Charlotte Henderson | Universidade de Coimbra (original) (raw)

Papers by Charlotte Henderson

ABSTRACT Occupational health, from a bioarchaeological perspective, focuses on using evidence of ... more ABSTRACT Occupational health, from a bioarchaeological perspective, focuses on using evidence of skeletal degeneration to study past activity-patterns. However, there were other occupational risks. One of the most common in farming communities today is farmer's lung, which is caused by the inhalation of moulds, particularly on hay used as fodder. The aim of this study is to test whether enzyme-linked immunosorbent assays (ELISAs) can be used to identify this disease in a population likely to have been exposed. The skeletal sample studied consists of twenty identified and two non-identified individuals. All individuals were analysed osteologically for evidence of respiratory disease, and ELISAs were run on bone samples. Of the twenty identified individuals all adult males are known, from census records and other documentary evidence, to have engaged in either large or small-scale farming. Their wives, based on limited documentary evidence, are likely to have assisted in these tasks. The population was therefore significantly at risk of developing farmer's lung. Farmer's lung was not identified at the time as a disease; therefore none of the death certificates record this as a cause of death although six (out of twenty) list pulmonary disease. While this does include phthisis, medical texts of the time indicate that the tuberculosis bacillus was not necessarily the actual cause of this lung disease. The osteological and documentary evidence support the potential for farmer's lung as an occupational health risk in this population. Funding. Wolfson Research Institute Small Grant was used to study farmer's lung. C. Henderson is funded by FCT grant SFRH/BPD/82559/2011.

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In this paper, we present a review of research in Portugal on entheseal changes (EC), widely used... more In this paper, we present a review of research in Portugal on entheseal changes (EC), widely used to record activity-patterns. This is explored chronologically and thematically, from the beginning of the research on EC addressing the development of research methods tested through their use in identified collections, which sought to infer if the physical activity leads to EC, to a workshop in 2009, dedicated to EC, through to the recently published outputs of the working groups set up at that meeting. We will also discuss the role of individuals and the world class identified skeletal collections. Key trends include the systematic development of recording methods, their testing and Resumo No presente trabalho, apresenta-se uma revisão da investigação desenvolvida em Portugal no que concerne ao tema das alterações das enteses (AE), que têm sido amplamente utilizadas para registar padrões de atividade em populações do passado. O tema é explorado cronológica e tematicamente, desde o iní...

International Journal of Osteoarchaeology, 2016

International journal of paleopathology, Mar 1, 2018

Differential diagnosis is a fundamental step in every palaeopathological study. It is a challengi... more Differential diagnosis is a fundamental step in every palaeopathological study. It is a challenging exercise since many intrinsic and extrinsic factors may negatively impact the accurate interpretation of bone changes in human skeletal remains. Among these, the completeness and preservation of skeletal elements plays a significant role. This study aims to explore the limits of differential diagnosis in the analysis of disarticulated, fragmented bones. The sample consists of twelve adult bone fragments with noticeable changes. The remains were identified in a dis-articulated skeletal assemblage from the former necropolis of Juncal (Porto de Mós, Portugal), which probably closed in the late 19th century/early 20th century. They were analysed visually and with X-radiography, and the changes carefully described prior to differential diagnosis. Six bones presented signs of healed bone trauma and one showed features compatible with leg amputation. Periosteal reactions were observed in sev...

Archaeological and Anthropological Sciences, 2015

International Journal of Osteoarchaeology, 2017

Bulletins et Mémoires de la Société d'Anthropologie de Paris, 2017

Entheseal changes have been widely used in anthropology to study activity patterns, but there is ... more Entheseal changes have been widely used in anthropology to study activity patterns, but there is an increasing awareness that ageing is associated with these changes. The aim of this study was to test each feature of the new Coimbra method for its variability, side asymmetry and its relationship with age. In addition to this, an overall relationship with age was tested for a larger sample. Males 16 and over from the Coimbra skeletal collection of historically identified individuals were recorded using the new method (N = 260). To reduce the impact of occupation, side variability in asymmetry and age were only tested in the labourers (N = 51). All occupation groups were included to test the overall relationship with age using a random forest test. The results show that scores lack variability for many of the features and entheses. Where there is side asymmetry this is typically in favour of higher scores in the right side, excepting the biceps brachii insertion. Most of the features ...

