BACKGROUND: Neurosurgery exhibits notably lower representation of Black, Hispanic, and female surgeons compared to various other medical and surgical specialties. Existing research focuses on medical students\' views on surgeons, factors influencing female medical students\' preferences in surgical fields, and the perceived interests and concerns of students contemplating a career in neurosurgery. However, there is a significant gap in understanding the unique concerns and perspectives of female medical students interested in neurosurgery.
METHODS: Semi-structured interviews with female medical students were recruited from medical schools in the DC area. Interview questions were based on Lent and Brown\'s Social Cognitive Career Theory. Transcripts were analyzed thematically into codes.
RESULTS: In total, 8 female medical students from our institution participated. We identified three major themes that influenced medical students decision making: sense of belonging (diversity, mentorship, passionate), self-efficacy (ambitious/\"gunner\", intense/competitive), and outcome expectations (innovation/research, immediate impact, procedural/surgical aspect, salary, work-life balance).
CONCLUSIONS: Female medical students face distinct challenges and factors to consider when choosing a career in neurological surgery. The biggest concern for female students was a sense of belonging. It is imperative to enhance the diversity within the neurosurgical specialty and boost the representation of female neurosurgeons. Early interventions designed to tackle and alleviate their specific concerns are pivotal in achieving this goal.

BACKGROUND: Medical students often face challenges in choosing a career path due to limited exposure to specialized fields like neurosurgery. Understanding their perceptions and experiences is crucial in addressing the gaps in neurosurgical education and inspiring future neurosurgeons.
METHODS: A cross-sectional study was conducted involving 461 medical students, utilizing convenience sampling. Data collection employed a validated, self-administered tool. Statistical analysis in SPSS Version 25 included t-tests and chi-square tests, comparing scores based on age, gender, year of study, and exposure to the formal neurosurgical rotations in their institute. Significance value was set at P < 0.05.
RESULTS: In the study of 461 medical students, 79.8% identified with the 19-23 age group, and 63.8% affirmed neurosurgery exposure. Medical students\' perceptions included: 167 (36.3%) students found neurosurgery teaching sufficient; 164 (35.6%) disagreed that obtaining neurosurgical history is difficult; 224 (48.6%) agreed on neurosurgical disease complexity; and 250 (54.2%) found these diseases challenging and interesting. A majority of 183 (39.7%) respondents agreed that neurosurgical diseases had poor outcomes. Regarding training for neurosurgical surgery, 205 (44.5%) participants strongly agreed on its length, and 215 (46.7%) consented to extensive operating hours. However, 167 (36.3%) strongly disagreed about the ample job prospects in Pakistan.
CONCLUSIONS: Enhancing neurosurgery education with quality, consistency, and adaptability is essential to bridge gaps and inspire future neurosurgeons. These findings guide improvements in educational programs, preparing a skilled workforce to meet evolving health-care demands.

BACKGROUND: Understanding the various principles in physiology is very important for medical students to apply their knowledge in clinical practice. Most of the students learn physiology just to clear exams. There is a need to understand the student\'s perception on the significance of learning physiology in medical colleges, its role in clinical practice, research, and the subject of career choice.
METHODS: A descriptive cross-sectional questionnaire-based study was conducted in a medical college in Karnataka, India. A total of 100 medical students studying in year 2 MBBS were enrolled into the study. Responses were collected, validated, and analyzed to understand the perception.
RESULTS: All the participants (100%) felt physiology is an important subject in the medical curriculum and 93% of participants felt physiology knowledge was essential to become a better doctor. It was observed that 48% of the participants were interested in pursuing research in physiology and only 24% of the participants agreed on considering physiology as a carrier option.
CONCLUSIONS: Medical students perceived physiology as an important and interesting subject in the medical curriculum. However, only few of the students were inclined to do research in physiology and agreed on pursuing physiology as a carrier option. The scope of study in physiology is vast due to the large variety of interdisciplinary topics included in different systems. Subsequent decrease in job opportunity, lack of awareness of research opportunities, and lower pay scale in the medical colleges in India lead to less interest in students for considering physiology as a carrier option.

