Rearrest Rates Research Articles

Exploring the impacts of individual residential mobility, housing, and social disorganization on recidivism among parolees

The impact of housing and individual residential mobility on recidivism is nuanced. Individuals may move from prosocial environments to criminogenic environments, or from neighborhoods that are more, or less, socioeconomically disadvantaged. We explore these phenomena using data on individuals on parole in the District of Columbia with community-level Census data. We hypothesize that residential mobility will affect recidivism through changes in both housing types and neighborhood characteristics. Findings suggest that people immediately placed into treatment-oriented or transitional housing had lower rates of rearrest than those in other housing situations. Results of the community-level measures of social disorganization were mixed.

A retrospective, multi-agency ‘target trial emulation’ for the comparison of post-resuscitation epinephrine to norepinephrine

IntroductionEpinephrine and norepinephrine are the two most commonly used prehospital vasopressors in the United States. Prior studies have suggested that use of a post-ROSC epinephrine infusion may be associated with increased rearrest and mortality in comparison to use of norepinephrine. We used target trial emulation methodology to compare the rates of rearrest and mortality between the groups of OHCA patients receiving these vasopressors in the prehospital setting. MethodsAdult (18–80 years of age) non-traumatic OHCA patients in the 2018–2022 ESO Data Collaborative datasets with a documented post-ROSC norepinephrine or epinephrine infusion were included in this study. Logistic regression modeling was used to evaluate the association between vasopressor agent and outcome using two sets of covariables. The first set of covariables included standard Utstein factors, the dispatch to ROSC interval, the ROSC to vasopressor interval, and the follow-up interval. The second set added prehospital systolic blood pressure and SpO2 values. Kaplan-Meier time-to-event analysis was also conducted and the vasopressor groups were compared using a multivariable Cox regression model. ResultsOverall, 1,893 patients treated by 309 EMS agencies were eligible for analysis. 1,010 (53.4%) received an epinephrine infusion and 883 (46.7%) received a norepinephrine infusion as their initial vasopressor. Adjusted analyses did not discover an association between vasopressor agent and rearrest (aOR: 0.93 [0.72, 1.21]) or mortality (aOR: 1.00 [0.59, 1.69]). ConclusionsIn this multi-agency target trial emulation, the use of a post-resuscitation epinephrine infusion was not associated with increased odds of rearrest in comparison to the use of a norepinephrine infusion.

Examining the Relationship Between Prison Sexual Misconduct and Sexual Recidivism among Federal Sex Offenders

This study examines how sex offenders who engage in prison sexual misconduct (PSM) compare to other sex offenders who do not offend in prison in terms of sexual, violent, and nonviolent rearrest rates upon their release. Differences in the connection between PSM and recidivism between two groups were also examined: offenders with a history of adult victims (ASO) and offenders with a history of child victims (CSO). The findings reveal that for the sample as a whole, PSM is associated with overall recidivism, but it is not associated specifically with sexual, violent, or nonviolent offending. For ASO, PSM was significantly associated with sexual rearrest but not violent rearrest, while for CSO, PSM was significantly associated with violent rearrest but not sexual rearrest. Implications of these findings and directions for future research are discussed.

Risk of arrhythmia in post-resuscitative shock after out-of-hospital cardiac arrest with epinephrine versus norepinephrine

