Systematic Denial Research Articles

Abstract B139: Redlining bias and progression of chronic health conditions in survivors of childhood cancer: A report from the St. Jude lifetime cohort study

Abstract Background/Aims: Racial health disparities have been linked to racial and residential segregation. Redlining bias is a special form of racial and residential segregation involving the systematic denial of mortgages, insurance, and other financial services to racial/ethnic minorities. This study examined associations between redlining bias and the progression of chronic health conditions (CHCs) in adult survivors of childhood cancer. Methods: We included 1,670 adult survivors of childhood cancer from the St. Jude Lifetime Cohort Study who had undergone two or more clinical assessments. Over 200 individual CHCs were graded using a modified CTCAE version and aggregated to determine the global CHC burden. CHC progression from baseline to follow-up evaluation was classified as either worsening over time (from Grade 2 to 3-5 or from Grade 3 to 4-5) or new-onset (from Grades 0-1 to 2-5). Survivors' home addresses at baseline (2007-2020) were linked to contemporary redlining bias data (2010-2017) created by Beyer et al. (J Clin Oncol, 2021). Redlining bias was defined as the odds ratio of a mortgage application denial for properties in a local area versus all metropolitan statistical areas and further classified as high (≥2.0), moderate (1.0-1.9), low (0.5-0.9), or least bias (<0.5). Multivariable logistic regression tested associations of risk for worsening/new-onset CHCs (vs. no progression) with redlining bias (high vs. moderate/low/least bias), adjusting for age, sex, treatment factors, personal socioeconomic status (SES; education and health insurance), and lifestyle factors. Joint effects of redlining bias and personal SES on CHC progression were also evaluated. Results: Survivors’ mean±SD age at baseline was 31.7±8.3 years; 17.5% lived in high and 19.5% in moderate redlining neighborhoods. The bivariate analysis found that living in a neighborhood classified as having high redlining bias (vs. moderate/low/least bias) increased the risk of progression of the global burden of CHCs (OR=1.32, 95% CI: 1.02-1.70). Multivariable analysis found significant associations of redlining bias with the risk of worsening/new-onset of individual CHCs such as cardiomyopathy (OR=1.63, 95% CI: 1.07-2.48), peripheral motor neuropathy (OR=1.56, 95% CI: 1.00-2.44), asthma (OR=1.85, 95% CI: 1.04-3.32), and restrictive pulmonary deficit (OR=1.79, 95% CI: 1.05-3.04). Considering joint effects, survivors enrolled in public insurance programs and living in a high redlining area had a higher risk of progression of the global burden of CHCs (OR=1.73, 95% CI: 1.05-2.87) and of worsening/new-onset in peripheral motor neuropathy (OR=3.18, 95% CI: 1.57-6.42) and restrictive pulmonary deficit (OR=5.29, 95% CI: 2.46-11.37) CHCs. Conclusions: The significant associations of redlining bias with the progression of CHCs among adult survivors of childhood cancer suggest an urgent need for interventions (typically social or healthcare policies) targeting neighborhoods with high discriminatory exposures to prevent CHC burden in this population. Citation Format: Jaesung Choi, Madeline R. Horan, Nickhill Bhakta, Deo Kumar Srivastava, Kirsten K. Ness, Gregory T. Armstrong, Melissa M. Hudson, I-Chan Huang. Redlining bias and progression of chronic health conditions in survivors of childhood cancer: A report from the St. Jude lifetime cohort study [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B139.

Challenges in navigating the education-migration pathways, and subjective well-being of highly educated immigrants: the case of Indian student immigrants in the United Kingdom.

