Research on medical interpreters (MIs) in recent years has informed us of the visible and active participating roles that MIs play in the doctor-interpreter-patient triadic encounter. The use of multi-faceted, authentic data has also allowed both verbal and nonverbal nuances to be studied. However, while empirical studies have shown that physician empathy in medical communication is beneficial to the patient's healthcare outcomes, empathy in medical interpreting, especially the one that is expressed nonverbally, is rarely examined in medical interpreting research, even though MI is the key communication facilitator and in principle shares a communicative goal with the doctor. This study aims to acquire a deeper understanding of how an MI's empathy is constructed nonverbally and perceived by service users, and how it affects interlocutors and the communication process. This research argues that MI empathy in communication is desired and should be incorporated in the training, assessment, and most importantly, in the interpreting practice. Three sets of research questions are thus formed: 1) How do Mis communicate empathy, if any, for and to the patient? 2) How do the other medical interview participants (doctor and patient) and observers (video observers) perceive the empathic performance of the interpreters? Is there any discrepancy? Why? and 3) How do internal and external factors such as an MI's nonverbal sensitivity and personality traits influence empathic performance? The findings are expected to inform medical interpreting training and assessment and to enhance doctors' awareness of the roles of MIs so that a more patient-centred and empathic communication environment can be nurtured.

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Gun violence is a public health crisis in the United States. Research shows that violence functions similarly to a communicable disease. An exposure such as someone witnessing violence or being a victim of violence is a major risk factor to the exposed person becoming a perpetrator of violence themselves. Victims of gun violence are seen in emergency rooms at alarming rates and despite gun related deaths increasing over the past few decades, there is not a significant quantity of research on violence intervention. As physicians are key players in individual and community health, they have an ethical imperative to intervene. Both doctors and patients believe that physicians can play a role in addressing gun safety and risk of firearm injury. Gun violence interventions by physicians can be either preventative, working to avoid an initial firearm related injury, or interventional, working to avert additional firearm related injuries. Outpatient clinical attempts to prevent firearm injury can be modeled after pre-established methods like bicycle helmet safety screening. Inpatient or post injury methods include more comprehensive approaches that focus on breaking the cycle of violence and preventing reinjury. Gun violence is a public health crisis that requires physician action. / Urban Bioethics

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Mental illness affects 1.2 million children and youth in Canada. Female adolescents, in particular, suffer significant consequences associated with this. While family physicians are often the first line of contact for a health-related concern, little is known about how the promotion of lifestyle medicine to enhance the mental wellbeing of female adolescents is being communicated. Using a qualitative content analysis approach, a survey about counseling on lifestyle medicine was completed by 126 Hamilton Family Physicians giving a response rate of 25.2%. Key informants discussed with the highest agreement the following three themes: lifestyle medicine factors, barriers, and improvements for communication to female adolescent patients. The global prevalence of female adolescent mental health issues in combination with the use of screening tools was showcased within this study population. Results indicated that Hamilton family physicians integrate global recommendations into their line of care with patient-centered dialogue, awareness of patient needs, and lifestyle medicine education. / Thesis / Master of Science (MSc)

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INTRODUCTION: The demand for healthcare services is expected to increase significantly faster than the rate of growth of healthcare providers in the United States. One method for meeting the demand is the utilization of physician assistants in the management of patient care. Medical doctors and residents have traditionally provided radiation oncology patient care. It was not until recently that the use of physician assistants in radiation oncology became common practice. However, the most effective utilization of physician assistants in radiation oncology has not been fully elucidated at this time. REVIEW OF THE LITERATURE: The demand for radiation oncology services is expected to increase in part because people are living longer; there is increased cancer survivorship, and better treatment modalities. Physician assistants are capable of providing high quality patient care comparable to medical doctors and improving patient satisfaction. The need for Physician assistants in radiation oncology is expected to increase significantly by 2020. Effective models of team-based care are becoming increasingly important as the demand for radiation oncology services increases. PAs can be used in a variety of different models including shared, independent, and mixed models of team-based care. The utilization of physician assistants in radiation oncology is maximized when physician assistants provide care that otherwise could only be performed by a medical doctor. For example, when radiation oncology centers use a mixed model of team-based medicine, the practice can bill services provided by a physician assistant at 100% of the medical doctor service fee rate thus maximizing the cost effectiveness of physician assistants. METHODS: This study is aimed at determining the statistical difference in terms of new patient and established patient visits within an academic medical center radiation oncology unit before and after the addition of a physician assistant. A pre- and post-physician assistant analysis of new and established patient visits will be analyzed using a paired T-test. CONCLUSION: This study is unique in that it is focusing on a single radiation oncology center. A significant limitation of the study will be the small, single center, sample size. However, the results of this study can be used in the future as a reference for the expected impact of a physician assistant on a radiation oncology center.

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