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To investigate the association between serum calcium and risk of breast cancer using a large cohort and a systematic review with meta-analysis. From the Swedish Apolipoprotein Mortality Risk (AMORIS) Study we included 229,674 women who had baseline measurements of serum total calcium and albumin. Multivariable Cox regression was used to assess the association between total and albumin-corrected calcium and breast cancer risk. For the systematic review, an electronic search of MEDLINE and EMBASE databases was performed to identify other prospective cohorts assessing the relationship between serum calcium and breast cancer risk. We pooled the results of our AMORIS cohort with other eligible studies in a meta-analysis using a random effects model. I-2 test was used to assess heterogeneity. In the AMORIS study, 10,863 women were diagnosed with breast cancer (mean follow-up: 19 years). We found an inverse association between total serum calcium and breast cancer when comparing the fourth quartile to the first quartile (HR: 0.94, 95% CI: 0.88-0.99, p value for trend 0.04) and similar results using albumin-corrected calcium. In the systematic review, we identified another two prospective cohorts evaluating pre-diagnostic serum total calcium and breast cancer. Combining these studies and our findings in AMORIS in a meta-analysis showed a protective effect of serum calcium against breast cancer, with a summary RR of 0.80 (95% CI: 0.66-0.97). No substantial heterogeneity was observed. Our findings in AMORIS and the meta-analysis support an inverse association between serum calcium and breast cancer risk, which warrants mechanistic investigations.

To investigate the association between serum calcium and risk of breast cancer using a large cohort and a systematic review with meta-analysis. From the Swedish Apolipoprotein Mortality Risk (AMORIS) Study we included 229,674 women who had baseline measurements of serum total calcium and albumin. Multivariable Cox regression was used to assess the association between total and albumin-corrected calcium and breast cancer risk. For the systematic review, an electronic search of MEDLINE and EMBASE databases was performed to identify other prospective cohorts assessing the relationship between serum calcium and breast cancer risk. We pooled the results of our AMORIS cohort with other eligible studies in a meta-analysis using a random effects model. I-2 test was used to assess heterogeneity. In the AMORIS study, 10,863 women were diagnosed with breast cancer (mean follow-up: 19 years). We found an inverse association between total serum calcium and breast cancer when comparing the fourth quartile to the first quartile (HR: 0.94, 95% CI: 0.88-0.99, p value for trend 0.04) and similar results using albumin-corrected calcium. In the systematic review, we identified another two prospective cohorts evaluating pre-diagnostic serum total calcium and breast cancer. Combining these studies and our findings in AMORIS in a meta-analysis showed a protective effect of serum calcium against breast cancer, with a summary RR of 0.80 (95% CI: 0.66-0.97). No substantial heterogeneity was observed. Our findings in AMORIS and the meta-analysis support an inverse association between serum calcium and breast cancer risk, which warrants mechanistic investigations.

To investigate the association between serum calcium and risk of breast cancer using a large cohort and a systematic review with meta-analysis. From the Swedish Apolipoprotein Mortality Risk (AMORIS) Study we included 229,674 women who had baseline measurements of serum total calcium and albumin. Multivariable Cox regression was used to assess the association between total and albumin-corrected calcium and breast cancer risk. For the systematic review, an electronic search of MEDLINE and EMBASE databases was performed to identify other prospective cohorts assessing the relationship between serum calcium and breast cancer risk. We pooled the results of our AMORIS cohort with other eligible studies in a meta-analysis using a random effects model. I-2 test was used to assess heterogeneity. In the AMORIS study, 10,863 women were diagnosed with breast cancer (mean follow-up: 19 years). We found an inverse association between total serum calcium and breast cancer when comparing the fourth quartile to the first quartile (HR: 0.94, 95% CI: 0.88-0.99, p value for trend 0.04) and similar results using albumin-corrected calcium. In the systematic review, we identified another two prospective cohorts evaluating pre-diagnostic serum total calcium and breast cancer. Combining these studies and our findings in AMORIS in a meta-analysis showed a protective effect of serum calcium against breast cancer, with a summary RR of 0.80 (95% CI: 0.66-0.97). No substantial heterogeneity was observed. Our findings in AMORIS and the meta-analysis support an inverse association between serum calcium and breast cancer risk, which warrants mechanistic investigations.

To investigate the association between serum calcium and risk of breast cancer using a large cohort and a systematic review with meta-analysis. From the Swedish Apolipoprotein Mortality Risk (AMORIS) Study we included 229,674 women who had baseline measurements of serum total calcium and albumin. Multivariable Cox regression was used to assess the association between total and albumin-corrected calcium and breast cancer risk. For the systematic review, an electronic search of MEDLINE and EMBASE databases was performed to identify other prospective cohorts assessing the relationship between serum calcium and breast cancer risk. We pooled the results of our AMORIS cohort with other eligible studies in a meta-analysis using a random effects model. I-2 test was used to assess heterogeneity. In the AMORIS study, 10,863 women were diagnosed with breast cancer (mean follow-up: 19 years). We found an inverse association between total serum calcium and breast cancer when comparing the fourth quartile to the first quartile (HR: 0.94, 95% CI: 0.88-0.99, p value for trend 0.04) and similar results using albumin-corrected calcium. In the systematic review, we identified another two prospective cohorts evaluating pre-diagnostic serum total calcium and breast cancer. Combining these studies and our findings in AMORIS in a meta-analysis showed a protective effect of serum calcium against breast cancer, with a summary RR of 0.80 (95% CI: 0.66-0.97). No substantial heterogeneity was observed. Our findings in AMORIS and the meta-analysis support an inverse association between serum calcium and breast cancer risk, which warrants mechanistic investigations.