ObjectiveTo determine the rates of clinically significant tachyarrhythmias and mortality in the management of post-resuscitative shock after return of spontaneous circulation (ROSC) in patients with out-of-hospital cardiac arrest (OHCA) who receive a continuous epinephrine versus norepinephrine infusion. DesignRetrospective cohort study. SettingA large multi-site health system with hospitals across the United States.Patients: Adult patients admitted for OHCA with post-resuscitative shock managed with either epinephrine or norepinephrine infusions within 6 h of ROSC. InterventionsNone. Measurements and main resultsBetween May 5th, 2018, to January 31st, 2022, there were 221 patients admitted for OHCA who received post-resuscitative epinephrine or norepinephrine infusions. There was no difference in the rate of tachyarrhythmias between epinephrine and norepinephrine infusion in univariate (47.1% vs 41.7%, OR 1.24, 95% CI 0.71–2.20) or multivariable analysis (OR 1.34, 95% CI 0.68–2.62). Patients treated with epinephrine were more likely to die during hospitalization than those treated with norepinephrine (90.0% vs 54.3%, OR 6.21, 95% CI 2.37–16.25, p < 0.001). Epinephrine treated patients were more likely to have re-arrest during hospital admission (55.7% vs 14.6%, OR 5.77, 95% CI 2.74–12.18, p < 0.001). ConclusionThere was no statistically significant difference in clinically significant cardiac tachyarrhythmias in post-OHCA patients treated with epinephrine versus norepinephrine infusions after ROSC. Re-arrest rates and in-hospital mortality were higher in patients who received epinephrine infusions in the first 6 h post-ROSC. Results of this study add to the literature suggesting norepinephrine may be the vasopressor of choice in post-OHCA patients with post-resuscitative shock after ROSC.

Synthetic Control Analysis of the Short-Term Impact of New York State’s Bail Elimination Act on Aggregate Crime

We conduct an empirical evaluation of the short-term impact of New York’s bail reform on crime. New York State’s Bail Elimination Act went into effect on January 1, 2020, eliminating money bail and pretrial detention for nearly all misdemeanor and nonviolent felony defendants. Our analysis of effects on aggregate crime rates after the reform informs the understanding of bail reform and general deterrence, rather than specific deterrence via re-arrest rates of the detained/released population. We conduct a synthetic control analysis for a comparative case study of the impact of bail reform. We focus on synthetic control analysis of post-intervention changes in crime for assault, theft, burglary, robbery, and drug crimes, constructing a dataset from publicly reported crime data of 27 large municipalities. Due to the short time frame before the onset of COVID-19 and its far-reaching effects, we restrict attention to a short post-intervention time period. Nonetheless, evaluation of short-term impacts may still inform hypotheses of general deterrence of bail reform policy. Our findings, including placebo checks and other robustness checks, show that for assault, theft, and drug crimes, there is no significant impact of bail reform on aggregate crime. For robbery, we find a statistically significant increase; for burglary, the synthetic control is more variable and our analysis is deemed less conclusive. Since our study assesses the short-term impacts, further work studying long-term impacts of bail reform and on specific deterrence remains necessary. Supplementary materials for this article are available online.

Veterans Treatment Courts: An Exploratory Analysis of the Effect of Veteran Mentors

Few studies have investigated the effect of mentorship on participants’ clinical or criminal justice outcomes in veterans treatment courts (VTCs). This study is an exploratory analysis of a VTC in Hillsborough County, Florida. Descriptive and inferential statistics were used to examine behavioral health changes between baseline and follow-up and compare participants with/without a mentor. Post hoc analyses explored the effect of mentorship on graduation and re-arrest rates. Participants with a mentor had significant improvements in mental health, trauma, substance use, and social support; and significantly higher levels of positive social interaction than those without a mentor. Mentor status was not meaningfully related to graduation and re-arrest rates in bivariate analyses, but post hoc analyses found that social support mediated the relationship between mentor satisfaction and re-arrest and graduation rates.

Prehospital Administration of Norepinephrine and Epinephrine for Shock after Resuscitation from Cardiac Arrest