Journal of Archaeological Science: Reports, 2017

Annals of Human Biology, 2016

International Journal of Osteoarchaeology, 2016

International Journal of Paleopathology, 2016

Annals of human biology, Jan 27, 2015

The inference of the state of wealth, or poverty, from human skeletal remains is a difficult task... more The inference of the state of wealth, or poverty, from human skeletal remains is a difficult task as the limited number of skeletal changes is mediated by numerous other physiological, biomechanical and pathological events. In recent years, identified skeletal collections have become valuable resources in enabling aetiologies of these changes to be understood while controlling for some known causative factors, e.g. age, sex and occupation. This has favoured more rigorous data analysis and interpretation. This study compares the presence of osteological makers of occupation - specifically degenerative joint changes (DJC) - between socio-economically framed occupational groups whilst controlling for age-at-death. A total of 603 individuals were distributed into 7 occupational groups used as a proxy for their socio-economic status. The results demonstrated that age was a contributing factor for DJC. Differences between occupational groups were only found for the hips, right shoulder an...

La reconstruction des activités à partir de l'étude du squelette représente une part non négl... more La reconstruction des activités à partir de l'étude du squelette représente une part non négligeable de la recherche en Anthropologie biologique. L'étude des modifications des enthèses est une des approches les plus employées ces quinze dernières années, mais elle fait toujours l'objet de nombreuses critiques. Lors du Workshop "Musculoskeletal Stress Markers (MSM)” organisé en 2009 à l'Université de Coimbra, trois groupes de travail avaient été créés afin de tenter de remédier au principaux problèmes concernant la terminologie, les méthodes d'enregistrement des modifications des enthèses, et la définition des activités dans les sociétés traditionnelles et industrielles. Après une phase de travail à distance, il semblait nécessaire d'organiser un nouveau workshop afin de regrouper dans un environnement de travail propice les 11 chercheurs impliqués. Un nouveau workshop, financé par la Wenner-Gren, à donc été organisé à Coimbra en juillet 2013. Les princip...

Eighteen years ago the seminal work “The Field Guide to Joint Disease in Archaeology” was publish... more Eighteen years ago the seminal work “The Field Guide to Joint Disease in Archaeology” was published. While this provided an excellent guide at the time, rheumatology has moved on. The aim of this poster is to highlight new diagnostic concepts of importance to palaeopathology by focusing on two diseases which share common features: rheumatoid (RA) and psoriatic arthritis (PsA). These diseases are relatively common in modern clinical settings (prevalence RA ranges from 20 to 50 per 100 000 in North American and North European countries, while PsA ranges from 20 to 100 per 100 000), but rarely found archaeologically. This may be due to the older diagnostic criteria, the poor survival of the hands and feet in archaeological contexts, the association of osteoporosis with both diseases leading to poor survival of the skeleton or be a combination of these factors. Psoriatic and rheumatoid arthritis share features such as lytic lesions in the hands and the involvement of the cervical spine....

The Coimbra Method records qualitative changes at fibrocartilaginous entheses using specific feat... more The Coimbra Method records qualitative changes at fibrocartilaginous entheses using specific features scored separately at the margin and on the entheseal surface. These features include porosity (fine and macro), bone formation, erosion, and cavitations. Initial tests of interobserver error in 2010 showed overall percentage agreements around 70%, but agreement on specific features such as bone formation and fine porosity were lower (52.5% - 61.9%), and the variability between observer pairs was high (65.3-78.1%). On-line consultations between the international collaborators to refine feature definition with the aim of decreasing interobserver error rates had limited success. Percentage agreement between four observers eventually improved to 85.8% and 77.9% for the subscapularis and common extensor origin, but only after intensive in-person collaboration and discussion. Difficulties included: 1) poor representation of features using photographs for training; 2) lack of a common unde...

Forensic anthropology has played an important role in the identification of people killed and mis... more Forensic anthropology has played an important role in the identification of people killed and missing as a result of natural disasters. Due to the number and complexity of cases, the main contribution of forensic anthropology is to categorise people by narrowing them down based on bone characteristics. In this sense, activity levels and body mass index (BMI) reflected in bones add individualization characteristics that support the identification process. A sample of 24 males from Coimbra Identified Skeletal Collection (CEIMA), aged between 19 and 25 were selected. Body Mass Index (Ruff 1991) and cross-sectional properties of the femur (Wescott 2006) were estimated and analyzed to detemine the relationship between activity levels and BMI of individuals. Four entheseal changes were recorded using the Villotte absence and presence method (Villotte et al. 2010): semimbranosus origin, iliopsoas, triceps surae insertions and plantar fascia origin. The evidence demonstrates that the lower ...

