Feasibility of Investigational Procedures and Efficacy of a Personalized Omega-3 Dietary Intervention in Alleviating Pain and Psychoneurological Symptoms in Breast Cancer Survivors.

BACKGROUND: Breast cancer survivors (BCS) are at risk for psychoneurological symptoms (PNS) and inflammation for years following cancer treatment. Fish, particularly salmon, provides a rich source of omega-3 long chain fatty acids (omega-3LC), which has an anti-inflammatory effect. However, the benefit of omega-3LC on PNS is not well-known. AIMS: This study evaluated the feasibility and the initial efficacy of a personalized meal plan with dietary omega-3LC in reducing PNS. METHODS: A prospective, randomized controlled trial design (n = 46) was used to evaluate the feasibility of a personalized meal plan using two omega-3LC dose levels (high and low omega-3LC) in reducing PNS including pain, depression, fatigue, sleep, and stress. RESULTS: The recruitment rate was 4.9% with overall retention rate of 74% and 67.1% adherence to personalized meal plan and dietary procedures. Of participants who completed the investigation, 94% completed fish adherence logs and consumed ≥70% of the assigned quantity of fish. Saliva collection was 97.8% at baseline and 100% at follow-up. BCS in the high omega-3LC group had a significant decrease in pain (p < .01), perceived stress (p < .05), sleep (p < .001), depression (p < .001), and fatigue (p < .01) over the course of intervention. There were trends of PNS improvement in the low omega-3LC group but the differences did not reach statistical significance. CONCLUSION: Our results support the feasibility of our investigational design, procedures, and intervention. The outcomes provide preliminary support for an expanded research effort using fish as a source of omega-3LC and personalized dietary planning as a vehicle for symptom self-management in BCS.

Self-Efficacy Survey Study of Pain Self-Management in Patients with Cancer.

BACKGROUND: Cancer pain prevalence remains high, and variance in self-efficacy for managing pain may explain why some patients experience greater pain severity. AIM: This study explored perceptions of self-efficacy in relation to cancer pain severity and treatment related characteristics. METHOD: A descriptive cross-sectional survey was administered to 50 cancer outpatients. Data analysis involved descriptive and correlational statistical analyses. RESULTS: Self-efficacy to manage pain was significantly associated with time since diagnosis and ability to deal with frustration, and inversely associated with pain severity level. A large proportion of patients reported low satisfaction self-managing their pain. Most patients reported independently self-managing their cancer pain; however, satisfaction with pain management was low for a large proportion of patients. Time since cancer diagnosis and ability to deal with frustration due to cancer pain were positively associated with cancer pain self-efficacy, whereas pain self-efficacy had a significant inverse correlation with cancer pain severity. CONCLUSIONS: Enhancing self-efficacy to self-manage under-treated cancer pain is important with implications for improving pain outcomes and quality of life. Further investigation on unmet needs and preferences for cancer pain self-management support is warranted.

Needs Assessment to Inform and Improve Educational Practices Surrounding Omega-3 Consumption during Pregnancy.

OBJECTIVES: Adequate dietary consumption of long chain omega-3 fatty acids (n-3 LCPUFA) during pregnancy has been associated with better maternal and infant health outcomes. Given that the primary source of n-3 LCPUFA is fish and fish oils, concerns surrounding contamination and uncertainty of safe fish intake guidelines have negatively affected consumption of fish during pregnancy. Although obstetric healthcare providers are in a unique position to influence dietary intake patterns, a gap exists in their understanding the knowledge and practices surrounding n-3 LCPUFA. This needs assessment investigation evaluated knowledge, attitudes and prescribing/recommending practices of obstetric practitioners surrounding n-3 LCPUFA consumption and/or supplementation to generate evidence supporting the development of targeted educational initiatives. METHODS: A cross-sectional, needs assessment was conducted using anonymous online-survey of affiliate members of the American College of Nurse Midwives (N = 105). A 24-item, previously validated (α = 0.86) needs assessment survey (Obstetric Clinicians Omega-3 Survey, OCOS) was used to assess attitudes, knowledge, and prescribing practices surrounding n-3 LCPUFA. RESULTS: The total OCOS score representing attitudes, knowledge and prescribing patterns collectively was 69.48% (Mean = 79.90(± 12.44), score range = 24-115). Scores for the sub-domains included attitude 68.33% (Mean = 20.50(± 3.64), score range = 6-30); knowledge 71.40% (Mean = 30.70(± 5.43), score range = 9-43); and prescribing patterns 68.31% (Mean = 28.69(± 5.39), score range = 9-42). CONCLUSIONS FOR PRACTICE: Although the majority of respondents had fair-moderate n-3 LCPUFA knowledge, attitudes and prescribing/recommending, our results highlight an opportunity for additional research and educational outreach targeting improved n-3 LCPUFA knowledge and practices. Specific areas of educational interest included associated health outcomes, dosing and safe consumption guidelines.