Introduction Shock after resuscitation from out-of-hospital cardiac arrest (OHCA) is often treated with vasopressors. We examined whether infusion of epinephrine versus norepinephrine was associated with prehospital rearrest and neurologically favorable survival among OHCA patients. Methods This retrospective study included OHCA cases in Seattle, Washington from 2014-2021 who had return of spontaneous circulation (ROSC) followed by vasopressor infusion. Our primary exposure was infusion of epinephrine or norepinephrine. Our primary outcome was prehospital rearrest. Secondary outcomes included survival and neurologically favorable outcome (Cerebral Performance Category score of 1 or 2). We used multivariable logistic regression to test associations between exposures and outcomes adjusting for key covariates. Results Of 451 OHCA patients with ROSC followed by vasopressor infusion, 253 (56%) received norepinephrine and 198 (44%) received epinephrine infusions. Those who received epinephrine were older (median 66 [interquartile ranges {IQR} 53-79] vs 63 [IQR 47-75] years), but otherwise had similar baseline characteristics. Patients who received epinephrine were twice as likely to rearrest (55% vs 25%). After adjustment, the difference in rearrest rates between epinephrine and norepinephrine persisted (OR 3.28, 95%CI 2.25-5.08), and the odds of pulses at hospital arrival were lower in the epinephrine group (OR 0.52 95%CI 0.32-0.83). After adjustment, there was no difference in neurologically favorable survival, survival to hospital admission, or survival to discharge. Conclusion Patients who received epinephrine infusions after ROSC suffered prehospital rearrest more frequently than those who received norepinephrine. Survival and neurological status at hospital discharge were similar. Future trials should examine the optimal approach to hemodynamic management for post-OHCA shock.

Project Inspire pilot study: A hospital-led comprehensive intervention reduces gun violence among juveniles delinquent of gun crimes.

Gun violence disproportionately affects young Black men, but the impact extends to families and communities. Those at highest risk are teens delinquent of gun crimes. While there is no nationally accepted juvenile rate of recidivism, previous literature reveals rearrest rates from 50% to 80% in high-risk youth, and some reports show that up to 40% of delinquent juveniles are incarcerated in adult prisons before the age of 25 years. We hypothesize that Project Inspire, a hospital-led comprehensive intervention, reduces recidivism among high-risk teens. Led by a level 1 trauma center, key community stakeholders including the juvenile court, city, and city police department joined forces to create a community-wide program aimed at curbing gun violence in high-risk individuals. Participants, aged 13 to 18 years, are selected by the juvenile gun court. They underwent a rigorous 3-week program with a curriculum incorporating the following: trauma-informed training and confidence building, educational/professional development, financial literacy, entrepreneurship, and career-specific job shadowing and mentorship. Rates of recidivism were measured annually. Project Inspire has hosted two classes in 2018 and 2019, graduating nine participants aged 14 to 17 years. Sixty-seven percent were Black. All were males. At 1 year, none of the graduates reoffended. At 2 years, one participant reoffended. At 3 years, no additional participants reoffended. No graduate reoffended as a juvenile. Thus, the overall rate of recidivism for Project Inspire is 11% to date. Eighty-nine percent of graduates received a diploma, general educational development, or obtained employment. Project Inspire is a hospital-led initiative that effectively reduces recidivism among juveniles delinquent of gun crimes. This sets the framework for trauma centers nationwide to lead in establishing impactful, comprehensive, gun-violence intervention strategies. Prognostic and Epidemiological; Level V.

Relationships between substance use disorders, 'severe mental illness' and re-arrest in a county detention facility: A 4-year follow-up cohort study.

A growing body of literature demonstrates strong association between poor mental health and criminal recidivism, but research from county jails is limited. Our aim was to examine the relationship between re-arrest and severe mental illnesses-schizophrenia, bipolar disorder and major depressive disorder-together and separately and with substance use disorders, separately and as comorbid conditions, in a mid-sized county jail cohort in the southeastern United States. We examined the full cohort of 8097 individuals who were booked into the County Detention Facility between 31 January 2014 and 31 January 2015. Their incarceration data were merged with data from the local health system to investigate the presence of severe mental illness and substance use disorder diagnoses. Re-arrest data were tracked for 4years after the index arrest. Approximately 60% of the cohort was re-arrested within 4years. People with substance use disorders, with or without severe mental illness, had higher re-arrest rates than those with severe mental illness alone or neither diagnosis. Drug-associated arrests did not explain this finding. Using detailed mental illness diagnosis data with a complete cohort of detained arrestees, we have shown the wide range of need among such individuals. By demonstrating that drug-associated crimes per se do not drive repeated arrest, we underscore a need to examine other factors that promote the cycle of repeated arrest in this population. Each individual requires treatment tailored to their personal psychiatric and criminogenic needs.