Migration is generally considered to be a driver of enhancing the subjective well-being of immigrants; however, personal characteristics such as educational attainment, migration channel, and country of origin may moderate the impact of immigrant life on expected well-being. Therefore, the present study aimed to explore the intersections between the lived experiences of post-secondary Indian immigrant students in the United Kingdom (UK), the challenges they encounter as immigrants, and how these experiences could impact their subjective well-being. A qualitative research design was employed, which included a focus group discussion and 24 in-depth interviews with postgraduate students who had migrated from India to the United Kingdom. Four themes generated from the thematic analysis, which overall indicated that individuals who came to the United Kingdom as international students to study, work, and settle over time often found themselves unable to leverage their educational credentials to establish expected subjective well-being. This was primarily due to the systematic denial of their agency (capability) to overcome challenges in the host society. Reasons include becoming involuntarily immobile in the host country, incongruency between past expectations and present experiences and prospects, socio-emotional and financial costs associated with immigrant life that hinder the freedom of agency, and bureaucratic burdens. All these reasons can generate an unconducive environment for those immigrants who took part in the study, ultimately decreasing their life satisfaction and positive feelings while increasing negative feelings. In conclusion, the findings question the widely held belief that migration can increase subjective well-being and describe how migration comes at a cost, along with several other challenges, particularly for those who have moved first to learn, secondly to earn, and then to settle in. The channel of migration (migration for education and then to settle in) thus plays a crucial role in determining the outcomes of migration while influencing the anticipated subjective well-being of migrants.

OVERCOMING THE CREATIVE CRISIS OF THE FASHION INDUSTRY

The paper uses the advent of generative AI in fashion to critically examine the tenets of contemporary fashion design. As an exemplary case study, the work of Demna Gvasalia’s at the helm of Balenciaga is critically scrutinized and discussed as the result of the fashion industry’s ever-increasing speed and high demand of products at every price range. Within a hyper-globalized industry, fashion designers are forced to accelerate their design process with low production costs and high profits in mind. Given the systematic denial of fashion design understood as intentional creation by mainstream luxury fashion labels, fashion’s creative process is already heavily revolving around self-reference and copying, much like generative AI. The integration of visual literacy and academic referencing competences in fashion design education are proposed as strategies to break the cycle of copying and self-reference in fashion and to expand, deepen and diversify the practice of fashion design.

Endangered Urban Commons: Lahore’s Violent Heritage Management and Prospects for Reconciliation

The debate on urban commons yields relevance for shared histories and heritage in divided and post-conflict societies. Albeit memory is always subjective, heritage management tends to engender a linear view of the past that suggests a preconceived future development. Where the past is denigrated to prove the impossibility of ethnoreligious communities’ coexistence even though they have lived together peacefully for centuries, it risks corroborating us-them divisions for posterity and undermines reconciliation and peacebuilding. In this historically informed article, we argue that urban change in Lahore since 1947 has gone hand in hand with the purposive destruction of the common heritage shared by India and Pakistan. This interpretation of the past for the future reflects different forms of violence that surface in heritage management. Based on empirical data collected on heritage practices in the Old City of Lahore, Pakistan, we analyse the approach of the Walled City of Lahore Authority towards heritage management. Our focus on ignored dimensions and objects of heritage sheds light on the systematic denial of a shared history with Hindus and Sikhs before and during the 1947 partition of British India. This partial ignorance and the intentional neglect, for instance, of housing premises inhabited once by Hindus and other non-Muslim minorities, prevent any constructive confrontation with the past. By scrutinising the relationship between urban change, nostalgia, memory and heritage, this article points out that heritage management needs to be subjected to a constructive confrontation with the past to pave the ground for future reconciliation.

THE CASE AGAINST urethral failure is not a critical factor in female urinary incontinence. Now what? The integral theory system.

