Self-Management Education for Bipolar Disorders: A Hermeneutic-Phenomenological Study on the Tacit Knowledge of Mental Health Nurses.

Background: Self-management of bipolar disorder (BD) education is a complex nursing intervention in which patients and informal caregivers are taught to be actively involved in self-monitoring and self-regulating activities. Some studies question if nurses are sufficiently equipped to deliver these educational tasks. Other studies suggest that nurses have gathered their knowledge implicitly by experience, but to date, this tacit knowledge is not described from the experiences of mental health nurses (MHNs) in ambulant BD care. Objective: To detect the tacit knowledge used by MHNs by interpreting their experiences in delivering self-management education to people with BD and their informal caregivers. Methods: A phenomenological-hermeneutical study amongst MHNs (N = 9) from three ambulant BD care clinics in the Netherlands. Face-to-face, open, in-depth interviews guided by a topic list, were conducted and transcribed verbatim prior to the hermeneutical analysis. Findings: We found five categories resembling the complex character of self-management interventions provided by MHNs: Building a trustful collaboration, Starting a dialogue about needs and responsibilities, Explaining BD, Utilizing mood monitoring instruments, and Conceptualizing self-management of BD. Conclusion: Eventually MHNs use tacit knowledge to cope with situations that demand an outside-the-box approach. Self-management education is partially trained and partially mastered through experience. Practice implications: In order to facilitate long-term self-management of BD, the collaboration of a supporting network is essential.

Gene expression in Large White or Duroc-sired female and castrated male pigs and relationships with pork quality.

This study assessed expression of 12 genes in 24 pig longissimus samples earlier subjected to a proteomic study by our group. Genes were selected on the basis of the earlier proteomic results. Pigs differed in rearing environment (indoors or outdoors), sire breed (Duroc or Large White) and gender (female or castrated male). At slaughter they experienced different stress conditions. The proportion of gene expression changes influenced by treatment factors was consistent with the proportion of protein changes in an earlier proteomic analysis of the same pigs. Expression levels of genes were often correlated. Gene expression was generally not correlated with the levels of the corresponding protein. Finally, most meat quality traits were correlated with the expression of at least one of the studied genes. The most meaningful of these was the association of a slower pH decline with lower levels of HSP72 expression and higher levels of HSP72 protein. ANXA2 and cMDH expression were also associated with various meat quality traits. These relationships may be related to pre-slaughter stress levels and fibre type composition.

Pig Longissimus lumborum proteome: Part I. Effects of genetic background, rearing environment and gender.

A 2×2×2 factorial experiment on Longissimus lumborum of 24 pigs found that rearing environment (indoors or outdoors), breed of sire (Duroc or Large White), and gender (female or castrated male) influenced 22, 10, and 88 proteins of the soluble fraction, respectively, containing 220 matched spots in total. Some proteins were influenced by more than one main effect. Outdoor rearing resulted in lower levels of enzymes of the glycolytic pathway suggesting a more oxidative metabolism. Breed of sire slightly altered the balance of enzymes of the glycolytic pathway. Gender had profound effects. In particular, different enzyme levels suggest a more lipid oriented energy metabolism, and a higher extractability of myofibrillar proteins suggest altered control of the contractile apparatus, in castrated males. Differences in extractability did not explain the profound gender effects. Glycogen content, ultimate pH, drip and thawing losses showed main or interactive effects of the three treatment factors.

Pig Longissimus lumborum proteome: Part II: Relationships between protein content and meat quality.

Gender, rearing environment and breed of sire influenced 50.5% of the matched protein spots of the soluble fraction and some meat quality traits [Kwasiborski, A., Sayd, T., Chambon, C., Santé-Lhoutellier, V., Rocha, D., & Terlouw, C. (2008). Muscle proteome in pigs: Part I: Effects of genetic background, rearing environment and gender. Meat Science]. Multiple regression analyses determined that 1 or 2 proteins explained between 24% and 85% of variability in Longissimus meat quality. Regression models differed between treatment groups, but relationships between proteins and meat quality traits seemed to be related to common underlying mechanisms. Thus, proteins retained in models for ultimate pH, lightness, drip, thawing and cooking loss were related to the glycolytic pathway, phosphate transfer, or fibre type composition. Another model for thawing loss retained proteins related to denaturation of myofibrils or lipid content. The models for redness involved proteins related to post-mortem oxidative activity. Thus, proteins correlated with meat quality traits were related to biochemical mechanisms known to be involved in meat quality. Relative contributions of these mechanisms may vary according to gender, sire breed or rearing environment.

Identifying and describing patients' learning experiences towards self-management of bipolar disorders: a phenomenological study.

