additional increment in diameter resulted in a significant addition to the tree's total carbon stores:

"If you think of adding a ring of new growth to the circumference of a large tree and its branches every year, that ring adds up to a lot more carbon than the ring of a small tree.' explains Dr Mildrexler. "This is why specifically letting large trees grow larger is so important for climate change because it maintains the carbon stores in the trees and accumulates more carbon out of the atmosphere at a very low cost."

The study highlights the importance of protecting existing large trees and strengthening the 21-inch rule so that additional carbon is accumulated as 21-30" diameter trees are allowed to continue to grow to their ecological potential, and letting a sufficient number of sub-21 inch trees grow further and become additional large, effective carbon stores.

Dr Mildrexler argues that this is among the most effective short-term options for stabilizing climate change and providing other valuable ecosystem services:

"Large trees are the cornerstones of diversity and resilience for the entire forest community. They support rich communities of plants, birds, mammals, insects, and micro-organisms, as well as act as giant water towers that tap into groundwater resources and cool our planet through evaporation."

"There is a real need for monitoring forest condition beyond what the forest service does on their inventory plots, and so local communities can also play their part to provide citizen science data and learn about the living forests on their lands, contributing to community income and mitigating climate change."

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Pictured here is a Ponderosa pine, Pinus ponderosa

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Pictured here: Ponderosa pine, Pinus ponderosa, and Douglas fir, Pseudotsuga menziesii

GUY FAWKES DAY NOV 5.

 

GUY FAWKES THE ONLY MAN TO ENTER PARLIAMENT WITH HONEST INTENTIONS

ANARCHIST GRAFFITI 

The burning question of Bonfire Night pollution

UNIVERSITY OF LEEDS

Research News

 

IMAGE: AN AIR FILTER BEFORE AND AFTER THE EXPERIMENT, SHOWING THE AMOUNT OF POLLUTING MATERIALS COLLECTED ON BONFIRE NIGHT 2017 view more 

CREDIT: MICHAEL ADAMS

Bonfire Night celebrations contaminate our air with hugely elevated amounts of soot, scientists have found.

Researchers from the University of Leeds were monitoring air quality to determine whether soot created by fires and fireworks, known as black carbon, could help to create ice in clouds.

They found soot in the atmosphere around Guy Fawkes Night events was around 100 times its normal level.

Ice occurs naturally in clouds, but tiny particles of desert dust, soil dust, fungus and bacteria swept high into the air can cause supercooled water droplets in clouds to freeze around them. High concentrations of these ice-nucleating particles can cause clouds to freeze, potentially impacting the earth's climate.

The team carried out experiments on 5 November 2016 into the early hours of the following day, and in 2017 from November 4 and 5, filtering the air with samples taken hourly. Equipment was set up on the balcony of the School of Earth and Environment building, 15m from ground level and more than 0.5 km from any individual bonfires or firework displays, to give a representative view of the air quality across the city.

The filters were washed and the liquid subjected to different temperatures to replicate atmospheric conditions.

The researchers discovered black carbon produced on Bonfire Night did not act as ice nucleating particles - but they did not expect to see such high levels of the polluting matter in the atmosphere.

Black carbon particles are so small, they can penetrate deep into the lungs and cause irritation. Long term exposure can cause harmful effects on the heart and lungs and contributes to millions of deaths worldwide each year.

The paper, A major combustion aerosol event had a negligible impact on the atmospheric ice-nucleating particle population, has been published in Journal of Geophysical Research: Atmospheres today.

The research was funded by the European Research Council.

Lead author Michael Adams, Research Fellow in Atmospheric Ice Nucleation, said: "Our measurements showed that whilst pollution emitted on Bonfire Night shouldn't have any effect on whether clouds are liquid or ice, the elevated concentrations of soot and other pollutants in the atmosphere should be a warning to those with pre-existing health conditions, as the aerosol particles are in the size range where they can enter the lungs and cause problems."

Research supervisor Benjamin Murray, Professor of Atmospheric Science in Leeds' School of Earth and Environment, said: "Bonfire Night is a massive pollution event across the UK. People with existing health problems, such as heart and lung conditions, are at increased risk."