Exploring Cancer Pain Self-Management Needs and Preferences: A Meta-Ethnography.

Self-management of chronic disease and related symptoms provides a framework for understanding the contextual factors that influence self-management knowledge and skills that patients and families require to manage their condition on a day-to-day basis. The management of cancer pain is a significant issue for patients and families, and their experience can provide insight on cancer pain self-management support needs and preferences. A meta-synthesis of 20 qualitative research articles on self-management of cancer pain was conducted to gain a deeper understanding of the self-management support needs of patients with cancer pain. Noblit and Hare's meta-ethnographic model was used. The meta-synthesis resulted in increased understanding of the needs and preferences for self-management support of cancer pain and the role of the health care practitioner. Practical implications are presented.

Cup Feeding as a Supplemental, Alternative Feeding Method for Preterm Breastfed Infants: An Integrative Review.

Background The benefits of human milk for the preterm infant are well established. Preterm infants have lower breastfeeding rates and often face breastfeeding challenges. It is important that feeding practices for preterm infants optimize their chances of breastfeeding. Objective The purpose of this integrated review is to synthesize and critically analyze research related to the safety and efficacy of cup feeding as an alternative, supplemental feeding method for breastfed infants. Data Sources The electronic data bases of PubMed, CINAHL and were used to identify studies published in English from 1998- 2017. Design Using inclusion and exclusion criteria, 27 articles were initially assessed. After further screening 19 articles were included in the full review and of these 5 more were excluded. Lastly, an in-depth review of these 14 studies resulted in 2 more exclusions, for a total of 12 studies that met full inclusion and exclusion criteria. Review Methods Studies were examined for information on safety and efficacy of cup feeding as an alternative, supplemental feeding method for preterm breastfed infants. Studies were grouped into categories of outcomes that included (a) safety and physiologic properties; (b) breastfeeding outcomes. Results Use of cup feeding resulted in more stable heart rate and oxygen saturation than bottle feeding with similar weight gain. Additionally, breastfeeding rates were higher at discharge with continued higher rates at 3 and 6 months post-discharge for cup fed infants. Conclusions Premature infants face more breastfeeding obstacles than term infants. The potential for cup feeding as an alternative to bottle-feeding for breast fed preterm infants is positively supported by these results It is fundamentally important for NICU professionals to establish a protocol, education and training for the potential use of this feeding method for this vulnerable population.

What Is the Evidence for Use of a Supplemental Feeding Tube Device as an Alternative Supplemental Feeding Method for Breastfed Infants?

BACKGROUND: According to the Healthy People 2020 goals, the sustainability of breastfeeding duration rates within the United States has not been achieved. To increase these rates, it is important that women with breastfeeding difficulties receive the support needed to continue breastfeeding. When supplementation occurs, it is essential that the breastfeeding relationship be preserved. Various methods of supplementation are often recommended including use of the supplemental feeding tube device (SFTD). PURPOSE: The question guiding this brief is "What evidence exists to support the use of an SFTD as a method of supplementation for breastfed infants?" SEARCH STRATEGY: The PubMed and CINAHL databases were queried for original research published in English from 1990 through July 2016. Search terms included "supplemental feeding tube," "breastfeeding," "term infants," "premature infants," "Supplemental Nursing System," "Lact-aid," and "supply line." FINDINGS: Very limited research exists on the use of SFTDs as a method of supplementation for breastfed infants; however, existing research suggests that an SFTD may be useful as a supplementation method for breastfed infants. High-quality research is needed to evaluate the efficacy of using an SFTD for supporting exclusive and all breastfeeding rates. IMPLICATIONS FOR PRACTICE: Nurses and providers need to be educated and trained in the use of SFTDs as well as all supplemental feeding methods. Information on efficacy and SFTD use should also be included in policies related to breastfeeding and human milk use. IMPLICATIONS FOR RESEARCH: Further research should determine best methods of supplementation for breastfed infants and should examine differences in breastfeeding rates when using the SFTD for supplementation.

