Short-term Trips Research Articles

A comprehensive examination of antecedents of cultural intelligence amongst students

PurposeThe purpose of this paper is to investigate the various antecedents that impact the development of cultural intelligence (CQ) among students. The study also explores how growing up as a third culture kid (TCK) or a monoculture kid (MCK) impacts the relationship between the antecedents and CQ.Design/methodology/approachUsing data from 307 students consisting of both TCKs and MCKs, the authors test the direct effects and moderation model amongst the antecedents and CQ. Convenience sampling was employed to choose the participants for the study. Data were collected using a structured questionnaire and administered to the students via e-mail.FindingsThe results indicated that short-term trips abroad, undertaking a cross-cultural management course, local culture proficiency, watching films from other cultures, language of work proficiency, having friends from other cultures and interaction with people from different nationalities had a significant effect on CQ.Practical implicationsThis study provides a list of variables that facilitate the development of intercultural competence amongst students, which can be used as a base by academic institutions to develop various courses, classroom activities and university programs. Also, classifying students as TCKs and MCKs helps us understand which CQ antecedents are more important for which category of students.Originality/valueThis is one of the first studies on antecedents of CQ, which explores the impact of being a TCK or MCK on the development of students’ CQ.

Maintenance of Certification: You Can Make Your Global Health Work Count.

* Abbreviations: ABP — : American Board of Pediatrics GH — : global health MOC — : maintenance of certification PIM — : performance-improvement module QI — : quality improvement Global health (GH), defined as issues that transcend national boundaries and a call for actions by key stakeholders to determine the well-being of all people,1 is an expanding field. In 2014, 25% of active pediatric-training programs had dedicated GH tracks, and 66% had faculty identified to lead GH efforts for their training programs.2 Those traveling abroad for GH experiences as trainees are likely to remain involved later in their careers in varying capacities.3,4 GH also includes pediatricians engaged locally with immigrant or refugee communities in the United States. Engagement in GH activities takes various forms, from clinical care to advocacy, research, and policy making.5 As with other niche areas of pediatrics, GH practitioners may wrestle with issues relevant to their unique areas of practice, including incorporating GH activities into professional requirements and development.6 Challenges include maintaining clinical skills relevant for the US setting or skills relevant for short-term trips internationally, balancing between staying current with US medicine and practicing in a resource-limited sphere, finding continued learning activities relevant to the practice of pediatrics internationally, and charting a career path in this field. Thus, there is a growing population of board-certified pediatricians who may want or need to incorporate a GH focus into their maintenance of certification … Address correspondence to Tonya Arscott-Mills, MD, MPH, Botswana-University of Pennsylvania Partnership, PO Box 45498, Riverwalk, Gaborone, Botswana. E-mail: tonyaarscottmillsbup{at}gmail.com

Short-Term Medical Relief Trips to Help Vulnerable Populations in Latin America. Bringing Clarity to the Scene.

Non-profit organizations provide international medical relief trips to low/middle-income countries (LMIC) in order to provide healthcare to medically underserved areas. Short-term medical relief trips (STMRT) take a large amount of time and resources, and arouse concerns about their actual effectiveness. Here we develop a novel tool for consistently assessing how U.S. organizations provide primary care to Latin America through short-term medical relief trips. First, in Part 1, we create a “Best Practice” (BP) framework focused on the efficacy, sustainability, and long-term impact of the organizations based on a review of the last 27 years of available literature published in peer-reviewed journals. Second, in Part 2, out of 581 total medical relief organizations in the US, we identify the 19 organizations currently providing short-term primary care services to Spanish-speaking countries in Latin America. We use the BP framework to analyze the website content and secondary sources of these 19 organizations. We find that only three of the 19 organizations met 80% or more of the criteria defining BP according to the framework and four out of the 19 did not perform well in any of the framework’s three aspects of efficacy, sustainability, and long-term impact. Because there exists no current standardized way of assessing the methods implemented and services offered by STMRT, we provide suggestions about using this novel framework as a self-assessment tool for STMRT organizations.

