Despite common associations with plague pits and mass graves, many individuals who succumbed to the Black Death in the mid-fourteenth century AD, and to the numerous subsequent outbreaks of plague, were buried in parish cemeteries. This limits the usefulness of contemporaneous cemetery assemblages for the establishment of comparative, non-catastrophic (or 'attritional') demographic profiles for medieval populations in Britain. Drawing from three earlier cemeteries, this study reveals similarities in age-at-death and survivorship profiles for adults, offering a characteristic pre-Black Death profile that helps reinforce the distinctiveness of the over-representation of individuals aged 15-24 years among plague burials.

In archaeology, far more research has been performed on paleofeces of ancient humans than their companion animals, for which little is known. This study presents a multiproxy analysis of a paleofeces of dog origin, recovered from the medieval fortification of Gradina-Radaljevo (Serbia). The specimen was first recorded non-invasively through stereomicroscopy and micro-computed tomography, which documented a compact, flat-conical morphology containing highly digested bone fragments, charcoal, and sediment inclusions, features typical of carnivore digestion. Subsequent petrographic thin-sectioning and µFTIR confirmed a hydroxylapatite-rich matrix with cancellous and compact bone fragments, plant remains, and vegetal voids corresponding to cereal husk imprints, suggesting dietary ingestion of both animal and plant material. Paleoparasitological screening identified 26 helminth eggs belonging to Ascaris sp., Trichuris sp., and Dicrocoelium sp. Their morphology and low abundance indicate passive passage via ingestion of contaminated food, herbivore dung, or human waste rather than true infection of the host. Palynological analysis revealed low pollen diversity dominated by Poaceae, Cyperaceae, and fern spores, alongside wetland NPPs and Glomus fungi, reflecting environmental ingestion and scavenging behaviors. ZooMS of ingested bone fragments identified Suidae and Gallus, while aDNA analysis recovered Suidae, Bovidae, Phasianidae, and Canidae, including Canis lupus familiaris, further supporting a dog origin for the specimen. Together, these results indicate an omnivorous scavenging dog living near the settlement, consuming household refuse and fecal material, thereby mirroring human–animal interaction, sanitation practices, and parasite circulation in medieval Europe. This study sheds light on the complexity of human, dog and herbivore coexistence, contributing to the understanding of hygienic and sanitary conditions in medieval Europe.

Abstract Reconstruction of past diets poses significant challenges for historians and archaeologists alike. Archival records from Delft’s orphanage between 1650 and 1725 provide data regarding the number and weight of plant and animal food items purchased. Cesspit evidence offers complementary insights into diet based on the edible plant and animal species present in the fill as well as some insights into the health of the inhabitants based on parasite presence. Both disciplines have limitations when reconstructing past food consumption practices of the Delft orphans. Yet the individual biases can be mitigated when the results are compared and combined. The purchase lists of the orphanage show the amounts of (staple) foods purchased and, by extension, their relative importance in the diet. At the same time, bioarcheological research shows a variety of consumed plants that are not specifically listed in the archival sources. Zooarchaeological research provides insights into the age of the animals listed as being purchased for food by the orphanage and the parts of the animals used. The intersection of historical and bioarcheological evidence reveals that the diet of orphanage inhabitants was neither monotonous nor meager, though evidence of parasitic infections suggests some health challenges.

Chapter 7 reviews the diversity of parasites found in the Roman period, their regional distribution, and their association with other diseases. First, Ledger and Mitchell provide an overview of methods to detect both ectoparasites and endoparasites in the archaeological record. The authors then present evidence for parasitic infection at Roman period sites across the Empire to demonstrate the breadth of parasitic infections that Roman populations experienced. They discuss the various cultural factors that impacted disease burden in Roman populations, such as animal husbandry practices, food preparation, and sanitation regimes. A discussion of the health implications for those infected with various parasites follows, and the authors take care to note that the presence of certain ectoparasites can trigger epidemic diseases that have the potential to devastate populations.

