Objective: To describe the development of the University of North Carolina (UNC) TR x ANSITION Scale that measures the health-care transition and self-management skills by youth with chronic health conditions. Methods: Item and scale development of the UNC TR x ANSITION Scale was informed by two theoretical models, available literature, and expert opinion interviews and feedback from youth with chronic conditions, their parents, and interdisciplinary collaboration. Through an iterative process, three versions of the scale were piloted on a total of 185 adolescents and emerging adults with different chronic illnesses. This clinically administered scale relies on a semi-structured interview format of the patient and does not rely solely on patient report, but is verified with information from the medical record to validate responses. Results: Following the item development and the three iterations of the scale, version 3 was examined in a more intensive fashion. The current version of the UNC TR x ANSITION Scale comprises 33 items scattered across the following 10 domains: Type of illness, Rx¼medications, Adherence, Nutrition, Self-management, Informed-reproduction, Trade/ school, Insurance, Ongoing support, and New health providers. It requires approximately 7-8 min to administer. With a sample of 128 adolescents and young adults, ranging in age from 12 to 20, inter-rater reliability was strong (r ¼ 0.71) and item-total correlation scores were moderate to high. Content and construct validity were satisfactory, and the overall score was sensitive to advancing age. The univariate linear regression yielded a beta coefficient of 1.08 (p < 0.0001), indicating that the total score increased with advancing age. Specifically, there was about a one point increase in the total score for each year of age. Conclusion: The UNC TR x ANSITION Scale is a disease-neutral tool that can be used in the clinical setting. Initial findings suggest that it is a reliable and valid tool that has the potential to measure health-care transition skill mastery and knowledge in a multidimensional fashion.

Participation in a three-hour HAICC resulted in medical students' increased knowledge about and attitudes toward the role of interdisciplinary teams in health care.

A majority of experienced medical students did not assess several important risk factors of a patient concerned about HIV infection, and many would have provided incorrect information related to HIV testing and prevention of infection. Patient contact in traditional clinical settings did not influence prevention knowledge or behavior. More innovative methods are needed to train students in HIV-infection prevention and counseling.

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Introduction: Chronic kidney disease (CKD) and its progression to end-stage kidney disease (ESKD), requiring lifelong dialysis or kidney transplant, has become a public health epidemic and a financial burden on healthcare systems. The lack of available and appropriately targeted kidney disease education may account for the low awareness of kidney disease, especially among high risk populations. This low awareness can lead to late detection of CKD and an increased likelihood of progression to ESKD. This study utilized focus groups to assess community perceptions of kidney disease, barriers to health care, and educational interventions.Methods: Seventeen focus groups were conducted with 201 participants in 5 rural North Carolina counties to assess perceptions of kidney disease, barriers to health care and strategies for raising awareness. Qualitative data analysis was performed based on a grounded theory approach.Results: Of the 201 participants, 74% were African-American, 96% knew someone with diabetes or hypertension, and 76% of groups contained at least one participant with a family member or friend diagnosed with ESKD. Participants were aware that kidneys acted as filters and mechanisms to cleanse the blood, and stated that alcohol, soda, obesity, diet, and urination problems were risk factors for developing CKD. Participants consistently mentioned that symptoms and risk factors for CKD were key pieces of knowledge. Affordability of health services, medicine, and insurance was seen as the biggest barrier to health care in the communities studied; knowing how to better communicate with physicians was also important. Television and word-of-mouth were mentioned most often as the best tools for outreach and education. Wal-Mart (a chain of large, discount department and grocery stores) and community churches were most commonly mentioned as potential places for screenings.

Objectives. An emphasis on pharmaceutical care has made interdisciplinary teamwork increasingly important. However, required interdisciplinary education is rare in pharmacy education. The purpose of this paper is to discuss pharmacy student participation in a required interdisciplinary case conference designed and implemented for health professional students. Methods. At the University of North Carolina at Chapel Hill, 439 health professional students, including 113 doctor of pharmacy students, participated in a required series of 2 simulated interdisciplinary case conferences. Evaluation focused on changes in knowledge and attitudes of both students and facilitators and included preconference and postconference surveys of students and postconference surveys of facilitators. Results. In general, students' knowledge of other health care professionals increased. With regard to pharmacy students' attitudes toward interdisciplinary care, students reported generally positive attitudes, with a greater improvement in their attitudes preconference to postconference in pharmacy students than in other students. Conclusions. Results show that interdisciplinary experiences can assist students in developing appreciation for the expertise that each health profession offers.

BackgroundJust over 10 percent of US adults over twenty years of age have chronic kidney disease (CKD). Early detection is essential to delay or halt CKD's progression, but screening and early detection of CKD in high risk populations is inconsistent, especially in rural and underserved communities.ObjectiveThe objective of this study was to evaluate the effectiveness of the Screening for Occult Renal Disease questionnaire as a simple, self-report tool to identify individuals with increased likelihood of prevalent CKD in a rural North Carolina setting.MethodsOver an eight month period, in the context of the Kidney Education Outreach Program (KEOP), sixteen CKD screenings were conducted in two underserved, rural NC communities. For this study, the SCORED questionnaire was administered prior to the execution of the regular KEOP screening protocol.ResultsFor 172 participants for whom both blood and urine specimens were collected, there were fifteen (8.7%) who demonstrated less than normal kidney function. The SCORED sensitivity and specificity were 100% and 42%, respectively. The positive predictive value was 14% and the negative predictive value was 100%. The positive likelihood ratio for low eGFR was 1.7 and conversely, the negative likelihood ratio for low eGFR was zero.ConclusionIn this study, the SCORED performed comparably to previous settings in established datasets and cohort studies, with high sensitivity and negative predictive values that allow for ruling out the presence of disease. SCORED appears to provides a practical alternative to the administration of regular CKD screening protocols that can be difficult to organize and administer in rural settings. The need for further evaluation of SCORED in underserved, high-risk communities is recommended.

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