Evidence-based insertion and maintenance bundles are effective in reducing the incidence of central line-associated bloodstream infections (CLABSI) in intensive care unit (ICU) settings. We studied the adoption and compliance of CLABSI prevention bundle programs and CLABSI rates in ICUs in a large network of acute care hospitals across Canada.

Although first identified 120 years ago, knowledge of the Toalean technoculture of Middle Holocene Sulawesi, Indonesia, remains limited. Previous research has emphasised the exploitation of largely terrestrial resources by hunter-gatherers on the island. The recent recovery of two modified tiger shark teeth from the Maros-Pangkep karsts of South Sulawesi, however, offers new insights. The authors combine use-wear and residue analyses with ethnographic and experimental data to indicate the use of these artefacts as hafted blades within conflict and ritual contexts, revealing hitherto undocumented technological and social practices among Toalean hunter-gatherers. The results suggest these artefacts constitute some of the earliest archaeological evidence for the use of shark teeth in composite weapons.

One defining characteristic of Homo sapiens is the production and use of personal ornamentation. Evidence from Africa and western Eurasia has dominated discussion, but a growing number of finds directs attention towards Island Southeast Asia. In this article, the authors report on an assemblage of Nautilus shell beads from the Indonesian cave site of Makpan, Alor Island. The highly standardised forms, mostly with two perforations, and evidence of use wear, indicate that these beads were utilised as appliqués. Dating to the terminal Pleistocene, these beads appear to form part of a wider tradition also attested on Timor and Kisar, suggesting an early inter-island network across southern Wallacea.

The coronavirus disease 2019 (COVID-19) pandemic has placed significant burden on healthcare systems. We compared Clostridioides difficile infection (CDI) epidemiology before and during the pandemic across 71 hospitals participating in the Canadian Nosocomial Infection Surveillance Program. Using an interrupted time series analysis, we showed that CDI rates significantly increased during the COVID-19 pandemic.

Secret societies, involving restricted and hierarchically organised initiation rituals, are conspicuous in the chronicles of many past and present societies. These rarely leave a substantial written record and yet archaeology can provide vivid insight into past performances, for example in relation to Roman ‘mystery cults’. Far less research, however, has focused on Australia and the Pacific Islands. This article presents archaeological evidence for ceremonies practised on Woeydhul Island in the Western Torres Strait, exploring initiation rituals at the cusp of contemporary memory. By doing so, it provides a detailed and long-term history for Torres Strait Islander secret societies and ritual activities involving dugong bone mounds, stone arrangements and worked stingray spines.

Stories are important to all modern peoples, and this behaviour was no doubt also the case during the deep past. Consequently, it is important that archaeologists understand that artefacts made and discarded thousands of years ago were woven with stories by the peoples who produced them. In some regions of the world, these stories remain accessible by collaborating with the Traditional Owners of the lands from which they were recovered, while in others such an approach is impossible. Nevertheless, researchers need to remember that items carried meaning usually invisible to those outside communities—a principle often taught and cited, but possibly not fully appreciated. Here we tell the Yuin (coastal New South Wales, Australia) story of Gymea and her connection to fishing technologies. This story is told in order to demonstrate the depth of information that is not accessible to archaeologists if Indigenous collaborators are not sought out or available.

Cultural evolutionary theory conceptualises culture as an information-transmission system whose dynamics take on evolutionary properties. Within this framework, however, innovation has been likened to random mutations, reducing its occurrence to chance or fortuitous transmission error. In introducing the special collection on children and innovation, we here place object play and play objects – especially functional miniatures – from carefully chosen archaeological contexts in a niche construction perspective. Given that play, including object play, is ubiquitous in human societies, we suggest that plaything construction, provisioning and use have, over evolutionary timescales, paid substantial selective dividends via ontogenetic niche modification. Combining findings from cognitive science, ethology and ethnography with insights into hominin early developmental life-history, we show how play objects and object play probably had decisive roles in the emergence of innovative capabilities. Importantly, we argue that closer attention to play objects can go some way towards addressing changes in innovation rates that occurred throughout human biocultural evolution and why innovations are observable within certain technological domains but not others.