While the term "ethic" has variable definitions by different authors, what they share in common is a sense that it provides a system of accepted beliefs that control behavior, based on morals (Peters 2013). Ethics in archaeology and anthropology is an area that has been discussed progressively more over time in recent years (González-Ruibal 2018; Turner, Wagner, and Cabana 2018). This piece explores thoughts on the need for and application of ethical guidelines in osteoarchaeology, how they can be helpful and constructive, but also how there might be differences in opinion among populations in different parts of the world. As for all areas of science, we need a robust set of ethics for how we should study and interpret excavated skeletal material to avoid fraudulent publications or misleading claims from unsound methodology or fabricated data (D'Angelo 2012; Waddington 2016). However, the elements of ethics that apply to human osteoarchaeology go far beyond those of some other branches of the sciences, when the focus of that osteoarchaeological research is the remains of our own species (Clegg 2020; Clough 2020; Squires, Errikson, and Márquez-Grant 2020). Regarding osteoarchaeology, ethical views associated with human remains are generally distinct from those held about the study of nonhuman animals. The perspective that the remains of our own species are different and more important to us than are the remains of those of other mammals is one that is found in many different populations (see for example AAPA 2003; BABAO 2019). Ethical norms regarding human remains will not be the same for all populations in different regions of the world. This will depend upon religious beliefs, cultural values, and traditional behaviors for each population (Márquez-Grant and Fibiger 2011; Scarre and Scarre 2006). For example, we might expect populations from countries subjected to colonialism in recent centuries to rightly push back to regain autonomy over their cultural heritage, so having differing views to their colonizers. Countries with a more homogenous integrated population might show less variation in views to those with many distinct minority groups speaking different languages and expressing their unique cultures. Ethical views about human remains may also vary depending upon whether the remains are skeletonized or mummified, or of children as opposed to adults (Squires, Davuidson, and Piombino-Mascali 2024). Europe has a long history of the display of relics or even entire bodies of saints at religious shrines and processions, one which persists on saints days in countries such as Greece and Spain today (Freeman 2011). We also see the open display of human remains in churches in countries such as Italy, which can be visited by all (Zenou 2023). In contrast, people from some cultures feel that human remains should either not be on display at all or should just be viewed by the descendent community of the deceased individuals. For this reason, some populations, such as indigenous communities from Australia and North America, have asked for the return and reinterment of human remains of their ancestors curated in museums (Clegg 2020; Turnbull 2020). Due to this complexity, some professional organizations have compiled ethical guidance for how we might handle and care for the remains of human ancestors found in archaeological contexts (AAPA 2003; BABAO 2019). In 2023, the International Journal of Osteoarchaeology added a section to the journal author guidelines entitled Ethics, Human Remains, and Engagement with Culturally Affiliated Descendent Communities (https://onlinelibrary.wiley.com/page/journal/10991212/homepage/forauthors.html). Our aim was to avoid situations where papers are submitted to the journal presenting the analysis of skeletal material from those indigenous communities where they have strong views about their ancestors but where those communities have not been consulted or given their permission. This could happen if human remains were collected by explorers in the 1700s or 1800s and brought back to the explorer's country of origin or in situations today where a government may have a different ethical perspective regarding human remains to those of some of its indigenous minority communities. Our guidance ensures that for such a paper to be accepted by the IJO, evidence must be given to show that those indigenous communities have been consulted, given their permission for the remains of their ancestors to be studied and the results published, and that new knowledge has been shared with the affiliated descendant community so they benefit from the increased understanding. Comparable guidance in their author guidelines can also be found in our sister journal in the field, the American Journal of Biological Anthropology. Some have advocated going further with regard to ethics, proposing that it should be standard practice for research published in the field of human bioarchaeology to have been assessed and approved by a research ethics committee before the study commences and that papers contain an ethics statement detailing a range of information relevant to the field, such as for destructive sampling and use of illustrations of the human remains (Squires, Roberts, and Márquez-Grant 2022). This is standard for medical research on living patients and works well where participants can choose to give or withhold their consent to take part in a study (Coleman and Bouësseau 2008). However, not all undertaking research on human skeletal remains have access to an ethics committee. Furthermore, the applicability and implications of a similar approach for those who cannot give consent for research on their bodies as they died hundreds or even thousands of years ago is a complex issue with the potential to trigger a range of views. Recently, a thought-provoking paper entitled "Cremated Bone in Archaeology: Ethical Considerations in the Excavation, Analysis, Storage and Display of Cremated Bone in the United Kingdom" was published in the International Journal of Osteoarchaeology (Squires et al. 2025). This highlighted that even though the remains are highly fragmentary and no longer having the appearance of a human body (for example if placed in a ceramic pot when interred) the fact that they are the remains of a human means that from an ethical perspective they should be regarded with the same level of respect as is given to skeletalized or mummified human remains. The authors go on to share their recommendations for how we might better apply ethics to all aspects of interactions with cremated remains in Britain, from excavation, processing, analysis, storage, curation, and display. We at the IJO very much welcome this contribution to the field. One key challenge with defining and creating a set of ethical standards for osteoarchaeology is that the views of different members of the same population will not all be the same, even before we consider the differences noted above between populations in different regions of the world. We need to develop an approach that deals with the issue where some people may be really interested to see their ancestors and hear about the scientific research undertaken on those remains, while others in the same population may feel that the dead should be left in the ground and not studied at all, let alone displayed in museums. Should we follow the view of a simple majority, or does it require 60%, 80%, 90%, or 100% of the population to share a view before it should be a requirement for everyone? One way to incorporate flexibility and choice in order to avoid those seeing human remains in a museum when they would prefer not to is to have signs explaining where human remains are displayed so people can plan to avoid that part of a museum if they wish (Squires, Davuidson, and Piombino-Mascali 2024). However, to some the mere fact that the remains are on display in the museum might cause them upset, whether or not they themselves actually see the remains. Having considered how different members of the same population will have different views, and populations in different regions of the world vary even further depending upon their cultural traditions, religious beliefs, and social identities, this would suggest that there cannot be one correct ethical view for everyone regarding osteoarchaeology. There will of course be some ethical perspectives shared by all, but there will be other aspects for which a local consensus viewpoint may be the best way forward. Future ethical guidelines will benefit from flexibility incorporating the choices made by cultures and populations across the world. In this regard, the Squires et al. 2025 paper sensibly focuses its recommendations on one region (Britain), as the populations of North America, Australia, Italy, or Greece might each have their own viewpoints on what they would wish to include in their own ethical guidance applying to osteoarchaeology. The author declares no conflicts of interest. Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