Influence of Feeding Type on Gut Microbiome Development in Hospitalized Preterm Infants.

BACKGROUND: Premature infants have a high risk for dysbiosis of the gut microbiome. Mother's own milk (MOM) has been found to favorably alter gut microbiome composition in infants born at term. Evidence about the influence of feeding type on gut microbial colonization of preterm infants is limited. OBJECTIVE: The purpose of this study was to explore the effect of feeding types on gut microbial colonization of preterm infants in the neonatal intensive care unit. METHODS: Thirty-three stable preterm infants were recruited at birth and followed up for the first 30 days of life. Daily feeding information was used to classify infants into six groups (MOM, human donor milk [HDM], Formula, MOM + HDM, MOM + Formula, and HDM + Formula) during postnatal days 0-10, 11-20, and 21-30. Stool samples were collected daily. DNA extracted from stool was used to sequence the 16S rRNA gene. Exploratory data analysis was conducted with a focus on temporal changes of microbial patterns and diversities among infants from different feeding cohorts. Prediction of gut microbial diversity from feeding type was estimated using linear mixed models. RESULTS: Preterm infants fed MOM (at least 70% of the total diet) had highest abundance of Clostridiales, Lactobacillales, and Bacillales compared to infants in other feeding groups, whereas infants fed primarily HDM or formula had a high abundance of Enterobacteriales compared to infants fed MOM. After controlling for gender, postnatal age, weight, and birth gestational age, the diversity of gut microbiome increased over time and was constantly higher in infants fed MOM relative to infants with other feeding types (p < .01). DISCUSSION: MOM benefits gut microbiome development of preterm infants, including balanced microbial community pattern and increased microbial diversity in early life.

Influence of anthropometric parameters on breastmilk provision in preterm infants.

OBJECTIVE: To explore how growth trends may relate to maternal provision of breastmilk to preterm infants in the Neonatal Intensive Care Unit (NICU). DESIGN: Non-experimental, retrospective, descriptive. SETTING: Level III, 40-bed suburban neonatal intensive care unit (NICU). PARTICIPANTS: 94 preterm infants (<37 post-menstrual age) admitted to the NICU between September 2011 and May 2013. METHODS: This retrospective chart review explored the relationship between infant growth during hospitalization and maternal provision of breastmilk at discharge. Growth data were collected including standard weekly growth measurements from birth through hospital discharge. In addition, average growth over time or growth velocity was assessed for weight (g/kg/d), head circumference (cm/d) and length (cm/d). Growth parameters at birth and discharge were plotted using the Olsen 2010 Growth Calculator for Preterm Infants to obtain standardized assessments of growth percentiles. Key growth factors were examined against the primary investigational outcomes of continued breastmilk provision at discharge and length of hospital stay. Variables included infant characteristics, number of daily direct-to-breast feedings (identified as traditional oral breastfeeding), and maternal characteristics. Statistical tests included student t-test and chi square. Logistic regression models were used to evaluate data and multiple regression was used to examine growth variables. RESULT: In this cohort, 44% of mothers continued to provide breastmilk at the time of infant discharge. Growth velocity was a significant predictor of continued provision of breastmilk at discharge (p=0 0.002, OR 1.39). Ponderal index, combined with other variables were highly predictive of length of stay (p<0.001, R2=0.858). Those infants whose first oral feed was direct-to-breast (versus bottle) were more likely to still be receiving breastmilk at discharge (adj OR 5.3). CONCLUSION: First oral feed being direct-to-breast and higher growth velocity are supportive of continued breastmilk provision throughout hospitalization. These results highlight a need for additional breastfeeding support for mother-infants dyads who provided a bottle as the first oral feed or with poorer growth progression.

Evidence of developmental continuity from birth to 1 year: sleep, temperament, problem solving, and recognition memory.