How Do We Know? Comparisons of Existing Datasets for Overseas Surgical Missions

Over five billion people lack access to safe surgery when they need it. Short-term surgical missions from high-resource countries are a popular strategy to try and address this deficit. Each year, thousands of providers spend billions of dollars participating in short-term surgical missions. These missions are poorly characterized in aggregate. In this exercise, we performed reviews of two databases in an attempt to identify and characterize short-term surgical missions to Uganda. The first, a traditional search of the medical literature. The second, an unorthodox search of the internet. We compare the results of each in terms of motive, trip length, operations performed, surgery type, country of origin, evidence of teaching, recurring missions, and year of mission. We found only one article in the academic literature that fits our criteria. We found 43 individual organizations responsible for 129 individual trips in our internet search. These are characterized in this paper. The medical literature contains few traces of short-term surgical trips in Uganda. The internet contains many traces. These traces are rich in both qualitative and quantitative data. It is possible to mine, organize, and evaluate this data to better understand what is happening on the ground in Uganda and potentially the rest of the world.

Dolgaya Spit: Tourism on the Azov Seacoast

The Krasnodar region is one of Russia’s four leaders in terms of tourism development. The number of tourists who visit the Krasnodar region has been rising year after year. Specially protected natural areas, which attract a lot of tourists, come under pressure. Nowadays, natural monuments turned into travel destinations, as a rule, of short-term trips (the so-called weekend journeys). The Dolgaya Spit area is an example of extensive use of natural monuments. It can be expected that tourist flow might exceed the current level, maybe by several times, on the back of rising popularity, the development of transport infrastructure and improved beach quality. To date, the failure to resolve the current problems for a long time has led to unfavorable consequences, with the natural monument degrading rapidly amid growing recreational pressure. The situation is quite complicated. On the one hand, the area’s economic prospects as a resort are unquestionable, although, on the other hand, the Dolgaya Spit needs protection because it is now under the influence of constantly rising anthropogenic factors.

The ethical experiences of trainees on short-term international trips: a systematic qualitative synthesis

BackgroundMedical student and resident participation in short-term international trips for trainees (STINTTs) has increased in the past few decades. However, there has been no systematic review of trainees’ actual ethical experiences. The authors sought to identify what ethical issues medical trainees encounter during STINTTs, as elicited by and reported in peer-reviewed, quantitative and qualitative research papers.MethodsThe authors systematically searched five academic databases finding 659 unique titles and abstracts. The authors applied inclusion and exclusion criteria to these titles and abstracts resulting in fourteen papers, which were analyzed using qualitative thematic synthesis.ResultsThe qualitative analysis of the papers generated four themes: (1) Trainees’ Concerns Over Perpetuating Medical Tourism; (2) Struggling to Identify and Balance the Benefits and Harms of STINTTs; (3) The Complicated Trainee Mens (mind); and (4) Ethical Situations Encountered by Trainees. The fourth theme, which was the largest, was further divided into (a) Navigating social and cultural dynamics, (b) Trainees’ experiences related to the learner role, and (c) Ethical situations not qualifying for other catagories. Some of these issues reported in the empirical research papers are well represented in the broader literature on STINTTs, while others were less so—such as mistreatment of trainees. All included papers were published after 2010, and comprised a total of less than 170 medical trainees.ConclusionsMedical trainees report experiencing a wide range of ethical challenges during short-term international trips in which they engage in clinical or research activities. The authors call educators’ attention to specific challenges that trainees face. The relevant literature covering US and Canadian STINTTs is relatively young and largely qualitative. The authors briefly sketch a program for expanding the research on this increasingly common educational experience.

Sustainability in humanitarian surgery during medical short-term trips (MSTs): feasibility of inguinal hernia repair in rural Nigeria over 6years and 13 missions.

