LABS: linear amplification-based bisulfite sequencing for ultrasensitive cancer detection from cell-free DNA.

Methylation-based liquid biopsies show promises in detecting cancer using circulating cell-free DNA; however, current limitations impede clinical application. Most assays necessitate substantial DNA inputs, posing challenges. Additionally, underrepresented tumor DNA fragments may go undetected during exponential amplification steps of traditional sequencing methods. Here, we report linear amplification-based bisulfite sequencing (LABS), enabling linear amplification of bisulfite-treated DNA fragments in a genome-wide, unbiased fashion, detecting cancer abnormalities with sub-nanogram inputs. Applying LABS to 100 patient samples revealed cancer-specific patterns, copy number alterations, and enhanced cancer detection accuracy by identifying tissue-of-origin and immune cell composition.

Improving access and managing population health through multidisciplinary partnerships.

The purpose of this article was to present Nebraska's model of collaboration between public health, public health nursing, medicine, and community partners. Another purpose was to provide exemplars of data trends and outcomes of the multiyear experience with the model. The goal of the collaborative model was to promote the concept of a medical home, improve access to care, and better manage population health for the diverse and vulnerable Medicaid population by implementing a change from fee-for-service to managed care. The vision was to better match population health needs to health services used and to reduce disparities. A unique feature of the model is the use of public health professionals and strategies.

Maternal health and child asthma health services use.

The primary purpose of this pilot study was to examine the influence of maternal health status on health services use in children with the diagnosis of asthma. A secondary purpose was to assess both preventive and illness-related child health services use patterns. Fifty-two asthmatic children and 43 mothers met the inclusion criteria. The majority of mothers (72%, n = 31/43) rated their own overall health as good to excellent. Eighty-six percent (n = 38/44) of the children had a medical home, 20% had peak flow meters, 26% had been to see a specialist, and 4% were currently under the care of a specialist. This pilot study raises important questions about the influence of maternal health on child health services use patterns for asthmatic children from low-income families. Understanding the influence of maternal health on health-seeking patterns for children with asthma is important for nursing intervention.

Health effects of life transitions for women and children: a research model for public and community health nursing.

Because maternal-child populations have traditionally been a major practice target for public and community health nursing (P/CHN), understanding the health effects of life transition experiences for women and their children is key to the advancement of P/CHN practice and research. To date there are no integrated conceptual models available that examine transition and its health effects in women, and ultimately their children, to single or multiple transitions. In order to help women and those with dependent children transition successfully, strong transition frameworks for nursing are needed. The purpose of this paper is to describe a conceptual model, Health Effects of Life Transition for Women and Children. Major components include the transition experience (developmental, situational, health illness), transition assets/risks (personal, environmental), cognitive-behavioral health indicators of transition (perception of situation, personal efficacy, change readiness, engagement, help-seeking, health behaviors, services use), transition adaptive outcomes of health (health status, intensity of need for nursing care) and competence (transition specific skill acquisition, health management, resourcefulness) and long-term preventive health outcomes (risk reduction, disability prevention, cost savings, mastery, injury prevention). The authors propose that cognitive-behavioral health indicators are foundational to a successful transition experience, are why some people have better transition outcomes than others, and when influenced by P/CHN intervention lead to improved long-term outcomes.

Reliability, validity, and scoring of the Health Status Questionnaire-12 version 2.0.

Measuring health status as an indicator of individual, population, and community health is critical in reducing health disparities in populations. The purpose of this study was to test the psychometric properties of the Health Status Questionnaire-12 (HSQ-12) Version 2.0, a brief self-reported health status instrument available within the public domain, in a low-income sample (N = 7,793). The internal consistency reliability was .88. Initial and confirmatory factor analysis revealed two factors explaining 67% of the variance, interpreted as super scales of physical and mental health. Second order factor analysis isolated one factor explaining 82% of the variance, interpreted as a total health status. Comparison of subjects with and without disabilities using t tests and the Mann-Whitney U Test showed that the scale, super scale, and total scale scores differentiated significantly. The HSQ-12 is a reliable, valid, and low-cost measure of health status.

Using focus groups to evaluate and strengthen public health nursing population-focused interventions.

Nebraska Health Connection Access Medicaid's (NHC AM) public health nursing (PHN) population-focused practice model is designed to provide enrollment, education, and PHN case management interventions for the Medicaid Managed Care population. Evaluation and continuous improvement of these interventions are, in part, completed through a collaborative effort between NHC AM and a quality management team at the University of Nebraska Medical Center College of Nursing. Focus group methodology was used to access non-English-speaking populations to evaluate and strengthen population-focused PHN interventions.

Using a writing group to promote faculty scholarship.

Writing productivity is an essential component of scholarship. Barriers to writing include intrapersonal characteristics, faculty role complexity, and time constraints. Writing groups can increase faculty members' writing, contributing to dissemination of nursing knowledge and advancement of professional nursing. The authors discuss the structure and processes of a writing group that can be adapted by faculty interested in using comentoring to increase their scholarship.

Participant satisfaction methods and outcomes in Medicaid managed care.

Participant satisfaction is an important outcome in evaluating the effectiveness of healthcare programs and benefits. With vulnerable populations, such as Medicaid beneficiaries, determining participant satisfaction poses unique challenges. The purpose of this article is to discuss participant satisfaction methods and outcomes from a multi-year experience of surveying Medicaid Managed Care (MMC) participants in Nebraska (2000-2005). Using a variety of survey methods, the foci were to measure satisfaction with MMC enrollment, understanding of MMC guidelines, and satisfaction with education services provided. Results illustrate response rate patterns and outcome trends that contribute to quality improvement knowledge useful for others surveying Medicaid populations.