The effects of custodial vs. non-custodial sentences on re-offending: A systematic review of the state of knowledge

As part of a broad initiative of systematic reviews of experimental or quasiexperimental evaluations of interventions in the field of crime prevention and the treatment of offenders, our work consisted in searching through all available databases for evidence concerning the effects of custodial and non-custodial sanctions on reoffending. For this purpose, we examined more than 3,000 abstracts, and finally 23 studies that met the minimal conditions of the Campbell Review, with only 5 studies based on a controlled or a natural experimental design. These studies allowed, all in all, 27 comparisons. Relatively few studies compare recidivism rates for offenders sentenced to jail or prison with those of offenders given some alternative to incarceration (typically probation). According to the findings, the rate of re-offending after a non-custodial sanction is lower than after a custodial sanction in 11 out of 13 significant comparisons. However, in 14 out of 27 comparisons, no significant difference on re-offending between both sanctions is noted. Two out of 27 comparisons are in favour of custodial sanctions. Finally, experimental evaluations and natural experiments yield results that are less favourable to non-custodial sanctions, than are quasi-experimental studies using softer designs. This is confirmed by the meta-analysis including four controlled and one natural experiment. According to the results, non-custodial sanctions are not beneficial in terms of lower rates of re-offending beyond random effects. Contradictory results reported in the literature are likely due to insufficient control of pre-intervention differences between prisoners and those serving “alternative” sanctions

Child undernutrition in Kenya: trend analyses from 1993 to 2008-09

Background: Research on trends in child undernutrition in Kenya has been hindered by the challenges of changing criteria for classifying undernutrition, and an emphasis in the literature on international comparisons of countries’ situations. There has been little attention to within-country trend analyses. This paper presents child undernutrition trend analyses from 1993 to 2008–09, using the 2006 WHO criteria for undernutrition. The analyses are decomposed by child’s sex and age, and by maternal education level, household Wealth Index, and province, to reveal any departures from the overall national trends. Methods: The study uses the Kenya Demographic and Health Survey data collected from women aged 15–49 years and children aged 0–35 months in 1993, 1998, 2003 and 2008–09. Logistic regression was used to test trends. Results: The prevalence of wasting for boys and girls combined remained stable at the national level but declined significantly among girls aged 0–35 months (p < 0.05). While stunting prevalence remained stagnant generally, the trend for boys aged 0–35 months significantly decreased and that for girls aged 12–23 months significantly increased (p < 0.05). The pattern for underweight in most socio-demographic groups showed a decline. Conclusion: The national trends in childhood undernutrition in Kenya showed significant declines in underweight while trends in wasting and stunting were stagnant. Analyses disaggregated by demographic and socio-economic segments revealed some significant departures from these overall trends, some improving and some worsening. These findings support the importance of conducting trend analyses at detailed levels within countries, to inform the development of better-targeted childcare and feeding interventions

To Use or Not to Use: What Influences Why Women Veterans Choose VA Health Care

BACKGROUND AND OBJECTIVE: Effects of advances in Department of Veterans Affairs (VA) women's health care on women veterans' health care decision making are unknown. Our objective was to determine why women veterans use or do not use VA health care. DESIGN AND PARTICIPANTS: Cross-sectional survey of 2,174 women veteran VA users and VA-eligible nonusers throughout southern California and southern Nevada. MEASUREMENTS: VA utilization, attitudes toward care, and socio-demographics. RESULTS: Reasons cited for VA use included affordability (67.9%); women's health clinic (WHC) availability (58.8%); quality of care (54.8%); and convenience (47.9%). Reasons for choosing health care in non-VA settings included having insurance (71.0%); greater convenience of non-VA care (66.9%); lack of knowledge of VA eligibility and services (48.5%); and perceived better non-VA quality (34.5%). After adjustment for socio-demographics, health characteristics, and VA priority group, knowledge deficits about VA eligibility and services and perceived worse VA care quality predicted outside health care use. VA users were less likely than non-VA users to have after-hours access to nonemergency care, but more likely to receive both general and gender-related care from the same clinic or provider, to use a WHC for gender-related care, and to consider WHC availability very important. CONCLUSIONS: Lack of information about VA, perceptions of VA quality, and inconvenience of VA care, are deterrents to VA use for many women veterans. VA WHCs may foster VA use. Educational campaigns are needed to fill the knowledge gap regarding women veterans' VA eligibility and advances in VA quality of care, while VA managers consider solutions to after-hours access barriers