"The impact on clouds and climate was not clear. The good news is that Bonfire Night does not impact the formation of ice in supercooled cloud droplets. But, we know that BC causes climate warming in other ways.

"I was surprised to see levels of black carbon so persistently high for so long on multiple nights. It was striking how poor air quality was on Bonfire Night."

Weather conditions can affect how long the particles remain in the air. The team found the pollution was flushed out of the city within a few hours during the 2016 experiment, due to a brisk wind from the north.

But in 2017 the air was relatively still and the pollution lingered into the next day.

While providing insight into the levels of black carbon emitted on Bonfire Night, the team's discoveries have also contributed to the understanding of different sources of ice nucleating particles - a key research area in climate science.

Prof Murray said: "Clouds containing supercooled water and ice are first order importance for climate. Vast cloud systems made of a mixture of ice and water over the world's oceans buffer the warming effect of CO2.

"But the buffering capacity depends on how much ice is in them, which in turn depends on the concentration and distribution of ice nucleating particles.

"We found that aerosol particles emitted during the celebration are not as effective at nucleating ice as aerosol particle already present in the atmosphere.

"We conclude that aerosol particles emitted from combustion processes such as those observed on Bonfire Night are not an important source of ice nucleating particles."

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Further information

Picture:
An air filter before and after the experiment, showing the amount of polluting materials collected on Bonfire Night 2017
(Credit: Michael Adams)

For further details, contact University of Leeds press officer Lauren Ballinger at L.ballinger@leeds.ac.uk

University of Leeds

The University of Leeds is one of the largest higher education institutions in the UK, with more than 38,000 students from more than 150 different countries, and a member of the Russell Group of research-intensive universities. The University plays a significant role in the Turing, Rosalind Franklin and Royce Institutes.

We are a top ten university for research and impact power in the UK, according to the 2014 Research Excellence Framework, and are in the top 100 of the QS World University Rankings 2021.

The University was awarded a Gold rating by the Government's Teaching Excellence Framework in 2017, recognising its 'consistently outstanding' teaching and learning provision. Twenty-six of our academics have been awarded National Teaching Fellowships - more than any other institution in England, Northern Ireland and Wales - reflecting the excellence of our teaching.
http://www.leeds.ac.uk

 THE INJURIES OF CLASS 

Analysis reveals high burden of musculoskeletal disorders across the globe

WILEY

Research News

Musculoskeletal disorders--which affect muscles, tendons, ligaments, bones, and joints--can severely affect individuals' physical and mental health, and they're especially prevalent among aging adults. Although many researchers are studying these conditions and their rates in different regions of the world, no study to date has provided an overview of the burden of all musculoskeletal disorders. Investigators have now done so in Arthritis & Rheumatology, an official journal of the American College of Rheumatology.

For the analysis, researchers examined data from the Global Burden of Disease Study 2017, which assessed the extent of diseases and injuries across 21 regions and 195 countries and territories from 1990 to 2017. Musculoskeletal disorders included rheumatoid arthritis, osteoarthritis, low back pain, neck pain, gout, and related conditions.

The team found that there were approximately 1.3 billion prevalent cases and 121,300 deaths due to musculoskeletal disorders in 2017, as wells as 138.7 million disability-adjusted life years, or the number of years lost due to ill-health, disability, or early death. The burden of these diseases generally increased with age for both sexes, was more prevalent among females, and was higher in developed countries.

"Our study describes the enormous global burden of disability from musculoskeletal conditions in a single paper," said senior author Rachelle Buchbinder, MD, of the Cabrini Institute and Monash University, in Australia. "These conditions are under-recognized despite their enormous costs to individuals, the economy, and the health system. Also, there has been a lack of any significant decline in the burden from these conditions over time, which means that there is still insufficient emphasis on addressing the problem."

Dr. Buchbinder noted that policy makers must be made aware of the size of this growing problem, especially in light of rapidly aging populations around the world. "A global response is needed, and this should be integrated with other strategies that can address some of the modifiable and important risk factors of musculoskeletal disorders, including obesity, poor nutrition, smoking, and sedentary lifestyles," she said. "As well, there should be an emphasis on reducing low-value care for some of the most burdensome conditions such as low back pain and osteoarthritis that is contributing to the problem."