Association between a Post-Resuscitation Care Bundle and the Odds of Field Rearrest after Successful Resuscitation from Out-of-Hospital Cardiac Arrest: A Pre/Post Study

Objectives Rearrest after successful resuscitation from out-of-hospital cardiac arrest (OHCA) is common and is associated with worse patient outcomes. However, little is known about the effect of interventions designed to prevent rearrest. We assessed the association between a prehospital care protocol for immediate management after return of spontaneous circulation (ROSC) and rates of field rearrest and survival to discharge in patients with prehospital ROSC. Methods This was a retrospective study of adult patients with OHCA and field ROSC within a large EMS system before (April 2017–August 2018) and after (April 2019–February 2020) implementation of a structured prehospital post-ROSC care protocol. The protocol was introduced in September 2018 and provided on-scene stabilization direction including guidance on ventilation and blood pressure support. Field data and hospital outcomes were used to compare the frequency of field rearrest, hospital survival, and survival with good neurologic outcome before and after protocol implementation. Logistic regression was used to assess the association between the post-implementation period and these outcomes, and odds ratios were reported. The association between individual interventions on these outcomes was also explored. Results There were 2,706 patients with ROSC after OHCA in the pre-implementation period and 1,780 patients in the post-implementation period. The rate of prehospital rearrest was 43% pre-implementation vs 45% post-implementation (RD 2%, 95% CI −1, 4%). In the adjusted analysis, introduction of the protocol was not associated with decreased odds of rearrest (OR 0.87, 95% CI 0.73, 1.04), survival to hospital discharge (OR 1.01, 95% CI 0.81, 1.24), or survival with good neurologic outcome (OR 0.81, 95% CI 0.61, 1.06). Post-implementation, post-ROSC administration of saline and push-dose epinephrine increased from 11% to 25% (RD 14%, 95% CI 11, 17%) and from 3% to 12% (RD 9% 95% CI 7, 11%), respectively. In an exploratory analysis, push-dose epinephrine was associated with a decreased odds of rearrest (OR 0.68, 95% CI 0.50, 0.94). Conclusions Introduction of a post-ROSC care protocol for patients with prehospital ROSC after OHCA was not associated with reduced odds of field rearrest. When elements of the care bundle were considered individually, push-dose epinephrine was associated with decreased odds of rearrest.

Predictive Bias in Juvenile Risk Assessment: Considering Race/Ethnicity and Sex

This study examines the joint effects of race/ethnicity and sex on the classification quality of the Positive Achievement Change Tool (PACT). We assess predictive parity, calibration, and error rate balance using a statewide sample of youth who completed probation from 2007 to 2014. Similar rates of predictive parity were observed across groups. Calibration was observed consistently across groups, but only when low risk youth were used as the reference category. Black and Hispanic boys revealed the highest base rates of re-arrest and inaccurate classification (i.e., scored low risk but were rearrested). Our findings highlight the difficulty in making conclusions about test bias, especially when base rates of recidivism are not equal across groups. Implications for juvenile justice policy and practice are discussed.

Comparison of in-hospital and out-of-hospital cardiac arrest of trauma patients in Qatar