Mobile containers are a keystone human innovation. Ethnographic data indicate that all human groups use containers such as bags, quivers and baskets, ensuring that individuals have important resources at the ready and are prepared for opportunities and threats before they materialize. Although there is speculation surrounding the invention of carrying devices, the current hard archaeological evidence only reaches back some 100,000 years. The dearth of ancient evidence may reflect not only taphonomic processes, but also a lack of attention to these devices. To begin investigating the origins of carrying devices we focus on exploring the basic cognitive processes involved in mobile container use and report an initial study on young children's understanding and deployment of such devices. We gave 3- to 7-year-old children (N = 106) the opportunity to spontaneously identify and use a basket to increase their own carrying capacity and thereby obtain more resources in the future. Performance improved linearly with age, as did the likelihood of recognizing that adults use mobile carrying devices to increase carrying capacity. We argue that the evolutionary and developmental origins of mobile containers reflect foundational cognitive processes that enable humans to think about their own limits and compensate for them.

As the earliest image of a human being and the oldest piece of figurative art, the female figurine of Hohle Fels remains a significant discovery for understanding the development of symbolic behaviour in Homo sapiens. Discovered in southwestern Germany in 2008, this mammoth-ivory sculpture was found in several fragments and has always been assumed to be complete, never owning a head. In place of a head, there is instead a small loop that would allow her to be threaded, possibly to be worn as a pendant. Several hypotheses have been put forward as to her original use context, ranging from representing a fertility goddess to a pornographic figure. Yet none of these theses have ever suggested that she once had a head. Here we explore whether the female figurine of Hohle Fels was designed as a two-part piece, with the head made of perishable material culture, possibly woven plant or animal fibres; or that the artefact is a broken and reworked figurine with the head simply never found. By exploring the possibility that this figurine did originally have a second part—a head—we investigate issues surrounding the role of women and children in the Swabian Aurignacian.

Identifying the residues of children's activities in deep time contexts is essential if we are to build a comprehensive understanding of human cognitive and cultural development. Despite the importance of such data to human evolution studies, however, archaeologists have only recently begun to look for prehistoric children's material culture, and the identification of children's spaces is completely absent for deep time contexts. This paper draws together sociological and historical data regarding the universal need of Homo sapiens children for ‘secret’ places – places away from parental control. These spaces are important for the behavioural development of children and are universal in modern contexts. This paper demonstrates that these features can be identified in prehistoric archaeological records – and as such – researchers will have new datasets with which to interrogate the role of children in the development of their respective societies.

A new engraving of a horse head has been discovered during a recent re-examination of the Magdalenian osseous projectile point assemblage from La Madeleine curated in the Musée d'Archéologie Nationale (St-Germain-en-Laye, France). Found on one side of an unmodified tip of reindeer tine, this piece was uncovered in amongst a collection of distal (tip) fragments of antler sagaies. While this piece is not unique to La Madeleine – a number of similar pieces having been recovered in early excavations at this site – it nonetheless contributes another small piece of information regarding Magdalenian mobiliary art. The horse engraving is compared with other known finds from La Madeleine, as well as several additional Magdalenian sites in order to outline its place in the current state of knowledge regarding these enigmatic artefacts.

Whether Neanderthals were capable of behaviours commonly held to be the exclusive preserve of modern humans — such as abstract thought, language, forward planning, art, reverence of the dead, complex technology, etc. — has remained a fundamental question in human evolutionary studies since their discovery more than a hundred years ago. A lack of quantitative data on Neanderthal symbolism and complex behaviour is a key obstacle to the resolution of this question, with temporal analyses usually confined to single regions or short time periods. Here we present an approach to the issue of symbolism and complex behaviours among Neanderthals that examines the frequency of key proxies for symbolic and complex behaviours through time, including burials, modified raw materials, use of pigments, use of composite technology and body modification. Our analysis demonstrates that the number and diversity of complex Neanderthal behaviours increases between 160,000 and 40,000 years ago. Whether this pattern derives from preservation factors, the evolution of cognitive and behavioural complexity, cumulative learning, or population size is discussed. We take the view that it is not the apparent sophistication of a single specific item, nor the presence or absence of particular types in the archaeological record that is important. Instead, we believe that it is the overall abundance of artefacts and features indicative of complex behaviours within the Neanderthal archaeological record as a whole that should provide the mark of Neanderthal capabilities and cultural evolutionary potential.