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Background: The doctor-patient relationship may be affected by the indiscriminate use of social media platforms. The aim of this study was to evaluate the content of the photos posted on medical students' Facebook accounts to determine whether they have posted private patient information and compare this to their self-reported behavior of posting such photos. Methods: We performed a cross-sectional study of medical students from a Peruvian private university. With their permission, we reviewed their Facebook accounts for the publication of photos or documents that included private patient information (face, name, diagnosis, medical exams). Those who allowed access to their Facebook accounts were also asked to complete an online survey. We assessed variables related to sociodemographic aspects, self reported Facebook use, and what type of private patient information they posted. Results: A total of 160/220 students joined the study, 59% were women, mean age: 20 years. 25.7% self-reported having posted private patient information in their Facebook profiles but we found such information on 33.1% of the students' pages. Of the pages where private patient information was found, in 94% of cases, the patients' faces were identifiable, and in 7.6%, the patients' real names appeared. However, only half of the students believed that the information in their Facebook post might affect or influence the doctor-patient relationship. Association with narcissism, gender, and account privacy was not found. Having uploaded more than 250 photos (OR:2.90; CI95%:1.14-7.39) and posting photos tagged with the location of a hospital (OR:4.02; CI95%:1.36-11.9) were associated with having posted photos containing private patient information. Conclusion: One out of three of medical students posted patients' private information on their personal Facebook profiles. Development, dissemination, and implementation of guidelines related to ethics in social media platforms are needed.

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In this paper, we present findings from a qualitative study that gathered Nicaraguans' perceptions of short-term foreign medical missions, towards deepening the understanding of what Nicaraguans value or find limited in the work of such foreign missions operating in their country. Fifty-two interviews were conducted with patients, relatives of patients, Nicaraguan physicians and nurses who partnered with or observed missions at work, 'beneficiary' community leaders, and individuals who were unable or unwilling to access mission-provided healthcare. Factors underlying participants' positive and more critical accounts of foreign primary and surgical missions are described and analysed. Empirical investigation on how, whether or not, or on what bases short-term medical missions (STMs) have been perceived as beneficial, harmful, or otherwise by those on the receiving end of these efforts is limited. This study aims to contribute to the evidence base for reflecting on the ethical performance of trans-national STMs.

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Unmet needs in global health are important issues, not yet solved by the international community. A variety of individuals, non-governmental organizations (NGO) and government institutions have tried to address this situation, developing multiple types of international cooperation (IC), such as humanitarian aid (HA), cooperation for development (CD) and medical missions (MM). In the last decades, we have witnessed an exponential growth in the creation and participation of these projects. Moreover, in the last 20 years, Chile has experimented a real paradigm switch, from a receiver to a provider of IC. Due to the recent surge in interest and relevance of the topic, we performed a narrative revision of the literature related with IC. In the present article, we characterize the different types of IC, with emphasis in MM: we address the risks, controversies and ethical problems associated with these activities. We finally propose some guidelines for the future development and promotion of MM.

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BACKGROUND: The motivation to volunteer on a medical service trip (MST) may involve more than a simple desire for philanthropy. Some volunteers may be motivated by an intrinsic interest in volunteering in which the context of the volunteer activity is less important. Others may volunteer because the context of their volunteering is more important than their intrinsic interest in volunteering. Furthermore, MSTs may pose a variety of ethical problems that volunteers should consider prior to engaging in a trip. This study evaluated the motivations and barriers for graduate health care students volunteering for an MST to either the Dominican Republic or Mississippi. Volunteers' understanding of some of the ethical issues associated with MSTs was also assessed. METHODS: Thirty-five graduate health professions students who volunteered on an MST were asked to complete an online survey. Students' motivations and barriers for volunteering were assessed using a 5-point Likert scale and Fisher's exact test. Ethical understanding of issues in volunteering was assessed using thematic analysis. RESULTS: Students' motivations for volunteering appeared to be related to the medical context of their service more than an inherent desire for volunteer work. Significant differences were seen in motivations and barriers for some student groups, especially those whose volunteer work had less opportunity for clinical service. Thematic analysis revealed two major themes and suggested that students had an empirical understanding that volunteer work could have both positive and negative effects. CONCLUSIONS: An understanding of students' motivations for volunteering on an MST may allow faculty to design trips with activities that effectively address student motivations. Although students had a basic understanding of some of the ethical issues involved, they had not considered the impact of a service group on the in-country partners they work with.

