How Do We Explain ‛Autistic Traits’ in European Upper Palaeolithic Art?

Traits in Upper Palaeolithic art which are also seen in the work of talented artists with autism, including an exceptional realism, remain to be explained. Debate over explanations has been heated, ranging from such art having been created by individuals with autism spectrum conditions, to being influenced by such individuals, to being a product of the use of psychotropic drugs. Here we argue that 'autistic traits' in art, such as extreme realism, are the product of local processing bias or detail focus. The significance of local processing bias has implications for our understanding of Upper Palaeolithic society

Are there alternative adaptive strategies to human pro-sociality? The role of collaborative morality in the emergence of personality variation and autistic traits

Selection pressures to better understand other’s thoughts and feelings are seen as a primary driving force in human cognitive evolution. Yet might the evolution of social cognition be more complex than we assume, with more than one strategy towards social understanding and developing a positive pro-social reputation? Here we argue that social buffering of vulnerabilities through the emergence of collaborative morality will have opened new niches for adaptive cognitive strategies and widened personality variation. Such strategies include those that that do not depend on astute social perception or abilities to think recursively about other’s thoughts and feelings. We particularly consider how a perceptual style based on logic and detail, bringing certain enhanced technical and social abilities which compensate for deficits in complex social understanding could be advantageous at low levels in certain ecological and cultural contexts. ‘Traits of autism’ may have promoted innovation in archaeological material culture during the late Palaeolithic in the context of the mutual interdependence of different social strategies, which in turn contributed to the rise of innovation and large scale social networks

Autism spectrum conditions affect preferences in valued personal possessions

Although autism has been characterised as a disorder certain selective advantages of autism have been identified which may represent a selective trade-off for reduced ‘folk psychology’ and provide a potential explanation for the incorporation of autism genes in the human evolutionary past. Such potential trade-off skills remain to be explored in terms of selectively advantageous or disadvantageous behaviours in the distant past however. Here we present the results of an analysis of the relationship between AQ (autism quotient) and attitudes to valued personal possessions on the basis of a study of 550 participants. We find that individuals with autism have a reduced tendency to value and preserve objects as reminders of relationships/attachment figures and place a greater value on the direct practical function of their personal possessions. The latter strategy may have been more selectively advantageous in certain contexts whilst less advantageous in others in the distant evolutionary past

Should Autism Spectrum Conditions Be Characterised in a More Positive Way in Our Modern World?

In a special issue that focuses on complex presentations related to Autism, we ask the question in this editorial whether an Autism Spectrum Condition without complexity is a disorder, or whether it represents human diversity? Much research into Autism Spectrum Conditions (ASCs) over the years has focused on comparisons between neuro-typical people and people with Autism Spectrum Conditions. These comparisons have tended to draw attention to ‘deficits’ in cognitive abilities and descriptions of behaviours that are characterised as unwanted. Not surprisingly, this is reflected in the classification systems from the World Health Organisation and the American Psychiatric Association. Public opinion about ASC may be influenced by presentations in the media of those with ASC who also have intellectual disability. Given that diagnostic systems are intended to help us better understand conditions in order to seek improved outcomes, we propose a more constructive approach to descriptions that uses more positive language, and balances descriptions of deficits with research finding of strengths and differences. We propose that this will be more helpful to individuals on the Autism Spectrum, both in terms of individual self-view, but also in terms of how society views Autism Spectrum Conditions more positively. Commentary has also been made on guidance that has been adjusted for people with ASC in relation to the current COVID-19 pandemic

Optimizing production rates through enhanced well design

For decades, reservoir and drilling engineers have independantly strived to provide optimal production rates through various methods. The method studied for this research was based on a post-drilling analysis of optimizing production rates by designing a well path that could be drilled sucessfully. This was achieved by combining a wellflow simulator, NETool™, with a torque and drag modelling program, Power Plan®, to prove better results could be obtained. The work consisted of creating a methodology that was sucessfully implemented to first optimize the production rates by modifying an existing well path. Each new well path was placed in the torque and drag program to analyze the torque, sideforces and hookloads experienced on the drillsting. The success of the study was dependant on not exceeding the limitations of the system which in this case included the drillstring, connections and topdrive system. A component of cost-based risk was incorporated into the study to add a measure of uncertainty associated with drilling each new well path. This analysis proved very successful in obtaining higher production rates and a future in-depth study is recommended to develop an advanced tool that will integrate the two areas of oil and gas engineerin

The influence of a positive empathetic interaction on conditioned pain modulation and manipulation induced analgesia in people with lateral epicondylalgia