Surgical teaching missions are known to contribute significantly in reducing the local burden of disease. However, the value of short-term medical service trips (MSTs) remains under debate. Humanitarian surgery is highly dependent on funding, and consequently, data evaluation is needed to secure funding for future projects. The aim of this trial is to evaluate the results of 6-year MSTs to rural Nigeria with a specific emphasis on hernia repairs. Retrospective series of consecutive operations performed between 2011 and 2016 in rural Nigeria during 13 MSTs. Operations were categorized into type and number of procedures and origin of the surgeon. In terms of inguinal hernia repairs additional data was evaluated such as frequency of local anaesthesia (LA) and the type of hernia. The total amount of disability-adjusted life years (DALYs) averted during each mission are presented and discussed with regard to sustainability of these missions. From 2011 to 2016, a total of 1674 patients were operated. Of these, 1302 patients were operated for 1481 hernias of which 36.7% accounting as inguinoscrotal hernias. The percentage of operations performed by Nigerian staff increased from 31 to 55%. Overall, eighteen percent of the operations was solely performed by Nigerians. Totally, we averted 8092.83 DALY's accounting for 5.46 DALY's per hernia. The presented missions contribute significantly to an improvement in local healthcare and decrease the burden of disease. We were able to show the sustainable character of these surgical missions. As a next step, we will analyse the cost-effectiveness of MSTs.

Guidelines for responsible short-term global health activities: developing common principles

BackgroundGrowing concerns about the value and effectiveness of short-term volunteer trips intending to improve health in underserved Global South communities has driven the development of guidelines by multiple organizations and individuals. These are intended to mitigate potential harms and maximize benefits associated with such efforts.MethodThis paper analyzes 27 guidelines derived from a scoping review of the literature available in early 2017, describing their authorship, intended audiences, the aspects of short term medical missions (STMMs) they address, and their attention to guideline implementation. It further considers how these guidelines relate to the desires of host communities, as seen in studies of host country staff who work with volunteers.ResultsExisting guidelines are almost entirely written by and addressed to educators and practitioners in the Global North. There is broad consensus on key principles for responsible, effective, and ethical programs--need for host partners, proper preparation and supervision of visitors, needs assessment and evaluation, sustainability, and adherence to pertinent legal and ethical standards. Host country staff studies suggest agreement with the main elements of this guideline consensus, but they add the importance of mutual learning and respect for hosts.ConclusionsGuidelines must be informed by research and policy directives from host countries that is now mostly absent. Also, a comprehensive strategy to support adherence to best practice guidelines is needed, given limited regulation and enforcement capacity in host country contexts and strong incentives for involved stakeholders to undertake or host STMMs that do not respect key principles.

Antecedents of Cross-Cultural Adaptation Stress in Short-Term International Assignments

ABSTRACTThis study examines the role of cultural intelligence, perceived language fluency, and number of previous international experiences during a short-term international community service project in a foreign country. Based on a sample of 171 undergraduate and graduate students, the findings suggest that motivational cultural intelligence significantly impacted lowering cross-cultural adaptation stress levels experiences during short-term trips, while perceived language ability significantly increased stress levels. In addition, the control variables of age and gender were also found to significantly impact stress levels. Implications for research and practice are discussed.

Foundations, foibles and discovery: internationalising a campus through short-term trips abroad

This article examines how the political science department of a small, regional university (Shippensburg University of Pennsylvania) has tried to develop activities that will help internationalise the student body and the campus. The article examines, in an attempt to prepare and internationalise students, the departments’ short-term study abroad opportunities. In particular, the article evaluates one course as a case study and proposes a new method aimed at trying to assess its efficacy. In doing so, this article will review the literature on the impact of study abroad, focusing on short-term study (or faculty-led) experiences and discuss the pedagogical motivations of such courses. Finally, the article will propose, and preliminarily test, a new method of assessing short-term study about courses. The conclusion of this article speculates on the final results and details the substantial barriers to replication and augmentation of these programmes.

