Browsing by Subject "Childhood"

Few studies have historically assessed the surges and troughs of public perception regarding juvenile offenders across over a century of legislative and social change. Furthermore, a minority of juvenile crime investigations have holistically examined the interplay between changing demographic conditions (notably, economic stability, racial composition and crime rates) with its accompanying ideological shifts. Through a theoretical emphasis on social constructionism and moral panic theory, this dissertation illuminates the cyclical nature of juvenile justice reform and illustrates that panics regarding juvenile offenders are more closely related to fears regarding the maintenance of power and the insecurity that comes with historical change than with an authentic threat of juvenile crime. Over 9,000 records in The New York Times, Congressional record, and Supreme Court decisions were coded and analyzed to reveal three chronological partitions of the social construction of youthful offenders: (1) the 1890s-1930s during which the most destabilizing force to those in positions of power revolved squarely around urbanization, industrialization, and the waves of immigration from Eastern and Southern Europe; (2) the 1930s-1970s during which faith in juvenile offender rehabilitation was replaced with punitive policies stressing deterrence and an increased focus on the "problem" of racial minorities; (3) the 1970s-present which demonstrates the declining discussion of race in print media and legislative debates even as its effects in sentencing and prosecution grow in strength. This dissertation illuminates the ways in which insecurity and panic breed violence and expounds upon that notion to specify that how the violence manifests itself, whether through punitive policies or interpersonal crime, depends on the resources available and the historically-situated social norms. Over time, however, the explicit racial hostility in rhetoric and policy has been replaced with an evasion the recognition that race undoubtedly affects both juvenile justice policies as well as their implementation. In order to combat the inevitable instability that accompanies historical change, a resurgence of dialogue acknowledging the connection between race and juvenile justice is urged.

Background: There is a significant disparity in survival rates for pediatric cancer in low and middle-income countries compared to high-income countries. A variety of factors contribute to this disparity including late stage disease at presentation, high rates of abandonment of care, and lack of supportive care. In Mwanza, Tanzania, a residential hostel was created to reduce these barriers among patients being treated for childhood cancer at Bugando Medical Centre (BMC). This study explores the potential benefit of the hostel in terms of event free survival and quality of life and examines the barriers and facilitators for completing care and the perceptions of the hostel. Methods: The study had three major components. A medical record review was conducted for 229 patients who presented to BMC in 2016-17, looking at survival outcomes. Surveys were collected from patients and caregivers who presented in 2018. In-depth interviews were conducted to explore patient/caregiver experiences. Data was collected at BMC and was analyzed with survival curves, hazard models, logistic regression, t-tests and applied thematic analysis. Results: One-year EFS was not significantly different for patients who presented to BMC before the hostel opened compared to those that presented after the hostel opened. However, a proportional hazard model showed a significantly lower hazard for patients that stayed at the hostel compared to patients that did not. Participants that stayed at the hostel also scored significantly higher in emotional functioning compared to patients that did not stay at the hostel. In-depth interview participants highlighted barriers and facilitators for completing care and described the benefits of the hostel including psychosocial support and reduced financial burden. Conclusions: Higher one-year event free survival and better scores in emotional wellbeing were observed for patients that stayed at the hostel. Caregivers and patients shared positive perceptions of the hostel as a facilitator for completing care. Key supportive care programs such as a hostel can be beneficial for improving pediatric cancer outcomes in LMICs.