Assessing reliability, validity, and clinical utility of the BEST-Index in measuring living skills among forensic inpatients

The assessment of behavioral change as a result of inpatient treatment in forensic psychiatry is an important precondition for violence risk prediction in forensic psychiatry. In relation to a multitude of diagnostically based risk assessment instruments, there is a shortage of appropriate instruments with which to carry out valid and reliable therapeutic assessments that are behaviorally based and therefore appropriate for use within varied psychiatric contexts. There is also a need for instruments which will offer assessors the opportunity to examine possible relationships between criteria of social risk and criteria of more general aspects of social functioning. Tapping the issues pointed out above, the authors present an overview of a normatively based social profiling instrument (the BEST-Index), and discuss evidence for its validity, reliability, and aspects of clinical utility.     

An apple a day does not always keep the doctor away...

The authors describe a case of suicide in the workplace. A 45-year-old man employed by a fruit and vegetable packing company was found dead in a room containing a modified atmosphere for the packaging of fruits and vegetables. The rescue team measured the carbon monoxide (CO) concentration of the ambient air with a digital CO tester and found a level higher than 600 particles per million. Analysis of an arterial blood sample taken with an airtight syringe revealed the absence of CO but high levels of carbon dioxide (CO(2)). Autopsy revealed no significant injury and police investigators found a handwritten note of intent, describing a recent personal crisis. The authors concluded that the cause of death was suicide by asphyxiation secondary to CO(2) intoxication and notably oxygen (O(2)) depletion. This manner of suicide is rare and most cases previously described in the literature were accidental intoxications. To the best of our knowledge, this is the first case of suicide by CO(2) intoxication and O(2) depletion in a room with a modified atmosphere.     

Employment Niches for Recent Refugees: Segmented Labour Market in Twenty-first Century Australia

A survey of three refugee groups (ex-Yugoslavs, black Africansand people from the Middle East) in Western Australia indicatesthat the recent humanitarian arrivals are concentrated in labourmarket niches such as cleaning services, care of the aged, meatprocessing, taxi driving, security and building. Apart fromthe building industry, these employment niches are situatedin the ‘secondary labour market’ comprising low-statusand low-paid jobs that locals avoid. This article identifiesseveral interrelated mechanisms through which the recent Australianrefugee intake has been relegated to undesirable jobs: non-recognitionof qualifications as a systemic barrier, discrimination on thebasis of race and cultural difference by employers, ‘ethnic-pathintegration’ and the lack of mainstream social networksthat could assist in the job search, and the recent ‘regionalsponsored migration scheme’ through which the governmenttries to address the shortage of low-skilled labour in depopulatingcountry areas. The data show massive loss of occupational statusamong our respondents and confirm the existence of the segmentedlabour market, where racially and culturally visible migrantsare allocated the bottom jobs regardless of their ‘humancapital’. Changes in the nature of the segmented labourmarket in the increasingly mobile global workforce are analysed.Some of these insights are drawn from two other research projectson Bosnian and Afghan refugees in Australia undertaken by theauthors.