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Compound-specific isotopic analysis of amino acids (CSIA-AA) is increasingly used in ecological and biogeochemical studies tracking the origin and fate of nitrogen (N). Its advantages include the potential for resolving finer-scale trophic dynamics than possible with standard bulk SIA and for reconstructing historical changes in the food webs of consumers from analyses of specimens in preserved sample archives. For the latter, assessing the effects of chemical preservatives on δ15NAA has been inconclusive because the conventional CSIA approach for derivatized AAs by gas chromatography-combustion-isotope ratio mass spectrometry (GC-C-IRMS) has analytical errors (0.4–1.0‰) in the range expected from chemical preservation. Here, we show improved analytical precision (0.15 ± 0.08‰) for 11 underivatized AA standards analyzed by high-pressure liquid chromatography followed by offline elemental analysis-IRMS (HPLC/EA-IRMS). Using this method, we report the first high-precision tests of preservation effects on δ15NAA in Northern Anchovy (Engraulis mordax) kept 1.5-yr in ethanol and up to 27-yr in formaldehyde. We found minimal methodological induced fractionation for eight AAs, and preservation effects on δ15N were similar regardless of duration and preservative used. Although some of the AAs differed significantly from frozen control samples (AA average +1.0 ± 0.8‰), changes in δ15N in the source AA phenylalanine and trophic position estimates were statistically insignificant. Our results are encouraging for resolving fine-scale natural variability using HPLC/EA-IRMS on chemically preserved specimens and for ultimately reconstructing biogeochemical records and trophic dynamics over long time scales.

Warm conditions in the North Pacific in 2014-15 were a result of the continuation of the North Pacific marine heat wave, a large area of exceptionally high SST anomalies that originated in the Gulf of Alaska in late 2013. The North Pacific heat wave interacted with an El Niño developing in the equatorial Pacific in 2015. Weekly periods of exceptionally high temperature anomalies (>2˚C) occurred until the start of the El Niño (winter of 2015), when SSTs were still high but not as high as those due to the marine heat wave. During the 2015-16 El Niño, the depth of the 26.0 kg m-3 isopycnal (d26.0) was considerably shallower than during the 1982- 83 and 1997-98 events. The area affected by the marine heat wave and the 2015-16 El Niño in the mixed layer was comparable to the 1997-98 El Niño, but lasted longer. Water column stratification in the upper 100 m during 2015-16 was as strong as the most extreme values during the 1997-98 El Niño. This stratification was primarily driven by the warming of the upper 100 m. Despite notable perturbations, the effects of the 2015- 16 El Niño on hydrographic properties in the CalCOFI domain were not as strong as those observed during the 1997-98 El Niño. Warm ocean conditions, stratification, nutrient suppression, and silicic acid stress likely favored initiation of a toxic Pseudo-nitzschia bloom in fall 2014. Very low zooplankton displacement volumes were associated with anomalously warm and saline surface waters off Baja California. In contrast, during the 1997-98 El Niño, zooplankton volume was near average. Off California, pelagic red crab (Pleuroncodes planipes) adults were abundant in the water column and frequently washed up on beaches of southern California from January 2015 into 2016, and central California by September 2015. Glider measurements of integrated transport up to June 2015 did not detect anomalous northward advection. As expected, HF radar indicated northward surface currents along the central California coast in fall and winter 2015-16. Northward advection appeared to be much stronger during the 1997-98 El Niño. Throughout 2015-16, the zooplankton community on the Oregon shelf was dominated by lipid-poor tropical and sub-tropical copepods and gelatinous zooplankton, indicating poor feeding conditions for small fishes that are prey for juvenile salmon. The presence of rarely encountered species increased copepod species richness during 2015-16 to levels higher than the 1998 El Niño. We infer that the unusual copepod vagrants of 2015-16 originated from an offshore and southwesterly source; an important difference from the southerly origin of vagrants during the 1997-98 El Niño. The very warm conditions caused sardine spawning to shift from central California to Oregon. Mesopelagic fish assemblage off southern California exhibited higher abundances of species with southern affinities, and lower abundances of species with northern affinities. Forage fish (Pacific herring, northern anchovy, and Pacific sardine) were much less abundant in 2015-16 compared to previous years. In contrast, catches of salmon were close to average off northern California. Catches of young-ofthe- year rockfishes were high off central California, but low off both northern and southern California. Seabirds at Southeast Farallon Island in 2015 exhibited reduced breeding populations, reduced breeding success, lower chick growth rates, and lower fledging weights. Common murres were negatively affected in central and northern California, but seabird responses were species-specific. It is clear from the results presented here that the warm anomaly effects on the ecosystem were complicated, regionally specific, and that we do not fully understand them yet.

