Late Precontact Settlement on the Northern Seward Peninsula Coast: Results of Recent Fieldwork

Changing Arctic settlement patterns are associated with shifts in socioeconomic organization and interaction at both the inter- and intraregional levels; analysis of Arctic settlement patterns can inform research on the emergence and spread of Arctic maritime adaptations. Changes in late precontact settlement patterns in Northwest Alaska suggest significant shifts in subsistence and/or social organization, but the patterns themselves are not well understood. Prior research around Kotzebue Sound suggests three possible scenarios: (1) population decrease and dispersion from settlement centers after 550 cal bp, (2) population stability and dispersion after 550 cal bp, and (3) different settlement patterns in the northern and southern areas of Kotzebue Sound. We analyze site distribution and radiocarbon data from new research on the northern Seward Peninsula coast to address questions about local late precontact settlement patterns. Our results point to denser late precontact occupation of this region than previously understood, suggesting either population stability and dispersion after 550 cal bp or the development of differential settlement patterns around the Kotzebue Sound region. This research provides new information about late precontact settlement patterns in Northwest Alaska and contributes to the broader debate about the changing nature of Arctic maritime adaptations during the dynamic late Holocene period. Results also indicate that people in this region were well integrated into both Kotzebue Sound and more distant socioeconomic systems despite potential reduction or change in interaction spheres during the late precontact period

GIS Spatial Analysis of Arctic Settlement Patterns: A Case Study in Northwest Alaska

In northwest Alaska, archaeologists hypothesize that environmental variability was a major factor in both growing coastal population density, with large aggregated villages and large houses, between 1000 and 500 years ago (ya), and subsequent decreasing population density between 500 ya and the contact era. After 500 ya people are thought to have dispersed to smaller settlements with smaller house sizes in coastal areas, and perhaps, upriver. This settlement pattern was identified through research at four site locations over 30 years ago. The changing geographic distribution of sites, associated settlement size, and house size has not been examined in detail. A more careful examination of changing northwest Alaskan settlement patterns is needed before larger questions about socio-economic organization can be addressed. I use Geographic Information Systems (GIS) to evaluate the evidence for a geographic redistribution of Arctic peoples during the Late Holocene. The author constructed a database of settlement location and site attribute information, specifically the number of houses within each settlement and the size (m2). Data were collected from a dataset of Western Arctic National Parklands (WEAR), the Alaska Heritage Resource Survey (AHRS) database of archaeological sites in Alaska, 409 unpublished site reports and field notes curated by the National Park Service (NPS) and Bureau of Indian Affairs (BIA), and the results of recent fieldwork in northwest Alaska. A total of 486 settlements were identified within the northwest Alaska with 128 settlements having temporal and site attribute data. The author incorporated settlement size data into a GIS database and then carried out global, Moran\u27s I, local Moran\u27s I, and local Getis-Ord spatial analyses to test whether settlement redistribution occurred and if key settlement locations shifted after 500 ya. The site attribute data (number of houses and average size of houses) are used to test the additional aspects of the proposed settlement pattern change after 500 ya. A total of 83 settlements with 465 houses are used to test if the average size of settlements and average house size changed after 500 ya. The results of the spatial analyses indicate no statistically significant patterns in the spatial distribution of settlements. Site attribute analysis shows no statistical difference in the average number of houses per village or the average size of houses before or after 500 ya. The results of this work build our understanding of regional settlement patterns during the late Holocene. By testing settlement pattern change, i.e. settlement distribution, settlement size, and house size, future research into settlement pattern change can begin to evaluate likely causes for the observed changes. My method, specifically the use of GIS as a method for testing settlement pattern change, can be applied to other regions and temporal scales

GIS Spatial Analysis of Arctic Settlement Patterns: A Case Study in Northwest Alaska