International Journal of Osteoarchaeology, 2016

International journal of paleopathology, Mar 1, 2018

Archaeological and Anthropological Sciences, 2015

International Journal of Osteoarchaeology, 2017

Bulletins et Mémoires de la Société d'Anthropologie de Paris, 2017

Journal of Archaeological Science: Reports, 2017

Annals of Human Biology, 2016

International Journal of Osteoarchaeology, 2016

International Journal of Paleopathology, 2016

Annals of human biology, Jan 27, 2015

International Journal of Osteoarchaeology, 2016

BABAO Annual Conference, 2019

Entheseal change (EC) morphology has been used within bioarchaeology to reconstruct behaviours of... more Entheseal change (EC) morphology has been used within bioarchaeology to reconstruct behaviours of past peoples but ECs are known to have a complex and multifactorial aetiology. Research on identified collections requires documented occupation, but females are often excluded due to the use of non-specific terms. This study of 90 female and male skeletons dating from the medieval period (11th-16th centuries) in Edinburgh, Scotland explores skeletal changes associated with occupational activities. The research incorporates the socioeconomic history of medieval women and takes a broad approach to the analysis of occupation and activity in archaeological collections by including palaeopathological diagnosis, age, the new Coimbra Method for EC scoring, asymmetry, and biomechanics. Preliminary results confirm higher Coimbra EC scores with increased age over 50 and the lowest EC scores for individuals under 30. While scores are higher in males, females have similar prevalence rates. Of those with right/left asymmetry, females had higher EC scores on the right while males were higher on the left. The true prevalence rate (TPR) for ECs and degenerative joint changes were significantly similar at only one joint and otherwise, there was no association between the two sets of scores. Future research directions involve increasing the sample size to 250, cross-sectional analysis of 3D scanned humeri, and a biomechanical case study with living volunteers performing one historic occupational activity. This research can help us to better understand the complex aetiology of ECs and is developing approaches to study females, unknown skeletal collections, and the biomechanics of archaeological activity.

Presented at AAPA 2019, 2019

Entheseal change (EC) morphology has been used within bioarchaeology to reconstruct behaviors of ... more Entheseal change (EC) morphology has been used within bioarchaeology to reconstruct behaviors of past peoples but ECs are known to have a complex and multifactorial etiology. Research on identified collections requires documented occupation, but females are often excluded due to the use of non-specific terms.
This study of 102 male and female skeletons dating from the medieval period (1130-1560) in Edinburgh, Scotland explores skeletal changes associated with a number of occupational activities. The research incorporates the socioeconomic history of medieval women and takes a broad approach to the analysis of occupation and activity by including paleopathological diagnosis, age, the new Coimbra Method EC scoring, and biomechanics. Preliminary results confirm higher Coimbra EC scores with increased age over 50 and with degenerative joint changes. While scores are higher in males, females have similar prevalence rates. Results also show that conditions such as leprosy, tuberculosis, or severe genu valgus are associated with lower EC scores in both males and females which implies a potentially lower level of activity for those with some chronic or debilitating conditions when compared to individuals of similar age and within the same population. Future research directions involve increasing sample size to 250, cross-sectional analysis of 3D scanned humeri, and a biomechanical case study with living volunteers performing one historic occupational activity. This research can help us to better understand the complex etiology of ECs and is developing approaches to study females, unknown skeletal collections, and the biomechanics of archaeological activity.

Objectives: To test the impact of bone mineral density and metacarpal cortical index on entheseal... more Objectives: To test the impact of bone mineral density and metacarpal cortical index on entheseal changes in the rotator cuff. These changes, visible on dry bone, are known increase in frequency with age: this ageing effect may be linked to lower bone mineral density.

To determine whether manual labour reduces risk of osteoporosis, by increasing maximal bone mineral density.

Methods: Male skeletons from the Coimbra identified skeletal aged 20+ at death were recorded for entheseal change presence using the new Coimbra method for recording (n=249). These skeletons have known sex, age-at-death, cause of death and occupation and lived between 1826-1938. Occupations were categorised as: heavy manual, manual, non-manual and soldiers following standard methods. Radiogrammetry in a subset of these individuals (n=147) was used to calculate the second metacarpal cortical index. In a smaller subset (n=126) bone mineral density was measured in the left proximal femur using dual x-ray absorptiometry at several sites (dry rice surrounding the bone was used as a soft tissue substitute).