Objective: Conditioned pain modulation (CPM) and manipulation induced analgesia (MIA) are two forms of endogenous analgesia. Many forms of analgesia can be influenced by the nature of the patient clinician interaction. The aim of this study was to evaluate the influence of an empathetic and supportive interaction on CPM and MIA in people with Lateral Epicondylalgia (LE). Methods: In a double-blind, randomised, controlled trial, 68 participants with LE were assigned to two groups: the empathetic and neutral interaction groups. The interactions were carried out by a trained, professional role play actor, playing the part of a research assistant (RA). The RA actor spent 15min prior to CPM and MIA assessment interacting with the participants in an empathetic or neutral manner. Immediately after the interaction, a blinded assessor measured pressure pain threshold (PPT) at the symptomatic elbow and ipsilateral wrist during CPM and MIA testing. Linear mixed models were used to evaluate differences in CPM and MIA responses between the interaction groups. Results: There was a significant difference in CARE scores between the groups (p\u3c0.001), indicating that the intervention group experienced a more empathic interaction. Both groups showed a significant increase in PPT measures, indicative of a CPM and MIA analgesic response (p\u3c0.001), however the analgesic responses were greater in the group that had experienced a supportive, empathetic interaction (post CPM, wrist: p\u3c0.001; elbow: p=0.001), (post MIA wrist: p=\u3c0.001; elbow: p=0.001). Discussion: A single session of empathetic interaction positively influenced both CPM and MIA responses in people with LE

Revue narrative de la littérature sur la formation en soins ambulatoires en médecine interne au Canada

Background: The Canadian healthcare system faces increasing patient volumes and complexity amidst funding constraints. Ambulatory care offers a potential solution to some of these challenges. Despite growing emphasis on the provision of ambulatory care, there has been a relative paucity of ambulatory care training curricula within Canadian internal medicine residency programs. We conducted a narrative review to understand the current state of knowledge on postgraduate ambulatory care education (ACE), in order to frame a research agenda for Canadian Internal Medicine ACE. Methods: We searched OVID Medline, Embase, and PsycINFO for articles that included the concepts of ambulatory care and medical or health professions education from 2005-2015. After sorting for inclusion/exclusion, we analyzed 30 articles, looking for dominant claims about ACE in Internal Medicine literature. Results: We found three claims. First, ACE is considered to be a necessary component of medical training because of its distinction from inpatient learning environments. Second, current models of ambulatory care clinics do not meet residency education needs. Third, ACE presents opportunities to develop non-medical expert roles.  Conclusions: The findings of our narrative review highlight a need for additional research regarding ACE in Canada to inform optimal ambulatory internal medicine training structures and alignment of educational and societal needs. Contexte : Le système canadien des soins de santé fait face à des volumes croissants de patients et de cas complexes en même temps qu’à des contraintes budgétaires. Les soins ambulatoires offrent une solution pour relever certains de ces défis.  Malgré l’importance grandissante portée aux soins ambulatoires, on observe un manque relatif de cursus de formation en soins ambulatoires dans les programmes de résidence en médecine interne.  On a effectué une revue narrative en vue de comprendre l’état actuel des connaissances sur la formation en soins ambulatoires (FSA) postgraduée afin d’encadrer un programme de recherche portant sur la FSA à l’intention des étudiants en médecine interne canadiens. Méthodologie : On a consulté OVID Medline, Embase et PsycINFO pour trouver des articles publiés entre 2005 et 2015, portant sur les concepts de soins ambulatoires et d’éducation médicale ou des professionnels de la santé. Après la sélection d’articles selon des critères d’inclusion et d’exclusion, nous en avons examiné 30 en recherchant les affirmations dominantes sur la FSA dans la littérature en médecine interne. Résultats :  On a dégagé trois affirmations soit 1) la FSA est tenue pour une composante nécessaire de tout programme d’études de médecine parce qu’elle se distingue de l’environnement d’apprentissage hospitalier; 2) les modèles actuels de cliniques de soins ambulatoires ne répondent pas aux besoins de formation des résidents; 3) la FSA permet de développer des rôles autres que ceux de l’expert médical.  Conclusions : Les conclusions de notre analyse documentaire mettent en lumière la nécessité d’effectuer d’autres recherches sur la FSA au Canada pour connaître quelles seraient les structures optimales pour dispenser la formation en soins ambulatoires pour la médecine interne et établir une adéquation entre les besoins de formation et les besoins de la société. &nbsp