Subject of the Debate “Urethral failure is a critical factor in female urinary incontinence Now what?” The CASE FOR by Hokanson, DeLancey pinpointed inadequacy of bladder causation for urgency urinary incontinence (UUI) and poor urethral support for stress urinary incontinence (SUI) as responsible for long‐standing lack of progress in incontinence science. They proposed “Urethral failure” as causation for SUI and UUI. The CASE AGAINST, by Peter Petros agrees “abnormal detrusor function as cause for (UUI) is a failed concept, and SUI surgery results are sometimes suboptimal, but rejects “urethral failure” as cause for UUI and SUI. In answer to, “Now what?,” Petros presents the Integral Theory System. SUI and UUI are dysfunctions of the bladder's binary control mechanism, mainly ligament laxity because of defective collagen/elastin. The urethra is an emptying tube. Pelvic muscle forces reflexly contract against ligaments to close urethra, open it (micturition) and stretch the vagina underlying urethelial stretch receptors to mechanically support them, preventing premature activation of micturition (UUI). High validated cure rates for SUI and UUI by repair of weakened ligaments question viability of the “urethral failure” concept.ConclusionsThe major achievement of this debate (both sides) is not what causes UUI or SUI, or what doesn't, though clearly, this is important. It is calling out a 50‐year ossification of the whole construct of UUI, ranging from flawed definitions to systematic denial of known cures, all of which have stalled treatment of the one billion women who suffer with incontinence. The time has come for change.

Primjena UN doktrine „Odgovornost za pružanje zaštite“ i zločini nad Rohinja narodom u Mijanmaru / Implementation of un Doctrine “Responsibility to Protect” and Crimes Commited Against Rohingy People in Myanmar

After the serious shortcomings of the mechanism of the UN system of response to frequent cases of serious threats and survival of human groups were identified at the end of the 20th century, the report “Responsibility to Provide Protection” was submitted in 2001 and incorporated into the UN system in order to improve the mechanism for responding to these threats. At the beginning of the 21st century, the Rohingya people of Myanmar faced systematic denial of basic human rights and decades of crime. The paper presents the attitude of the international community towards the denial of basic human rights and crimes against the Rohingya community in Myanmar. The elaboration of the mentioned relationship was made following the principle of the doctrine of responsibility for providing protection. We found that the international community did not apply the principles of responsibility for protection and did not take the necessary measures to protect and restore the basic human rights of the Rohingya, although there were reliable indications that crimes against humanity and other crimes had been committed against them for decades.

Choosing my gender: Challenges faced by transgender persons in India

The golden thread that runs through the equality scheme of the Indian Constitution (Articles 14, 15, 16, 19, and 21) is the “enjoyment of life by all citizens and an equal opportunity to grow as human beings irrespective of their race, caste, religion, community, social status, and gender.” One of the basic tenets of the equality scheme lies in the recognition and acknowledgment of the right of choice and self-determination. Nonrecognition of transgender in the Indian legal framework has resulted in the systematic denial of equal protection of the law and widespread socioeconomic discrimination in society at large as well as in Indian workplaces. The article below brings into discussion the significant challenges faced by the transgender population that further fuel their inability to uplift themselves in Indian society.

How Hate Crime Laws Perpetuate Anti-Muslim Racism

Abstract This essay focuses on two cases in which Muslim youth were murdered yet law enforcement refused to classify the murders as hate crimes. It examines the 2015 murders of Deah Barakat, Yusor Abu-Salha, and Razan Abu-Salha in Chapel Hill, North Carolina and the 2017 murder of Nabra Hassanen in Reston, Virginia. This author argues that the denial of these cases as hate crimes contributes to the diminishment of anti-Muslim racism and should be understood as a form of racial gaslighting—a systematic denial of the persistence and severity of racism. In conversation with those advocating for rethinking the criminal justice system through prison abolition and restorative justice, it posits that seeking state recognition for hate crimes cannot provide justice given that the state is responsible for constructing Muslims as a national security threat. It explores how anti-Muslim racism is upheld through extremely narrow and problematic definitions of racism and hate crimes, through an approach to hate crimes that prioritizes punishment over civil rights, and through creating a dilemma for Muslim communities who must seek recognition of anti-Muslim racism from the same state that enacts surveillance and violence on them.