Results: Logistic regression showed no effect (p<0.05) of occupation on total bone mineral density, bone mineral density at the femoral neck or metacarpal cortical index. Total bone mineral density was found to have an effect on some types of entheseal change presence, but this was not statistically significant when age was taken into account. Metacarpal cortical index was found to have a minimal impact on some entheseal changes: mineralisation (Chi2=4.65, p=0.03, df=-1, Nagelkerke pseudo R2=0.06) and erosions (Chi2 =7.46 , p=0.006, df=-1, Nagelkerke pseudo R2=0.09) even when age was taken into account.

Conclusions: Occupation was expected to have an impact on bone mineral density and many of the individuals in this study undertook heavy manual labour. The fact that this showed no effect may be due to socio-economic factors, such as poor nutrition. It is possible that rotator cuff entheseal changes, particularly erosions may be impacted by localised low bone mineral density not captured by this study. Further research is needed to study the relationship between osteoporosis and cross-sectional geometry, which may be a better indicator of loading than occupation.

Funding: Fundação para a Ciência e a Tecnologia SFRH/BPD/82559/2011, SFRH/BPD/74015/2010.

El objetivo de este trabajo es analizar la frecuencia de cambios entesiales en una muestra del si... more El objetivo de este trabajo es analizar la frecuencia de cambios entesiales en una muestra del sitio Rua dos Barcos, y su posible relación con la actividad física. El sitio se encuentra en la freguesia de Santa Iria da Ribeira de Santarém (Portugal), y fue excavado en 2003. Se recuperaron un total de 144 esqueletos correspondientes al período medieval. Los cambios entesiales se registraron en 87 individuos, pero sólo aquellos con sexo y edad se consideraron para el presente análisis, resultando así en una muestra final de 71. Se registraron once entesis en los miembros superiores e inferiores, en ambos lados, usando el nuevo método Coimbra para el registro de entesis (Henderson et al. 2015). Los resultados muestran frecuencias algo más altas para los individuos masculinos, especialmente en los miembros inferiores. En el grupo de adultos mayores se observa una tendencia similar. Finalmente, los valores altos también se relacionan con la formación ósea en las zonas 1 y 2 de la mayoría de las entesis. Estos resultados indican que los cambios no pueden ser asociados exclusivamente a las actividades físicas, y además es necesario considerar los diferentes tamaños muestrales para cada entesis registrada.

Directional asymmetry is widely found in humans. In the case of the attachments of the musculoske... more Directional asymmetry is widely found in humans. In the case of the attachments of the musculoskeletal soft tissues to bone, the entheses, asymmetry in entheseal change (EC) presence has been interpreted as indicative of asymmetric muscle usage. Previous studies have shown that there is variation in enthesis area. The aim of this presentation is to study directional asymmetry for enthesis area (standardised by body size) in relation to occupation.

The enthesis size of skeletons from the identified skeletal collection in Coimbra were measured along two chords meeting bisecting perpendicularly at the midpoint of the enthesis. These chord measurements were multiplied together and divided by local joint size to standardise for body size directional asymmetry was calculated. Occupations were categorised as per previously published methods into four categories: heavy manual, manual, nonmanual and soldier. ANOVAs were used to study differences in directional asymmetry with occupation.

Directional asymmetry shows less variability between occupations than was expected. The relationship between enthesis size and muscle cross-sectional area, which is a direct indicator of strength, is still not understood, nor is the development of the enthesis in relation to soft tissue thickness.

Introduction: The size of entheses is known to be affected by the presence of entheseal changes (... more Introduction: The size of entheses is known to be affected by the presence of entheseal changes (ECs) and bone- forming diseases, e.g. diffuse idiopathic skeletal hyperostosis. The aim of this presentation is to study the relationship between enthesis size (as standardised by joint size), EC and occupation. The hypothesis is that heavy manual workers have the largest entheses.

Materials and methods: All male skeletons from the Coimbra identified skeletal collection were recorded using three recording methods: Villotte (presence and absence), the new Coimbra recording methods and entheses were measured in two axes at 90 degrees to each other. These chords were multiplied together to approximate area and divided by joint size (e.g. vertical humeral head) using the measurement of the joint upon which they act to standardise body size. Occupations were categorised into non-manual, manual, heavy manual and soldiers. Bone-formers were excluded from analysis. Three rotator cuff entheses were recorded.

Results: Only the left infraspinatus showed differences between occupations when all entheses were included. For entheses with no EC only the right subscapularis supported the hypothesis. Area was typically larger for individuals with erosions, cavitations and bone formation in any zone, but smaller for those with textural change, fine porosity and macropores. These relationships are maintained even when entheses with bone formation in either zone are excluded.