BackgroundCardiac arrests in admitted hospital patients with trauma have not been described in the literature. We defined “in-hospital cardiac arrest of a trauma” (IHCAT) patient as “cessation of circulatory activity in a trauma patient confirmed by the absence of signs of circulation or abnormal cardiac arrest rhythm inside a hospital setting, which was not cardiac re-arrest.” This study aimed to compare epidemiology, clinical presentation, and outcomes between in- and out-of-hospital arrest resuscitations in trauma patients in Qatar. It was conducted as a retrospective cohort study including IHCAT and out-of-hospital trauma cardiac arrest (OHTCA) patients from January 2010 to December 2015 utilizing data from the national trauma registry, the out-of-hospital cardiac arrest registry, and the national ambulance service database.ResultsThere were 716 traumatic cardiac arrest patients in Qatar from 2010 to 2015. A total of 410 OHTCA and 199 IHCAT patients were included for analysis. The mean annual crude incidence of IHCAT was 2.0 per 100,000 population compared to 4.0 per 100,000 population for OHTCA. The univariate comparative analysis between IHCAT and OHTCA patients showed a significant difference between ethnicities (p=0.04). With the exception of head injury, IHCAT had a significantly higher proportion of localization of injuries to anatomical regions compared to OHTCA; spinal injury (OR 3.5, 95% CI 1.5–8.3, p<0.004); chest injury (OR 2.62, 95% CI 1.62–4.19, p<0.00), and abdominal injury (OR 2.0, 95% CI 1.0–3.8, p<0.037). IHCAT patients had significantly higher hypovolemia (OR 1.66, 95% CI 1.18–2.35, p=0.004), higher mean Glasgow Coma Scale (GCS) score (OR 1.4, 95% CI 1.3–1.6, p<0.00), and a greater proportion of initial shockable rhythm (OR 3.51, 95% CI 1.6–7.7, p=0.002) and cardiac re-arrest (OR 6.0, 95% CI 3.3–10.8, p=<0.00) compared to OHTCA patients. Survival to hospital discharge was greater for IHCAT patients compared to OHTCA patients (OR 6.3, 95% CI 1.3–31.2, p=0.005).Multivariable analysis for comparison after adjustment for age and gender showed that IHCAT was associated with higher odds of spinal injury, abdominal injury, higher pre-hospital GCS, higher occurrence of cardiac re-arrest, and better survival than for OHTCA patients.IHCAT patients had a greater proportion of anatomically localized injuries indicating solitary injuries compared to greater polytrauma in OHTCA. In contrast, OHTCA patients had a higher proportion of diffuse blunt non-localizable polytrauma injuries that were severe enough to cause immediate or earlier onset of cardiac arrest.ConclusionIn traumatic cardiac arrest patients, IHCAT was less common than OHTCA and might be related to a greater proportion of solitary localized anatomical blunt injuries (head/abdomen/chest/spine). In contrast, OHTCA patients were associated with diffuse blunt non-localizable polytrauma injuries with increased severity leading to immediate cardiac arrest. IHCAT was associated with a higher mean GCS score and a higher rate of initial shockable rhythm and cardiac re-arrest, and improved survival rates.

Clustering of adverse and positive childhood experiences: The nature and correlates of risk and protective factors

BackgroundDespite the increased attention paid to the separate effects of cumulative stress and protection on offending, the extent to which distinct clusters of risk and protective factors exist and have unique effects on justice-related outcomes is under-studied. ObjectiveThe current study examines for unique clustering of Adverse Childhood Experiences (ACE) and Positive Childhood Experiences (PCE) and the extent to which they predict juvenile recidivism. Participants and settingThe sample consists of a cohort of youth adjudicated delinquent in Florida who received a community-based sanction. MethodsThe study first utilized latent-class analysis to identify distinct classes based upon the youths' ACE and PCE exposures. Next, two sets of regression models were estimated; the first investigated correlates of class membership and the second assessed whether class membership predicted recidivism. ResultsSeven distinct classes of ACE/PCE clusters were found, composing 9.9 % to 20.5 % of the sample each. Relative to the class with low ACE and low PCE, those with low ACEs and high PCE evidenced 27.5 % lower rearrest rates, as did the Moderate Risk/Moderate Protection group. ConclusionsNot only do distinct groupings of ACE and PCE exposures exist, but these groups have different likelihoods of future offending, where a youth's cumulative protection appears to be more important than their risk level. This has important policy implications as it offers further support for the use of strength-based treatment approaches.