Archaeologists have been interested in relationship between environmental variability and cultural change for the last six decades. By understanding how, when, and why humans adapt to environmental change, archaeologists and anthropologists can better understand the development and complexity of human cultures. In northwest Alaska, archaeologists hypothesize that environmental variability was a major factor in both growing coastal population density, with large aggregated villages and large houses, between 1000 and 500 years ago (ya), and subsequent decreasing population density between 500 ya and the contact era. After 500 ya people are thought to have dispersed to smaller settlements with smaller house sizes in coastal areas, and perhaps, upriver. This settlement pattern was identified through research at four site locations over 30 years ago. The changing geographic distribution of sites, associated settlement size, and house size has not been examined in detail. A more careful examination of changing northwest Alaskan settlement patterns is needed before larger questions about socio-economic organization can be addressed. I use Geographic Information Systems (GIS) to evaluate the evidence for a geographic redistribution of Arctic peoples during the Late Holocene. I constructed a database of settlement location and site attribute information, specifically the number of houses within each settlement and the size (m 2). Data were collected from a dataset of Western Arctic National Parklands (WEAR), the Alaska Heritage Resource Survey (AHRS) database of archaeological sites in Alaska, 409 unpublished site reports and field notes curated by the National Park Service (NPS) and Bureau of Indian Affairs (BIA), and the results of recent fieldwork in northwest Alaska. A total of 486 settlements were identified within the northwest Alaska with 128 settlements having temporal and site attribute data. I incorporated settlement size data into a GIS database and then carried out global, Moran’s I, local Moran’s I, and local Getis-Ord spatial analyses to test whether settlement redistribution occurred and if key settlement locations shifted after 500 ya. The site attribute data (number of houses and average size of houses) are used to test the additional aspects of the proposed settlement pattern change after 500 ya. A total of 83 settlements with 465 houses are used to test if the average size of settlements and average house size changed after 500 ya. The results of the spatial analyses indicate no statistically significant patterns in the spatial distribution of settlements. Site attribute analysis shows no statistical difference in the average number of houses per village or the average size of houses before or after 500 ya. The results of this work build our understanding of regional settlement patterns during the late Holocene. By testing settlement pattern change, i.e. settlement distribution, settlement size, and house size, future research into settlement pattern change can begin to evaluate likely causes for the observed changes. My method, specifically the use of GIS as a method for testing settlement pattern change, can be applied to other regions and temporal scales

Bayesian Assessment of Northern Alaskan Chronological Issues: Implications for Future Research

Cultural interaction and exchange across the Bering Strait of northern Alaska played a central role in the emergence of Arctic maritime adaptations. Yet poor chronological control limits our ability to explore processes of cultural change over the last 5000years. We address this problem by synthesizing the available radiocarbon record for the region, carrying out Bayesian analysis of a regional radiocarbon database, and analyzing the BAR-1 (Birnirk) site using new dates published in this paper. Our synthesis and our illustrative analysis of the BAR-1 site highlights several intriguing temporal and spatial trends with implications for interaction between cultural groups. Our analysis also underscores the uncertainty associated with dating cultural phases and identifies specific areas where additional research is needed to further our understanding of cultural interaction in this complex region

Demographic Fluctuations and the Emergence of Arctic Maritime Adaptations

Our goal is to study the role of demographic change in the development and spread of maritime adaptations in the North American Arctic over the last 6000 years. We compile and analyze a regional radiocarbon database (n = 935) for northern Alaska, using Oxcal to analyze demographic patterns in summed probability distributions. We find that northern Alaskan populations grew significantly over the last 4500 years, although growth was punctuated by three periods of decline from approximately 3700 to 3125 cal BP, 1000 cal BP, and 600 cal BP. We assess possible alternative explanations for the observed demographic patterns (e.g. calibration and taphonomic effects, investigator bias). Region-wide erosion and calibration effects likely contribute to the dearth of radiocarbon dates around 1000 cal BP, and sampling bias may contribute to the post-600 cal BP decline. However, we conclude that the overall pattern reflects regional population growth, decline, and recovery. Population growth predates intensification of marine resource procurement by at least 1200 years; we hypothesize that population growth was a possible driver for late Holocene marine intensification in the Arctic. These findings have further implications for understanding the process of intensification and the development of complexity in coastal hunter-gatherer societies

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine