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This issue of ‘Das Mittelalter’ explores the voice of small things.2 We approach artefacts that are no bigger than one’s hand not as silent witnesses to people’s lives, but as agents that actively engage with human beings through the senses, shape their social identities and evoke emotions.3 For close to forty years or more, archaeologists have argued that medieval people understood objects to have particular social meaning as indicated by the curation of heirlooms, the re-use of prehistoric axes as grave gifts, or the special relationship to devotional objects such as pilgrim badges.4 A similar situation exists across other cognate disciplines from discussions of seals in art history or the particular meanings of things in plays as discussed by literary scholars.5 When the miniature scale is addressed, it often is in terms of the uniqueness of an object with a particular emphasis placed on craftwork and materials or related to their biographies and histories of use. Much less attention has been paid to bodily, sensorial and emotive experiences, that is, the ‘corporeal choreographies’ that can result from the engagement with the diminutive.6 peer-reviewed

In archaeology, gender is not a simple man-woman binary classification. It is the performance and embodiment of an identity that intersects with age, sex, race, sexuality, and class. One is not born, but rather becomes, a gendered person over time. Ideally, gender is explored as one of the structuring principles in societies. Gender archaeology challenges the notion that gender is timeless, biologically determined, and universal. By addressing questions to the material evidence—landscape, space, architecture, food, bodies, and artifacts—it investigates gendered roles and identities. A gender role comprises societal expectations: how people are supposed to walk, talk, dress, and act. This can be more straightforward than explorations of gendered identities, which are personal conceptions of self. Genders can be performed or embodied differently throughout the life course, meaning that people consistently (re)negotiate gender roles and identities throughout time. However, some studies still equate gender with sex, view gender as a binary (man and woman), or implicitly assume that gender identities follow Western or European models. We must be aware that, like now, gender exists on a wide spectrum, and assume the presence of various identities, including trans or pan folkx as well as categories of normative women and men. From its inception in the 1980s, gender archaeology, drawing on inspiration from other areas of the humanities and civil rights movements (as well as anthropology more generally), endeavored to change archaeological practice. It highlighted the problematic assumptions made in the present about the past, including ideas of universal male dominance. Challenges to this were rooted in second-wave feminist activism: women were demanding space, both within contemporary society and in accounts of the past. Feminist archaeologists firstly engaged in the process of making women visible. Drawing from wider post-structural and postcolonial thinking, from the mid-1990s onward, gendered approaches moved toward conversations of “difference” including explorations of power as well as agency, moving on from the “add women and stir” approach. This meant dismantling the concepts of apparently stable gendered identities of “man” or “woman” and embracing the fluidity of identity, characteristic of third-wave feminism. This resulted in wider conversations on sexualities, the body/embodiment, ethnicity, personhood, and life course. At this time, too, there was a surge in studies of masculinities, which had been left out in the pursuit of making women visible. Yet archaeology remains dominated by stories of anonymous, elite white men. With signs of renewed feminist activism (the fourth wave?), there is hope for different, better and inclusive narratives. Peer reviewed 2024-02-21

Purpose Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) persist as public health issues in developing countries and among disadvantaged communities in high-income countries, with rates in Aboriginal and Torres Strait Islander peoples in Australia among the highest recorded globally. A robust evidence base is critical to support policy recommendations for eliminating RHD, but available data are fragmented and incomplete. The End RHD in Australia: Study of Epidemiology (ERASE) Project aims to provide a comprehensive database of ARF and RHD cases in Australia as a basis for improved monitoring and to assess prevention and treatment strategies. The objective of this paper is to describe the process for case ascertainment and profile of the study cohort. Patients and methods The ERASE database has been built using linked administrative data from RHD registers, inpatient hospitalizations, and death registry data from 2001 to 2017 (mid-year). Additional linked datasets are available. The longitudinal nature of the data is harnessed to estimate onset and assess the progression of the disease. To accommodate systematic limitations in diagnostic coding for RHD, hospital-only identified RHD has been determined using a purposefully developed prediction model. Results Of 132,053 patients for whom data were received, 42,064 are considered true cases of ARF or RHD in the study period. The patient population under 60 years in the compiled dataset is more than double the number of patients identified in ARF/RHD registers (12,907 versus 5049). Non-registered patients were more likely to be older, non-Indigenous, and at a later disease stage. Conclusion The ERASE Project has created an unprecedented linked administrative database on ARF and RHD in Australia. These data provide a critical baseline for efforts to end ARF/RHD in Australia. The methodological work conducted to compile this database resulted in significant improvements in the robustness of epidemiological estimates and entails valuable lessons for ARF/RHD research globally.

Scholarly work on castles draws on multiple sources from history, archaeology, art and architectural history to literary and religious studies. This places it inaunique position to be able to bring different threads together to tell full stories of women’s lives. But a challenge exists to explore medieval women’s gendered roles and their lived experience without falling prey to the trap of inserting women into traditional narratives of male power. As a first step in response to my own call for fuller archaeological accounts of women’s lived experiences, this article focuses on one elite woman – Gundrada Oosterzele-Scheldewindeke, later de Warenne (d. 1085). It endeavours to capture her world through an examination of the material connections and relationships of her life. While people and places are important in this, the emphasis here is placed on our knowledge of the things that shaped Gundrada’s life and death. These range from castle architecture, her much-discussed Tournai stone tombslab, an assemblage of hairpins and a devotional text, the Crowland Psalter, as well as an archaeological object with possible amuletic properties. Drawing these different strands of evidence together shows how we can foreground women, not by marking them as exceptional but to highlight that they were part of and participative within the networked material world.

Background In 2018, the World Health Organization prioritized control of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), including disease surveillance. We developed strategies for estimating contemporary ARF/RHD incidence and prevalence in Australia (2015–2017) by age group, sex, and region for Indigenous and non‐Indigenous Australians based on innovative, direct methods. Methods and Results This population‐based study used linked administrative data from 5 Australian jurisdictions. A cohort of ARF (age Conclusions This study provides the most accurate estimates to date of Australian ARF and RHD rates. The high Indigenous burden necessitates urgent government action. Findings suggest RHD may be underestimated in many high‐resource settings. The linked data methods outlined here have potential for global applicability.

This book should be read by everyone who has an interest in castle studies and the social history of Tudor England more generally. It is a well-researched volume and the first interdisciplinary study devoted to Tudor castles. Audrey M. Thorstad rightly believes in understanding the value of Tudor castles beyond militarism. They are not viewed as an end to castle building nor as castles in decline but as entities worthy of study in their own right. non-peer-reviewed 2023-06-11

In Australia, disease registers for acute rheumatic fever (ARF) and rheumatic heart disease (RHD) were previously established to facilitate disease surveillance and control, yet little is known about the extent of case-ascertainment. We compared ARF/RHD case ascertainment based on Australian ARF/RHD register records with administrative hospital data from the Northern Territory (NT), South Australia (SA), Queensland (QLD) and Western Australia (WA) for cases 3&ndash, 59 years of age. Agreement across data sources was compared for persons with an ARF episode or first-ever RHD diagnosis. ARF/RHD registers from the different jurisdictions were missing 26% of Indigenous hospitalised ARF/RHD cases overall (ranging 17&ndash, 40% by jurisdiction) and 10% of non-Indigenous hospitalised ARF/RHD cases (3&ndash, 28%). The proportion of hospitalised RHD cases (36%) was half the proportion of hospitalised ARF cases (70%) notified to the ARF/RHD registers. The registers were found to capture few RHD cases in metropolitan areas (SA Metro: 13%, QLD Metro: 35%, WA Metro: 14%). Indigenous status, older age, comorbidities, drug/alcohol abuse and disease severity were predictors of cases appearing in the hospital data only (p &lt, 0.05), sex was not a determinant. This analysis confirms that there are biases associated with the epidemiological analysis of single sources of case ascertainment for ARF/RHD using Australian data.

Medieval women are typically portrayed as secluded, passive agents within castle studies. Although the garden is regarded as associated with women there has been little exploration of this space within medieval archaeology. In this paper, a new methodological framework is used to demonstrate how female agency can be explored in the context of the lived experience of the medieval garden. In particular, this study adopts a novel approach by focusing on relict plants at some medieval castles in Britain and Ireland. Questions are asked about the curation of these plants and the associated social practices of elite women, including their expressions of material piety, during the later medieval period. This provides a way of questioning the ‘sacrality’ of medieval gardening which noblewomen arguably used as a devotional practice and as a means to further their own bodily agency through sympathetic medicine. This article was written as part of my Marie Skłodowska-Curie Fellowship 2017– 2019, entitled, ‘HeRSTORY’, based at the Department of Archaeology, University of Reading, UK, where working with Professor Roberta Gilchrist I enjoyed unlimited opportunity to tend and nurture my own ideas. This paper adds to her work on the ‘Contested Garden’. Thanks to Professor Madeline Gray and Gwynedd Archaeological Trust for permission to use David Longley’s images of the Beaumaris effigy. Dr Rachel Delman kindly shared the rosemary reference with me. To develop further my research of relict plants studies at medieval castles, a new project ‘Sowing Seeds of Interdisciplinary Work peer-reviewed

Purpose Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) persist as public health issues in developing countries and among disadvantaged communities in high-income countries, with rates in Aboriginal and Torres Strait Islander peoples in Australia among the highest recorded globally. A robust evidence base is critical to support policy recommendations for eliminating RHD, but available data are fragmented and incomplete. The End RHD in Australia: Study of Epidemiology (ERASE) Project aims to provide a comprehensive database of ARF and RHD cases in Australia as a basis for improved monitoring and to assess prevention and treatment strategies. The objective of this paper is to describe the process for case ascertainment and profile of the study cohort. Patients and methods The ERASE database has been built using linked administrative data from RHD registers, inpatient hospitalizations, and death registry data from 2001 to 2017 (mid-year). Additional linked datasets are available. The longitudinal nature of the data is harnessed to estimate onset and assess the progression of the disease. To accommodate systematic limitations in diagnostic coding for RHD, hospital-only identified RHD has been determined using a purposefully developed prediction model. Results Of 132,053 patients for whom data were received, 42,064 are considered true cases of ARF or RHD in the study period. The patient population under 60 years in the compiled dataset is more than double the number of patients identified in ARF/RHD registers (12,907 versus 5049). Non-registered patients were more likely to be older, non-Indigenous, and at a later disease stage. Conclusion The ERASE Project has created an unprecedented linked administrative database on ARF and RHD in Australia. These data provide a critical baseline for efforts to end ARF/RHD in Australia. The methodological work conducted to compile this database resulted in significant improvements in the robustness of epidemiological estimates and entails valuable lessons for ARF/RHD research globally.

Objective To assess trends in cancer incidence and survival for Indigenous and non-Indigenous Australians in the Northern Territory. Design Retrospective analysis of population-based cancer registration data. Setting New cancer diagnoses in the NT, 1991-2012. Main outcome measures Age-adjusted incidence rates; rate ratios comparing incidence in NT Indigenous and non-Indigenous populations with that for other Australians; 5-year survival; multivariable Poisson regression of excess mortality. Results The incidence of most cancers in the NT non-Indigenous population was similar to that for other Australians. For the NT Indigenous population, the incidence of cancer at several sites was much higher (v other Australians: lung, 84% higher; head and neck, 325% higher; liver, 366% higher; cervix, 120% higher). With the exception of cervical cancer (65% decrease), incidence rates in the Indigenous population did not fall between 1991-1996 and 2007-2012. The incidence of several other cancers (breast, bowel, prostate, melanoma) was much lower in 1991-1996 than for other Australians, but had increased markedly by 2007-2012 (breast, 274% increase; bowel, 120% increase; prostate, 116% increase). Five-year survival was lower for NT Indigenous than for NT non-Indigenous patients, but had increased for both populations between 1991-2000 and 2001-2010. Conclusion The incidence of several cancers that were formerly less common in NT Indigenous people has increased, without a concomitant reduction in the incidence of higher incidence cancers (several of which are smoking-related). The excess burden of cancer in this population will persist until lifestyle risks are mitigated, particularly by reducing the extraordinarily high prevalence of smoking.