UNASSIGNED: Work engagement is a positive, fulfilling, work-related state of mind characterized by vigor, dedication, and absorption, and it affects the quality of care nurses give. Chinese nurses working in Japan experience differences in nursing practice and difficulties in career development. Therefore, the nursing practice environment and occupational career may affect their work engagement. However, little research has been completed on the factors affecting Chinese nurses\' work engagement in Japan.
UNASSIGNED: To clarify the relationship between the nursing practice environment, occupational career, and work engagement of Chinese nurses in Japan.
UNASSIGNED: A cross-sectional study.
UNASSIGNED: Japanese hospitals (beds>19).
UNASSIGNED: 149 Chinese nurses employed in Japan.
UNASSIGNED: Using a cross-sectional study design, we mailed 640 paper questionnaires, which included a QR code for online responses, to 58 Japanese hospitals that employed Chinese nurses. A survey request form and internet address were sent to the WeChat app, where Chinese nurses in Japan communicate. The contents included attribute-related questions, the Nursing Practice Environment Scale, the Occupational Career Scale, and the Utrecht Work Engagement Scale. A multivariate analysis was conducted with nine adjustment factors, such as gender, educational background, and work engagement, as the dependent variables. The significance level was set at p<.05.
UNASSIGNED: Participants\' average age was 28.4 years, and the average years of nursing in Japan was 3.8. The work engagement score was 3.09, which is the low-medium level. The nursing practice environment was positively associated with work engagement (β=0.46, 95 %CI=1.02,1.99, p<.001), with nurse participation in hospital affairs among the subscales having the strongest effect on work engagement (β=0.41, 95 %CI=0.68,1.49, p<.001). The occupational career score was also positively associated with work engagement (β=0.42, 95 %CI= 0.51,1.08, p<.001), and among the subscales, forming and coordinating interpersonal relationships had the most influence on participants\' work engagement (β=0.39, 95 %CI=0.42,0.94, p<.001).
UNASSIGNED: Based on the results, we suggest that the work engagement of Chinese nurses could be enhanced by providing them with the same opportunities to train and improve their skills as Japanese nurses, as well as by helping them form relationships with patients and colleagues.

BACKGROUND: Alcohol misuse is the fourth leading cause of death in the United States and a significant problem in the US military. Brief alcohol interventions can reduce negative alcohol outcomes in civilian and military populations, but additional scalable interventions are needed to reduce binge and heavy drinking. SMS text messaging interventions could address this need, but to date, no programs exist for military populations.
OBJECTIVE: We aimed to develop an SMS text messaging intervention to address binge and heavy drinking among Airmen in Technical Training in the US Air Force.
METHODS: We implemented a 2-phase, mixed methods study to develop the SMS text messaging intervention. In phase 1, a total of 149 respondents provided feedback about the persuasiveness of 49 expert-developed messages, preferences regarding message frequency, timing and days to receive messages, and suggested messages, which were qualitatively coded. In phase 2, a total of 283 respondents provided feedback about the persuasiveness of 77 new messages, including those developed through the refinement of messages from phase 1, which were coded and assessed based on the Behavior Change Technique Taxonomy (BCTT). For both phases, mean persuasiveness scores (range 1-5) were calculated and compared according to age (aged <21 or ≥21 years) and gender. Top-ranking messages from phase 2 were considered for inclusion in the final message library.
RESULTS: In phase 1, top-rated message themes were about warnings about adverse outcomes (eg, impaired judgment and financial costs), recommendations to reduce drinking, and invoking values and goals. Through qualitative coding of suggested messages, we identified themes related to warnings about adverse outcomes, recommendations, prioritizing long-term goals, team and belonging, and invoking values and goals. Respondents preferred to receive 1 to 3 messages per week (124/137, 90.5%) and to be sent messages on Friday, Saturday, and Sunday (65/142, 45.8%). In phase 2, mean scores for messages in the final message library ranged from 3.31 (SD 1.29) to 4.21 (SD 0.90). Of the top 5 highest-rated messages, 4 were categorized into 2 behavior change techniques (BCTs): valued self-identity and information about health consequences. The final message library includes 28 BCTT-informed messages across 13 BCTs, with messages having similar scores across genders. More than one-fourth (8/28, 29%) of the final messages were informed by the suggested messages from phase 1. As Airmen aged <21 years face harsher disciplinary action for alcohol consumption, the program is tailored based on the US legal drinking age.
CONCLUSIONS: This study involved members from the target population throughout 2 formative stages of intervention development to design a BCTT-informed SMS text messaging intervention to reduce binge and heavy drinking, which is now being tested in an efficacy trial. The results will determine the impact of the intervention on binge drinking and alcohol consumption in the US Air Force.