Archaeological sediments can be used to retrieve evidence for parasites that infected past populations, giving evidence for disease, diet, sanitation, and migration in the past. To increase our understanding of parasite infections in Roman Britain and determine which parasites may have infected people living at Vindolanda, sediment samples were collected from a drain connected to a latrine at the bath complex of Vindolanda. These samples were used to look for preserved parasite eggs and cysts deposited in the drain with the faeces of people who used the latrine. Microscopic analysis was used to identify eggs of helminths, and enzyme-linked immunosorbent assay (ELISA) was used to look for protozoan parasites that can cause severe diarrhoea. Eggs of Ascaris sp. (roundworm) and Trichuris sp. (whipworm) were found by microscopy and Giardia duodenalis was detected using ELISA. All of these parasites are transmitted by the faecal-oral route, usually through contaminated food and water. This is the first evidence for G. duodenalis in Roman Britain. A range of zoonotic and faecal-oral parasites have been found at other sites in Roman Britain, yet the drain studied from Vindolanda only contained faecal-oral parasites that can be transmitted directly between humans. This predominance of faecal-oral parasites is similar to a pattern found in large urban sites in the Roman Mediterranean and other military sites in the empire. In contrast, sites from larger urban cities in Roman Britain, such as London and York, appear to have a more diverse range of parasites.

The Black Death epidemic of Yersinia pestis (1347-50 CE) killed about half the population of England, and many historical changes have been ascribed to it. But we still know surprisingly little about how the epidemic actually affected people's daily lives. This study reports results from a broad bioarchaeological study, with 18 skeletal and molecular indicators from 336 adults from Cambridge, England (940-1561 CE). Results reveal two major findings. First, although the epidemic killed millions, no dramatic changes in skeletal indicators of health and lifestyle are directly ascribable to the epidemic. Most indicators either remained stable, or changed in response to other known historical trends. Traumatic though the plague was, it did not transform medieval people's health and lifeways radically. Secondly, there were important long-term health trends beginning before the Black Death, notably a decline in stature. This may be due to a general 14th -century environmental and economic deterioration which left the population more vulnerable to novel epidemic diseases.

While the interaction between humans and their parasites is well studied today, taking a long view of infection throughout human evolution helps to place the current picture in context and identify trends in infection over time. After considering how early technologies may have facilitated the transmission of parasites to humans, we examine the association between humans and parasites through time using archaeological and genetic evidence. Techniques such as microscopy, immunoenzymatic assays and DNA analysis have identified a range of protozoa, helminths and ectoparasites in our ancestors. Evidence is discussed for the origins and impact upon societies through time for protozoa causing malaria, leishmaniasis, Chagas' Disease and diarrhoeal illnesses, helminths such as schistosomiasis, soil-transmitted helminths, Taenia tapeworms, fish tapeworms and liver flukes, and ectoparasites such as fleas, body lice and pubic lice. Prevalence studies show widespread infection for some parasites, such as 36% with falciparum malaria in ancient Egypt, and 40% with Chagas disease in prehistoric Peru and northern Chile. Humans have been responsible for the inadvertent spread of a range of parasites around the world, ranging from African heirloom parasites with early human migrations to the introduction of malaria and schistosomiasis to the Americas with the transatlantic slave trade in the 1600s-1800s. It is clear that the epidemics due to bacterial pathogens spread by ectoparasites since the Bronze Age must have had major impacts upon past societies, particularly for bubonic plague and epidemic typhus.