ACCESSIBLE SUMMARY: Existing evidence suggest that patient education in promoting self-management strategies of bipolar disorder (BD) is effective. However, results across the full range of service users with BD vary. Learning experiences of service users look to be a crucial factor to take into account when designing, delivering, and evaluating effective interventions that promote self-management in chronic illness. What learning activities service users actually undertake themselves when self-managing BD that might explain varying success rates, and guide future self-management educational programmes has not been examined. Unlike previous studies that suggest that outcomes in self-management depend on individual learning activities, the current study found that learning to self-manage BD takes place in a social network that functions as a learning environment in which it is saved for service users to make mistakes and to learn from these mistakes. Especially, coping with the dormant fear of a recurrent episode and acknowledging the limitations of an individual approach are important factors that facilitate this learning process. Practitioners who provide patient education in order to promote self-management of BD should tailor future interventions that facilitate learning by reflecting on the own experiences of service users. Community psychiatric nurses should keep an open discussion with service users and caregivers, facilitate the use of a network, and re-label problems into learning situations where both play an active role in building mutual trust, thereby enhancing self-management of BD. ABSTRACT: Existing evidence suggest that self-management education of bipolar disorder (BD) is effective. However, why outcomes differ across the full range of service users has not been examined. This study describes learning experiences of service users in self-managing BD that provide a possible explanation for this varying effectiveness. We have conducted a phenomenological study via face-to-face, in-depth interviews, guided by a topic list, along service users with BD I or II (n = 16) in three specialised community care clinics across the Netherlands. Interviews were digitally recorded and transcribed verbatim prior to analysis in Atlas.ti 7. Unlike existing studies, which suggest that individual abilities of service users determine outcomes in self-management of BD, the current study found that self-management of BD is a learning process that takes place in a collaborative network. We identified five categories: acknowledgment of having BD, processing the information load, illness management, reflecting on living with BD, and self-management of BD. The success of self-management depends on the acknowledgment of individual limitations in learning to cope with BD and willingness to use a social network as a back-up instead. Especially, the dormant fear of a recurrent episode is a hampering factor in this learning process.

Presence of cues from stressed conspecifics increases reactivity to aversive events in cattle: evidence for the existence of alarm substances in urine.

In gregarious species like cattle, the presence of partners often affects fear-related reactions. The first experiment investigated whether behavioral and physiological responses to stress depend on the emotional state of the partner. Aubrac heifers were presented with food in a novel environment. Compared to heifers in the presence of a companion that had been previously habituated to the environment without receiving shocks, those in the presence of a companion animal that had previously received electric shocks in that environment had a stronger increase of cortisol response (11.2+/-1.1 vs. 7.4+/-0.9 ng/mL), showed a significantly longer latency to feed (60.1+/-12.3 vs. 17.8+/-5.9 s), and fed more slowly (54.5+/-11.4 vs. 110+/-7.3 s). After repeated exposure to the test conditions, when heifers of both treatments fed rapidly after entrance, response to an unexpected air blast from the feeding bucket was measured. Heifers in the presence of a stressed companion showed an increased latency to feed again compared to those with a nonstressed companion (44.5+/-5.1 vs. 22.8+/-4.3 s). Stressed companions urinated during tests; therefore the second experiment investigated whether heifers respond differently to urine collected from stressed and nonstressed conspecifics. In a first test, heifers were presented with food on a grid in a bucket in a novel environment. They had a longer latency to feed when the bucket contained urine from stressed rather than from nonstressed conspecifics underneath the grid (128.1+/-9.6 vs. 108.2+/-4.9 s). In a second test, heifers were presented with a novel object in a familiar environment. Heifers showed a longer latency to explore the object when it had been sprayed with urine from stressed compared to urine from nonstressed conspecifics (215.2+/-45.0 vs. 25.8+/-8.6 s). The results show that heifers perceive the state of increased stress of conspecifics and become more fearful as a result. They further show that this perception is at least partly mediated by olfactory cues in the urine.

Schedule-induced polydipsia experience decreases plasma corticosterone levels but increases plasma prolactin levels.

To determine the neuroendocrine pattern of response to excessive drinking induced by exposure of rats to an intermittent distribution of food (schedule-induced polydipsia, SIP), the present experiment investigated changes in plasma corticosterone, prolactin and catecholamines in chronically catheterized rats that had developed or not this form of adjunctive behaviour. It was found that rats that engage in excessive drinking displayed decreased plasma levels of corticosterone and increased levels of prolactin during the course of a SIP session. There was, however, no differences between groups in plasma catecholamine levels. The difference observed between SIP-pos and SIP-neg rats were entirely condition-specific, since they disappeared in the absence of access to water.

The propensity for schedule-induced polydipsia is related to differences in conditioned avoidance behaviour and in defense reactions in a defeat test.