Discussion and Conclusions: Standardised enthesis area was not found to have a relationship with occupation categories. Fibrocartilaginous enthesis size seems to match cross-sectional growth trends of muscles during adolescence, but cease to increase in size once local epiphyses have fused. New bone growth around the margins of entheses does increase the footprint size, but this does not explain the size differences for other changes. In vivo research is needed to interpret the relationship between soft and hard tissues.

Introduction: The aim of this work is to study the changes in entheseal change frequency through ... more Introduction: The aim of this work is to study the changes in entheseal change frequency through time in Portugal to assess the effect of increased urbanisation and industrialisation. Previous research has found that agriculturalists have the lowest frequency of entheseal changes in the past, with hunter-gatherers the second highest and those living in an industrial setting having the highest frequencies. However, this study was a meta-analysis of previously published papers and was subject to several limiting factors, such as inter-observer error. But more seriously, the method used to record entheseal changes was not biologically appropriate. This study therefore aims to address these issues by using a newly devised biologically appropriate recording method, and using one observer to record all entheseal changes.

Materials and Methods: To achieve this aim one researcher recorded eleven entheses (upper and lower limb), in right and left sides, using the new Coimbra method for recording entheses (Henderson et al., 2015). Eight archaeological sites were recorded; these were predominantly medieval (due to preservation issues), different socio-economic status sites, and with different economic practices.

Results: The results show that different sites have very different profiles of frequencies of each feature. Trends in the upper limb are more disparate than in the lower limb, with the triceps surae enthesis having the most consistent pattern of changes between sites.

Discussion and Conclusions: Activity is not the only explanatory factor in these results, different age and sex profiles contributing to the different trends. Small sample sizes in the individual sites also contribute to high frequencies of some changes. However, this approach is vital to understand temporal trends in entheseal changes.

Introduction: Jurmain (1999) proposed that models should be created to test the relationship betw... more Introduction: Jurmain (1999) proposed that models should be created to test the relationship between activities and their skeletal markers. The aim of this study was to use a model generated from clinical literature contemporaneous to the sample and to test its associations with skeletal changes. For this purpose, the activity tested was sewing.

Materials and Methods: The sample (n=21), selected from the Coimbra identified skeletal collection, consists of seamstresses, shoemakers and tailors, and an age and sex matched control sample of equal number. The indicators recorded were entheseal changes, degenerative joint changes, markers of occupational stress (MOS) and robusticity index (RI). The model suggests changes in the dominant side related to repetitive circular and pedalling movements associated with sewing, alongside changes associated with a hunched posture. Descriptive and inferential statistics were used to analyse bilateral asymmetry (Wilcoxon test) and the association of the indicators with occupation, age at death, sex and RI (Fisher’s exact test).

Results: Little association was found between occupation and the indicators, rather age at death and sex was more important. Bilateral asymmetry was rarely found. Specific MOS related to sewing were found in the control sample, thus the model is not supported. There was an almost non-existent association between the indicators and RI.

Discussion and Conclusions: No clear association was found between occupation and the indicators, contradicting the model. Age had a stronger association, suggesting that occupation itself is not a determining factor, whereas age and sex are. The model created is not effective or viable, since few differences were found between the samples. The use of both left and right sides in the tasks performed could explain the results of bilateral asymmetry. Similar studies, applied to a larger sample size, are needed to better understand the occupation factor in the development of the indicators.

Introduction: Activity-patterns, not specifically occupation, have been widely studied using chan... more Introduction: Activity-patterns, not specifically occupation, have been widely studied using changes to the bony imprints of tendons on bone (entheses). However, it has been demonstrated that ageing has the strongest effect on the presence of these entheseal changes (ECs). In a prior test of the Coimbra method for recording ECs, the clear detection of age effects was problematic due to the small sample size (n=31) and low variability in ECs (Henderson et al., 2013). The method has recently been revised and the aim of this study is to test the effects of age on ECs scored with the “new Coimbra method” (Henderson et al., 2015) using a larger sample.

Materials and Methods: Labourers, the largest single occupation group represented (n=60) in the Coimbra collection, were recorded using the “new Coimbra method” ( ibid.). Age ranged from 16 to 96 and all were male. Three entheses were recorded: subscapularis and biceps brachii insertions, and the common extensor origin. Boxplots were used to visualise the data. Asymmetry and the effect of age were calculated (Henderson et al., 2013).

Results: Mean values of age for each feature score indicate an increase in age for higher scores, except for fine porosity and textural change, which show the opposite trend. Mean ages are more dispersed on the right side, compared to the left. Asymmetry tests for the labourers indicate that the majority have equal scores for features on the right and left sides.