International Classification of Diseases, 10th Revision codes for rheumatic heart disease (RHD) include valvular heart disease of unspecified origin, limiting their usefulness for estimating RHD burden. A cross-disciplinary national consultation developed an algorithm to improve RHD identification in hospital data. The algorithm has been operationalised and piloted. The algorithm developed categorised 32% of RHD-coded patients as probable/possible RHD. We outline a series of research initiatives to improve identification of RHD in administrative data thereby contributing to monitoring the RHD burden globally.

Objective: To describe the epidemiology, clinical features, management and outcomes of hepatocellular carcinoma (HCC) in the Northern Territory over the past decade. Design, setting and patients: An NT-wide epidemiology study covering the period 1991–2010 and a clinical cohort study including patients diagnosed during 2000–2011. HCC diagnoses were provided by the NT Cancer Registry and cross-checked against clinical records. Main outcome measures: Age-adjusted incidence of HCC; management; clinical features; and median and 1-year survival. Results: There were 145 incident cases of HCC in the NT during 1991–2010, giving an age-adjusted annual incidence of 22.7/100 000 (95% CI, 17.2–26.8) for Indigenous Australians and 4.0/100 000 (95% CI, 2.1–5.8) for non-Indigenous Australians — an incidence rate ratio of 5.9 (95% CI, 4.7–7.4). There was no significant change in annual age-adjusted incidence over this period. The most common causative factors were hepatitis B virus in Indigenous people and hepatitis C virus in non-Indigenous people. Most people were diagnosed late, only 13/80 were diagnosed by screening, and outcomes were poor, with 28/80 overall surviving to 1 year. Outcomes were better among those managed through a centralised multidisciplinary service than among those who were not (adjusted hazard ratio for death at 1 year, 0.35 [95% CI, 0.16–0.81]). Conclusion: HCC incidence remains high in the Indigenous people of the NT. More resources are needed for HCC surveillance and management programs in this population.

Aims To assess outcomes of women in the Pregnancy and Neonatal Diabetes Outcomes in Remote Australia (PANDORA) cohort with gestational diabetes mellitus (GDM) managed by lifestyle modification compared with women without hyperglycaemia in pregnancy. Methods Indigenous (n = 97) and Europid (n = 113) women managed by lifestyle modification were compared to women without hyperglycaemia (n = 235). Multivariate linear and logistic regressions assessed whether GDM-lifestyle women had poorer outcomes compared to women without hyperglycaemia. Results Women with GDM-lifestyle had higher body mass index and lower gestational weight gain than women without hyperglycaemia. On univariate analysis, gestational age at delivery was lower and induction rates were higher in women with GDM-lifestyle than without hyperglycaemia. On multivariable regression, GDM-lifestyle was associated with lower gestational age at delivery (by 0.73 weeks), lower birthweight z-score (by 0.26, p = 0.007), lower likelihood of large for gestational age (LGA) [OR (95% CI): 0.55 (0.28, 1.02), p = 0.059], and greater likelihood of labour induction [2.34 (1.49, 3.66), p Conclusion Women with GDM managed by lifestyle modification had higher induction rates and their offspring had lower birthweight z-scores, with a trend to lower LGA than those without hyperglycaemia in pregnancy. Further studies are indicated to explore reasons for higher induction rates.