BACKGROUND: Research evidence is limited regarding developmentally appropriate care. Variations exits with respect to test procedure type, infant age at testing, and test relatedness. PURPOSE: To assess developmental continuity using multiple developmental measures from birth to 12 months in a single cohort of term infants. METHODS: A secondary analysis, longitudinal, correlational design was used to assess developmental continuity in a single cohort of infants (n 27). Measures included: sleep, using the Motility Monitoring System (first 48 hours of life); temperament, using the Infant Characteristics Questionnaire (ICQ, 6 months) and the Revised Infant Temperament Questionnaire (RITQ, 12 months); problem-solving, using the Willatts Infant Planning Test (PS, 9 and 12 months); and the Fagan Test of Infant Intelligence (FTII, 6 and 9 months). RESULTS: Using Spearmen correlation, significant correlations included: (1) Sleep and ICQ: transitional sleep and "unpredictable" (r 0.455, P .017), "unadaptable" (r 0.420, P .026), and "dull" (r 0.416, P .028); (2) ICQ and FTII 6 months (r -0.512, P .008); (3) RITQ "approachability" and quiet sleep (r 0.662, P .005); (4) arousals in active sleep and PS at 9 months (r -0.528, P .016). IMPLICATIONS FOR PRACTICE: Given our reported continuity between early sleep and later developmental measures, sleep-wake state should be considered in caregiving and environmental control to support sleep. Parental education on facilitating sleep-wake regulation in the home environment is essential. IMPLICATIONS FOR RESEARCH: These data support the existence of continuity between early sleep and later developmental milestones warranting a larger-scale investigation. Specific focus on development of care strategies for facilitating sleep immediately following birth is warranted.

Work-health balance of cancer survivors returning to work: A meta-ethnography.

PURPOSE: This meta-ethnography investigates the multifaceted health-related experiences of cancer survivors returning to work (RTW), recognizing the pivotal role of employment in overall well-being, particularly in the context of increasing cancer cases among working-age adults. METHOD: Following the methodology of Noblit and Hare, a comprehensive literature search was conducted from 2013 to 2023 in databases including PubMed, Scopus, CINAHL, PsycINFO, and Embase. Qualitative studies assessing cancer survivors' experiences, motivation, concern, resilience, and need in the process of RTW were identified. Eligible studies were assessed for quality using the Critical Appraisal Skills Program Checklist, and their findings were subsequently synthesized. RESULTS: Seventeen studies were included for analysis. The finding revealed five key themes: motivations (voluntary and involuntary), cancer-related concerns, resilience, needs for cancer healthcare support, and workplace accommodation. Voluntarily RTW was primarily linked to desires of normalcy, while involuntary RTW was often financially driven. Cancer survivors often face physical, psychological, and social challenges in the RTW process. Resilience played a crucial role in their readaptation to the workplace. Participants expressed the need for additional guidance from healthcare providers and tailored support from the workplace to facilitate a smoother RTW experience. CONCLUSION: Cancer survivors aspire to be actively engaged, have their specific needs addressed, and achieve success in their return-to-work endeavors. Occupational guidance and accommodation from healthcare providers and employers play a pivotal role in empowering survivors to balance cancer and work, facilitating the return-to-work process, and enhancing the quality of survivorship.

Use of a Supplemental Feeding Tube Device and Breastfeeding at 4 Weeks.

BACKGROUND: Mothers having difficulty breastfeeding their infants may use alternative supportive feeding methods. Although a supplemental feeding tube device is commonly used, efficacy for supporting sustained breastfeeding remains unknown. PURPOSE: To describe supplemental feeding tube device use by breastfeeding mothers as an alternative feeding method through exploration of associations between supplemental feeding tube device use and continued breastfeeding at 4 weeks of infant's age. METHOD: Forty mothers participated. They were interviewed during the birth hospitalization and at 4 weeks postpartum. Questions addressed use of supplemental feeding tube devices, breastfeeding issues, and continued breastfeeding relationships. We examined the relationship between LATCH scores at 2 to 3 days of life. RESULTS: Breastfeeding mothers who chose to supplement with bottle-feeding instead of use of a supplemental feeding tube device were 30% less likely to continue breastfeeding at a medium/high/exclusive level. CONCLUSION: Use of the supplemental feeding tube device may help avoid the potentially detrimental effect of bottle-feeding on continued breastfeeding.

Symptom Patterning Across the Cancer Care Trajectory for Patients Receiving Chemoradiation for Head and Neck Cancer: A Retrospective Longitudinal Study Using Latent Transition Analysis.