Discussion and Conclusions: Age is the most important factor in increasing scores for bone formation, erosion and macropores, whereas fine porosity and textural change are most commonly found in younger individuals. Sample size is still small, given the large number of features recorded for each enthesis and lack of variability in the scores. Larger samples are needed to understand the relationship between EC features and age.

Introduction: Individualization of human remains in forensic or archaeological contexts in mass b... more Introduction: Individualization of human remains in forensic or archaeological contexts in mass burials is one of the first challenges that must be resolved by bone analysis. The in-situ characteristics of remains provide the primary evidence that researchers rely upon to achieve individualization. However, some cases require intensive laboratory analysis in which skeletal features are examined for individualization. It has been established that entheseal changes (EC) are related with ageing, sex hormones, body size, and biomechanical load. Except for the latter, all the other factors are systemic. Biomechanical loads, caused by occupation and other activities, could have asymmetrical effects on EC, especially in upper limbs. This study focuses on the analysis of the characteristics of the entheses, namely size and changes, to determine their potential use within the individualization process.

Materials and Methods: A sample of males from the identified skeletal collection of the University of Antioquia, between 20 and 53 years old at time of death were selected. The maximum length of y-axis and x-axis of 24 fibrocartilaginous entheses were measured to the nearest 0.1 mm. EC were recorded using the new Coimbra method. Size and EC were recorded and analysed to estimate symmetry and likeness between right and left side.

Results: General trends suggest that biceps brachii, iliopsoas, quadriceps femoris, vastus lateralis and triceps surae show the most symmetric size between right and left side. Triceps brachii, semitendinosus, semimembranosus, iliopsoas, vastus lateralis and triceps surae evidenced the greatest visual similarities between sides.

Discussion and Conclusions: The aim of this analysis was to test the similarities in size and EC between sides. The evidence demonstrates that iliopsoas, vastus lateralis, and triceps surae are the entheses that show the most similar sizes and morphological characteristics between sides, which could potentially be used in the individualization process.

A previous meta-analysis of entheseal changes (EC, previously called musculoskeletal stress marke... more A previous meta-analysis of entheseal changes (EC, previously called musculoskeletal stress markers) demonstrated that the subsistence strategy with the lowest scores for EC were agriculturalists (Henderson 2013). This was surprising given that our bodies should be best adapted, through evolution, to a hunter-gatherer lifestyle. A recent study demonstrated that agonist/antagonist enthesis pairs show that one enthesis has a tendency to have a higher frequency than its “opposer” (Villotte et al. 2014). The aim of this study was to undertake a meta-analysis of published data to test this for a wide range of sites and entheses.

This updated meta-analysis used all papers, dissertations and theses found using a search in GoogleScholar presenting scored data using any method for recording EC in the upper limb. Over 160 papers were found, but the majority were either irrelevant, or did not present data appropriately. Only 31 papers could be included. Six agonist/antagonist pairs of entheses were utilised.

Results demonstrate that there are general trends for one enthesis to have a higher frequency of EC than its “opposer”. However, reversals in trends occur: more commonly in the hunter-gatherer populations than in the agricultural samples (OR 2.4) and only one reversal in the industrial sample. Males exhibited more reversals than females. Site specific comparisons demonstrated differences in trends through time at some sites (e.g. Chapman 1997).

Studying relationships between agonist and antagonist pairs shows promise for future studies of activity-patterns using entheses. Currently meta-analyses are limited by the lack of reporting standards for EC.

Identified human skeletal collections and their associated obituary records are useful sources to... more Identified human skeletal collections and their associated obituary records are useful sources to test many bioarchaeological research questions. However, the documentary evidence available does not necessarily assist in the identification of economic variables, particularly the identification of poverty. These collections do provide evidence of occupation and this can be used as a proxy for economic status, particularly when associated with known area of abode based on the assumption that spatial inequalities are synonymous with differential housing conditions. The aim of this study is to use both occupation and area of abode to compare the presence of entheseal changes (ECs) between those inferred to live in poverty and higher status individuals. The hypothesis will be that those identified as living in poorer circumstances will have more ECs due to heavier, repetitive, workloads and inadequate nutrition when compared to higher status individuals. The research was conducted in ninety-nine males (7-36 years old) from the Coimbra identified skeletal collection and the ECs recorded using the new Coimbra method. No difference in presence of ECs could be found between the two samples. However, the majority of the individuals in this sample died from tuberculosis. The muscle wasting associated with this chronic disease, may have had a role to play in the individuals' ability to undertake heavy manual labour and in the development of the ECs themselves. Place of abode bore no relation to occupation.