THE SEIGNURIAL HALL and chamber have been assumed, in both Britain and Ireland, to be typically located in the only building to generally survive on medieval residential sites. In England this idea has seen some revision, but in Ireland there has been little recent scholarship on medieval residential spaces. As a consequence, the term 'hall-house' is still used by Irish scholars as a label for some two-storey, 13th-century buildings, providing both a description and interpretation. The inference is that these buildings acted as both halls and elite residences at the same time during the High to Late Middle Ages. This contradicts what we know of the complex social codes of the time. Drawing on new empirical research, this article challenges the 'hall-house' classification, and explores different ways in which the spaces of these Irish medieval buildings can be better understood. This research was conducted as part of a PhD project completed at University College Dublin, School of Archaeology, and funded by the Irish Research Council. The article has benefitted from the expertise and input of Professor Tadhg O’Keeffe, Dr Rob Sands, Conor McDermott and Dr Neil Carlin. Thanks to Dr Seamús Ó Murchú for his assistance in map making. I would like to thank the landowners who gave permission for access for the surveys. peer-reviewed

Background Induction of labour (IOL) has become more common among many populations, but the trends and drivers of IOL in the Northern Territory (NT) of Australia are not known. This study investigated trends in IOL and associated factors among NT Aboriginal and non-Aboriginal mothers between 2001 and 2012. Methods A retrospective analysis of all NT resident women who birthed in the NT between 2001 and 2012 at ≥32 weeks gestation. Demographic, medical and obstetric data were obtained from the NT Midwives’ Collection. The prevalence of IOL was calculated by Aboriginal status and parity of the mother and year of birth. The prevalence of each main indication for induction among women was compared for 2001–2003 and 2010–2012. Linear and logistic regression was used to test for association between predictive factors and IOL in bivariate and multivariate analysis, separately for Aboriginal and non-Aboriginal mothers. Results A total of 42,765 eligible births between 2001 and 2012 were included. IOL was less common for Aboriginal than non-Aboriginal mothers in 2001 (18.0 % and 25.1 %, respectively), but increased to be similar to non-Aboriginal mothers in 2012 (22.6 % and 24.8 %, respectively). Aboriginal primiparous mothers demonstrated the greatest increase in IOL. The most common indication for IOL for both groups was post-dates, which changed little over time. Medical and obstetric complications were more common for Aboriginal mothers except late-term pregnancy. Prevalence of diabetes in pregnancy increased considerably among both Aboriginal and non-Aboriginal mothers, but was responsible for only a small proportion of IOLs. Increasing prevalence of risk factors did not explain the increased IOL prevalence for Aboriginal mothers. Conclusions IOL is now as common for Aboriginal as non-Aboriginal mothers, though their demographic, medical and obstetric profiles are markedly different. Medical indications did not explain the recent increase in IOL among Aboriginal mothers; changes in maternal or clinical decision-making may have been involved.

Background. Between November 2003 and January 2004, outbreaks of norovirus in 3 Australian jurisdictions involving 83 cases of illness were associated with imported oyster meat. Methods. Cohort studies were conducted in 2 jurisdictions to identify relative risks of illness for the consumption of oysters. A case series was conducted in the third jurisdiction. Results. The cohort studies conducted in the first 2 jurisdictions identified relative risks of illness of 17 (95% confidence interval, 5-51) and 35 (95% confidence interval, 5-243), respectively, for the consumption of oysters. Multiple strains of norovirus were detected in fecal specimens from 8 of 14 patients and in 1 of the 3 batches of implicated oyster meat using seminested reverse-transcriptase polymerase chain reaction methods. Traceback investigations revealed that all oyster meat was harvested from the same estuary system in Japan within the same month. Conclusions. These outbreaks demonstrate the potential of foodborne disease to spread internationally and the need for national and international collaboration to investigate such outbreaks. Foodborne illness related to norovirus is underestimated because of underreporting of human cases and challenges in laboratory detection of viruses in foods, both of which can delay public health action.