Rethinking the role of underground political work in the struggle for the liberation of Mozambique, late 1950s- 1970s

Studies on underground (or clandestine forms of political struggle) remain largely unknown with just a few of them published. The study focuses on underground political work in southern Mozambique from the 1950s to the 1970s. The main argument that the study seeks to make is that despite the intensification of colonial exploitation for the benefit of the Portuguese capital, violent repression, imprison and systematic denial of the exercise of political rights for most of the Mozambican people, the people of southern Mozambique had already a period of active underground political growth, inspired by the international political environment (decolonization process after World War II) and after connected to FRELIMO and its platform. Small cells, mostly connecting educated, assimilated people, civil servants, artists, writers, painters, self-employed and workers developed underground activities ranging from the political task of organization, to political awareness, propaganda and spying, to the military task of recruitment for training abroad and to provide the military. Therefore, they countered Portuguese state propaganda and articulated an alternative political agenda. The underground political work had connections and continuity with other forms of struggle, such as with the colonial resistance of the 1950s and the FRELIMO struggle. The study combines primary and secondary written materials and oral accounts with underground political activists/militants.

Comrades Do Not Always Agree: How to Promote Cooperation between the Followers of Marx and Sraffa?

In this note I propose two different levels of analysis for organizing the conversation around the Sraffa/Marx polemic. First, the “pragmatic approach” takes into account the immediate circumstances prevailing in the teaching of economics. In particular, we must understand that there is a systematic denial of Marxism in most economic departments, which are dominated by the mainstream neoclassical school, Keynesian thought, and various minor heterodox currents. Second, the “in-depth approach” leaves aside these circumstances and investigates the frontiers of socialist and radical political economics regardless of how well versed in Marxist theory a typical economist may be. Both levels are necessary, but we need to distinguish clearly so that we know when it is most useful to focus on one or the other. JEL Classification: B24, B51

Genocide Denial as Testimonial Oppression

ABSTRACT This article offers an argument of genocide denial as an injustice perpetrated not only against direct victims and survivors of genocide, but also against future members of the victim group. In particular, I argue that in cases of persistent and systematic denial, i.e. denialism, it perpetrates an epistemic injustice against them: testimonial oppression. First, I offer an account of testimonial oppression and introduce Kristie Dotson’s notion of testimonial smothering as one form of testimonial oppression, a mechanism of coerced silencing particularly pertinent to genocide denialism. Secondly, I turn to the epistemology of genocide denialism and, using the example of Turkey’s denialism of the Armenian genocide, show how it presents what Linda Martín Alcoff calls a substantive practice of ignorance. Thirdly, I apply these considerations to individual practices of genocide denial and analyse the particular characteristics of testimony on genocide, the speaker vulnerabilities involved and the conditions under which hearers will reliably fail to meet the dependencies of a speaker testifying to genocide. Finally, I explore the harms that testimonial oppression perpetrates on members of the victim group, insofar as it systematically deprives them of epistemic recognition.

Intersection of Bias, Structural Racism, and Social Determinants With Health Care Inequities.

* Abbreviation: SDoH — : social determinant of health Race, and more specifically, racism, is recognized as an important social determinant of health (SDoH) and a key driver of health inequities.1–3 The study “Race, Postoperative Complications, and Death in Apparently Healthy Children” in this issue of Pediatrics provides new evidence of race as a critical social determinant of surgical outcomes.4 The investigators demonstrate that apparently healthy Black children had a higher risk of postoperative mortality, complications, and serious adverse events than their white counterparts. Identifying these disparities using the National Surgical Quality Improvement Program pediatric database highlights the importance of health care practices to more deliberately consider equity in their quality improvement portfolios. The analyses were done among children with American Society of Anesthesiologists physical status 1 (normal healthy patients) or 2 (patients with mild systemic disease, such as mild asthma). By excluding children with significant comorbidities, this study helps advance knowledge beyond most previous pediatric disparities research focused on identifying disparities by exploring potential root causes. The findings suggest that, although preoperative comorbidities have previously been proposed as a factor contributing to postoperative disparities, they do not explain the results in the current study. Implicit racial bias has been proposed as another potential source of health care … Address correspondence to Tiffani J. Johnson, MD, MSc, Department of Emergency Medicine, University of California, Davis, 4150 V St, Suite 2100, Sacramento, CA 95817. E-mail: tjo{at}ucdavis.edu

