Penologiese ondersoek rakende die assessering en evaluering van oortreders vir korrektiewe toesig

Summaries in English and AfrikaansDie proefskrif poog om 'n penologiese evaluering rakende die assessering van oortreders vir korrektiewe toesig weer te gee. Korrektiewe toesig is 'n vonnisopsie wat oortreders binne die gemeenskap rebabiliteer. 'n Literatuurstudie oor die ontwikkeling van korrektiewe toesig in verskillende wereldlande is ingestel asook die wetlike ontstaan en praktiese toepassing in Suid-Afrika. Korrektiewe toesig is met deeglike navorsing deur die Krugel-Werkgroep vooraf gegaan. Die Witskrif rakende die Departement van Korrektiewe Dienste wat op navorsing gevolg bet, is gedurende Mei 1991 in die parlement van Suid-Afrika ter tafel gele. Parlementsdebatte is gevolg deur wetswysigings van onder andere die Strafproseswet, 1977 en die Wet op Gevangenisse, 1959. Eenstemmigheid het genoemde parlementsitting gekenmerk wat gevolg het tot die instelling van korrektiewe toesig. Korrektiewe toesig soos deur die Departement van Korrektiewe Dienste toegepas word, is ondersoek maar veral die funksionering van huisarres, monitering en gemeenskapsdiens. Die assessering van oortreders en hul promovering vanaf maksimum intensiewe na medium - en na minimum - van huisarres sowel as monitering is nagegaan. Assesseringsmetodes van die State Georgie en Wisconsin in die V.S.A. asook ander kriteria is ondersoek om die geskiktheid van oortreders te klassifiseer deur middel van 'n seleksieproses. 'n Profielstudie van kandidate by die Kaapstadse gemeenskapskorreksie-kantoor is opgestel met 'n ondersoek vanuit 624 gevalle asook die menings van landdroste in Pretoria en die distrik van Wonderboom rakende korrektiewe toesig.This thesis is an attempt to give a penological evaluation relating to the assessment and suitability of offenders for correctional supervision. Correctional supervision is a sentencing option aimed at rehabilitating offenders within community context. This research will focus on the development of correctional supervision in differnt countries around the world inclusive of South Africa. The implementation of correctional supervision in South Africa was precede by research done by the Kriigel Commission. In May 1991 a White paper was tabled in Parliament regarding the broadening of the mission of the Department of Correctional Services. Much debate in Parliament resulted in amendments to inter alia the Criminal Procedures Act, 1977 and the Prisons Act, 1959. In this thesis the application of cor!'ectional supervision as redered by the Department of Correctional Services is investigated with special reference to house arrest, monitoring and community service. Assessment and promotion from maximum intensive to medium intensive and to minimum intensive supervision are also looked at. Assessment methods and other criteria in the States of Georgia and Wisconsin in the United States of America are investigated in order to propose classification categories for the selection of offenders. A profile of an offender under supervision was undertaken with 624 cases from the Cape Town office for Correctional Supervision as well as in Pretoria and the district of Wonderboom.Criminology and Security ScienceD.Litt. et Phil. (Kriminologie

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used