‘Know Thyself and Change the World’: The Western Pilgrimage Narrative and South Asia

This paper summarises recurring elements of contemporary pilgrimage narratives related to South Asia and their role in neo-colonial ‘globalisation.’ While sacred sites are visited by both local and international pilgrims, their recreation as story cannot be regarded as innocent, interwoven as it is in historical domination and appropriation. The paper focuses on two contemporary narratives that draw on the motif of odyssey. It explores, in part, the increasing role of social media and technology in the most recent incarnations of the paradigm

‘Unlikely Adventures’ in Sacred and Secular Space: India and the Sikh Diaspora

The Sikh relationship with pilgrimage models is ambivalent and complicated; however, this relationship has been revived and reinvented because of several historical, cultural, and political transitions: the extensive Sikh diaspora; familiarity of pilgrimage in the Indian subcontinent; the effects of Partition and Sikh independence initiatives; and the secular and tourist components of pilgrimage. The shift from adherence to the wisdom of the Guru as the focus of the pious life to a physical journey involving geographical sites is a phenomenon that partly resulted from the partition of the Punjab in 1947; thus, the personal, social, and spiritual intersect intriguingly with political motivations. While pilgrimage narratives therefore have a limited place in Sikhism, diasporic writers can create a fictional response and rewriting of the pattern I have identified in previous studies. Balli Kaur Jaswal’s most recent novel, The Unlikely Adventures of the Shergill Sisters, focuses on a pilgrimage undertaken by three sisters after their mother’s death. This novel is an uncomfortable interweaving of Western concepts of the ‘dying wish’ and engages the ongoing controversy about the purpose of pilgrimage in Sikhism. It also revisits the paradigm of pilgrimage in the Indian epic Ramayana from a feminist perspective. This article engages with both the author’s critical exegesis related to the novel, and her personal reflection on pilgrimage to the ancestral geography of the subcontinent

Resurrecting the Ancient Unities : The Incarnation of Myth and the Legend of Logres in C.S. Lewis\u27 \u3ci\u3eThat Hideous Strength\u3c/i\u3e

Examines how Lewis’s idea of “transposition […] the incorporation of the eternal into the material” operates in That Hideous Strength

"To Our Remotest Border": Christianity and Empire in Canadian Writing

Alluding to Abraham's commission in the book of Genesis, a familiar passage for the founders of religious colonies, Sullivan, like the Pilgrim Fathers before him, conflates election and territorial possession: God's dominion and the dominion of the British Crown. At the same time, in this conflation some puzzling paradoxes emerge: the land is "our" dominion; it is chosen by our fathers; the land is both "true freedom's fairest scene" and yet "bound." Unlike the Pilgrim Fathers, the upholders of the Dominion also view themselves as representatives of Britain. The passage, then, embodies a vision of Canadian territory as sacred only after being claimed as political dominion; it also suggests a tension between freedom and imprisonment, empire and nation, complicity and rebellion

Family history of prostate and colorectal cancer and risk of colorectal cancer in the Women's health initiative.

BackgroundEvidence suggests that risk of colorectal and prostate cancer is increased among those with a family history of the same disease, particularly among first-degree relatives. However, the aggregation of colorectal and prostate cancer within families has not been well investigated.MethodsAnalyses were conducted among participants of the Women's Health Initiative (WHI) observational cohort, free of cancer at the baseline examination. Subjects were followed for colorectal cancer through August 31st, 2009. A Cox-proportional hazards regression modeling approach was used to estimate risk of colorectal cancer associated with a family history of prostate cancer, colorectal cancer and both cancers among first-degree relatives of all participants and stratified by race (African American vs. White).ResultsOf 75,999 eligible participants, there were 1122 colorectal cancer cases diagnosed over the study period. A family history of prostate cancer alone was not associated with an increase in colorectal cancer risk after adjustment for confounders (aHR =0.94; 95% CI =0.76, 1.15). Separate analysis examining the joint impact, a family history of both colorectal and prostate cancer was associated with an almost 50% increase in colorectal cancer risk (aHR = 1.48; 95% CI = 1.04, 2.10), but similar to those with a family history of colorectal cancer only (95% CI = 1.31; 95% CI = 1.11, 1.54).ConclusionsOur findings suggest risk of colorectal cancer is increased similarly among women with colorectal cancer only and among those with both colorectal and prostate cancer diagnosed among first-degree family members. Future studies are needed to determine the relative contribution of genes and shared environment to the risk of both cancers

Bioavailable insulin-like growth factor-I as mediator of racial disparity in obesity-relevant breast and colorectal cancer risk among postmenopausal women

Bioavailable insulin-like growth factor (IGF)-I interacts with obesity and exogenous estrogen in a racial disparity in obesity-related cancer risk, yet their interconnected pathways are not fully characterized. We investigated whether circulating bioavailable IGF-I acted as a mediator of the racial disparity in obesity-related cancers such as breast and colorectal (CR) cancers and how obesity and estrogen use regulate this relationship

Changes in the inflammatory potential of diet over time and risk of colorectal cancer in postmenopausal women