The idea that entheseal changes (ECs) are the result of repetitive physical movements has been th... more The idea that entheseal changes (ECs) are the result of repetitive physical movements has been the theoretical basis (Benjamin et al. 2006) for inference of activities in ancient populations. However, it has been possible to demonstrate that there are additional factors as the age and sex involved in bone response to biomechanical loads (Jurmain et al. 2012). Furthermore, Henderson (2013) proposes that one of the main factors involved in the expression of ECs may be related to the level of adaptation to loading of the musculoskeletal system, such that better adaptation to biomechanical load leads to a lower frequency of ECs. In this sense it is possible that the expression of EC may be related to an overload and not the biomechanical load itself (if within in an individual’s physiological limits for repetition and force). This meta-analysis relates to the assumption that individuals who inhabited mountainous terrain often have lower EC in relation to those living in the plains because their regular capacity (defined during skeletal development) is increased and therefore there is less likely to be overloading. Publications which used presence/absence of EC and differentiated the male and female individuals were chosen as these were most numerous (fewer than 6% of papers read could be used). Entheses are only used which have an acceptable sample size: ischial tuberosity, greater trochanter, iliopsoas, linea aspera, patella tendon, plantar fascia, quadriceps femoris, soleus, and triceps surae. Odds ratios, and their p-values (95%), were calculated to compare hilly (used as the control) and flat terrain.

The results show seven ECs with a statistically signifi cant difference. Higher frequencies in the plains for females: greater trochanter, iliopsoas, linea aspera, patella tendon, soleus and triceps surae; while four were found for males, but the direction of difference was not uniform with quadriceps femoris and triceps surae having higher frequencies in hilly terrain and the greater trochanter and linea aspera in the plains.

In human remains, studies of subsistence strategies and task division of labour has focussed on a... more In human remains, studies of subsistence strategies and task division of labour has focussed on assessing changes to tendon attachments on the skeleton, i.e. entheseal changes (EC). The aim of this study is to compare the ratio of changes between agonist and antagonist muscle pairs of the upper limb to test whether different subsistence strategies can be identified. The hypothesis is that where labour is non-intensive the agonist and antagonist scores will be equal and where harder labour is performed this will result in greater imbalance. However, there are a number of limitations which must be considered when interpreting these results, including the multi-factorial aetiology of EC.

Data were collated from papers published since 1995. Methods for recording entheses differ as do reporting methods. Ratios were calculated by recording method. These ratios were compared to those from identified skeletons with known occupations. The agriculturalists have ratios demonstrating stronger muscle use in one direction, while the hunter-gatherers generally have a more even distribution, for those papers where mean score is presented, but the picture is less clear where percentage EC presence is presented, where these are closer to one on the right side, compared to the left.

In conclusion the results are conflicting and are dependent on reporting method (mean score or percent) as well as subsistence strategy. Furthermore the non-manual workers, on the left side, have the greatest ratios, indicating that these ratios are not directly indicative of overall workload. This is unsurprising given their multifactorial aetiology.

Research has found that entheses size is affected by the presence of entheseal changes (ECs), not... more Research has found that entheses size is affected by the presence of entheseal changes (ECs), notably that entheses with bone formation are larger than normal [1]. The aim of this study is to test whether this is the same for all features of ECs described by the new Coimbra method [2]. Only skeletons (male) aged 7 to 35 were recorded to remove the effect of ageing. Identified skeletons from Coimbra (n=98, age mean=25.5, sd=6.64) were recorded using previously described methods [1,2 ]. The entheses recorded were the supra- and infraspinatus and subscapularis. Wilcoxon rank sum test was used to test whether differences in size were statistically significant (p<0.05) results were plotted using boxplots to check for outliers. The results indicate that the size of entheses (even when standardised by joint size) with any type of EC is larger than in normal entheses. Chord measurements of the enthesis do not take into account actual surface size but provide an approximation. Bone formation in both zones 1 and 2 of the enthesis can affect the outline of the enthesis but other changes, e.g. pores, do not. The association between size, force distribution and ECs requires further study to interpret these results.

This research was funded by Fundação para a Ciência e a Tecnologia grant SFRH/BPD/82559/2011.

References
[1] Henderson CY (2013) Technical note: Quantifying size and shape of entheses. Anthropological Science 121:63-73. DOI: 10.1537/ase.121017.
[2] Wilczak CA, Henderson C, Mariotti V, Pany-Kucera D, and Villotte S (2014) Meet me in Coimbra: An international saga of interobserver error rates. American Association of Physical Anthropology, pp. 272-272.