Globalization of Craniofacial Plastic Surgery: Foreign Mission Programs for Cleft Lip and Palate.

International Humanitarian Interchanges are a bona fide component of surgery and medicine. Additionally, these programs also provide substantial benefit both to the doers and the recipients.The foreign mission program is potentially a weapon of foreign policy which is underutilized and underestimated.Physician job dissatisfaction is increasing. However, the happiness and satisfaction of the participants in the short-term multidisciplinary trips, repeated, well-organized and respectful, with rather complete integration of the surgical system of the sister countries (“Plan B”), approaches 100%.The theory of the International Humanitarian Interchanges is based on substance, on medical theory. These trips are particularly successful in interchanges with medium-resourced countries.Furthermore, the academic visiting professor (“Plan A”: hi-resource place to hi-resource place), the One Man Can Save the World model (“Plan C”: to the low-resource place), and the intriguing Horton Peace Plan have possibilities for long-term benefit to the doer, recipient, the field of surgery, and the body of knowledge. In all of these, our country and the family of nations advance.The theoretical basis is not always religious nor the grand strategy plan; both have either proselytizing or political dominance as primary motives, and are mentioned as historically helpful.

In The Absence of Language: Modeling a Transformative, Short-Term Abroad Experience

This essay explores models for short-term, faculty-led study abroad in cases where language skills cannot be expected of students, focusing on issues of local immersion and relationship-building. It explicates three models undertaken by the author, detailing the strengths and weaknesses of common trip structures and related course outlines, and offers recommendations for successful trip modelling. It further explores the relationship between short-term abroad trips and cultural tourism, focusing on a model that allows students a pedagogical space to reflect critically on anthropological stereotypes.

Anticipatory Service Network Design of Bike Sharing Systems

Today‘s conurbations suffer from inefficiency in transportation systems. Bike sharing systems (BSS) combine the advantages of public and private transportation to better exploit the given transportation infrastructure. They provide bikes for short-term trips at automated rental stations. However, spatio-temporal variation of bike rentals leads to imbalances in the distribution of bikes, causing full or empty stations in the course of the day. Ensuring the reliable provision of bike and free bike racks is crucial for the viability of these systems. On the tactical planning level, target fill levels of bikes at stations are determined to provide reliability in service. On the operational planning level, the BSS operator relocates bikes in vehicles among stations based on target fill levels. A recent approach in tactical service network design (SND) anticipates relocation operations of BSS by means of a dynamic transportation model yielding the required demand of relocation services (RS). A RS is described by pickup and return station, time period, and the number of relocated bikes. RS represent the design decision for implementing a service between two stations in each period for each day of the system operation. The output of the SND model are the time-dependent target fill levels at stations and the set of cost-efficient RS to facilitate these target fill levels. However, the existing approach neglects the sequence of RS into tours, thus leading to a weak anticipation of operational decisions. We extend an existing SND approach by including the concept of service tours (ST). RS are sequenced in ST which start and end at the depot. Experiments shows that the ST obtained by the extended SND yield a stronger anticipation of operational decisions.

A one night stand? Reproductive excursions of female roe deer as a breeding dispersal tactic