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Desde el triunfo de la Revolución la formación de profesionales en Cuba se acompaña de un importante componente de formación sociohumanista. La voluntad por el desarrollo social y el bienestar humano reclama un sostenido esfuerzo por desarrollar el conocimiento, la ciencia, la tecnología y ponerlos al servicio de las mayorías. La Revolución cubana no solo ha hecho un notable esfuerzo por desarrollar el conocimiento, la educación, la cultura; sino también por compartir generosamente sus avances con otros pueblos que lo necesitan. El campo de la salud es probablemente el mejor ejemplo de esa vocación humanista de proyección universal. Una de las mayores faenas en este campo fue la Misión Milagro, que nació como una iniciativa de Fidel Castro y Hugo Chávez en el marco de la Alternativa Bolivariana para las Américas. Esto conllevó la integración e interacción de varias disciplinas en función de la prestación de servicio científico-técnico donde la Oftalmología jugó un papel fundamental desde las subespecialidades. Dicho proceso tributó -de manera general, en la integración sistemática de una serie de contenidos y métodos disciplinarios- a una mejor comprensión de la realidad, así como a un enriquecimiento de la investigación interdisciplinaria. El objetivo de este trabajo es caracterizar el impacto y la influencia de la Misión Milagro en el proceso de integración interdisciplinaria de los profesionales de Oftalmología(AU)

Since the triumph of the Revolution, the training of professionals in Cuba has had an important social-humanistic component. Social development and human well-being calls for sustained efforts to increase knowledge, to develop science and technology and to put them at the service of the vast masses. The Cuban Revolution has not only made a remarkable effort to develop knowledge, education and culture, but also has generously shared their progress with others peoples in need. The healthcare field is probably the best example of that universally projected humanistic vocation. One of the major tasks in this field was the "Miracle Mission" which was born at the initiative of Fidel Castro and Hugo Chßvez in the context of the Bolivarian Alternative for the Americas. This led to the integration and interaction of various disciplines based on the provision of scientific and technical service where Ophthalmology played a leading role in subspecialties. This process contributed in a general way to the systematic integration of a series of discipline contents and methods, to better understanding of the realities, as well as to enrichment of interdisciplinary research(AU)

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Desde el triunfo de la Revolución la formación de profesionales en Cuba se acompaña de un importante componente de formación sociohumanista. La voluntad por el desarrollo social y el bienestar humano reclama un sostenido esfuerzo por desarrollar el conocimiento, la ciencia, la tecnología y ponerlos al servicio de las mayorías. La Revolución cubana no solo ha hecho un notable esfuerzo por desarrollar el conocimiento, la educación, la cultura; sino también por compartir generosamente sus avances con otros pueblos que lo necesitan. El campo de la salud es probablemente el mejor ejemplo de esa vocación humanista de proyección universal. Una de las mayores faenas en este campo fue la Misión Milagro, que nació como una iniciativa de Fidel Castro y Hugo Chávez en el marco de la Alternativa Bolivariana para las Américas. Esto conllevó la integración e interacción de varias disciplinas en función de la prestación de servicio científico-técnico donde la Oftalmología jugó un papel fundamental desde las subespecialidades. Dicho proceso tributó -de manera general, en la integración sistemática de una serie de contenidos y métodos disciplinarios- a una mejor comprensión de la realidad, así como a un enriquecimiento de la investigación interdisciplinaria. El objetivo de este trabajo es caracterizar el impacto y la influencia de la Misión Milagro en el proceso de integración interdisciplinaria de los profesionales de Oftalmología(AU)