Entheseal changes (ECs) occur at the interface of the soft and hard tissues where the muscles tra... more Entheseal changes (ECs) occur at the interface of the soft and hard tissues where the muscles transfer their energy to the skeleton and have, consequently, been used to infer activity patterns in past populations. However, the relationship between fibrocartilaginous entheses, development and activity pattern is still poorly understood. The aim of this research is to categorise the variety of changes and size of entheses in relation to puberty and activity-patterns in individuals. Hypothesis: ECs in the upper limb will be most prevalent in the post-pubescent manual workers and these entheses will be larger than the those who died during puberty.

Methods: New Coimbra method, measurements of entheses alongside a method to record puberty were used to record males aged 35 and under in the Coimbra identified skeletal collection (n=99). Results: All types of entheseal changes are seen in those who died during the growth spurt, dependent on enthesis and side. The size of rotator cuff entheses is larger in those performing heavy manual labour in both the growth spurt and post-pubescent groups, but is reversed for most other entheses. Overall most entheses are larger in the post-pubescent. Discussion: The results indicate the need to question the assumptions that activity-patterns and the ageing process are the causes of EC and further study the growth and development of these structures. Most importantly it highlights the need to consider each enthesis and type of change separately rather than ranking ECs by enthesis to study which muscles were most commonly used.

This article presents a consensus terminology for entheseal changes that was developed in English... more This article presents a consensus terminology for entheseal changes that was developed in English by an international team of scholars and then translated into French, Italian, Portuguese, Spanish and German. Use of a standard, neutral terminology to describe entheseal morphology will reduce misunderstandings between researchers, improve the reliability of comparisons between studies, and eliminate unwarranted etiological assumptions inherent in some of the descriptive terms presently used in the literature.

6th - 8th of July, 2016. Department of Life Sciences, University of Coimbra. The aim of this i... more 6th - 8th of July, 2016. Department of Life Sciences, University of Coimbra.

The aim of this interdisciplinary conference is to bring together researchers interested in disease, injury and other effects of occupations (in the broadest sense) on the human skeleton to improve the interpretation of these changes in archaeological and forensic contexts.
Why Occupational Health?

Identifying occupation, task division and activity-patterns from skeletal remains past populations and using this to assist forensic identification, has been an alluring prospect in bioarchaeology from its earliest inceptions. Some occupation identification can be made by pathognomonic changes, e.g. “phossy jaw” which was characteristic of those working with white phosphorous in the matchstick industry, however, the majority of skeletal changes cannot be ascribed to a single task or occupation, e.g. entheseal changes or cross-sectional geometry. Recent research has highlighted that the multifactorial aetiology of many skeletal changes previously used to identify activity-patterns cannot be applied simplistically.
Conference Content

This conference will build on recent advances in related fields to provide a direction for future research on using skeletal changes to identify occupations (and activity-patterns) based on what is currently known. Abstracts are invited on a diverse range of approaches including: palaeopathology, biomechanics, ethnography, modern medicine, forensic science, archaeology, socio-cultural
Deadlines

The deadline for abstracts is the end of February and for early registration, is the 3rd of April.

Differential diagnosis is a fundamental step in every paleopathological study. It is a challengin... more Differential diagnosis is a fundamental step in every paleopathological study. It is a challenging exercise since many extrinsic and intrinsic factors may negatively impact the accurate interpretation of bone changes in human skeletal remains. Among them, one may stress the limited range of bone tissue response to injury and disease, as well as the possible lack of completeness and preservation of the skeletal remains. This study aims to explore the limits of differential diagnosis in the analysis of fragmentary bone pieces. The sample consists of eleven adult long-bone specimens with exuberant changes. The specimens were identified in a non-articulated skeletal assemblage from the former necropolis of Juncal (Porto de Mós, Portugal), which probably ended functions in the late 19th century/early 20th century. The bone specimens were analysed through visual inspection and conventional X-radiography, and the changes carefully described prior to differential diagnosis. Five specimens presented signs of healed bone trauma (i.e., fracture) and one showed traits of a leg amputation. Periosteal lesions were observed in three bone pieces, one of them resembling an overlying skin ulcer. Two bone specimens were identified as belonging to the same individual due to the matching bone changes. Despite the incomplete remains, a broader diagnosis was possible for most cases, aided by the type and exuberance of the lesions. However, a differential diagnosis on the etiology of the changes is unattainable since we only have access to single bones rather than complete skeletons.