South elevation elevation, Sunshine Coast University Library, Maroochydore

View to south-east elevation with corrugated steel cladding, plywood, concrete block and colonnade, as seen from exterior.

South-east elevation, Sunshine Coast University Library, Maroochydore

View to south-east elevation; entrance stair, plywood and sheet steel cladding and colonnade, as seen from exterior.

Timber batten screen to north-east elevation, Sunshine Coast University Library, Maroochydore

View of timber batten screen to verandah behind and entrance stair, as seen from exterior.

Batten screen to north-east elevation, Sunshine Coast University Library, Maroochydore

View of timber batten screen to north-east elevation with verandah behind.

South-east elevation, Sunshine Coast University Library, Maroochydore

View to south-east elevation as seen from exterior.

North-west elevation, Sunshine Coast University Library, Maroochydore

North-west elevation as seen from Building K.

Entrance elevation, Sunshine Coast University Library, Maroochydore

View to entrance verandah on north-east elevation and sunshades to north-west elevation.

Front elevation, Canal House, Noosa Waters, Sunshine Coast

Street elevation.

Front elevation, Canal House, Noosa Waters, Sunshine Coast

Street elevation.

Linking client and employee perceptions of the organization: A study of client satisfaction with health care services

Client satisfaction with health care sen ices has usually been researched in terms of socio-demographic and predispositional characteristics associated with the client. The present study included organizational characteristics as predictors of client satisfaction with health care services. Participants in the research were clients and employees of an Australian public-sector health care organization who responded to separate client and employee questionnaires. Hierarchical regression analyses indicated that, after controlling for a number of client characteristics, organizational characteristics, as perceived by employees, accounted for a significant proportion of additional variance in client satisfaction with health care services. Results of the present study provided some support for the proposition that employee perceptions of the working environment should be considered in a more comprehensive understanding of client satisfaction with health care services. Limitations of the study highlight practical difficulties in the assessment of client outcomes and methodological complexities in linking individual and organizational processes.

Tuberculosis and health sector reform: experience of integrating tuberculosis services into the district health system in rural South Africa

SETTING: Hlabisa health district, South Africa. OBJECTIVE: To describe the integration of a vertical tuberculosis control programme into an emerging 'horizontal' district health system, within the context of health sector reform. DESIGN: Descriptive account of the process of integration of the programme into the health system. RESULTS: A highly 'vertical' system of delivering tuberculosis treatment (with poor programme outcomes) was converted into a (horizontal' team, integrated within the district health system, that used available resources such as village clinics and community health workers, with improved programme outcomes. CONCLUSIONS: In some settings at least, integration of tuberculosis 'programmes' into the district health system as tuberculosis 'teams' is feasible, and may produce highly cost-effective outcomes.

Lessons from a comprehensive clinical audit of users of psychiatric services who committed suicide

Objective: Characteristics of patients who committed suicide were examined to provide a picture of the treatment they received before death and to determine whether and how the suicides could have been pre vented by the service system. Methods: The unnatural-deaths register was matched to the psychiatric case register in the state of Victoria in Australia to identify suicides by people with a history of public-sector psychiatric service use who committed suicide between July 1, 1989, and June 30, 1994. Data on patient and treatment characteristics were examined by three experienced clinicians, who made judgments about whether the suicide could have been prevented had the service system responded differently. Quantitative and qualitative data were descriptively analyzed. Results: A total of 629 psychiatric patients who had committed suicide were identified. Seventy-two percent of the patients were male, 62 percent were under 40 years old, and 51 percent were unmarried. They had a range of disorders, with the most common being schizophrenia or schizoaffective disorder (36 percent). Sixty-seven percent had previously attempted suicide. A total of 311 patients (49 percent) received care within four weeks of death. Twenty percent of the suicides were considered preventable. Key factors associated with preventability were poor staff-patient relationships, incomplete assessments, poor assessment and treatment of depression and psychological problems, and poor continuity of care. Conclusions: Opportunities exist for the psychiatric service system to alter practices at several levels and thereby reduce patient suicides.