PubMed · 9526317
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
M J Hill. 1998. Implementing lessons we learned as children.. https://pubmed.ncbi.nlm.nih.gov/9526317/
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
Title III of the Superfund Amendments and Reauthorization Act (SARA Title III) established a new federal approach to managing toxic chemical hazards. This legislation required industry to disclose the type and quantity of such chemicals and also required the establishment of state and local government organizations to receive those data, evaluate community vulnerability, develop local emergency response plans, and communicate with the public. This paper reviews the law's historical context and empirical studies of its implementation. The available evidence suggests that significant progress has been made in reducing chemical hazards but there is considerable variation across jurisdictions in the effectiveness of the law's implementation. The research results reviewed here suggest a variety of ways in which SARA Title III implementation can be improved.
Explore the source record for details and available documents.
OBJECTIVE: To measure patients' perceptions of patient centredness and the relation of these perceptions to outcomes. DESIGN: Observational study using questionnaires. SETTING: Three general practices. PARTICIPANTS: 865 consecutive patients attending the practices. MAIN OUTCOME MEASURES: Patients' enablement, satisfaction, and burden of symptoms. RESULTS: Factor analysis identified five components. These were communication and partnership (a sympathetic doctor interested in patients' worries and expectations and who discusses and agrees the problem and treatment, Cronbach's alpha=0.96); personal relationship (a doctor who knows the patient and their emotional needs, alpha=0.89); health promotion (alpha=0.87); positive approach (being definite about the problem and when it would settle, alpha=0.84); and interest in effect on patient's life (alpha=0.89). Satisfaction was related to communication and partnership (adjusted beta=19.1; 95% confidence interval 17.7 to 20.7) and a positive approach (4.28; 2.96 to 5.60). Enablement was greater with interest in the effect on life (0.55; 0.25 to 0.86), health promotion (0.57; 0.30 to 0.85), and a positive approach (0.82; 0.52 to 1.11). A positive approach was also associated with reduced symptom burden at one month (beta=-0.25; -0.41 to -0.10). Referrals were fewer if patients felt they had a personal relationship with their doctor (odds ratio 0.70; 0.54 to 0.90). CONCLUSIONS: Components of patients' perceptions can be measured reliably and predict different outcomes. If doctors don't provide a positive, patient centred approach patients will be less satisfied, less enabled, and may have greater symptom burden and higher rates of referral.