Changing the narrative in diagnosis and management of pain in the sacroiliac joint area

The sacroiliac joint (SIJ) is often considered to be involved when people present for care with low back pain where the sacroiliac joint (SIJ) is located. However, determining why the pain has arisen can be challenging, especially in the absence of a specific cause such as pregnancy, disease, or trauma, where the SIJ may be identified as a source of symptoms with the help of manual clinical tests. Nonspecific SIJ-related pain is commonly suggested to be causally associated with movement problems in the sacroiliac joint(s); a diagnosis traditionally derived from manual assessment of movements of the SIJ complex. Management choices often consist of patient education, manual treatment, and exercise. Although some elements of management are consistent with guidelines, this perspective argues that the assumptions on which these diagnoses and treatments are based are problematic, particularly if they reinforce unhelpful, pathoanatomical beliefs. This article reviews the evidence regarding the clinical detection and diagnosis of SIJ movement dysfunction. In particular, it questions the continued use of assessing movement dysfunction despite mounting evidence undermining the biological plausibility and subsequent treatment paradigms based on such diagnoses. Clinicians are encouraged to align their assessment methods and explanatory models to contemporary science to reduce the risk of their diagnoses and choice of intervention negatively affecting clinical outcome

The pervasive and multifaceted influence of biocrusts on water in the world's drylands

The capture and use of water are critically important in drylands, which collectively constitute Earth's largest biome. Drylands will likely experience lower and more unreliable rainfall as climatic conditions change over the next century. Dryland soils support a rich community of microphytic organisms (biocrusts), which are critically important because they regulate the delivery and retention of water. Yet despite their hydrological significance, a global synthesis of their effects on hydrology is lacking. We synthesized 2,997 observations from 109 publications to explore how biocrusts affected five hydrological processes (times to ponding and runoff, early [sorptivity] and final [infiltration] stages of water flow into soil, and the rate or volume of runoff) and two hydrological outcomes (moisture storage, sediment production). We found that increasing biocrust cover reduced the time for water to pond on the surface (−40%) and commence runoff (−33%), and reduced infiltration (−34%) and sediment production (−68%). Greater biocrust cover had no significant effect on sorptivity or runoff rate/amount, but increased moisture storage (+14%). Infiltration declined most (−56%) at fine scales, and moisture storage was greatest (+36%) at large scales. Effects of biocrust type (cyanobacteria, lichen, moss, mixed), soil texture (sand, loam, clay), and climatic zone (arid, semiarid, dry subhumid) were nuanced. Our synthesis provides novel insights into the magnitude, processes, and contexts of biocrust effects in drylands. This information is critical to improve our capacity to manage dwindling dryland water supplies as Earth becomes hotter and drier.This work was conducted as part of the Powell Working Group “Completing the dryland puzzle: creating a predictive framework for biological soil crust function and response to climate change” supported by the John Wesley Powell Center for Analysis and Synthesis, funded by the US Geological Survey. J.B. and S.R. were funded by USGS Ecosystems and Land Use Change Mission Areas, by the US Department of Energy (DESC-0008168), and by the Strategic Environmental Research and Development Program (RC18-1322). J.D. is supported by grants from the Holsworth Wildlife Research Endowment & The Ecological Society of Australia, and a scholarship from China Scholarship Council (No. 201706040073). B.C. is supported by grants from the National Science Foundation (award DEB-1844531) and DePaul University. M.A.B. is supported by a grant from the National Science Foundation (award DEB-1638966). B.W. was supported by the Max Planck Society and a Paul Crutzen Nobel Laureate Fellowship. E.H.-S. was supported by CONACYT grant 251388 B. F.T.M. was supported by the European Research Council (ERC grant agreement 647038 [BIODESERT]) and Generalitat Valenciana (CIDEGENT/2018/041)

'Going the extra mile' for older people with dementia: Exploring the voluntary labour of homecare workers.

