Background This study was based on the American Association of Critical-Care Nurses'(AACNs') interest in determining the value and influence of specialty certification. Objectives To examine relationships between AACN specialty certification and empowerment, and, secondarily, to examine these variables as related to intent to leave the current position and the nursing profession. Methods AACN members were asked to participate in a Web-based survey; 6589 AACN members completed the surveys. Results Perceptions of empowerment differed significantly among nurses certified by AACN and nurses without such certification. Additional analyses revealed significant differences in empowerment related to position, education, salary, ethnicity, sex, intent to leave the current position, and intent to leave the profession. Forty-one percent of the participants indicated intent to leave their current position in the next year; only 6.9% indicated their intent to leave the profession in the next year. Intent to leave current position differed significantly according to age, sex, years of experience, ethnicity, educational level, and certification. Conclusions The value of specialty certification and the importance of empowerment among critical care nurses are affirmed. The next step in the continued journey toward increasing retention of critical care nurses, and thereby improving patient care, is to evaluate existing programs focused on retention and identify needed enhancements.

Scientific and policy debates following new genetic discoveries have been intense and emotional when they have involved questions about the causes of, and solutions for, racial and ethnic health disparities in the United States. The difference in prevalence of diseases, allele frequency and genotype frequency among racial/ethnic groups are well known. The genomic profile for a given disease could have different genetic variants for different racial/ethnic groups. Do these results indicate that we have to consider different genetic tests and different genomic medicine for different racial/ethnic groups? If we do this, what is the impact on ethnic and class disparities in health care services in the United States? Current advances in genetic medicine are very promising; however, we must consider the possible impacts of these findings on health disparities, and how genetic medicine can be extended to everyone, not just those who can pay the often high price. If genomic medicine is to be a valid and reliable technology for all citizens regardless of wealth, race, ethnicity, or other determinants of social disadvantage, public health policymakers have to consider a number of policy issues and implications.

No instruments have been located that examine attitudes concerning feeding decisions of mothers of preterm infants. The purpose of this study was to describe the development and psychometric testing of the Preterm Infant Feeding Survey (PIFS). The PIFS was adapted from the Breastfeeding Attrition Prediction Scale. The five-subscale, 78-item PIFS was tested with 105 mothers of preterm infants shortly after hospital admission. Individual subscale Cronbach's alpha values ranged from .75 to .82. Factor analysis demonstrated a five-factor solution. The PIFS is the first instrument to examine factors that contribute to feeding decisions of mothers of high-risk preterm infants; this knowledge will support the planning of interventions to improve breastfeeding outcomes for this population. Further psychometric testing with larger samples is recommended.

Magnesium imbalance in leptospirosis has, for the most part, been neglected by the medical and leptospirosis communities. In a recent, retrospective study, serum concentrations of magnesium were followed in 15 patients with severe leptospirosis. The results revealed that 14 of the 15 patients developed hypomagnesaemia at some time during the first 10 days of their illness. In severely ill patients, such magnesium deficiency can worsen clinical outcome. Magnesium concentrations may affect a number of organ systems and mental status. Since altered mental status in leptospirosis is a poor prognostic indicator, it is suggested that serum concentrations of magnesium be monitored closely in patients with leptospirosis. Any hypomagnesaemia can then be treated promptly, in an effort to reduce the morbidity and mortality attributable to the disease.