Since the triumph of the Revolution, the training of professionals in Cuba has had an important social-humanistic component. Social development and human well-being calls for sustained efforts to increase knowledge, to develop science and technology and to put them at the service of the vast masses. The Cuban Revolution has not only made a remarkable effort to develop knowledge, education and culture, but also has generously shared their progress with others peoples in need. The healthcare field is probably the best example of that universally projected humanistic vocation. One of the major tasks in this field was the Miracle Mission which was born at the initiative of Fidel Castro and Hugo Chávez in the context of the Bolivarian Alternative for the Americas. This led to the integration and interaction of various disciplines based on the provision of scientific and technical service where Ophthalmology played a leading role in subspecialties. This process contributed in a general way to the systematic integration of a series of discipline contents and methods, to better understanding of the realities, as well as to enrichment of interdisciplinary research(AU)

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A senior dental student describes the deep sense of personal satisfaction from participating in a weeklong charity dental care trips to the Dominican Republic. Care, primarily consisting of extractions, was provided to individuals living in conditions that encourage dental disease at the same time the availability of oral healthcare services are essentially nonexistent.

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This article focuses on current trends in scholarly literature concerning the evaluation of short-term medical missions. The paucity of information on short-term medical missions in general has contributed to the lack of sufficient frameworks for evaluating them. While examples in the scholarly literature are sparse, in those rare cases where missions are evaluated, they tend to (1) produce their own criteria for evaluation, and (2) evaluate themselves based on metrics that emphasize their perceptions of accomplishments. I draw on interviews (n=31) as well as participant-observation regarding medical missions, to critique these trends. The data analyzed derive from an on-going ethnographic study began in Sololá, Guatemala in 1999, which since 2011 has been directly focused on short-term medical missions. More specifically, my data suggest potential conflict of interest inherent to both volunteering and hosting a short-term medical mission. NGO hosts, who maintain long-term residence in Sololá, may differ from short-term volunteers in both how they understand volunteer obligations as well what they consider helpful volunteer activity. These same organizations may remain financially tied to volunteer labour, limiting their own perceptions of what missions can or should do. I argue that these conflicts of interest have created an evaluation environment where critical questions are not asked. Unless these hard questions are addressed, short-term medical mission providers cannot be certain that their own activities are consonant with the moral imperatives that purportedly drive this particular humanitarian effort. This study demonstrates how ethnographic methods can be instrumental in attempts to evaluate humanitarian endeavours.

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Participation in short-term global health programmes for low-income countries is increasing amongst practising clinicians and trainees from high-income countries. However, few studies explicitly examine the perceptions of programme recipients. In July 2012, we conducted semi-structured interviews with a purposive sample of 47 adults receiving care from Medical Ministry International, an international non-governmental organisation providing short-term medical programmes in the Dominican Republic. Thirty interviews met criteria for inclusion. Transcripts were independently coded using a descriptive approach. After thematic saturation, 20 interviews were included in the final analysis. Nine major themes were identified: misidentification, access, identified needs, social determinants, faith, language, student involvement, areas for improvement and respect. Recipients were reluctant to discuss programme improvement directly and frequently misidentified the researcher as a caregiver, suggesting a need to separate clearly programme evaluation from care provision. They viewed student involvement positively in a setting where supervision is emphasised, suggesting a potential to develop measures of supervision's adequacy. Finally, recipients' perceptions of respect as an important but intangible programme element encourage broadening the ethical discourse around short-term programmes beyond only tangible goods and services. Our findings support the usefulness of qualitative methods for short-term programme evaluation and generate important hypotheses for future research.

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Within the context of global health development approaches, surgical missions to provide care for underserved populations remain the least studied interventions with regard to their methodology. Because of the unique logistical needs of delivering operative care, surgical missions are often described solely in terms of cases performed, with a paucity of discourse on medical ethics. Within surgery, subspecialties that serve patients on a non-elective basis should, it could be argued, create mission strategies that involve a didactic approach and the propagation of sustainable surgical care. The ethical considerations have yet to be described for paediatric neurosurgical outreach missions. We present here the perspectives of neurosurgeons who have participated in surgical outreach missions in Central America, South America, Eastern Europe and sub-Saharan Africa from the vantage point of both the visiting mission team and the host team that accommodates the mission efforts.

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