Derecho a la atención sanitaria para madres y menores de 18 años afectados con labio y/o paladar hendido en República Dominicana

Objetivo: identificar y describir, desde la perspectiva del derecho fundamental a la salud, la garantía de la atención sanitaria en menores dominicanos afectados con labio y/o paladar hendido (LPH) y sus madres. Métodos: en tanto este es un estudio descriptivo, se realizaron encuestas semiestructuradas y se aplicó la observación no participante en los territorios de residencia de familias con menores afectados por LPH, atendidos en una fundación de República Dominicana. Resultados: la mayoría de familias afectadas por LPH pertenecen a clases sociales vulnerables con limitada capacidad de pago para adquirir seguros de salud. De las 39 familias abordadas, 26 madres no contaron con seguro de salud durante la gestación, pero los 39 pacientes con LPH sí contaban con algún tipo de aseguramiento. Se evidenció negación sistemática en la prestación de servicios sanitarios, barreras administrativas, invisibilización de la problemática del LPH en los servicios de salud y en definitiva, un sistema de salud excluyente en la práctica. Conclusión: pese a que la atención sanitaria a gestantes y menores de 18 años se reconoce constitucionalmente como un derecho fundamental a cargo del Estado, la forma en que opera el sistema de salud dominicano supedita la atención a la capacidad de pago de las familias, lo que genera inequidades sociales y sanitarias que vulneran el goce efectivo del derecho a la salud de las madres y los menores que nacen con LPH.

Precarity in Transit: Travellers by Helon Habila

This article offers a reading of Helon Habila’s latest novel Travellers, which was inspired by the onset of the so-called European refugee crisis in 2013. The essay pays special attention to the embodied act of narration and its exploitation by Habila as a mode of cultivating a compassionate understanding of forcibly displaced persons and their often precarious lives in prolonged transit. The analysis follows Butler’s idea of narrative as a mode, on the one hand, of humanising lives violently erased, as they all too often are in the event of involuntary migration, and, on the other, of restoring to “the ethically conscious” world their “capacity to mourn”, where it has been undermined by the systematic denial of human suffering by the nation state and dominant asylum discourse. Theoretical as this approach may appear at first glance, the essay’s goal is to demonstrate that, for Habila’s protagonist, learning to listen to other people’s stories properly and compassionately means to distance himself from the abstract projections of refugee subjecthood he himself endorses as the cosmopolitan intellectual he represents at the outset.

Permission to Narrate a Pandemic in Palestine

Permission to Narrate a Pandemic in Palestine

The Potential of Domestic and International Courts to Protect Women’s Right to Family Life in the North Caucasus

Abstract The North Caucasus region of Russia is known for spawning the highest number of adverse judgments from the European Court of Human Rights compared to any other Russian region—over 500 as of mid-2020. Since 2005, the Court has found Russia responsible for enforced disappearances, extrajudicial killings and torture carried out on a mass scale during the second Chechen war and in its aftermath. The Head of the Chechen Republic, Ramzan Kadyrov, has become internationally infamous for the brutal repression of even his mildest critics, ensuring that most Chechens will be too afraid to claim their rights in any forum. Domestically, the Russian federal authorities have either ignored or tacitly condoned the increasing subversion of state law in the region in favour of de facto customary norms—adat—and elements of sharia law that have had a devastating effect mainly on women’s and girls’ rights. Harmful traditional practices such as ‘honour killings’, child marriage, bride-kidnapping, and—in certain remote mountain regions of Dagestan—female genital mutilation take place on a regular basis. Yet such violations, however grave, do not easily lend themselves to litigation. This practice note focuses on one of the few areas in the region in which systematic focused litigation is being carried out in domestic courts, often against enormous odds: the systematic denial of women’s right to family life after divorce or the death of their children’s biological father.