BACKGROUND: Patients with head and neck cancer (HNC) experience a multitude of symptoms because of the tumor and its treatment. OBJECTIVE: To identify the symptom patterns present in cancer treatment and survivorship periods for patients with HNC using latent class analysis. METHODS: A retrospective longitudinal chart review was conducted to examine symptoms reported by patients who received concurrent chemoradiation for HNC in a regional Northeastern United States cancer institute. Latent class analysis was performed to identify the latent classes present across multiple timepoints during treatment and survivorship for the most commonly reported symptoms. RESULTS: In 275 patients with HNC, the latent transition analysis revealed 3 latent classes for both treatment and survivorship periods: (1) mild, (2) moderate, and (3) severe symptoms. Patients were more likely to report a greater number of symptoms in a more severe latent class. During treatment, moderate and severe classes had representation of all most common symptoms: pain, mucositis, taste alterations, xerostomia, dysphagia, and fatigue. Different symptom patterns emerged for survivorship, with prominence of taste alterations and xerostomia across all classes, and all symptoms present in the severe class. The probability of symptom expression varied more in the survivorship period compared with the treatment period. CONCLUSIONS: Patients reported numerous symptoms during active treatment persisting into survivorship. Patients tended to transition to more severe symptomatology as treatment progressed and to more moderate symptomatology as survivorship evolved. IMPLICATIONS FOR PRACTICE: Examining the trend of persistent moderate symptomatology into survivorship is useful to optimize symptom management.

A Descriptive Survey Study of Patient Needs and Preferences for Cancer Pain Self-Management Support.

OBJECTIVES: To characterize the needs and preferences for pain self-management support (SMS) among patients with cancer during the transition of cancer care from the hospital to the home setting. SAMPLE & SETTING: 38 participants with cancer pain at a research-intensive cancer center in New England. METHODS & VARIABLES: A descriptive, cross-sectional survey study was conducted to investigate relationships among preferred and received support, extent and management of transitional change, and pain outcomes. Pain intensity and interference were measured using the Brief Pain Inventory-Short Form, transitional change was measured using the Measurement of Transitions in Cancer Scale, and SMS was measured using dichotomous questions. RESULTS: About half of participants reported concordance between preferred and received cancer pain SMS in the hospital and at home. The extent of transitional change in cancer care was found to be a significant predictor of average pain intensity in the hospital and pain interference at home. Satisfaction with cancer pain SMS was a significant predictor of pain intensity at home. IMPLICATIONS FOR NURSING: The extent of change during care transitions should be considered when fulfilling patient needs and preferences for cancer pain SMS to optimize outcomes.

An Integrative Review of the Role of the Oral and Gut Microbiome in Oral Health Symptomatology During Cancer Therapy.

PROBLEM IDENTIFICATION: Both chemotherapy and radiation therapy cause considerable symptom burden on patients' oral health, influencing nutritional status and quality of life. The role of the oral and gut microbiome in oral health alterations during cancer therapy is an emerging area of science in symptom management. LITERATURE SEARCH: PubMed®, CINAHL®, and Scopus® were searched for articles published from January 2000 through July 2020. DATA EVALUATION: Articles published in English that were focused on chemotherapy and/or radiation therapy were included in the review. SYNTHESIS: Of the 22 identified studies, 12 described oral health symptoms during chemotherapy and radiation therapy for head and neck cancer. Ten studies assessed symptoms during treatment for a variety of solid tumors and blood cancers, with four of these describing microbial interventions for the management of oral mucositis. Interventions varied, but the results supported the benefits of probiotics and synbiotics in reducing mucositis severity. Overall, less diverse oral and gut microbiome environments were associated with increased severity of oral health symptomatology. IMPLICATIONS FOR PRACTICE: Additional research is needed to determine how the oral and gut microbiome and microbial interventions may be used to improve oral health management during cancer treatment.

Genetic and non-genetic factors associated with health and vitality traits in beef calves.

Awareness and interest in calf health and wellbeing is intensifying, prompting change in the management and breeding decisions of producers and associated policy-makers. The objectives of the present study were to 1) quantify the risk factors associated with subjectively measured scores of vigor and birth size as well as diagnoses of scour and pneumonia in a large national dataset of beef calves, and 2) to estimate the contribution of genetic variance to such phenotypic measures. After edits, the data consisted of health and birth size data subjectively scored by producers on 88,207 calves born in 6,126 Irish beef herds. Vigor was recorded on a scale of 1 (very poor) to 5 (very good). Birth size was also scored on a scale of 1 (very small) to 5 (very large). Scour and pneumonia were both scored independently based on the suspected number of occurrence of each (0 = no occurrence, 1 = one occurrence, or 2 = more than one occurrence). On average, 14.7% of calves were recorded as having had at least one occurrence of scour within the first 5 mo of life, whereas 6.4% of calves were recorded as having had at least one occurrence of pneumonia within the first 5 mo of life. Relative to female calves, male calves had a worse vigor score and a suspected greater incidence of both scour and pneumonia. Relative to singletons, twins were, on average, smaller at birth, they had a worse vigor score, and they were more prone to scour. Calves born in the later periods of the calving season (i.e., late and very late) had a greater incidence of scour relative to calves in the herd born earlier in the calving season. Heritability estimates for vigor, birth size, and pneumonia were 0.12 (0.02), 0.33 (0.03), and 0.08 (0.02), respectively; no genetic variance was detected for scour. Breeding for vigorous calves that are less susceptible to pneumonia could provide producers with an additional strategy to ensure consumer concerns regarding food quality, safety, and calf wellbeing are being met.