Breeding dispersal, defined as the net movement between successive breeding sites, remains a poorly understood and seldom reported phenomenon in mammals, despite its importance for population dynamics and genetics. In large herbivores, females may be more mobile during the breeding season, undertaking short-term trips (excursions) outside their normal home range. If fertilisation occurs, leading to gene flow of the male genome, this behaviour could be considered a form of breeding dispersal from a genetic point of view. Here, we investigated ranging behaviour of 235 adult roe deer using intensive GPS monitoring in six populations across Europe within the EURODEER initiative. We show that excursions are common from June to August among females, with 41.8% (vs. 18.1% of males) making at least one excursion. Most individuals performed only one excursion per season and departure dates for females were concentrated in time, centred on the rutting period, suggesting a link with reproduction. The distance females travelled during excursions was significantly greater than the site-specific average diameter of a male home range, while travel speed decreased once they progressed beyond this diameter, indicating search behaviour or interaction with other male(s) outside the resident male's territory. Because adults are normally highly sedentary, the potential for mating with relatives is substantial; hence, we conclude that rut excursions could be an alternative tactic enabling females to avoid mating with a closely related male. To understand better the ultimate drivers at play, it will be crucial to explore the genetic causes and consequences of this behaviour.

Charitable platforms in global surgery: a systematic review of their effectiveness, cost-effectiveness, sustainability, and role training.

ObjectiveThis study was designed to propose a classification scheme for platforms of surgical delivery in low- and middle-income countries (LMICs) and to review the literature documenting their effectiveness, cost-effectiveness, sustainability, and role in training. Approximately 28 % of the global burden of disease is surgical. In LMICs, much of this burden is borne by a rapidly growing international charitable sector, in fragmented platforms ranging from short-term trips to specialized hospitals. Systematic reviews of these platforms, across regions and across disease conditions, have not been performed.MethodsA systematic review of MEDLINE and EMBASE databases was performed from 1960 to 2013. Inclusion and exclusion criteria were defined a priori. Bibliographies of retrieved studies were searched by hand. Of the 8,854 publications retrieved, 104 were included.ResultsSurgery by international charitable organizations is delivered under two, specialized hospitals and temporary platforms. Among the latter, short-term surgical missions were the most common and appeared beneficial when no other option was available. Compared to other platforms, however, worse results and a lack of cost-effectiveness curtailed their role. Self-contained temporary platforms that did not rely on local infrastructure showed promise, based on very few studies. Specialized hospitals provided effective treatment and appeared sustainable; cost-effectiveness evidence was limited.ConclusionsBecause the charitable sector delivers surgery in vastly divergent ways, systematic review of these platforms has been difficult. This paper provides a framework from which to study these platforms for surgery in LMICs. Given the available evidence, self-contained temporary platforms and specialized surgical centers appear to provide more effective and cost-effective care than short-term surgical mission trips, except when no other delivery platform exists.

Assessing the impacts of international volunteer tourism in host communities: a new approach to organizing and prioritizing indicators

This paper explores the use of indicators to evaluate the impacts of volunteer tourism in host communities, based on an online questionnaire sent to 183 volunteer tourism organizations. Little research exists demonstrating how volunteer tourism programs impact host communities or how impacts can be assessed, but the literature suggests the use of indicators to do so. Social indicator research and systems thinking assert that impact evaluation must be comprehensive and that indicators must consider interconnectivities present in the tourist system; we propose a framework of indicator development that addresses this. Data analysis focuses on volunteer tourist activities and how organizations prioritize indicators to assess diverse impacts of volunteer tourism in host communities. Comparisons are drawn between organizations in Latin America and international organizations (based in the USA, Canada, the UK, Australia and New Zealand) that send volunteers abroad. Differing volunteer activities suggest unique approaches between in-country and international organizations. The usefulness and degree of assessment of diverse indicators of the local impacts of volunteer tourism are quantified, while discrepancies between indicator usefulness and assessment raise questions. Comparisons between international and in-country organizations, large and small organizations, and organizations focusing on long-term vs. short-term trips suggest differing organizational priorities and impacts of volunteer tourism.

