How do implicit and explicit partner evaluations update in daily life? Evidence from the lab and the field.

Evidence suggesting that implicit partner evaluations (IPEs), but not explicit evaluations (EPEs), can predict later changes in satisfaction and relationship status has led researchers to postulate that IPEs must be especially sensitive to relational reward and costs. However, supporting evidence for this assumption remains scarce, and very little is known regarding how IPEs versus EPEs actually update in everyday life. Two studies (one in-lab dyadic interaction study, N = 255, and one 14-day dyadic diary study, N = 348) investigated updating in IPEs and EPEs in the context of real-life relationship experiences. Study 1 revealed that the level of positive and negative experiences that a couple encountered while discussing a divergence of interests in their relationship predicted pre-to-post changes in EPEs, but not in IPEs. Study 2 revealed that IPEs showed less sensitivity to everyday relationship experiences across multiple metrics over the course of 14 days. Specifically, compared with EPEs, IPEs fluctuated less at the within- (vs. between-) person level, showed less-abrupt changes from day-to-day, and had a substantially weaker relationship with same-day positive and negative experiences. Rather than covarying with same-day experiences, IPEs appeared sensitive to relationship experiences aggregated across multiple prior days as well as to highly diagnostic relationship experiences, such as breakup. Consistent with recent advances in social-cognitive research, these findings support a modified account of IPE sensitivity, according to which IPEs show only gradual shifts under everyday circumstances, but more-dramatic shifts under highly diagnostic circumstances. Implications of these findings for close relationships and implicit social cognition research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Machine learning uncovers the most robust self-report predictors of relationship quality across 43 longitudinal couples studies.

Given the powerful implications of relationship quality for health and well-being, a central mission of relationship science is explaining why some romantic relationships thrive more than others. This large-scale project used machine learning (i.e., Random Forests) to 1) quantify the extent to which relationship quality is predictable and 2) identify which constructs reliably predict relationship quality. Across 43 dyadic longitudinal datasets from 29 laboratories, the top relationship-specific predictors of relationship quality were perceived-partner commitment, appreciation, sexual satisfaction, perceived-partner satisfaction, and conflict. The top individual-difference predictors were life satisfaction, negative affect, depression, attachment avoidance, and attachment anxiety. Overall, relationship-specific variables predicted up to 45% of variance at baseline, and up to 18% of variance at the end of each study. Individual differences also performed well (21% and 12%, respectively). Actor-reported variables (i.e., own relationship-specific and individual-difference variables) predicted two to four times more variance than partner-reported variables (i.e., the partner's ratings on those variables). Importantly, individual differences and partner reports had no predictive effects beyond actor-reported relationship-specific variables alone. These findings imply that the sum of all individual differences and partner experiences exert their influence on relationship quality via a person's own relationship-specific experiences, and effects due to moderation by individual differences and moderation by partner-reports may be quite small. Finally, relationship-quality change (i.e., increases or decreases in relationship quality over the course of a study) was largely unpredictable from any combination of self-report variables. This collective effort should guide future models of relationships.

Nurse titrated analgesia and sedation in intensive care increases the frequency of comfort assessment and reduces midazolam use in paediatric patients following cardiac surgery.

BACKGROUND: Pain and sedation protocols are suggested to improve the outcomes of patients within paediatric intensive care. However, it is not clear how protocols will influence practice within individual units. OBJECTIVES: Evaluate a nurse led pain and sedation protocols impact on pain scoring and analgesic and sedative administration for post-operative cardiac patients within a paediatric intensive care unit. METHODS: A retrospective chart review was performed on 100 patients admitted to a tertiary paediatric intensive care unit pre and post introduction of an analgesic and sedative protocol. Stata12 was used to perform Chi-squared or Student's t-test to compare data between the groups. RESULTS: Post protocol introduction documentation of pain assessments increased (pre protocol 3/24h vs post protocol 5/24h, p=0.006). Along with a reduction in administration of midazolam (57.6mcg/kg/min pre protocol vs 24.5mcg/kg/min post protocol, p=0.0001). Children's pain scores remained unchanged despite this change, with a trend towards more scores in the optimal range in the post protocol group (5 pre protocol vs 12 post protocol, p=0.06). CONCLUSIONS: Introducing a pain and sedation protocol changed bedside nurse practice in pain and sedation management. The protocol has enabled nurses to provide pain and sedation management in a consistent and timely manner and reduced the dose of midazolam required to maintain comfort according to the patients COMFORT B scores. Individual evaluation of practice change is recommended to units who implement nurse led analgesic and sedative protocols to monitor changes in practice.

On the neural implausibility of the modular mind: Evidence for distributed construction dissolves boundaries between perception, cognition, and emotion.

Firestone & Scholl (F&S) rely on three problematic assumptions about the mind (modularity, reflexiveness, and context-insensitivity) to argue cognition does not fundamentally influence perception. We highlight evidence indicating that perception, cognition, and emotion are constructed through overlapping, distributed brain networks characterized by top-down activity and context-sensitivity. This evidence undermines F&S's ability to generalize from case studies to the nature of perception.

How does the introduction of a pain and sedation management guideline in the paediatric intensive care impact on clinical practice? A comparison of audits pre and post guideline introduction.

UNLABELLED: Despite the use of guidelines to inform practice for pain and sedation management there are few evaluations of the effect of their introduction on clinical practice. Previous evaluations of the protocols and guidelines used to manage pain and sedation in the paediatric intensive care unit (PICU) report increases in pain and sedation medication administration post guideline introduction. In most reported cases the guideline was accompanied by a treatment algorithm. To our knowledge there is no published data on the effect of introducing a guideline without a treatment algorithm on pain and analgesia administration. PURPOSE: To evaluate the impact the introduction of a pain and sedation guideline will have on clinical practice. METHODS: A 19 bed PICU was audited for one month prior to the introduction of a guideline and one month post. FINDINGS: The proportion of patients receiving oral Clonidine increased (p=0.001) and the administration of Ketamine, particularly via bolus (p=0.003), reduced after the introduction of the guideline. The use of a validated pain tool to assess pain increased by 25% and communication of management plans increased by 25%. The documentation of the use of boluses increased by 36%. CONCLUSION: The introduction of a clinical practice guideline for pain and sedation management in PICU contributes to changes in medication administration, use of validated pain assessments, improved documentation of boluses and communication of management plans.

Expressive Writing Can Impede Emotional Recovery Following Marital Separation.

Marital separation and divorce are common life events that increases risk for poor health outcomes, yet few intervention studies explore how to mitigate this increased risk. This study implemented an expressive writing (EW; see Pennebaker, 1997) intervention for adults who experienced a recent marital separation. Ninety participants (32 men) were randomly assigned to and completed one of three experimental writing tasks: traditional EW, a novel (narrative-based) type of EW or control writing. Up to nine months after this writing, participants judged to be actively engaged in a search for meaning concerning their separation reported significantly worse emotional outcomes when assigned to either EW condition relative to control writing. Within the control condition, those participants actively engaged in a search for meaning reported the lowest levels of separation-related disturbance. We discuss these results in terms of the factors that may limit and promote psychological recovery following marital separation.