The authors also stressed the need for standardized methods for collecting data on the prevalence and impact of musculoskeletal disorders across the world.

Additional information

NOTE: The information contained in this release is protected by copyright. Please include journal attribution in all coverage. For more information or to obtain a PDF of any study, please contact:

Dawn Peters +1 781-388-8408 (US)
newsroom@wiley.com
Follow us on Twitter @WileyNews

Full Citation: "Prevalence deaths and disability adjusted life years (DALYs) due to musculoskeletal disorders for 195 countries and territories 1990-2017." Saeid Safiri, Ali-Asghar Kolahi, Marita Cross, Catherine Hill, Emma Smith, Kristin Carson-Chahhoud, Mohammad Ali Mansournia, Amir Almasi-Hashiani, Ahad Ashrafi-Asgarabad, Jay Kaufman, Mahdi Sepidarkish, Seyed Kazem Shakouri, Damian Hoy, Anthony D. Woolf, Lyn March, Gary Collins, and Rachelle Buchbinder, MD. Arthritis & Rheumatology; Published Online: November 5, 2020. (DOI: 10.1002/art.41571).

URL Upon Publication: http://doi.wiley.com/10.1002/art.41571

Disclosures: The GBD 2017 Study was funded by Bill and Melinda Gates Foundation; however, the organization was not involved in any way in the preparation of the Arthritis & Rheumatology article. The report was supported by Shahid Beheshti University of Medical Sciences, Tehran, Iran (grant No 21740-4-7). Rachelle Buchbinder is supported by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. Marita Cross is supported by the Institute of Bone and Joint Research and the Global Alliance for Musculoskeletal Health.

Author Contact: media@monash.edu or +61 3 9903 4840

About the Journal

Arthritis & Rheumatology is an official journal of the American College of Rheumatology (ACR) and covers all aspects of inflammatory disease. The American College of Rheumatology (http://www.rheumatology.org) is the professional organization whose members share a dedication to healing, preventing disability, and curing the more than 100 types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members include practicing physicians, research scientists, nurses, physical and occupational therapists, psychologists, and social workers. The journal is published by Wiley on behalf of the ACR. For more information, please visit http://wileyonlinelibrary.com/journal/art.

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Wiley drives the world forward with research and education. Through publishing, platforms and services, we help students, researchers, universities, and corporations to achieve their goals in an ever-changing world. For more than 200 years, we have delivered consistent performance to all of our stakeholders. The Company's website can be accessed at http://www.wiley.com.

 

Researchers study strength-training gender gap, possible solutions

PENN STATE

Research News

 

UNIVERSITY PARK, Pa. -- Strength training is an important part of any exercise routine, but some women may not be getting the recommended hours. New Penn State research discovered some of the barriers preventing women from strength training, as well as some solutions to overcoming those obstacles.

In a study of college students, researchers found that women were less likely than men to participate in muscle-strengthening activities and use weight areas in campus recreation facilities. But, the researchers also found that women were more likely to feel uncomfortable using campus recreation facilities -- and weight areas in particular.

Oliver Wilson, graduate student in kinesiology, said the study suggests that there are gender differences in both physical exercise habits and campus facility use. He added that there may be opportunities for school administrators, policy makers and others to help provide equal opportunities for everyone.

"Ideally, all students -- regardless of gender identity, race and ethnicity, sexual orientation, religion, and/or socio-economic status -- should participate in muscle-strengthening activities," Wilson said. "Implementation and enforcement of policies, facility design and equipment layout, supportive social environments, and other opportunities for students to build the skills and confidence to participate in muscle-strengthening activities are necessary to provide equitable opportunities for all."

According to the researchers, previous research has consistently found disparities in physical activity between men and women. Additionally, prior work has found certain areas of campus recreational facilities to be highly gendered spaces.

For example, the researchers said women may feel constrained from using the free weights section of some facilities due to a lack of knowledge or confidence, crowded spaces, or unsolicited advice from male peers.

