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Tsunamis are huge disasters that can significantly damage benthic organisms and the sea-bottom environment in coastal areas. It is of great ecological importance to understand how benthic ecosystems respond to such destructive forces and how individual species are affected. Investigating the effect of such disasters on animals that are seldom caught alive is particularly difficult. Bivalve mollusks are especially suitable for investigating how a tsunami affects coastal benthic species because they preserve an environmental record in their shells that can be extended back in time by crossdating the records of multiple individuals. Here we studied dead shells of Mercenaria stimpsoni, a long-lived clam, and precisely determined the time of death by using nuclear bomb–induced radiocarbon (bomb-14C) and by counting annual growth increments. First, a quasi-continuous, regional bomb-14C record was created by analyzing the shells of 6 live-caught M. stimpsoni individuals. Then 27 dead shells collected from the seafloor of Funakoshi Bay were 14C-dated and analyzed. The results showed that the huge tsunami that struck northeastern Japan on 11 March 2011 caused mass mortality of this bivalve in Funakoshi Bay. Nine of the 27 clams died during the March 2011 tsunami, probably by starvation after burial by tsunami deposits or exposure above the seafloor as a result of sediment liquefaction during the earthquake. The dating method used in this study can help us understand how long-lived marine organisms with low population density are affected by huge natural disasters such as a tsunami.
The purposes of this study were to develop a communication skills training (CST) workshop program based on patient preferences, and to evaluate preliminary feasibility of the CST program on the objective performances of physicians and the subjective ratings of their confidence about the communication with patients at the pre- and post-CST.
The CST program was developed, based on the previous surveys on patient preferences (setting up the supporting environment of the interview, making consideration for how to deliver bad news, discussing about additional information, and provision of reassurance and emotional support) and addressing the patient's emotion with empathic responses, and stressing the oncologists' emotional support. The program was participants' centered approach, consisted a didactic lecture, role plays with simulated patients, discussions and an ice-breaking; a total of 2-days. To evaluate feasibility of the newly developed CST program, oncologists who participated it were assessed their communication performances (behaviors and utterances) during simulated consultation at the pre- and post-CST. Participants also rated their confidence communicating with patients at the pre-, post-, and 3-months after CST, burnout at pre and 3 months after CST, and the helpfulness of the program at post-CST.
Sixteen oncologists attended a newly developed CST. A comparison of pre-post measures showed improvement of oncologists' communication performances, especially skills of emotional support and consideration for how to deliver information. Their confidence in communicating bad news was rated higher score at post-CST than at pre-CST and was persisted at 3-months after the CST. Emotional exhaustion scores decreased at 3-months after CST. In addition, oncologists rated high satisfaction with all components of the program.
Significance of results:
This pilot study suggests that the newly developed CST program based on patient preferences seemed feasible and potentially effective on improving oncologists' communication behaviors what patients prefer and confidence in communicating with patients.
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