Sensory Consumer and Descriptive Analysis of Steaks from Beef Animals Selected from Tough and Tender Animal Genotypes: Genetic Meat Quality Traits Can Be Detected by Consumers.

The objective of the present study was to determine if animals who were genetically divergent in the predicted tenderness of their meat actually produced more tender meat, as well as what the implications were for other organoleptic properties of the meat. The parental average genetic merit for meat tenderness was used to locate 20 "Tough genotype" heifers and 17 "Tender genotype" heifers; M. longissimus thoracis steaks from all heifers were subjected to sensory affective analysis (140 consumers) and sensory profiling using two trained sensory panels. All sample steaks were treated identically regarding pre- and post-mortem handling, storage, cooking and presentation (i.e., randomised, blind coded). For the affective consumer study, eight steaks were sectioned from the same location of the striploin muscles from each of the heifers. In total, 108 steaks from the Tender genotype and 118 from the Tough genotype were tested in the consumer study to determine the preference or liking of these steaks for appearance, aroma, flavour, tenderness, juiciness and overall acceptability. The consumer study found that the Tender genotype scored higher (p < 0.0001) for liking of tenderness, juiciness, flavour and overall acceptability compared to the Tough genotype. Similar results were generally found for the separate consumer age cohorts (18-64 years) with lower sensory acuity in the 65+ age cohort. For the descriptive analysis, the Tender genotype scored numerically more tender, juicy and flavoursome, although the differences were only significant for one of the panels. The critical outcome from this study is that parental average genetic merit can be used to pre-select groups of animals for tenderness, which, in turn, can be detected by consumers.

Large variability in feeding behavior among crossbred growing cattle.

The purpose of this study was to define an extensive suite of feeding behavior traits in growing crossbred cattle and to investigate their phenotypic inter-relationships as well as relationships with other performance and efficiency traits. Time-series feeding behavior data, as well as feed intake and liveweight records, were available for 624 growing crossbred cattle, of which 445 were steers and 179 were heifers. Feeding behavior repeatability estimates were calculated using linear mixed models. Additionally, partial Spearman correlations were estimated among 14 feeding behavior traits, as well as between feeding behavior with both performance and feed efficiency traits, using residuals retained from linear mixed models. The marginal contribution of several feeding behavior traits to the variability in metabolizable energy intake (MEI) was also determined. Repeatability estimates of 0.57, 0.36, and 0.48 were calculated for the number of feed events per day, the total time spent feeding per day, and the feeding rate, respectively. Cattle that ate more frequently each day, ate at a faster rate and consumed less energy in each visit to the feed bunk. More efficient cattle fed less often per day and fed for a shorter duration per day; they also had a slower feeding rate and fed for longer in each visit to the feed bunk. Moreover, heavier cattle fed for a longer duration per day had a faster feeding rate, but fed less often per day; heavier animals also fed first in the pen after the fresh feed was offered. The number of feed events per day and feeding time per day together explained an additional 13.4 percentage points of the variability in MEI above that already explained by all of growth rate, liveweight, and backfat depth. The results from the present study suggest that several repeatable time-series-related feeding behavior traits, that are less resource intensive to measure, may have a role as useful predictor traits of important but relatively difficult to record traits, such as feed intake and efficiency.

Animal-level factors associated with the achievement of desirable specifications in Irish beef carcasses graded using the EUROP classification system.