This report reviews the state of the California Current System (CCS) between winter 2012 and spring 2013, and includes observations from Washington State to Baja California. During 2012, large-scale climate modes indicated the CCS remained in a cool, productive phase present since 2007. The upwelling season was delayed north of 42°N, but regions to the south, especially 33° to 36°N, experienced average to above average upwelling that persisted throughout the summer. Contrary to the indication of high production suggested by the climate indices, chlorophyll observed from surveys and remote sensing was below average along much of the coast. As well, some members of the forage assemblages along the coast experienced low abundances in 2012 surveys. Specifically, the concentrations of all lifestages observed directly or from egg densities of Pacific sardine, Sardinops sagax, and northern anchovy, Engraulis mordax, were less than previous years’ survey estimates. However, 2013 surveys and observations indicate an increase in abundance of northern anchovy. During winter 2011/2012, the increased presence of northern copepod species off northern California was consistent with stronger southward transport. Krill and small-fraction zooplankton abundances, where examined, were generally above average. North of 42°N, salps returned to typical abundances in 2012 after greater observed concentrations in 2010 and 2011. In contrast, salp abundance off central and southern California increased after a period of southward transport during winter 2011/2012. Reproductive success of piscivorous Brandt’s cormorant, Phalacrocorax penicillatus, was reduced while planktivorous Cassin’s auklet, Ptychoramphus aleuticus was elevated. Differences between the productivity of these two seabirds may be related to the available forage assemblage observed in the surveys. California sea lion pups from San Miguel Island were undernourished resulting in a pup mortality event perhaps in response to changes in forage availability. Limited biological data were available for spring 2013, but strong winter upwelling coastwide indicated an early spring transition, with the strong upwelling persisting into early summer.

Aortoenteric fistula (AEF) is an uncommon but serious complication occurring after aortic surgery and may occur at any site in the gastrointestinal tract, with the duodenum being the most common. Conventional surgical repair of secondary AEF has high mortality, whereas endovascular repair has emerged as an alternative treatment despite concerns about persistent or recurrent infection. We report the case of a 91-year old man who was admitted with rectal bleeding from an aorto-appendiceal fistula 9 years after open abdominal aortic aneurysm repair. This rare site for AEF was diagnosed on computed tomography, and we present the first case of endovascular treatment of this uncommon complication. [ABSTRACT FROM AUTHOR]

This qualitative study sought to explore conceptual models employed by community mental health team (CMHT) staff in the care of their clients and how CMHT clinicians communicated with one another, particularly in relation to complex clinical work. The qualitative method of interpretive phenomenological analysis was used, and semistructured in-depth interviews with seven UK CMHT clinicians were conducted and analyzed. Four themes were evident in the data and showed that clinicians face complex and competing demands and draw on a range of therapeutic models in their work. It was also clear that much discussion centred primarily on pragmatic issues and lacked conceptual depth. The results underline the complex and challenging nature of CMHT work and suggest that a more systematic approach to interdisciplinary training within teams could be beneficial in increasing clinicians' knowledge, skills, and their understanding of the conceptual models used across different disciplines. [ABSTRACT FROM AUTHOR]

Purpose. Psychosocial factors are likely to play a crucial role in adjustment to upper limb amputation and prosthesis use, and yet have received only minimal exploration within the literature. This study therefore, sought to gain a rich understanding of the experience of living with an upper limb amputation and of using a prosthetic arm and hand. Methods. The qualitative method of Interpretive Phenomenological Analysis was used. Purposive sampling culminated in a homogenous sample of 11 males with unilateral upper limb amputations, who wore a prosthesis at least weekly. Semi-structured interviews were carried out, transcribed and analysed according to the methodology. Results. Participants identified a theme of ongoing awareness of difference in appearance and ability. Consequently, participants described themes of psychosocial and functional adjustment to minimize this sense of difference. This was facilitated by the participants' prostheses and their positive coping style. Within this, participants also identified the personal meanings of their prosthesis and highlighted the terms of its use. The minimization of their sense of difference resulted in participants regaining a sense of worth. Conclusions. The findings offer a greater psychological insight into adjustment from an upper limb amputation and the role of prostheses. These findings have implications for both the clinical rehabilitation of patients who undergo upper limb amputations, as well as for future research into the use and value of prostheses in facilitating the adjustment to this experience. [ABSTRACT FROM AUTHOR]