Recidivism Outcomes Under a Shifting Continuum of Control

Criminal justice systems across the United States are reducing reliance on prison incarceration and moving toward more local and noncustodial types of responses to felony offenders. Rather than wholesale decarceration, states and counties are shifting felons along what we call a “continuum of control,” which allows for people who previously might have been incarcerated in state prison to be sentenced to jail, jail plus probation, or probation without a custodial spell. With some notable exceptions, existing research has focused primarily on contrasting prison versus community placements and ignored the intermediary alternatives between the poles of the continuum. In this study, we compare the recidivism outcomes of felons sentenced to prison versus those sentenced to jail, jail plus probation, and probation alone. On balance, our findings show that jail incarceration results in the same or lower rearrest and reconviction rates than incarceration in prison. We also find consistent evidence that while rearrests are frequently higher for probation with or without a jail spell, reconvictions are consistently lower for similarly situated offenders than prison. These findings provide partial evidence in support of policies that move people convicted of felonies to less costly, more local, and less confining alternatives than prison.

Police‐driven diversion program in Wisconsin lowers rearrest rate

Completion of a six‐month diversion program for drug offenders in Madison, Wisconsin, led to a substantial reduction in the odds of rearrest compared with individuals not participating in the program, reports a newly published study. The results point to the importance of ongoing engagement of participants, in that mere assignment to the program without successful completion was not associated with reduced recidivism.

Does Speed Matter? The Association Between Case Processing Time in Juvenile Court and Rearrest

The present study assessed the relationship between case processing time and rearrest among a sample of first-time juvenile offenders referred to the Florida juvenile justice system and examined the extent to which this association varied by youth and case characteristics. Propensity score analyses suggested youth with longer case processing times had higher odds of being rearrested within 1 year compared to youth with shorter case processing times. Subgroup analyses suggested differences in the effects of case processing time by youth and case-level characteristics. According to results, policymakers should prioritize implementing and enforcing case processing time restrictions in their jurisdictions, particularly for detained youth and remain aware of the potential ensnaring implications of longer case processing times to reduce rearrest rates for first-time juvenile offenders.

Juvenile Second Chance Act Participation in Virginia: Impact on Rearrest, Reconviction, and Reincarceration

This study evaluates the recidivism impact of the Tidewater Reentry Initiative (TRI) for medium and high-risk juveniles released from secure statewide facilities. TRI used an intensive case management model combined with in-reach prerelease reentry planning. Impact was assessed using propensity score (PS) weighting in a geographic comparison design. Treatment youth were released from statewide facilities to the Tidewater area of Virginia; comparison youth were released to a comparison area. PSs were used to balance the samples on demographics, current case characteristics, and criminal history. Descriptively, treatment youth showed lower rearrest and reconviction rates at 6, 12, and 24 months following release than comparison youth. Survival analyses examined time to first rearrest, reconviction, and reincarceration, using 6 months to 6 years of follow-up data. Treatment youth were slower to be rearrested and reconvicted, which was significant at the p < .10 level in Cox proportional hazard models. These beneficial effects appear concentrated among the youth released as adults, but formal tests of the interaction were not significant. The intensive case management model seems to have promise to delay recidivism, although high recidivism rates suggest that the model is not intensive enough for high risk youth involved in the juvenile justice system.

Targeting intensive job assistance to ex‐offenders by the nature of offense: Results from a randomized control trial

AbstractAs many as two‐thirds of newly‐released inmates will be arrested for a new offense within 3 years. This study evaluates the impact of job assistance on recidivism rates among ex‐offenders. The job assistance program, run though the private company America Works, uses a network of employers to place clients. Ex‐offenders were randomly assigned to intensive job assistance (treatment group) or the standard program (control group). The intensive program is meant to improve average work readiness for ex‐offenders. It reduces the likelihood of subsequent arrest among nonviolent ex‐offenders, but has little effect on violent ex‐offenders. The rearrest rate for nonviolent ex‐offenders in the treatment group was 19 percentage points lower than those in the control group. The rearrest rate for violent ex‐offenders in the treatment group was indistinguishable from those in the control group. We estimate benefits from intensive job assistance from averted crimes and find that they outweigh the $5,000 up‐front cost for nonviolent ex‐offenders.

