Nothing Lasts Forever: Environmental Discourses on the Collapse of Past Societies

The study of the collapse of past societies raises many questions for the theory and practice of archaeology. Interest in collapse extends as well into the natural sciences and environmental and sustainability policy. Despite a range of approaches to collapse, the predominant paradigm is environmental collapse, which I argue obscures recognition of the dynamic role of social processes that lie at the heart of human communities. These environmental discourses, together with confusion over terminology and the concepts of collapse, have created widespread aporia about collapse and resulted in the creation of mixed messages about complex historical and social processes

Cognitieve revalidatie voor kinderen en jongeren met niet-aangeboren hersenletsel:wat zijn de effectieve componenten?

Veel kinderen en jongeren met niet-aangeboren hersenletsel (nah) ervaren problemen met cognitief functioneren, zoals een verminderd geheugen of slechtere concentratie. Dit artikel is gebaseerd op bevindingen en inzichten uit het proefschrift ‘executive functions of children and adolescents: novel perspectives on assessment and intervention’. Een belangrijk doel van het promotietraject was beter inzicht te krijgen in hoe we cognitieve functies en bijbehorende problemen bij kinderen en jongeren met nah kunnen verbeteren. Cognitieve problemen bij kinderen en jongeren kunnen mogelijk worden behandeld met cognitieve revalidatie. Interventies voor cognitieve revalidatie kunnen worden gecategoriseerd op basis van hun hoofdcomponenten: 1) strategiegebruik en/of metacognitie, 2) herhaald oefenen, en 3) externe hulpmiddelen. Resultaten van een literatuurstudie naar cognitieve revalidatie laten zien dat door interventies die zijn gebaseerd op metacognitie en/of strategiegebruik vooral adaptief gedrag en sociaal functioneren verbeteren. Interventies op basis van herhaald oefenen verbeterden de prestaties op taken die vergelijkbaar zijn met de geoefende taken. Multi-componenten-interventies die deze twee componenten combineren, leken te leiden tot verbeteringen in zowel cognitief als adaptief gedrag en sociaal functioneren. Externe hulpmiddelen verbeterden het functioneren in het specifieke gebied waarop het hulpmiddel was gericht, bijvoorbeeld het geheugen. De beschikbare gegevens suggereren dat interventies bestaande uit meerdere componenten, zoals een combinatie van metacognitie- en/of strategiegebruik en herhaald oefenen, veelbelovend zijn, omdat deze kunnen leiden tot verbeteringen in zowel het cognitieve als psychosociale functioneren van kinderen en adolescenten met nah

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Water and landscape: Ancient Maya settlement decisions

In this chapter we present the major transitions in Maya history from the Late Preclassic through Terminal Classic periods in the Maya Lowlands, focusing first on major settlement and subsistence systems, followed by major social and environmental costs. We particularly focus on how the Maya built and relied on increasingly complex water and agricultural systems to adapt in the humid tropics where everything in life was rainfall dependent. The seasonality of rainfall required innovative strategies to contain water throughout the long dry season in the face of growing population and socio-political complexity. Drastic changes occurred when several prolonged droughts struck the Maya area, resulting in them exploring new areas and subsistence practices. The chapter concludes with a few thoughts on how understanding ancient Maya water and land use is relevant for today's issues regarding sustainable land and water use

Tropical landscapes and the Ancient Maya: Diversity in time and space

Archaeologists have begun to understand that many of the challenges facing our technologically sophisticated, resource dependent, urban systems were also destabilizing factors in ancient complex societies. The focus of IHOPE-Maya is to identify how humans living in the tropical Maya Lowlands in present-day Central America responded to and impacted their environments over the past three millennia, and to relate knowledge of those processes to modern and future coupled human-environment systems. To better frame variability in ancient lowland Maya development and decline, the area that they once occupied may be subdivided into a series of geographical regions in which the collected archaeological data can be correlated with environmental differences. Although beginning as small agricultural communities occupying a variety of ecological niches in the humid tropics of Mesoamerica, the ancient Maya became an increasingly complex set of societies involved in intensive and extensive resource exploitation. Their development process was not linear, but also involved periods of rapid growth that were punctuated by contractions. Thus, the long-term development and disintegration of Maya geopolitical institutions presents an excellent vantage from which to study resilience, vulnerability, and the consequences of decision-making in ancient complex societies