Statistics show that over the past 2 decades, even in high-income countries, fewer and fewer students have listed neurosurgery as their top career option. Literature on medical students\' pursuit of neurosurgical careers in middle- and low-income countries are scarce. The aim of this research, conducted in Turkey with a middle-income economy, was to contribute insights relevant to medical education and neurosurgery across the world.
A survey was conducted with a target sample of fourth-year (167 students), fifth-year (169 students), and sixth-year (140 students) medical students (476 in total) from the Medical School at Istanbul Medeniyet University in Turkey. The response rates of the fourth-, fifth-, and sixth-year students were 62% (104/167), 53% (90/169), and 50% (70/140), respectively (in total, 266, including 147 female and 119 male).
In terms of the genuine intention, only 2.5% of men and 2.7% of women were committed to specializing in neurosurgery. This study further revealed that possible reasons for these students\' low motivation to specialize in neurosurgery were their beliefs that in neurosurgery, the physical and psychological demands were high, and the night shifts were intense, meaning they would not have a social life or spare time for their hobbies; that morbidity/mortality were high; and that financial incentives were insufficient, especially in public institutions.
Turkish medical students did not rank neurosurgery at the top of their career choices. Possible reasons for this are socioeconomic factors and the inadequate introduction of neurosurgery to medical students.

BACKGROUND: Nutrition science graduates contribute to the nutrition workforce by bringing specialist knowledge and skills needed to address future food challenges. This study aims to provide a snapshot of the current employment landscape for nutrition science graduates in Australia and how well their degrees prepare them for employment.
METHODS: A cross-sectional survey of Australian tertiary nutrition graduates was conducted to explore tertiary training, employment pathways and their perceived preparedness for practice.
RESULTS: This study included a final sample of 119 graduates from 17 Australian tertiary institutions. Almost two-thirds of respondents had completed further training. Most graduates (77%, n = 91) had worked in a food, nutrition science or health-related role after their degree; the most frequently cited employment settings were government or public health organisations; research, not-for-profit or nongovernment organisations; and the food industry. Work-integrated learning was identified as a key predictor of graduates working in a role that differed from their expectations as a student. The skill categories developed during nutrition training that were most valued in the workplace included nutrition and scientific knowledge, and professional and communication skills.
CONCLUSIONS: This study offers first insights into the current employment landscape for nutrition graduates across Australia. Findings show that current nutrition science professionals are highly qualified and prepared to navigate the evolving demands of nutrition practice. Regular review of graduate employment will inform nutrition science curriculum to enable graduates to be well equipped in the face of dynamic practice settings.