In line with previous research showing that animals predisposed to develop schedule-induced polydipsia when submitted to intermittent distribution of food show differential behavioural and neurochemical characteristics, the present experiments investigated the nature of defense reactions to aversive situations in rats that do or do not develop schedule-induced polydipsia. It was found that rats that engage in excessive drinking during intermittent feeding display more rapid active avoidance learning in a 2-way shuttle-box and show less freezing when confronted with an aggressive resident male in a defeat test than those that do not develop schedule-induced polydipsia. These results are consistent with the hypothesis that individual differences in the propensity to exhibit oral consummatory activities in conditions of mild stress are related to the ability to shift behavioural programmes in response to external stimulation.

Meta-analysis of effects of gender in combination with carcass weight and breed on pork quality.

Meta-analysis was performed to quantify the effects of gender in combination with carcass weight and breed on pork quality. Altogether published results from 43 references were used. The traits analyzed were pH at 45 min (pH45min) and pH at 24 h (pH24hr) postmortem, objective color attributes lightness (L*), redness (a*), and yellowness (b*; CIE color system), color and marbling scores, drip loss, intramuscular fat content (IMF), and backfat thickness (P2), as well as sensory scores of juiciness and tenderness. Data for 2 muscle types, LM and Musculus semimembranosus (SMM), were used for the analysis. Swine genders were defined as intact/entire male (EM), surgically castrated male (SM), immunocastrated male (IM), and entire female (EF). After standardization of scaled traits (color, marbling scores, juiciness, tenderness) and accounting for cold carcass weight (CW), statistical analysis was performed using mixed models where breed was included as random effect. The analysis found a general effect of gender on each trait and multiple comparisons identified significant differences among the individual genders for L* (lightness), marbling scores, IMF, P2 in LM, and pH24hr in SMM. For these traits, when genders were grouped into gender categories as "castrates" (IM, SM) and "natural genders" (EM, EF), significant differences were found among estimates related to these categories. Furthermore, significant differences were found between castrates and individual gender types, indicating that castrated animals statistically segregated regarding their pork quality and regardless of type of castration. Pork of SM/EM animals has been found to be the fattest/leanest and there is indication that IM pork has the lightest meat color. Carcass weight dependence was found to be nonlinear (quadratic) for a*, P2, and marbling scores, and linear for b* and color scores in LM and pH24hr in SMM. The analysis identified significant breed effects for all traits, with large variation in the actual magnitudes (∼10 to 100%) of breed effects among individual traits. The established CW dependencies of pork quality traits in combination with the other influencing factors investigated here provides pork producers with the opportunity to achieve desired pork quality targets for a wide range of CW (∼30 to 150 kg) under standard indoor-rearing conditions.

Identifying and monitoring pain in farm animals: a review.

One important objective for animal welfare is to maintain animals free from pain, injury or disease. Therefore, detecting and evaluating the intensity of animal pain is crucial. As animals cannot directly communicate their feelings, it is necessary to identify sensitive and specific indicators that can be easily used. The aim of the present paper is to review relevant indicators to assess pain in several farm species. The term pain is used for mammals, birds and fish, even though the abilities of the various species to experience the emotional component of pain may be different. Numerous behavioural changes are associated with pain and many of them could be used on farms to assess the degree of pain being experienced by an animal. Pain, as a stressor, is associated with variations in the hypothalamic-pituitary-adrenal axis as well as in the sympathetic and immune systems that can be used to identify the presence of pain rapidly after it started. However, most of these measures need sophisticated equipment for their assessment. Therefore, they are mainly adapted to experimental situations. Injuries and other lesional indicators give information on the sources of pain and are convenient to use in all types of situations. Histopathological analyses can identify sources of pain in experimental studies. When pronounced and/or long lasting, the pain-induced behavioural and physiological changes can decrease production performance. Some indicators are very specific and sensitive to pain, whereas others are more generally related to stressful situations. The latter can be used to indicate that animals are suffering from something, which may be pain. Overall, this literature review shows that several indicators exist to assess pain in mammals, a few in birds and very few in fish. Even if in some cases, a single indicator, usually a behavioural indicator, may be sufficient to detect pain, combining various types of indicators increases sensitivity and specificity of pain assessment. Research is needed to build and validate new indicators and to develop systems of pain assessment adapted to each type of situation and each species.

Bayesian meta-analysis of the effect of fasting, transport and lairage times on four attributes of pork meat quality.

Technological meat quality is a significant economic factor in pork production, and numerous publications have shown that it is strongly influenced both by genetic status and by rearing and slaughter conditions. The quality of meat is often described by meat pH at different times postmortem, as well as by color and drip loss. A meta-analysis based on a database built from 27 studies corresponding to a total of 6526 animals classified was carried out. The purpose of this meta-analysis was to study the effect of fasting, lairage and transport durations on four main attributes of the technological pork meat quality. A Bayesian hierarchical meta-regression approach was adopted. The results of our meta-analysis showed that fasting time had a significant effect on pH measured 24h post-mortem (pHu) and drip loss (DL) measured in longissimus muscle. While, lairage affected only the pHu in semimembranosus muscle. Interestingly, we found that DL was the lone attribute that was affected by transport time and its interaction with fasting time.

