We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
Online ordering will be unavailable from 17:00 GMT on Friday, April 25 until 17:00 GMT on Sunday, April 27 due to maintenance. We apologise for the inconvenience.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
To determine the prevalence and timing of autism spectrum disorder diagnosis in a cohort of congenital heart disease (CHD) patients receiving neurodevelopmental follow-up and identify associated risk factors.
Method:
Retrospective single-centre observational study of 361 children undergoing surgery for CHD during the first 6 months of life. Data abstracted included age at autism spectrum disorder diagnosis, child and maternal demographics, and medical history.
Results:
Autism spectrum disorder was present in 9.1% of children with CHD, with a median age at diagnosis of 34 months and 87.9% male. Prematurity, history of post-operative extracorporeal membrane oxygenation, and seizures were higher among those with autism (p = 0.013, p = 0.023, p = 0.001, respectively). Infants with autism spectrum disorder were older at the time of surgery (54 days vs 13.5 days, p = 0.002), and infants with surgery at ≥ 30 days of age had an increased risk of autism spectrum disorder (OR 2.31; 95% CI =1.12, 4.77, p = 0.023). On multivariate logistic regression analysis, being male (OR 4.85, p = 0.005), surgery ≥ 30 days (OR 2.46, p = 0.025), extracorporeal membrane oxygenation (OR 4.91, p = 0.024), and seizures (OR 4.32, p = 0.003) remained associated with increased odds for autism spectrum disorder. Maternal age, race, ethnicity, and surgical complexity were not associated.
Conclusions:
Children with CHD in our cohort had more than three times the risk of autism spectrum disorder and were diagnosed at a much earlier age compared to the general population. Several factors (male, surgery at ≥ 30 days, post-operative extracorporeal membrane oxygenation, and seizures) were associated with increased odds of autism. These findings support the importance of offering neurodevelopmental follow-up after cardiac surgery in infancy.
Ancient Gordion has long been recognized as a key Iron Age site for Anatolia and the eastern Mediterranean. Archaeological research has revealed much about its sequence of occupation. However, as yet no study has explored the underlying drivers of political and economic change at this site. This volume presents an overview of the political and economic histories supporting emergent elites and how they constructed power at Gordion during the Iron Age (1200-300 BCE). Based on geochemical and typological analysis of nearly 2000 Late Bronze Age to Hellenistic ceramic samples, the volume contextualizes this primary dataset through the lens of ceramic production, consumption, exchange and emulation. Synthesizing site data sets, the volume more broadly contributes to our understanding of the pivotal role of groups and their economic, social, and ritual practices in the creation of complex societies.
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
The early twelfth century BCE collapse of the Hittite Empire transformed cultural landscapes across Anatolia (Sams 2011a). These changes have variously been interpreted as the disruptive result of incoming groups, drought, local responses to a volatile political environment, either by themselves or in combination (Genz 2011; Kaniewski et al. 2015; Voigt 2011). In some regions, sites were abandoned or destroyed, while in others community organization was substantially altered. Gordion was occupied continuously through this transition, but the Early Iron Age (EIA YHSS 7) community’s material culture and social organization is marked by profound changes across a variety of spheres (i.e. ceramics, foodways, and house and storage structures).
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Archaeologists have long grappled with understanding the nature of transformations in human societies. Some of these transformations are seen as “revolutionary,” including the development of tools, the creation of imagery, the domestication of plants and animals, and the rise of urban and state-level societies. While the complexity and diversity of these reconfigurations has become more apparent with every new study, social group restructuring is crucial to each. Cultural transformations may share characteristics, but the organization and workings of social groups appear specific to each threshold of change. From this perspective, we argue that fundamental societal transformations are more intimately entangled with innovations in group formation – new modes of kin definition, religious groupings, political organizations and manipulation of ancient social media – than driven by technological innovation.
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
For over a millennium (1400–330 BCE), the inhabitants of Gordion repeatedly created novel social and political identities. The formation of the Iron Age Phrygian polity produced some of the most striking of these in the aftermath of the Late Bronze Age (LBA) Hittite collapse. Subsequently, identities were reshaped through Lydian, then Persian entanglements. Under each of these political regimes, local communities experimented with new and distinctive patterns of political and social formation under regime-specific economic strategies.
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
In this chapter we review and contextualize the ceramic assemblages from Gordion sampled for this study. Over the course of more than 50 years of excavation, different teams with diverse sampling and curation strategies and rationales collected archaeological ceramics from this site. These varying practices have directly impacted the character of our sampling regime. To clarify the similarities and difference between the assemblages sampled, we begin with a short overview of excavations and artifact curation at Gordion. We outline how and what criteria we used to sample each of the curated ceramic assemblages. One of our goals was to define the local resources available to potters by comparing the geochemistry of ceramics to the geochemistry of potential local resources, distributed over the widely varying geomorphological and geological landscape that surrounds the site. This chapter therefore also outlines our sediment sampling strategies. The final section of this chapter highlights the methodological issues inherent in both the sample and in sampling (sample size relationships and bias), and the means we used to redress these issues.