District nursing vacancies are recognised as high in comparison to many other nursing specialities. The role is often considered as an option for nurses after a period of registration as a nurse, which may be informed by multiple factors. The objectives of the study were to explore barriers to district nurse employment from the perspective of undergraduate nurses. A descriptive qualitative design was employed using focus groups as the method of data collection in accordance with study approval reference no: 21/NAH/006, 30/03/23. Participants were recruited from the current undergraduate nursing programme (n=60). Thematic analysis was chosen as a flexible method of qualitative data analysis. The study produced themes relating to role ambiguity, personal preferences, educational opportunities and recruitment and employer engagement. The experiences provided an insight into the barriers to recruitment of student nurses into district nursing on qualification. Increased engagement from community nurse providers is required to inform the role and incentivise entering this career option. Educational strategies that support community career pathways are required to ensure a balanced view of nursing roles among undergraduates.

OBJECTIVE: This study aimed to evaluate the extent of confidence in medical and dental students regarding their careers after being enrolled in their germane institutes and to identify the magnitude of uncertainty in medical and dental students about their careers and the important causes of this uncertainty.
METHODS: This study was conducted among enrolled students in different medical and dental colleges and universities of Pakistan, including the public and private sectors, from March 1 to March 15, 2023. The level of confidence in their career was evaluated using a close-ended questionnaire of a three-point Likert scale developed and tested by the investigators and approved by the Ethical Review Board (ERB) along with the synopsis. Data were managed and analyzed using Microsoft Excel 19 (Microsoft Corporation, USA) and IBM SPSS Statistics for Windows, version 27 (released 2020; IBM Corp., Armonk, New York, United States).
RESULTS: This study included 1,126 students from public and private medical and dental institutes. The majority of participants 965(85.7%) were satisfied with their chosen profession, and 1,042 (92.5%) students believed they could make a positive contribution to society. Out of the total participants, 246 (21.8%) students showed their intention of changing careers if provided with a comparable/alternative opportunity. A very small proportion, 154 (13.7%), were dissatisfied with their current clinical training and studies. The study also revealed that extra and unjustified academic pressure from institutions is the leading cause of uncertainty among students. Moreover, the lack of psychological support and counseling provided during the academic years adds to the magnitude of uncertainty.
CONCLUSIONS: In Pakistan, a staggering number of medical and dental students are unsure of their future careers and career prospects. The main causes of this uncertainty are the extra, unwarranted academic pressure that institutions place on students and the dearth of psychological support and counseling offered during the course of studies. This study not only highlights the prevailing uncertainty among medical students but also identifies the causes behind it. Addressing these causes can alleviate the prevailing uncertainty and bring about satisfactory and productive academic achievements without suffering from worries about the future.

BACKGROUND: Global nursing workforce shortage represents an impediment to the delivery of safe, evidence-based healthcare. Despite collective efforts, a consistent stream of nurses leaving the profession remains, particularly within the first five years of practice, which is exacerbated in rural communities. The aim of the study was to compare self-efficacy, grit, and rural career aspirations among nursing graduates between their second and fourth year of their nursing profession.
METHODS: As part of a longitudinal investigation, a repeated cross-sectional design was utilised. Participants included, 117 (response rate 52.2%) who completed an online questionnaire 18-24 months after graduating, and 32 participants (response rate of 21.0%) who agree to repeat the questionnaire 36-48 months after graduating. The questionnaire included demographic, employment, and measures examining general and occupational self-efficacy, grit, and rural career aspirations.
RESULTS: No differences between general and occupational self-efficacy or grit were identified between second- and fourth-year nurses. In addition, the importance placed on undertaking rural career also remains unchanged. However, a higher proportion of fourth year nurses were more likely to be in management or were considering leaving the profession.
CONCLUSIONS: This examination of early career nurses, now in their second and fourth-year post-graduation highlights self-efficacy, grit, and rural career aspirations remains stable between two- and four-years following graduation, while nursing in their fourth year were more likely to consider leaving the profession. Nursing retention is a \'Wicked Problem\' that is unavoidably a complex amalgam of macro, meso and micro factors that we are yet to fully appreciate.