Objective: To examine trends in caesarean section deliveries and factors associated with these trends for Indigenous and non-Indigenous mothers. Design: Total population-based study. Setting: Northern Territory of Australia, 1986-2012. Population: Pregnancies among Northern Territory residents, limited to singleton live births with cephalic presentations delivered at 37-42 weeks' gestation (n = 78 561). Methids: Descriptive analyses of demographic and obstetric risk factors. Poisson regression with robust variance to estimate the likelihood of caesarean delivery with and without labour compared with vaginal delivery, over time and between Indigenous and non-Indigenous mothers, adjusting for risk factors. Main Outcome Measures: Trends in caesarean sections and risk of caesarean delivery compared with vaginal delivery. Results: The total rate of caesarean deliveries in the Northern Territory increased between 1986 and 2012. From the year 2000, the rise was driven by increases in caesareans with labour among nulliparous mothers and no labour caesareans among multiparous mothers. Increases in demographic and obstetric risk factors explained the rise in caesareans with labour among nulliparous Indigenous mothers, whereas other unmeasured variables contributed to the rise among non-Indigenous mothers. Increases in previous caesarean delivery contributed to the rise in all caesareans among multiparous mothers. Following adjustment, the risk of Indigenous nulliparous mothers having a caesarean with labour was 47% greater than for non-Indigenous nulliparous mothers [adjusted risk ratio 1.47 (95% CI 1.34-1.60)]. Conclusions: Increases in demographic and obstetric risk factors partially explained the increase in caesarean rates in the Northern Territory and the contribution of these factors differed between Indigenous and non-Indigenous mothers.

To identify the causes of the gap in life expectancy between Indigenous and non-Indigenous populations of the Northern Territory and how the causes have evolved over time.Analysis of NT death data over four 5-year periods, 1 January 1981 to 31 December 2000 inclusive. A decomposition method using discrete approximations (Vaupel and Romo) was applied to abridged life tables for the Indigenous and non-Indigenous populations of the NT.Contribution of causes of death, grouped according to global burden of disease groups and categories, to the life expectancy gap.The gap between the life expectancy of Indigenous and non-Indigenous people in the NT did not appear to narrow over time, but there was a marked shift in the causes of the gap. In terms of disease groups, the contribution of communicable diseases, maternal, perinatal and nutritional conditions halved during the 20 years to 2000. Meanwhile, the contribution of non-communicable diseases and conditions increased markedly. The contribution of injuries remained static. In terms of disease categories, the contribution of infectious diseases, respiratory infections and respiratory diseases declined considerably; however, these gains were offset by significantly larger increases in the contribution of cardiovascular diseases and diabetes for Indigenous women and cardiovascular diseases, cancers and digestive diseases for Indigenous men.The main contributors to the gap in life expectancy between the Indigenous and non-Indigenous populations were non-communicable diseases and conditions, which are more prevalent in ageing populations. With the life expectancy of Indigenous people in the NT expected to improve, it is important that public health initiatives remain focused on preventing and managing chronic diseases.

The difficulty of establishing a diagnosis and confirming cure of strongyloidiasis is widely appreciated. As parasitological diagnosis is often unsatisfactory, serodiagnosis is frequently relied upon. The aim of this study was to investigate changes in Strongyloides-specific antibody levels among a group of 79 seropositive Indigenous Australians living in a Strongyloides-endemic region. Testing before and after treatment revealed that seroreversion occurred most commonly after multiple courses of ivermectin therapy, with antibody titres of 35/42 (83%) subjects becoming negative. Seroreversion was also common following a single course of ivermectin or multiple courses of a 3-day regimen of albendazole, with seroreversion occurring in 13/19 (68%) and 7/10 (70%) subjects respectively. One 3-day course of albendazole was less effective with 4/10 (40%) subjects seroreverting, whereas none of the five subjects receiving a single dose of albendazole and 1/10 (10%) of subjects receiving no therapy seroreverted. These results support the use of serological follow-up for strongyloidiasis, and indicate that reversion to negative serostatus after ivermectin therapy is frequent.