Minimising pain in farm animals: the 3S approach - 'Suppress, Substitute, Soothe'.

Recently, the French National Institute for Agricultural Research appointed an expert committee to review the issue of pain in food-producing farm animals. To minimise pain, the authors developed a '3S' approach accounting for 'Suppress, Substitute and Soothe' by analogy with the '3Rs' approach of 'Reduction, Refinement and Replacement' applied in the context of animal experimentation. Thus, when addressing the matter of pain, the following steps and solutions could be assessed, in the light of their feasibility (technical constraints, logistics and regulations), acceptability (societal and financial aspects) and availability. The first solution is to suppress any source of pain that brings no obvious advantage to the animals or the producers, as well as sources of pain for which potential benefits are largely exceeded by the negative effects. For instance, tail docking of cattle has recently been eliminated. Genetic selection on the basis of resistance criteria (as e.g. for lameness in cattle and poultry) or reduction of undesirable traits (e.g. boar taint in pigs) may also reduce painful conditions or procedures. The second solution is to substitute a technique causing pain by another less-painful method. For example, if dehorning cattle is unavoidable, it is preferable to perform it at a very young age, cauterising the horn bud. Animal management and constraint systems should be designed to reduce the risk for injury and bruising. Lastly, in situations where pain is known to be present, because of animal management procedures such as dehorning or castration, or because of pathology, for example lameness, systemic or local pharmacological treatments should be used to soothe pain. These treatments should take into account the duration of pain, which, in the case of some management procedures or diseases, may persist for longer periods. The administration of pain medication may require the intervention of veterinarians, but exemptions exist where breeders are allowed to use local anaesthesia (e.g. castration and dehorning in Switzerland). Extension of such exemptions, national or European legislation on pain management, or the introduction of animal welfare codes by retailers into their meat products may help further developments. In addition, veterinarians and farmers should be given the necessary tools and information to take into account animal pain in their management decisions.

Alternative rearing systems in pigs: consequences on stress indicators at slaughter and meat quality.

The objective of this study was to evaluate the effects of three alternative (ALT) rearing systems for growing pigs (outdoor: 150 m2/pig; straw bedding: 1.30 m2/pig; and hut with access to a courtyard: 1.30 m2/pig) compared with a conventional system (fully slatted floor: 0.65 m2/pig, considered as control), on pre-slaughter stress indicators in relation with meat quality. To that end, the number of skin lesions on whole carcasses, as well as blood creatine kinase (CK) activity and urine levels in cortisol and catecholamines (adrenaline and noradrenaline) were determined at slaughter. Glycolytic potential (GP) and ultimate pH of the semimembranosus muscle were also measured. The global correlation network calculated between all these parameters shows that the indicators of pre-slaughter muscle activity (plasma CK) and/or stress indicators (e.g. adrenaline) are negatively (r=-0.26, P<0.01; r=-0.29, P<0.05, respectively) correlated with muscle GP and positively (r=0.17, P<0.05; r=0.44, P<0.001, respectively) with meat ultimate pH. Although some traits measured were sensitive to the degree of pre-slaughter mixing, they differed across rearing systems. The differences were most pronounced for the comparison of outdoors v. slatted floor. The lower levels of plasma CK and urinary catecholamines, and the lower number of carcass skin lesions of pigs reared outdoors, were related to a lower meat ultimate pH. Thus, ALT rearing systems influence animal welfare and meat quality, by providing enriched environmental conditions to the animals.

Meta-analysis of the effects of dietary vitamin E supplementation on α-tocopherol concentration and lipid oxidation in pork.

Meta-analyses have been carried out to quantify the effect of dietary vitamin E on α-tocopherol accumulation and on lipid oxidation in porcine M. longissimus. Published results of 13 (vitamin E accumulation) and 10 (lipid oxidation) experiments respectively were used for the analyses. After a number of standardization procedures, a nonlinear relationship was found between the supplementary vitamin E and the accumulation of α-tocopherol in pork which approached a maximum value of 6.4 µg/g tissue. Pork lipid oxidation levels were described in terms of Thiobarbituric Acid Reacting Substances (TBARS) values. The statistical analysis revealed significant effect of vitamin E dose, muscle α-tocopherol concentration and supplementation time on TBARS, resulting in two prediction models for lipid oxidation. Meta-analysis has proven to be a valuable tool for combining results from previous studies to quantify the effects of dietary vitamin E. Further studies, carried out with standardized experimental protocols would be beneficial for model validation and to increase the predictive power of the derived models.