BMC癌：Breaking silence: a survey of barriers to goals of care discussions from the perspective of oncology practitioners

For patients with advanced or terminal cancer, decisions such as whether to be resuscitated or where to receive care at the end of life have a large impact on their quality of life, the cost of their care, and wellbeing of their families. Discussions between patients and clinicians to decide on goals of care can lead to fewer unwanted interventions, better patient outcomes, and lower costs, but few clinicians initiate or encourage these discussions.

The barriers that prevent clinicians from having goals of care discussions have not been studied, so the authors of this paper conducted a survey among physicians and nurses at one hospital. The survey asked oncology clinicians to rate the importance of possible barriers to goals of care discussions. Barriers related to the patient and their family, such as the patient (or a family member) not accepting a poor prognosis or lack of patient capacity to make decisions, rated as the highest barriers. Among other categories of barriers, lack of time also received a high rating.

确定的障碍的重要性凸显了对肿瘤学临床医生进行专门培训的必要性，即与可能需要支持以在整个疾病过程中做出决定的患者进行护理目标。

BMCChemical Engineering在使用renewabl:化学工程的作用e energy and alternative carbon sources in chemical production

BMCChemical Engineering，，，，one of the newest journals in theBMCseries, has recently begun publishing articles, including an important new review on the use of renewable energy in the chemical industry. In this review, Gabriele Centi and colleagues discuss changes within the chemistry and engineering industries brought about by the ongoing transition away from fossil fuels. They focus on the development of alternative carbon sources and the integration of renewable energy into chemical production. This review highlights the need for innovation to drive radical change in chemical production, assessment, and applied chemical engineering approaches.

BMC营养：Insulin resistance (HOMA-IR) and body fat (%) are associated to low intake of fruit and vegetables in Swedish, young adults: the cross-sectional lifestyle, biomarkers and atherosclerosis study

尽管有建议改变这些疾病，但尽管有建议改变生活方式，但在全球范围内越来越普遍，糖尿病和心脏病等生活方式疾病已变得越来越普遍。影响这些疾病后来发展的生活方式习惯是在成年初期形成的。在该人群中需要关注预防，但是很少有研究检查了年轻人特定的生活方式习惯和疾病危险因素的关联。

本文关于18-26岁的瑞典年轻人的作者研究了饮食建议和与代谢风险标志物（例如胰岛素抵抗和体内脂肪）的依从性。他们发现，超过一半的参与者吃的糖果比推荐的糖果多，而大约85％的水果和蔬菜少了，而90％的食物和90％的食物的全谷物或鱼类/海鲜的少于建议。

当他们之间的联系研究会议each dietary recommendation and specific risk markers, they found that eating the recommended amount of fruits and vegetables was associated with lower body fat in all participants. A similar association was seen in women eating the recommended amount of fish/seafood. They also saw lower insulin resistance in all participants meeting recommendations for fish/seafood, fruits and vegetables, and sweets. These results highlight the importance of helping young adults bring their dietary habits closer to recommendations in order to prevent diabetes and other diseases later in life.

BMCHealth Services Research：移民的经济激励是什么？分析在加勒比海工作国家和受欢迎目的地国家工作的卫生工作者之间的薪水差异

美国，英国和加拿大等高收入英语国家的卫生工作者短缺导致招募了来自贫困国家（包括加勒比海）的训练有素的卫生工作者。工作条件不佳和对其他地方生活水平的理解的看法导致卫生工作者从加勒比海地区迁徙。例如，自1991年以来在牙买加培训的所有医生中，大约有一半已经迁移到其他地方找到工作。详细了解移民的经济激励可以帮助加勒比政府设计政策以保留卫生工作者。

为了确定高收入国家卫生工作者增加的薪水，这项研究的作者使用购买力平价（PPP）比较美国，英国和加拿大的护士，医生和专家的薪水在四个加勒比国家。PPP汇率通过平衡这些国家之间的生活成本来对国家之间的薪水进行更现实的比较。

They found that salary gaps were lowest with the UK, ranging from 85% higher for nurses with little experience to 184% for doctors with over ten years experience, and highest with the US, ranging from 123% for doctors with little experience to over 500% for specialists. This evaluation highlighted the financial incentive for health workers to migrate, even those with little experience, draining the resources of Caribbean countries.

BMCMedical Education：A simple and short microbiology practical improves undergraduate nursing students’ awareness of bacterial traits and ability to avoid spreading infections

医院获得的感染是严重的风险，尤其是对于弱势患者。医务人员需要意识到风险并知道如何最大程度地减少它们，但是在护理学校课程中，实践课程的时间有限。

The authors of this paper sought to demonstrate the importance of hand hygiene to nursing students by adding two short practical sessions, totaling three hours, to a basic microbiology course at their institution. During the first session, the students touched bacterial culture plates to leave a sample of the bacteria normally found on their hands. In the second session, seven days later, the students examined the bacterial colonies that had grown on the culture plates, noting the number and characteristics of the bacterial colonies.

In order to measure the impact of this practical demonstration, the students were asked to fill out questionnaires before and after the pair of sessions testing their awareness of surfaces that could carry bacteria and actions that could facilitate infection. Awareness scores increased after the sessions, showing that a brief, simple addition to nursing school curricula could improve nursing students’ awareness of infection risk.