Objective: To summarise the available evidence concerning the prevalence, clinical manifestations, diagnosis and management of strongyloidiasis in Northern Australia. Methods: We searched Medline, Clinical Evidence and the Cochrane Library using MeSH terms and text words 'strongyloides OR strongyloidiasis'. For Australian studies we included text words '(parasite* OR parasitic OR helminth*) AND Australia*'. We examined references contained in retrieved studies or identified from direct contact with researchers. Studies consistent with our objective that described their methods were eligible for inclusion. Results: The prevalence in some tropical Aboriginal communities is high. Infection can be asymptomatic, cause a range of clinical syndromes or death. It may become chronic. Infected patients are at risk of developing severe disseminated disease particularly with immune compromise. There is little information about the relative frequency of different clinical outcomes. Available diagnostic tools are imperfect. Stool examination has a low sensitivity. Serology may have a low specificity in high prevalence populations and has not been evaluated in Aboriginal populations. Antihelmintic drugs are relatively safe and effective. Community programs based on treatment of stool-positive cases have been associated with a reduced prevalence of strongyloidiasis. We found no studies examining alternative public health interventions. Conclusion: There is a high prevalence in many Aboriginal communities. Strongyloides infection should be excluded prior to commencing immunosuppressive therapies in patients from endemic areas. Further studies examining the public health impact of strongyloidiasis, the role of the enzyme-linked immuno-sorbent assay serological test and population-based approaches to management of the disease in endemically infected Australian populations are needed.

Despite more than three decades of feminist critique, archaeological scholarship remains predominantly focused on the exploration of patriarchal narratives and is, therefore, complicit in reinforcing structural inequalities. Questions must be asked of how the construction of archaeological knowledge affects representation and impacts upon our 'archaeologies'. This article explores the relative absence of gendered approaches within archaeology through the lens of later medieval archaeology, with a micro-focus on castle studies in Britain and Ireland. Are there reasons for the silence in relation to gender in the archaeology of the later Middle Ages, and what lessons are there for bringing about a more inclusive archaeology? This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement number 74606. Thanks to Neil Carlin, Daisy Black and Aleks Pluskowski for commenting on this article. A very special thanks to Roberta Gilchrist for assistance and constructive comments. This article adds to the conversation she initiated in Antiquity in 1991. peer-reviewed

Background: Diabetes in pregnancy carries an increased risk of adverse pregnancy outcomes for both the mother and foetus, but it also provides an excellent early opportunity for intervention in the life course for both mother and baby. In the context of the escalating epidemic of chronic diseases among Indigenous Australians, it is vital that this risk is reduced as early as possible in the life course of the individual. The aims of the PANDORA Study are to: (i) accurately assess rates of diabetes in pregnancy in the Northern Territory (NT) of Australia, where 38% of babies are born to Indigenous mothers; (ii) assess demographic, clinical, biochemical, anthropometric, socioeconomic and early life development factors that may contribute to key maternal and neonatal birth outcomes associated with diabetes in pregnancy; and (iii) monitor relevant post-partum clinical outcomes for both the mothers and their babies. Methods/Design: Eligible participants are all NT women with diabetes in pregnancy aged 16 years and over. Information collected includes: standard antenatal clinical information, diagnosis and management of diabetes in pregnancy, socio-economic status, standard clinical birth information (delivery, gestational age, birth weight, adverse antenatal and birth outcomes). Cord blood is collected at the time of delivery and detailed neonatal anthropometric measurements performed within 72 hours of birth. Information will also be collected regarding maternal postpartum glucose tolerance and cardio-metabolic risk factor status, breastfeeding and growth of the baby up to 2 years post-partum in the first instance. Discussion: This study will accurately document rates and outcomes of diabetes in pregnancy in the NT of Australia, including the high-risk Indigenous Australian population. The results of this study should contribute to policy and clinical guidelines with the goal of reducing the future risk of obesity and diabetes in both mothers and their offspring. Refereed/Peer-reviewed