Mineralizing the Right to Prior Consultation: From Recognition to Disregard of Indigenous and Peasant Rights in Peru

AbstractBy using a sociolegal analysis, this article shows how the Peruvian State has used administrative mechanisms to prevent the free, prior and informed consultation of indigenous and peasant communities impacted by mining projects throughout the country. Prior consultation – a fundamental right for these communities – is being drained of its content by ad hoc procedures of a mining bureaucracy bent on ignoring it. For this, the main strategy has been to deny the identity of indigenous peoples and, by doing so, divest them of their collective rights. The goal has been to promote the expansion of the mining industry at all costs. In the context of an extractivist economy, indigenous rights loose substance. The state has thus moved from the discursive recognition of indigenous rights to its effective disregard. However, the reaction of other state agencies against the systematic denial of indigenous collective rights offers not only hope but the chance to assess the tension between economic and special human rights.

Critical Latinx Indigeneities and Education: An Introduction

Indigenous Latinx children and youth are a growing population that has been largely invisible in U.S. society and in the scholarly literature (Barillas-Chón, 2010; Machado-Casas, 2009). Indigenous Latinx youth are often assumed to be part of a larger homogenous grouping, usually Hispanic or Latinx, and yet their cultural and linguistic backgrounds do not always converge with dominant racial narratives about what it means to be “Mexican” or “Latinx.” Bonfil Batalla (1987) argued that Indigenous Mexicans are a población negada—or negated population—whose existence has been systematically denied as part of a centuries-long colonial project of indigenismo (indigenism) in Mexico and other Latin American countries. This systematic denial in countries of origin often continues once Indigenous people migrate to the U.S., as they are actively rendered invisible in U.S. schools through the semiotic process of erasure (Alberto, 2017; Urrieta, 2017). Indigenous Latinx families are often also overlooked as they are grouped into general categories such as Mexican, Guatemalan, Latinx, and/or immigrants. In this issue, we seek to examine the intersections of Latinx Indigeneities and education to better understand how Indigenous Latinx communities define and constitute Indigeneity across multiple and overlapping colonialities and racial geographies, and, especially, how these experiences overlap with, and shape their educational experiences.

Decolonial hermeneutics: revealing the exhaustion of the legal and political speech of liberalism.

O presente estudo articula uma análise hermenêutica crítica do constitucionalismo da modernidade e seus evidentes esgotamentos. Este ensaio analisaa questão da legitimação do direito e justificação de existência do Estado dentro da Modernidade Liberal, analisando os conceitos "universais" basilares de que a mesma se serve para construir sua base de legitimação, tais como democracia, povo e poder constituinte. A metodologia utilizada contempla método dialético e materialismo histórico, com a desconstrução hermenêutica dos conceitos "universais", devido à negação e exclusão sistemática de contextos de realidade que os mesmos promovem. Na sequência, leva-se a cabo a reconstrução hermenêutica dos conceitos de povo e democracia, atentando justamente para as realidades que o sistema liberal excluiu e negou.

“Na torpeza nauseante havia muita coisa pura”: despersonalização e afirmação do sujeito em Memórias do Cárcere e nas Recordações da Casa dos Mortos.

A “torpeza” e a “pureza” que dão título a este texto são observadas por Graciliano Ramos no presídio da Ilha Grande. Lançado num ambiente hostil e desconhecido, o autor registra o processo de negação dos direitos e da dignidade dos presidiários, descritos através de expressões como “rebanho” e “fantasmas”. A convivência com prisioneiros originários contextos sociais e culturais em ampla medida desconhecidos abre caminho ao estranhamento, mas também a aproximações. Em Memórias da casa dos mortos, Dostoiévski se encontra em posição semelhante, e registra, com grande ênfase, a “pureza” em meio à “torpeza”, a afirmação da vida e da personalidade entre os “mortos” recolhidos na “casa” siberiana. O presente artigo tem como objetivo estabelecer comparações e aproximações entre as memórias carcerárias de ambos os literatos, a partir da problemática da negação da dignidade humana, e, por outro lado, da resistência dos presidiários, que lutam para afirmar suas vidas e personalidades, diante de circunstâncias restritivas e brutais.