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Even when viewed at a distance of almost 3,000 years, the political and social upheavals of first millennium BCE Gordion are striking. The rise of Lydian influence across central Anatolia in the late MP period transformed local communities at Gordion, changing daily domestic practices and introducing new ways of enacting power. This transformation, commencing in the late seventh century BCE, was well underway at the time of the Persian conquest in the mid sixth century BCE. Evidence of this military attack is still visible in the siege works built against the Lower Town fortification system and the burnt remains of the Küçük Höyük mudbrick fortress. While widespread, the impact of Persian power and organizational structures across Anatolia was treated as largely ephemeral until recently (Dusinberre 2013; Khatchadourian 2012). The impacts of a Persian administrative presence were substantial, however, not only as disruptors of the local political order, but also as stimulants for new opportunities of group formation that superseded previous social, economic and political entanglements.
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
One of the most fundamental steps in answering questions about societies in the past is linking interpretative or theoretical issues to the data. In this chapter we explain how we use the Gordion archaeological ceramic assemblage to help understand the operation of groups and communities in the past. While we focus on quantitative approaches to ceramic compositional data and clustering protocols, we also make use of multiple lines of evidence, such as “legacy” ceramic data and contextual evidence. Together we view these through the lens of daily practices of producing, distributing and consuming goods, using them to inform and guide our reconstruction of groups and group dynamics at Gordion over time.
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Late Bronze Age Gordion, while well west of the Hittite political core, nonetheless seems to have been incorporated into its social and political sphere (Glatz 2011; Gunter 1991). Beginning in the Middle Bronze Age (MBA), Hittite influence enveloped agricultural communities across central Anatolia. Hittite texts document the nature of this relationship with provincial towns used as centers for collecting and redistributing goods, including agricultural land and products, as well as managing military armament (Imparati 2002). This undoubtedly created new tensions for local groups caught between their established social and economic relationships and those imposed by the Hittites. Hittite texts also hint at a complex negotiation between local power structures, interest groups and the state, the terms of which likely also created opportunities for local factions that could apparently levy “duties” for specific infractions. In other instances, central administrators directed local communities and their leaders to actively resist corrupt oversight, such as the potential for excess resource collection by local Hittite officials (Imparati 2002:100).
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
From the ninth to the seventh century BCE, Phrygia was one of multiple emerging polities across Anatolia. To the east, mid ninth century BCE Urartian rulers extended their power into northern Mesopotamia (Inomata and Coben 2006). To the west, along the Aegean coast, Greek colonists established new cities and broadened their influence south and east along the Mediterranean coast (Greaves 2011). In central Anatolia, Phrygia became the dominant political force (Fig. 7.1).
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
This book has sought to address the formation and transformation of social groups at the site of ancient Gordion, as a means to understand the complex processes of social change across the region during the highly dynamic period between the LBA and the conquest of Alexander the Great in the fourth century BCE. Sequences and patterns of group dynamics can provide critical insights into these processes of cultural transformation. In the introduction we proposed the idea that key societal transformations are likely to be driven by innovative and novel modes of group formation. Such transformations include substantial realignment of relationships between kin groups, religious affiliations, political organization and manipulations of ancient social media. In subsequent chapters we explored the nature of social groups chronologically, as a foundation for identifying novel features of Iron Age group formation. In this final chapter we bring together the key insights of this study of Phrygian Gordion and Iron Age societies in this region, to juxtapose and reframe previous explanations for the transformation of ancient societies more generally.
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Lisa Kealhofer, Santa Clara University, California,Peter Grave, University of New England, Australia,Mary M. Voigt, College of William and Mary, Virginia
Over the course of the ninth century BCE Phrygia emerged as an influential power in central Anatolia (Fig. 7.1). At the Phrygian capital of Gordion, groups created entirely new social and political configurations, elaborating and displaying status in ways that contrasted sharply with their Bronze Age and EIA predecessors. The territorial extent of Phrygia has been defined using multiple lines of evidence. Material evidence for the range of Phrygian influence includes strong ceramic parallels with pottery at sites to the southeast (Bahar 1999; Osborne 2020), as well as the distribution of monuments and inscriptions at least as far west as Daskyleion (DeVries 2000). Historical data for the Halys River (modern Kızılırmak) area in the east suggest the presence of a complex political palimpsest of multiple competing polities (Sams 2011a). By the late seventh century BCE both ceramics and Phrygian inscriptions at the fortified hilltop site of Kerkenes indicate Phrygian influence extended at least this far east (Summers 2018), but we know little about the ninth and eighth centuries BCE in this area. However, geographic delineation of Phrygia has not advanced understanding of the organization and practices of Phrygian power, arguably major drivers of political expansion at this time. In this chapter, we consider the Phrygian capital Gordion and the daily practices of local groups as a foundation for addressing Phrygian practices of power.