Biomedical subjects

Brian McKenna

Publications and source records attributed to Brian McKenna.

7 recordsLinked to original sources

PubMed2006

Outcome of patients rehabilitated through a New Zealand forensic psychiatry service: A 7.5 year retrospective study.

This paper describes a 7.5 year retrospective study of all patients discharged from inpatient forensic services to forensic community team (FCT) follow-up from the Auckland Regional Forensic Psychiatry Service. Patients' files were studied for clinical, criminal, and risk data, type of service delivered, and final level of function achieved in the community. Rearrest, re-hospitalization, and reimprisonment data were obtained from clinical, court, and prison records.105 patients were included. The most common diagnosis was a psychotic disorder, and index offending behaviour was typically violent. The median period of inpatient stay was 36 months and mean subsequent FCT follow-up 21.7 months (SD 17.8). The majority of patients were from Maori and Pacific Island ethnic groups. At the end of the study, half were in independent living, half were in some form of employment, and 19% were readmitted to a forensic hospital. One patient was rearrested but not reimprisoned whilst under forensic community team care. However, 9 of the 48 who were discharged to general mental health services were rearrested and 5 reimprisoned. Only two offences were as serious as the original index offence. Broad based assertive, mandated, and committed forensic rehabilitation can achieve high quality outcomes. These levels of function may not be sustained under less assertive care.

Adult↗

PubMed2006

Mentally abnormal homicide in New Zealand as defined by legal and clinical criteria: a national study.

BACKGROUND: Homicides by people with mental illness have been studied using either clinical or legal categorization of the homicide as abnormal. No previous study has employed both definitions in the same population. METHOD: A retrospective study of all homicides in New Zealand between 1988 and 2000 considered mentally abnormal homicide using a legal definition (when the courts deemed a contribution of mental illness was present) and a clinical definition (defined as the presence of a discharge diagnosis from inpatient mental health treatment) of 'mentally abnormal'. Rates, characteristics and time trends were investigated. RESULTS: Of the 844 cases, 7.1% met legal criteria for being mentally abnormal, while 7.7% had ever received a diagnosis for a psychotic illness, and a further 14.5% had been admitted to a psychiatric hospital for any other reason. The majority (60%) of perpetrators with a psychotic diagnosis received a mental health disposition from the court. Of these, 60% were first diagnosed with their psychotic illness prior to the homicide, while 28% were first diagnosed at the time of the offence and a further 12% after imprisonment. Of all those who received a psychotic diagnosis, 89% had post-conviction admissions or a mental health disposition. CONCLUSION: Legal and clinical definitions of mentally abnormal homicide detect similar rates of mentally abnormal homicide, but illustrate somewhat different dimensions of the relationship between mental illness and homicide.

Adult↗

PubMed2005

Microdevice DNA forensics by the simple tandem repeat method.

We review recent experiments on DNA forensics by the simple tandem repeat (STR) method using a 16-lane micromachined device as the active separation element. Separations by linear polyacrylamide matrices show very high data quality metrics when evaluated with statistically significant data sets. Full 16-locus multiplexes are verified on the multilane system. Multi-donor mixed samples are studied in the context of the limits of the laser-induced fluorescence detector and data-reduction software. The microdevice appears to be posed to outperform current capillary arrays in terms of stability and, through specialized sample loading, in the interpretation of complex mixtures.

DNA↗

PubMed2004

A high-performance multilane microdevice system designed for the DNA forensics laboratory.

We report preliminary testing of "GeneTrack", an instrument designed for the specific application of multiplexed short tandem repeat (STR) DNA analysis. The system supports a glass microdevice with 16 lanes of 20 cm effective length and double-T cross injectors. A high-speed galvanometer-scanned four-color detector was specially designed to accommodate the high elution rates on the microdevice. All aspects of the system were carefully matched to practical crime lab requirements for rapid reproducible analysis of crime-scene DNA evidence in conjunction with the United States DNA database (CODIS). Statistically significant studies demonstrate that an absolute, three-sigma, peak accuracy of 0.4-0.9 base pair (bp) can be achieved for the CODIS 13-locus multiplex, utilizing a single channel per sample. Only 0.5 microL of PCR product is needed per lane, a significant reduction in the consumption of costly chemicals in comparison to commercial capillary machines. The instrument is also designed to address problems in temperature-dependent decalibration and environmental sensitivity, which are weaknesses of the commercial capillary machines for the forensics application.

DNA↗

PubMed2004

Homicide and mental illness in New Zealand, 1970-2000.

BACKGROUND: Homicides by mentally ill persons have led to political concerns about deinstitutionalisation. AIMS: To provide accurate information about the contribution of mental illness to homicide rates. METHOD: Retrospective study of homicide in New Zealand from 1970 to 2000, using data from government sources. 'Mentally abnormal homicide'perpetrators were defined as those found unfitto stand trial, not guilty by reason of insanity, convicted and sentenced to psychiatric committal, or convicted of infanticide. Group and time trends were analysed. RESULTS: Mentally abnormal homicides constituted 8.7% of the 1498 homicides. The annual rate of such homicides was 1.3 per million population, static over the period. Total homicides increased by over 6% per year from 1970 to 1990, then declined from 1990 to 2000. The percentage of all homicides committed by the mentally abnormal group fell from 19.5% in 1970 to 5.0% in 2000. Ten percent of perpetrators had been admitted to hospital during the month before the offence; 28.6% had had no prior contact with mental health services. Victims were most commonly known to the perpetrator (74%). CONCLUSIONS: Deinstitutionalisation appears not to be associated with an increased risk of homicide by people who are mentally ill.

Adolescent↗

PubMed2002

Risk assessment of violence to others: time for action.

Possible expansion in the scope of practice of mental health nurses, together with the prevalence of nurses being assaulted by patients, accentuates the need for nurses to be more skilled in risk assessment. A literature search was undertaken on the topics of risk assessment, dangerousness, aggression, and violence in the data bases of CINAHL, MEDLINE and PSYCHLIT, in order to determine an evidence based approach to risk assessment of patient violence towards others. In the absence of reliable and valid nursing risk assessment measures, the approach suggested here focuses on the use of observation skills to detect behaviour antecedent to physical assault, and the ability to systematically assess evidence-based risk factors of violent action. Given this rudimentary framework, there is the need to adapt it to specific clinical settings. Failure to proceed rapidly with such developments may jeopardize the safety of both patients and staff.

Attitude of Health Personnel↗

PubMedDate not supplied

Clinical evaluation and long-term follow-up of dogs having coronoidectomy for elbow incongruity.

A retrospective study was performed describing the clinical presentations, radiographic findings, and surgical outcomes of 17 dogs (18 elbows) following medial coronoidectomy for the treatment of elbow joint incongruity as a sole disease entity. Complete resolution of lameness was achieved in 100% of the cases. The mean radiographic arthrosis grade progressed in 70% of the cases. Results of this study indicate that resolution of clinical lameness may be achieved with medial coronoidectomy in dogs with elbow incongruity; however, progression of degenerative joint disease with unknown, long-term clinical significance can be expected after surgery.

Animals↗