We examined the associations between changes in dietary inflammatory potential and risk of colorectal cancer (CRC) in 87,042 postmenopausal women recruited from 1993-1998 into the Women\u27s Health Initiative. Food frequency questionnaire data were used to compute patterns of change in dietary inflammatory index (DII) scores and cumulative average DII scores over 3 years. Cox regression models were used to estimate hazard ratios for CRC risk. After a median 16.2 years follow-up, 1,038 CRC cases were diagnosed. DII changes were not substantially associated with overall CRC, but proximal colon cancer risk was higher in the pro-inflammatory change DII compared to the anti-inflammatory stable DII groups (hazard ratio = 1.32; 95% confidence interval: 1.01, 1.74). Among non-users of nonsteroidal anti-inflammatory drugs (NSAID) (Pinteraction = 0.055) the pro-inflammatory stable DII group was at increased risk of overall CRC and proximal colon cancer. Also among non-users of NSAID, risks of overall CRC, colon cancer, and proximal colon cancer were higher in the highest quintile compared to the lowest cumulative average DII quintile (65%, 61%, and 91% increased risk, respectively). Dietary changes towards, or a history of, pro-inflammatory diets are associated with an elevated risk of colon cancer, particularly for proximal colon cancer and among non-users of NSAID

Sex hormone associations with breast cancer risk and the mediation of randomized trial postmenopausal hormone therapy effects

Introduction: Paradoxically, a breast cancer risk reduction with conjugated equine estrogens (CEE) and a risk elevation with CEE plus medroxyprogesterone acetate (CEE + MPA) were observed in the Women’s Health Initiative (WHI) randomized controlled trials. The effects of hormone therapy on serum sex hormone levels, and on the association between baseline sex hormones and disease risk, may help explain these divergent breast cancer findings. Methods: Serum sex hormone concentrations were measured for 348 breast cancer cases in the CEE + MPA trial and for 235 cases in the CEE trial along with corresponding pair-matched controls, nested within the WHI trials of healthy postmenopausal women. Association and mediation analyses, to examine the extent to which sex hormone levels and changes can explain the breast cancer findings, were conducted using logistic regression. Results: Following CEE treatment, breast cancer risk was associated with higher concentrations of baseline serum estrogens, and with lower concentrations of sex hormone binding globulin. However, following CEE + MPA, there was no association of breast cancer risk with baseline sex hormone levels. The sex hormone changes from baseline to year 1 provided an explanation for much of the reduced breast cancer risk with CEE. Specifically, the treatment odds ratio (95% confidence interval) increased from 0.71 (0.43, 1.15) to 0.92 (0.41, 2.09) when the year 1 measures were included in the logistic regression analysis. In comparison, the CEE + MPA odds ratio was essentially unchanged when these year 1 measures were included. Conclusions: Breast cancer risk remains low following CEE use among women having favorable baseline sex hormone profiles, but CEE + MPA evidently produces a breast cancer risk for all women similar to that for women having an unfavorable baseline sex hormone profile. These patterns could reflect breast ductal epithelial cell stimulation by CEE + MPA that is substantially avoided with CEE, in conjunction with relatively more favorable effects of either regimen following a sustained period of estrogen deprivation. These findings may have implications for other hormone therapy formulations and routes of delivery. Trial registration clinicaltrials.gov identifier: NCT00000611

Screening and brief interventions for hazardous and harmful alcohol use in primary care: a cluster randomised controlled trial protocol

A large number of randomised controlled trials in health settings have consistently reported positive effects of brief intervention in terms of reductions in alcohol use. However,although alcohol misuse is common amongst offenders, there is limited evidence of alcohol brief interventions in the criminal justice field. This factorial pragmatic cluster randomised controlledtrial with Offender Managers (OMs) as the unit of randomisation will evaluate the effectiveness and cost-effectiveness of different models of screening to identify hazardous and harmful drinkers in probation and different intensities of brief intervention to reduce excessive drinking in probation clients. Ninety-six OMs from 9 probation areas across 3 English regions (the NorthEast Region (n = 4) and London and the South East Regions (n = 5)) will be recruited. OMs will berandomly allocated to one of three intervention conditions: a client information leaflet control condition (n = 32 OMs); 5-minute simple structured advice (n = 32 OMs) and 20-minute brieflifestyle counselling delivered by an Alcohol Health Worker (n = 32 OMs). Randomisation will be stratified by probation area. To test the relative effectiveness of different screening methods all OMs will be randomised to either the Modified Single Item Screening Questionnaire (M-SASQ) orthe Fast Alcohol Screening Test (FAST). There will be a minimum of 480 clients recruited into the trial. There will be an intention to treat analysis of study outcomes at 6 and 12 months postintervention. Analysis will include client measures (screening result, weekly alcohol consumption,alcohol-related problems, re-offending, public service use and quality of life) and implementation measures from OMs (the extent of screening and brief intervention beyond the minimum recruitment threshold will provide data on acceptability and feasibility of different models of brief intervention). We will also examine the practitioner and organisational factors associated with successful implementation.The trial will evaluate the impact of screening and brief alcohol intervention in routine probation work and therefore its findings will be highly relevant to probation teams and thus the criminal justice system in the UK