Melissa Bopp, associate professor of kinesiology, said that because a person's college-age years are an important period for establishing good exercise habits, they wanted to investigate potential reasons and solutions for these disparities.

"It was important to ask these questions because we know that physical activity participation typically declines across students' time in college despite the access they may have to facilities," Bopp said. "It's important to understand why this decline happens before we can create strategies for promoting physical activity."

The researchers recruited 319 college students for the study. The participants were asked to complete a survey designed to measure physical activity and their use and comfort in using campus recreational facilities, as well as their reasons and potential solutions for feeling uncomfortable using the facilities.

According to Wilson, meaningful differences in physical activity behaviors, facility use, and comfort levels in using facilities between male and female students appeared once the data were analyzed.

"Women reported less muscle-strengthening activity, lower frequency of both weight use and informal sport participation, and higher frequency of cardio and group exercise participation," Wilson said. "Women also reported lower comfort using facilities in general -- as well as machine weights, free weights, and indoor running tracks -- compared to men."

The researchers found that the presence and behaviors of men, feeling like they don't know how to properly use the equipment, and feeling self-consciousness emerged as common themes women gave for not using weight equipment.

"It is uncomfortable using certain parts of the recreational facilities because it is often divided into mostly women using the cardio machines and men in the weight section," according to one anonymous participant quoted in the study. "So, even though I like using weights, it can be a little intimidating going into a room full of guys by myself to work out with weights."

The participants also provided potential solutions that could help them feel more comfortable participating in muscle strengthening activities. Themes included the addition of women's-only sections or hours, as well as implementing sexual harassment policies.

Bopp said the study -- recently published in the Journal of American College Health -- suggests that making campus recreational facilities more open and welcoming to all students may be key to ensuring equitable opportunities for all to get the exercise they need.

"I think that it's important to understand that despite the fact that we have wonderful resources for physical activity on our campus, they sometimes don't feel accessible to everyone," Bopp said. "Whether it's the culture or policies that need to be changed to create a welcoming environment remains to be seen, but it also informs us that physical activity behavior is complex -- just having a place to be active doesn't ensure exercise participation."

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David Guthrie, associated professor of education, and Crystal Colinear, undergraduate kinesiology student, also participated in this work.

 

ACA results in fewer low-income uninsured, but non-urgent ER visits haven't changed

WASHINGTON STATE UNIVERSITY

Research News

 

Since the Affordable Care Act's (ACA) Medicaid expansion program went into effect 10 years ago, the U.S. has seen a larger reduction in the number of uninsured low-income, rural residents, compared to their urban contemporaries.

But the likelihood of repeated visits to emergency rooms for non-urgent reasons has not decreased.

That's what Washington State University's Bidisha Mandal discovered in a new paper published in the journal Applied Economic Perspectives and Policy.

"Using emergency departments for non-urgent care is often a sign that people don't have convenient access to doctors," said Mandal, a professor in WSU's School of Economic Sciences. "With more people having insurance under the ACA, demand has increased for doctors. Supply seems to have gone up in cities, but not in rural areas."

Non-urgent visits put an additional strain on emergency rooms, and cost more for patients as well, she said.

One potential reason that non-urgent emergency room visits haven't decreased with more insurance is that Medicaid reimbursements for doctors are lower than other insurances. Physicians don't have a monetary incentive to increase the number of low-income patients they see.

"I was surprised to see that low-income rural residents actually had more insurance gains than urban residents," Mandal said. "But providers just don't have enough incentive to accept new Medicaid patients."

Low-income people benefited from the ACA's Medicaid expansion, and the Supreme Court ruling that made the expansion optional for states allowed researchers to compare outcomes between states that accepted or rejected the expansion, Mandal said.

She also found that the number of annual checkups has increased for low-income people in rural areas. But those additional visits haven't led to fewer non-urgent ER visits.

Mandel hopes policymakers looking to improve the ACA will read papers like hers to see and fix weaknesses in the law.

"There are definite gaps in the ACA, and I hope this paper helps fill some of them," Mandal said. "Having access to proper medical care is really important for our entire population."

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