This paper reports on a study that explored community psychiatric nurses' experiences of working with people who self-harm. Interpretative Phenomenological Analysis was used with eight experienced community psychiatric nurses who participated in semi-structured interviews. Established quality control procedures were utilized including audit of the analysis process and validating the results with participants. The participants described struggling to conceptualize self-harm behaviour and generally reported finding working with people who self-harm stressful particularly in terms of managing the emotional impact upon themselves and the boundaries of their professional responsibilities in relation to managing risk. The therapeutic relationship was viewed as crucial and a variety of coping methods to manage the impact of the work, which had largely developed through 'on the job', experience were described. The results highlight the potential difficulties faced by community staff and can be translated into clear recommendations for training and support. [ABSTRACT FROM AUTHOR]

There are few measures of pain for people with limited ability to communicate. Eight parents of adults with a known learning disability and associated physical health complaint were interviewed to explore their experience of identifying and managing the pain felt by their children. The parents did not often perceive their son or daughter to be in pain or discomfort, which was an unexpected finding given the sampling strategy. They described, however, specific ways of recognizing pain and would use a trial and error process to determine the cause. Parents had strategies for dealing with pain and reported mixed experiences of service interactions. The emerging themes can be related back to the pain literature and psychological theory. They emphasize the importance of involving parents in pain assessment and represent the first stage of research into a previously unexplored area. [ABSTRACT FROM AUTHOR]

This study sought to explore community mental health teams' (CMHTs) experiences of receiving an innovative introductory level training in cognitive analytic therapy (CAT). CMHTs are important providers of care for people with mental health problems. Although CMHTs have many strengths, they have been widely criticized for failing to have a shared model underlying practice. Inter-professional training which develops shared therapeutic models from which to plan care delivery is, therefore, essential. We have been developing such a training based on the psychotherapeutic principles of CAT. Twelve community mental health staff (six mental health social workers and six community psychiatric nurses) were interviewed by an independent interviewer following the completion of the training programme. The interviews were analysed using a qualitative thematic analysis. The analysis revealed that the programme increased the participants' self-assessed therapeutic confidence and skill and fostered the development of a shared model within the team, although the training was also perceived as adding to workload. The results of this study suggest that whole-team CAT training may facilitate cohesion and also suggest that having some shared common language is important in enabling and supporting work with 'difficult' and 'complex' clients, for example, those with personality disorders. Further development of such training accompanied by rigorous evaluation should be undertaken. [ABSTRACT FROM AUTHOR]

Women living with vulval pain can experience psychosocial difficulties. The current study explores the meaning and impact of vulval pain using interpretative phenomenological analysis. Interviews were conducted with eight women. Three overlapping super-ordinate themes emerged: (1) loss of femininity/sexual identity, (2) centrality of sex within relationships and (3) uncertainty surrounding the diagnosis. The participants here did not report the actual pain as being the central issue rather they felt the condition affected their sense of femininity, which was perceived in many ways as analogous to loss of sexual identity. Although they often avoided sexual contact, they also reported deep concern about the sexual needs of their partners and consequently often prioritised their partners, needs over their own in order to regain both their femininity and avoid anticipated rejection. The results indicate that the meaning the vulval pain had on the identity and relationships of the participants is the central concern in coping with this condition. These psychosocial factors need to be considered alongside existing medical management by health care professionals. [ABSTRACT FROM AUTHOR]

The processes through which people learn to live with CFS/ME are poorly understood and have not been rigorously explored within the literature. Semi-structured interviews were conducted with eight women and analysed using interpretative phenomenological analysis. Participants initially described being 'overwhelmed' by CFS/ME. Attempts at seeking help were unsatisfactory and participants described feeling let down and disbelieved. Participants reacted to this by identifying types of 'self-help' and assertively taking more responsibility for their illness and its treatment. Acquiring social support and greater knowledge were key mediating factors in the emergence of control and acceptance. The relevance of the themes to existing research and the implications for clinical practice are considered. Copyright © 2007 SAGE Publications Ltd. [ABSTRACT FROM AUTHOR]