Effect of Out-of-Hospital Sodium Nitrite on Survival to Hospital Admission After Cardiac Arrest

Therapeutic delivery of sodium nitrite during resuscitation improved survival in animal models of cardiac arrest, but efficacy has not been evaluated in clinical trials in humans. To determine whether parenteral administration of sodium nitrite given by paramedics during resuscitation for out-of-hospital cardiac arrest improved survival to hospital admission. Double-blind, placebo-controlled, phase 2 randomized clinical trial including 1502 adults in King County, Washington, with out-of-hospital cardiac arrest from ventricular fibrillation or nonventricular fibrillation. Patients underwent resuscitation by paramedics and were enrolled between February 8, 2018, and August 19, 2019; follow-up and data abstraction were completed by December 31, 2019. Eligible patients with out-of-hospital cardiac arrest were randomized (1:1:1) to receive 45 mg of sodium nitrite (n = 500), 60 mg of sodium nitrite (n = 498), or placebo (n = 499), which was given via bolus injection by the paramedics as soon as possible during active resuscitation. The primary outcome was survival to hospital admission and was evaluated with 1-sided hypothesis testing. The secondary outcomes included out-of-hospital variables (rate of return of spontaneous circulation, rate of rearrest, and use of norepinephrine to support blood pressure) and in-hospital variables (survival to hospital discharge; neurological outcomes at hospital discharge; cumulative survival to 24 hours, 48 hours, and 72 hours; and number of days in the intensive care unit). Among 1502 patients with out-of-hospital cardiac arrest who were randomized (mean age, 64 years [SD, 17 years]; 34% were women), 99% completed the trial. Overall, 205 patients (41%) in the 45 mg of sodium nitrite group and 212 patients (43%) in the 60 mg of sodium nitrite group compared with 218 patients (44%) in the placebo group survived to hospital admission; the mean difference for the 45-mg dose vs placebo was -2.9% (1-sided 95% CI, -8.0% to ∞; P = .82) and the mean difference for the 60-mg dose vs placebo was -1.3% (1-sided 95% CI, -6.5% to ∞; P = .66). None of the 7 prespecified secondary outcomes were significantly different, including survival to hospital discharge for 66 patients (13.2%) in the 45 mg of sodium nitrite group and 72 patients (14.5%) in the 60 mg of sodium nitrite group compared with 74 patients (14.9%) in the placebo group; the mean difference for the 45-mg dose vs placebo was -1.7% (2-sided 95% CI, -6.0% to 2.6%; P = .44) and the mean difference for the 60-mg dose vs placebo was -0.4% (2-sided 95% CI, -4.9% to 4.0%; P = .85). Among patients with out-of-hospital cardiac arrest, administration of sodium nitrite, compared with placebo, did not significantly improve survival to hospital admission. These findings do not support the use of sodium nitrite during resuscitation from out-of-hospital cardiac arrest. ClinicalTrials.gov Identifier: NCT03452917.

Targeting Intensive Job Assistance to Ex-Offenders by the Nature of Offense: Results from a Randomized Control Trial

As many as two-thirds of newly-released inmates will be arrested for a new offense within three years. This study evaluates the impact of job assistance on recidivism rates among ex-offenders. The job assistance program, run though the private company America Works, uses a network of employers to place clients. Ex-offenders were randomly assigned to intensive job assistance (treatment group) or the standard program (control group). The intensive program is meant to improve average work readiness for ex-offenders. It reduces the likelihood of subsequent arrest among non-violent ex-offenders, but has little effect on violent ex-offenders. The re-arrest rate for non-violent ex-offenders in the treatment group was 19 percentage points lower than those in the control group. The re-arrest rate for violent ex-offenders in the treatment group was indistinguishable from those in the control group. We estimate benefits from intensive job assistance from averted crimes and find that they outweigh the $5,000 up-front cost for non-violent ex-offenders.