bird by juanagui

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									This block of info completed by us, before sending template to experimenter
       Our Bird ID Number
       Application #
       Application Author
       Contact Information
For the bird from which the tissue was derived:
       Who completed this form
       Who cared for the bird prior to euthanasia
       Who performed the euthansia
       Who performed the dissection(s) and sample prep
       Species
       Gender
       Origin (answer one of the following)

                             purchased from this specific breeder/supplier:
                             hatched at this specific aviary:
                             collected from this specific field site:
      Family Information (if known)
                             mother ID
                             father ID
                             clutch size
                             clutch order
                             Hatchdate
      Age at capture or purchase
                             days since hatching, if hatchdate is known
                             estimated age, if hatchdate is unknown
                                                      minimum estimated age
                                                     maximum estimated age
      Age at euthanasia
                             days since hatching, if hatchdate is known
                             estimated age, if hatchdate unknown
                                                      minimum estimated age
                                                     maximum estimated age
      Date of euthanasia
      Time of Day of euthanasia
      Coloration
      Related physical samples submitted
                             a digital color photograph
                             blood, tissue or DNA sample
Recent conditions (in the week prior to sacrifice)
      Light                  cycle
                               Time lights went on, day of euthanasia
       Diet
                               seeds?
                                                              if yes, what kind?
                               commercial food preparation?
                                                              if yes, what kind?
                               fresh fruits?
                                                              if yes, what kind?
                               fresh veggies?
                                                              if yes, what kind?
                                eggshell
                                Feeding schedule
        Housing                 Was the bird held in captivity?
                                If captive, how was it housed?
                                Exposure to external environment: ventilation
                                Exposure to external environment: light
        Other birds in same cage?
                                  Number
                                  Gender
                                  Relationship
        Other birds in visual or acoustic but not physical contact?
                                  Number
                                  Gender
                                  Relationship
        Was the bird healthy prior to death?
        If the bird was not healthy, describe how so and justify inclusion in the analysis
        Descriptive record of experience during the week prior to sacrifice
Specific experimental manipulations
          developmental manipulation?
          hormonal manipulation?
          acoustic manipulation?
          social manipulation?
          other environmental manipulation?
         open text description of all experimental manipulations for this bird
Proximal Conditions at Euthanasia/Tissue Collection
        Behavior during the hour prior
                                did the bird sing?
                                                                if so, how much?
                                did the bird hear other birds singing?
                                                                    if so, describe
                                did the bird experience any other social
                                interactions?
                                                              if so, describe
     Prior to initiation of the euthanasia procedure, when was the last
     exposure to a human?
     Precise method of euthanasia
     Any unusual behavioral character at time of sacrifice
     Environment of Euthanasia
                                Size of room,
                                Light intensity
                                Light quality
                                Sound environment
                                Background noise
     Outside weather at time of sacrifice
                                temperature
                                humidity or precipitation
Samples collected

Comments
 (open field for anything not covered above)
                 data field format   our comments and explanation
o experimenter




                       name
                       name
                       name
                       name
                       name
                      choose


                 name and location
                 name and location
                 name and location

                     describe
                     describe
                    numerical
                    numerical
                   mm/dd/yyyy

                     numerical

                 numerical (days)
                 numerical (days)

                     numerical

                 numerical (days)
                 numerical (days)
                   mm/dd/yyyy
                    hh:mm            (local time, 24-hour clock)
                    describe
                                     submission is encouraged but not required
                     filename         (capturing coloration and any distinctive physical feature
                     sampleID

                      hh:hh          (Day:Night ratio)
hh:mm      (local time, 24-hour clock)

 choose    Why do we need this detail? Because of
describe   evidence that diet can have significant
 choose    effects on brain gene expression. Although
describe   we aren't trying to control this variable
 choose    directly, we do at least want to document it
describe   for potential post-hoc analyses of
 choose    unexplained trends, correlations,
describe   discrepancies, etc
 choose
 choose    if restricted, please describe
 choose
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numeric
 choose
 choose
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numeric
 choose
 choose
 choose    criteria: feeding on its own; feathers not fluffed; keel not
describe
describe

 choose    was the bird reared under conditions that differ from nor
 choose    was the bird exposed to any exogenous hormone treatm
 choose    was the bird's auditory experience different, at any point
 choose    was the bird's social experience different, at any point, fr
 choose    were there other experimental manipulations not capture
describe   PLEASE GIVE DETAILED DESCRIPTION


 choose
describe
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describe

choose
describe

describe
describe
describe   (e.g., highly agitated?)

describe   estimate of square footage
describe   e.g., low, average, high
describe   e.g., natural, fluorescent, incandescent, qualitative brigh
describe    (noisy or quiet)
describe   (white-noise vs biologically relevant sounds)

describe   note if ˚C or ˚F, please
describe
nctive physical features)
rs not fluffed; keel not visible through feathers.




ns that differ from normal, spontaneous rearing?
nous hormone treatments (systemic or localized)?
 different, at any point, from normal experience in a colony or aviary?
ferent, at any point, from normal experience in a colony or aviary?
nipulations not captured above?
 cent, qualitative brightness)

nt sounds)
This block of info completed by us, before sending template to experimenter
            Our Sample ID Number
            Our Bird ID Number
            Application #
            Application Author
            Contact Information
For the specific sample
              Time between death and tissue collection
              Name of region dissected
              method used to identify specific region
              method of tissue storage
              method of verification of accuracy of dissection
              other samples collected from same animal
              Intended Experimental Manipulation
             (group designation in Primary Experiment)
Comments
 (open field for anything not covered above)
xperimenter




               mm:ss
              describe
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