Homecare workers provide essential physical, social and emotional support to growing numbers of older people with dementia in the UK. Although it is acknowledged that the work can sometimes be demanding, some homecare workers regularly 'go the extra mile' for service users, working above and beyond the usual remit of the job. This form of voluntarism has been interpreted as an expression of an essentially caring nature, but also as the product of a work environment structured to tacitly endorse the provision of unpaid labour. This paper draws on a qualitative study of what constitutes 'good' homecare for older people with dementia. Using homecare workers' reflexive diaries ( n = 11) and interviews with homecare workers ( n = 14) and managers ( n = 6), we explore manifestations of, and motivations for, homecare workers going the extra mile in their everyday work. We describe three modes of voluntary labour based on these accounts which we characterise as affective, performative and pragmatic. Our study highlights the complex relationships between job satisfaction, social benefit and commercial gain in the homecare work sector. Further research is needed to define the full range of affective and technical skills necessary to deliver good homecare, and to ensure that homecare work is appropriately credited

Using a Reflective Diary Method to Investigate the Experiences of Paid Home Care Workers Caring for People With Dementia

This article reports on the use of an innovative reflective diary method with paid home care workers caring for people with dementia. It examines the key features of the diary design, recruitment and training of participants, diarists’ approaches and responses to diary-keeping, and evaluates the use of diaries in this context. Following training, 11 volunteers (all female) employed by a U.K.-based home care organization kept diaries of their experiences of caring for those with dementia. Using specially designed diaries, they wrote about their visits to clients for a period of approximately 4 months and were remunerated for up to 16 extra hours at their usual hourly rate of pay. Overall, home care workers engaged well with the process, keeping regular, lengthy, timely, and reflective diary entries. Diary-keeping provided a means for these workers to express their emotions about their work, while enhancing their self-insight and care practices. We demonstrate the feasibility of diaries for research with this occupational group and conclude that the written reflexivity employed in diaries can document, enrich, and improve the work of these caregivers

Accommodating Dynamic Oceanographic Processes and Pelagic Biodiversity in Marine Conservation Planning

Pelagic ecosystems support a significant and vital component of the ocean's productivity and biodiversity. They are also heavily exploited and, as a result, are the focus of numerous spatial planning initiatives. Over the past decade, there has been increasing enthusiasm for protected areas as a tool for pelagic conservation, however, few have been implemented. Here we demonstrate an approach to plan protected areas that address the physical and biological dynamics typical of the pelagic realm. Specifically, we provide an example of an approach to planning protected areas that integrates pelagic and benthic conservation in the southern Benguela and Agulhas Bank ecosystems off South Africa. Our aim was to represent species of importance to fisheries and species of conservation concern within protected areas. In addition to representation, we ensured that protected areas were designed to consider pelagic dynamics, characterized from time-series data on key oceanographic processes, together with data on the abundance of small pelagic fishes. We found that, to have the highest likelihood of reaching conservation targets, protected area selection should be based on time-specific data rather than data averaged across time. More generally, we argue that innovative methods are needed to conserve ephemeral and dynamic pelagic biodiversity

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Data from: Livestock grazing reinforces the competitive exclusion of small-bodied birds by large aggressive birds

1.Grazing by domestic livestock is sometimes promoted as a management tool to benefit biodiversity. In many situations, however, it can produce negative outcomes. 2.Here we examine the impacts of recent and historic livestock grazing on bird communities in the semi-arid woodlands in eastern Australia, testing the notion that grazing removes the suppressive effect of structurally complex vegetation on miners, thereby reducing the richness and abundance of small birds. 3.We used time- and area-limited searches of 108 sites varying in livestock grazing history and intensity, to explore the direct and indirect effects of grazing, habitat complexity and the abundance of aggressive, large-bodied birds on smaller-bodied birds using two-way analysis of variance and structural equation modelling. 4.Small birds were less abundant and had lower richness in the presence of miners. Our structural equation models indicated that recent grazing had direct suppressive effects on the abundance of miners, and both richness and abundance of all but the largest-bodied bird groups. However, higher levels of historic livestock grazing reinforced the competitive exclusion of the six small-bodied bird groups (insectivores, nectarivores, declining woodland birds, small ground foraging birds, all small birds, all non-miners) by aggressive miners via reductions in habitat complexity. Moreover, the strength of any suppressive effects on small birds or positive effects on large birds by miners increased with increasing miner abundance. 5.Synthesis and applications. Our results highlight the importance of vegetation structural complexity, not only for providing habitat for woodland birds, but as barriers to the invasion and competitive dominance of miners. Our findings suggest that management actions aimed at reducing tree and shrub density to promote open woodlands are likely to have significant negative consequences for the conservation of small woodland birds

Contrasting effects of aridity and grazing intensity on multiple ecosystem functions and services in Australian woodlands