Trauma consults on humanitarian surgery trips: A perspective on the Haitian trauma system and the humanitarian’s role

Ubiquitous access to surgical care, especially trauma surgery, is recognized as an essential component of public health. We present two trauma cases—an upper arm machete laceration and a penetrating chest wound—that highlight barriers facing trauma patients in Haiti and describe how it relates to humanitarian surgery trips. An Emory University student–faculty collaborative, partnering with the non-profit Project Medishare (PM) for Haiti since 2008, provides elective and urgent surgical care to the underserved population of the Haitian Central Plateau. This partnership collaborates with a main referral center known for providing quality surgical care at little or no cost. Elective urological and general surgical cases comprise the bulk of the case load but urgent trauma services have been provided when required. Future trauma system initiatives must focus on increasing access to vehicles, telecommunications, and first responders. Our recommendations are reinforced by preliminary results from a trauma needs assessment performed in the Central Plateau and surrounding departments during July 2013. Humanitarian teams can contribute by preparing for emergencies prior to departure and sharing new procedural knowledge with local providers. Supplementing the ability to intercede in emergency surgical situations furthers the goal of short-term surgical trips to diminish indigenous patient morbidity and mortality. We advocate extensive preparation for such situations and increased bidirectional knowledge sharing with local staff.

Mission as Prophetic Dialogue: A Case Study from Colombia

Over the last 100 years we have seen dramatic changes in the ways that Christian churches have approached mission. In the United States, mission is now dominated by activities such as short-term immersion trips, church-to-church global partnerships, young adult volunteer programs, or lay mission programs that send individuals or families for temporary assignments. In this context of rapid change, Steve Bevans and Roger Schroeder published their groundbreaking work, Constants in Context, which provides guidelines for mission—summarized by the term prophetic dialogue—that acknowledge that Christianity is by its nature mission-oriented, and that the nature of our mission must take into account centuries of wisdom and at the same time modify itself with changing times. Based on a case study in Colombia, this article proposes that the practice of international accompaniment in zones of violent conflict is an example of prophetic dialogue in practice, and thus can serve as a model for other twenty-first-century mission activities.

Essentials for health care providers traveling to low-resource countries

Essentials for health care providers traveling to low-resource countries M Gail Hill, Karen McCarty, Deborah BowersSchool of Nursing, University of Alabama at Birmingham, Birmingham, AL, USAAbstract: The purpose of this article is to provide recommendations regarding personal planning for short-term trips to low-resource areas with the purpose of providing health care. Recommendations are based on lessons learned by the three authors during almost 5 years of cumulative time spent in 15 different countries on three continents in international nursing experiences. Recommendations are organized according to essential needs and nice-to-have materials. Suggestions are further sorted by categories of medicines, clothing, entertainment, documentation, safety, personal hygiene, and miscellaneous. Consideration has been given to space and weight limitations, as well as to practical and potentially critical needs. Each recommendation comes from the lived experiences of one, two, or all three authors, and has been found to be worth sharing with those who would experience health care delivery under nonoptimal conditions.Keywords: international nursing, travel essentials, low-resource countries

Remapping disclosure: gay men's segmented journeys of moving out and coming out

Drawing on recent work that examines the contingent, personal nature of queer migration, this paper provides empirical support for recent claims that coming-out journeys are more complex than the linear, often rural-to-urban typologies that have framed them during the past two decades. Since coming-out journeys are rarely elaborated beyond a conceptual level, overly teleological understandings involving homophobic, rural places, inclusive urban homelands, and one-time, linear ‘flights’ and ‘escapes’ persist. Employing the migration narratives of 48 self-identified gay men who settled in Ottawa, Ontario, Canada, and Washington, DC, USA, this paper challenges the linearity and finality of coming-out migration by highlighting particular segments of the journey. These include short-term trips to scout the gay life potentials of places, migrations that result in a degree of re-entry into ‘the closet,’ relocations that allow men to test or try on different places and identities, and moves (or imminent moves) that ‘trigger’—rather than stem from—a coming-out process. Taken together, these segments suggest that coming-out journeys are ongoing, relational, and often discontinuous journeys influenced by both queer individuals' intersectional subjectivities (e.g., age, race, and class) and the social contexts of the places they encounter.