The aim of this study is to explore the causes and consequences of popliteal fossa involvement in children with musculoskeletal infection. Data was sourced from the prospective cohort study of children with musculoskeletal infection running at Peterborough City Hospital. Of the 180 children entered into the study between 2011 and 2024, fourteen (8%) were found to have oedema in the tissues of the popliteal fossa on MRI compatible with infection. Of these fourteen, eleven (79%) had septic arthritis of the knee, and three (21%) had no septic arthritis but did have pyomyositis of thigh muscles. Out of these fourteen, two children (14%) developed a DVT, one of whom died from massive pulmonary embolus within hours of their MRI scan. This has been the only death in the 180 children in the study group. This data would indicate that infection involving the popliteal fossa may spread from bacteria in the adjacent joint or muscles. The inflammation in the popliteal fossa can trigger thrombosis in the popliteal vein and so lead to DVT and potentially fatal PE. Unless a clinician palpates the popliteal fossa to assess for tenderness, involvement by infection may easily be missed until it is demonstrated on the MRI scan. In view of the potential for infection in the popliteal fossa to trigger thrombosis in the popliteal vein in 10-20% of cases, it would seem wise to treat such children with an antithrombotic medication until antibiotic treatment has ensured the inflammation around the vein has settled.

The detection of parasite infections in past populations has classically relied on microscopic analysis of sediment samples and coprolites. In recent years, additional methods have been integrated into paleoparasitology such as enzyme-linked immunosorbent assay (ELISA) and ancient DNA (aDNA). The aim of this study was to evaluate a multimethod approach for paleoparasitology using microscopy, ELISA, and sedimentary ancient DNA (sedaDNA) with a parasite-specific targeted capture approach and high-throughput sequencing. Using 26 samples dating from c. 6400 BCE to 1500 CE that were previously analyzed with microscopy and ELISA, we aimed to more accurately detect and reconstruct parasite diversity in the Roman Empire and compare this diversity to earlier and later time periods to explore temporal changes in parasite diversity. Microscopy was found to be the most effective technique for identifying the eggs of helminths, with 8 taxa identified. ELISA was the most sensitive for detecting protozoa that cause diarrhea (notably Giardia duodenalis). Parasite DNA was recovered from 9 samples, with no parasite DNA recovered from any pre-Roman sites. Sedimentary DNA analysis identified whipworm at a site where only roundworm was visible on microscopy, and also revealed that the whipworm eggs at another site came from two different species (Trichuris trichiura and Trichuris muris). Our results show that a multimethod approach provides the most comprehensive reconstruction of parasite diversity in past populations. In the pre-Roman period, taxonomic diversity included a mixed spectrum of zoonotic parasites, together with whipworm, which is spread by ineffective sanitation. We see a marked change during the Roman and medieval periods with an increasing dominance of parasites transmitted by ineffective sanitation, especially roundworm, whipworm and protozoa that cause diarrheal illness.

BACKGROUND:Our aim is to investigate the association between soft tissue infection in the popliteal fossa and hamstring muscles to determine the risk of DVT formation in children with infections in the knee and posterior thigh. METHODS:This prospective cohort study (the Peterborough Paediatric Musculoskeletal Infection Study) has gathered data for 181 children aged 0 to 15 years with infection of their limbs or spine. Those with MRI evidence for infection of the popliteal fossa of the knee were identified, as well as those with thrombosis in the venous system. RESULTS:Popliteal fossa infection was present in 15 children (8% of the 181 in the entire study). Most were associated with septic arthritis of the knee (80%), but some were due to pyomyositis of the hamstrings or calf (20%). Venous thrombosis was noted in 1.1% of the entire 181 study group, but 13% of those with popliteal fossa infection, a 12-fold difference (Fisher exact test statistic 0.0064, P <0.01). One of those with a DVT died from pulmonary embolism a few hours after their MRI scan had been performed. CONCLUSION:Thirteen percent of children with popliteal fossa infection had an associated DVT, so it may be an independent risk factor for thrombosis. To minimize the risk of DVT and its serious complications, we recommend that children presenting to the Emergency Department with pain in the knee, thigh or calf and raised inflammatory markers (CRP/ESR) suspicious for musculoskeletal infection should have their popliteal fossa examined, and if tender, an urgent Doppler ultrasound should be organised. On MRI, attention should be paid to the popliteal fossa on axial STIR images, and if oedema is present around the popliteal vessels, then prophylactic dose anticoagulation should be started, while those with a dilated popliteal vein on MRI should receive treatment dose anticoagulation. LEVEL OF EVIDENCE:Level II. A lesser quality prospective study with patients enrolled at different points in their disease.