Global change is expected to reduce the provision of multiple ecosystem services in drylands, the largest biome on Earth. Understanding the relative importance of climate change and overgrazing on ecosystems services is critical for predicting the effects of global change on ecosystem well-being. We generated a system-level understanding of the effects of climate (aridity intensity) and land use intensification (herbivore grazing intensity) on four regulating ecosystem services (C-storage, N-availability and P-availability, and organic matter decomposition) and one provisioning service (plant production) in wooded drylands from eastern Australia. Climate change and grazing intensity had different effects on multiple ecosystem services. Increasing aridity from 0·19 (dry subhumid) to 0·63 (arid) had consistent suppressive effects on C-storage, N-availability, decomposition and plant biomass services, but not on P-availability. The magnitude of these suppressive effects was greater than any effects due to grazing. All sites showed evidence of kangaroo grazing, but the heaviest grazing was due to cattle (dung: range 0–4545 kg ha−1; mean 142 kg ha−1). Any effects of grazing on ecosystem services were herbivore specific and ranged from positive to neutral or negative. Sheep, and to a lesser extent cattle, were associated with greater N-availability. Rabbits, however, had a greater effect on P-availability than aridity. Our study suggests that increases in livestock grazing may fail to sustain ecosystem services because of the generally stronger negative effect of increasing aridity on most ecosystem services in our model dryland. These services are likely therefore to decline with global increases in aridity. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd

Multiple trade-offs regulate the effects of woody plant removal on biodiversity and ecosystem functions in global rangelands

Woody plant encroachment is a major land management issue. Woody removal often aims to restore the original grassy ecosystem, but few studies have assessed the role of woody removal on ecosystem functions and biodiversity at global scales. We collected data from 140 global studies and evaluated how different woody plant removal methods affected biodiversity (plant and animal diversity) and ecosystem functions (plant production, hydrological function, soil carbon) across global rangelands. Our results indicate that the impact of removal is strongly context dependent, varying with the specific response variable, removal method, and traits of the target species. Over all treatments, woody plant removal increased grass biomass and total groundstorey diversity. Physical and chemical removal methods increased grass biomass and total groundstorey biomass (i.e., non-woody plants, including grass biomass), but burning reduced animal diversity. The impact of different treatment methods declined with time since removal, particularly for total groundstorey biomass. Removing pyramid-shaped woody plants increased total groundstorey biomass and hydrological function but reduced total groundstorey diversity. Environmental context (e.g., aridity and soil texture) indirectly controlled the effect of removal on biomass and biodiversity by influencing plant traits such as plant shape, allelopathic, or roots types. Our study demonstrates that a one-size-fits-all approach to woody plant removal is not appropriate, and that consideration of woody plant identity, removal method, and environmental context is critical for optimizing removal outcomes. Applying this knowledge is fundamental for maintaining diverse and functional rangeland ecosystems as we move toward a drier and more variable climate

Grazing and aridity have contrasting effects on the functional and taxonomic diversity of ants

Ants are one of the most abundant and ubiquitous organisms on Earth and play critical roles in multiple ecosystem services such as seed dispersal and nutrient cycling. Despite this, the effects of climatic and land use stressors on particular species or groups of ants are poorly known. We conducted a regional field survey across 108 locations in south-eastern Australia, using correlation network analysis and structural equation modelling to identify how ants respond to environmental stressors. We found contrasting relationships amongst ants, and aridity, and vertebrate grazing intensity and history. Increasing aridity was associated with reduced ant richness, whereas increasing grazing intensity was associated with greater ant richness directly, and indirectly, via reductions in litter depth and perennial grass density. However, these taxonomically diverse groups of ant species still shared contrasting responses to increasing aridity and grazing intensity. We found strong associations between grazing, aridity and the abundance of Seed Harvesters, weak indirect relationships with Generalist Foragers, but no relationships for Predators or Sugar Feeders. Taken together, our work identifies contrasting relationships amongst grazing, aridity and ants (ant ‘winners’ or ‘losers’) across contrasting ecological contexts. Given that increasing aridity is generally associated with lower grazing intensity, our results suggest that locations with more arid sites will have lower ant richness with fewer Seed Harvesters, whereas more mesic sites with high grazing intensity might increase ant richness, and the abundance of specific ant species. Such knowledge is important if we are to maintain critical ant-mediated functions as Earth becomes drier and grazing intensity increases.M.D-B. was supported by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie Grant Agreement No 702057 (CLIMIFUN) and by a Large Research Grant from the British Ecological Society (Grant Agreement No. LRA17\1193, MUSGONET)