Beef carcasses in Europe are classified on measures of carcass weight, conformation, and fat cover. These measurements provide the basis for payment to producers, with financial penalties for carcasses that do not conform to desirable characteristics. The objective of the present study was to identify animal-level factors associated with the achievement of a desirable carcass weight, conformation score, fat score, and age at harvest, as stipulated by Irish beef processors in accordance with the EUROP carcass classification system. The stipulated specifications were a EUROP conformation score ≥O=, a carcass weight between 270 and 380 kg, a EUROP fat score between 2+ and 4=, and an age at harvest ≤ 30 mo. In the present study, 59% of cattle failed to achieve at least one of these desired specifications. The logit of the probability of achieving the desired specifications was estimated using multivariable logistic regression and carcass data from 4,717,989 cattle finished and harvested in Ireland between the years 2003 and 2017. In comparison to beef-origin carcasses and after accounting for breed differences, the likelihood of dairy-origin carcasses achieving the desired age, conformation, fat, and weight specifications was 0.97, 0.88, 1.14, and 1.05, respectively. In comparison to heifer carcasses, the odds ratio (OR) of bull and steer carcasses simultaneously achieving all of the desired specifications (i.e. the overall specification) was 0.35 and 0.95, respectively. Additionally, after accounting for breed differences, heifers from the dairy herd were half as likely as heifers from the beef herd to achieve the overall specification, whereas the odds of dairy-origin bulls (OR = 3.46) and steers (OR = 2.41) achieving the overall specification was greater than that of their respective beef-origin counterparts. Finally, cattle with a greater breed proportion of Angus were most likely to achieve the overall specification. Results from the present study could provide a deeper understanding as to why animals fail to achieve desirable carcass specifications and could be implemented into the management decisions made on farm to ensure that the supply of beef carcasses that achieve the desired metrics is maximized.

The achievement of a given carcass specification is under moderate genetic control in cattle.

The objective of the present study was to estimate the genetic parameters associated with the achievement of desirable weight, conformation, and fat specifications, represented by a series of binary traits. The desired specifications were those stipulated by Irish beef processors, in accordance with the EUROP carcass grading system, and were represented by a carcass weight between 270 and 380 kg, a fat score between 2+ and 4= (between 6 and 11 on a 15-point scale), and a conformation score of O= or better (≥5 on a 15-point scale). Using data from 58,868 beef carcasses, variance components were estimated using linear mixed models for these binary traits, as well as their underlying continuous measures. Heritability estimates for the continuous traits ranged from 0.63 to 0.73; heritability estimates for the binary traits ranged from 0.05 to 0.19. An additional trait was defined to reflect if all desired carcass specifications were met. All genetic correlations between this trait and the individual contributing binary traits were positive (0.38 to 0.87), while all genetic correlations between this trait and the continuous carcass measures were negative (-0.87 to -0.07). The genetic parameters estimated in the present study signify that potential exists to breed cattle that more consistently achieve desirable carcass metrics at harvest.

International Board Certified Lactation Consultants' Practices Regarding Supplemental Feeding Methods for Breastfed Infants.

BACKGROUND: According to the Baby Friendly Hospital Initiative, when supplementary feeding occurs, mothers should be counseled on the use and risks of feeding bottles and teats. To help support this initiative it is important to understand the supplementation practices of Internationally Board Certified Lactation Consultants (IBCLC)®. RESEARCH AIMS: To determine (1) if the location of an IBCLC's practice has any impact on supplemental feeding methods; (2) the preferred methods of and the main reasons for supplementation; (3) the level of an IBCLC's confidence with supplemental feeding methods; (4) who is making supplemental feeding decisions; and (5) if there are geographical differences among supplementation choices and reasons for supplementation. METHODS: An exploratory, descriptive, cross sectional survey of IBCLCs was conducted to generate data about their use of supplemental feeding methods. The survey was sent via email invitation through the International Board of Lactation Consultant's Board of Examiners, with a response rate of 11.5% (N = 2,308). RESULTS: There was no standard method of supplementation among participants. Participants indicated that they were confident advising mothers on alternative feeding methods. Only 17.6% (n = 406) of participants reported that the IBCLC was the caregiver who recommended the method of supplementation used. The majority of participants believed the Supplemental Feeding Tube Device SFTD) best preserves the breastfeeding relationship, and this was their preferred method of supplementation. However, the bottle was ranked as the number one method used in the United States, Australia, and Canada. The use of alternative feeding methods may be overwhelming to the mother. CONCLUSION: Supplementation by alternative feeding methods might help preserve the breastfeeding relationship and help reach the World Health Organization's goal of increasing exclusive breastfeeding rates.