To investigate the association between serum calcium and risk of breast cancer using a large cohort and a systematic review with meta-analysis. From the Swedish Apolipoprotein Mortality Risk (AMORIS) Study we included 229,674 women who had baseline measurements of serum total calcium and albumin. Multivariable Cox regression was used to assess the association between total and albumin-corrected calcium and breast cancer risk. For the systematic review, an electronic search of MEDLINE and EMBASE databases was performed to identify other prospective cohorts assessing the relationship between serum calcium and breast cancer risk. We pooled the results of our AMORIS cohort with other eligible studies in a meta-analysis using a random effects model. I-2 test was used to assess heterogeneity. In the AMORIS study, 10,863 women were diagnosed with breast cancer (mean follow-up: 19 years). We found an inverse association between total serum calcium and breast cancer when comparing the fourth quartile to the first quartile (HR: 0.94, 95% CI: 0.88-0.99, p value for trend 0.04) and similar results using albumin-corrected calcium. In the systematic review, we identified another two prospective cohorts evaluating pre-diagnostic serum total calcium and breast cancer. Combining these studies and our findings in AMORIS in a meta-analysis showed a protective effect of serum calcium against breast cancer, with a summary RR of 0.80 (95% CI: 0.66-0.97). No substantial heterogeneity was observed. Our findings in AMORIS and the meta-analysis support an inverse association between serum calcium and breast cancer risk, which warrants mechanistic investigations.

For the past 150 years studies on Kiswahili language, literature and culture have engaged the scholarly attention of many researchers (Hauner 1979. In their analyses of Kiswahili literary works, however, most critical studies have, generally, tended to neglect the aspect of artistic design. Instead, the central focus has primarily been on two interlocking aspects of these works: (1) their content, values or thematic messages and (2) their cultural and socio-historical contexts (Dorsey 1988). This widespread tendency to undervalue the importance of artistic design in Kiswahili literary works is not surprising as it was largely promoted by some of the earlier European authorities who popularised the idea that Kiswahili literature `is not of literary interest´ and `that social, cultural, and historical commentary by anthologists are more relevant to this literature than literary study´ (Biersteker and Plane 1989:451). It is encouraging to see, however, that in recent years more and more scholars, like Mlamali (1980), Fiedel and Shariff (1986), Biersteker (1991) and Mbele (1996), to mention but a few, address issues of artistic design in their critical appraisals of Kiswahili literary works. This article is a modest attempt to follow their example by looking at Utenzi wa Shujaka as an object of design; how the poet has used the technical instruments of verbal craftsmanshjp in his bid to elicit an aesthetic response from his audience.

For the past 150 years studies on Kiswahili language, literature and culture have engaged the scholarly attention of many researchers (Hauner 1979. In their analyses of Kiswahili literary works, however, most critical studies have, generally, tended to neglect the aspect of artistic design. Instead, the central focus has primarily been on two interlocking aspects of these works: (1) their content, values or thematic messages and (2) their cultural and socio-historical contexts (Dorsey 1988). This widespread tendency to undervalue the importance of artistic design in Kiswahili literary works is not surprising as it was largely promoted by some of the earlier European authorities who popularised the idea that Kiswahili literature `is not of literary interest´ and `that social, cultural, and historical commentary by anthologists are more relevant to this literature than literary study´ (Biersteker and Plane 1989:451). It is encouraging to see, however, that in recent years more and more scholars, like Mlamali (1980), Fiedel and Shariff (1986), Biersteker (1991) and Mbele (1996), to mention but a few, address issues of artistic design in their critical appraisals of Kiswahili literary works. This article is a modest attempt to follow their example by looking at Utenzi wa Shujaka as an object of design; how the poet has used the technical instruments of verbal craftsmanshjp in his bid to elicit an aesthetic response from his audience.

For the past 150 years studies on Kiswahili language, literature and culture have engaged the scholarly attention of many researchers (Hauner 1979. In their analyses of Kiswahili literary works, however, most critical studies have, generally, tended to neglect the aspect of artistic design. Instead, the central focus has primarily been on two interlocking aspects of these works: (1) their content, values or thematic messages and (2) their cultural and socio-historical contexts (Dorsey 1988). This widespread tendency to undervalue the importance of artistic design in Kiswahili literary works is not surprising as it was largely promoted by some of the earlier European authorities who popularised the idea that Kiswahili literature `is not of literary interest´ and `that social, cultural, and historical commentary by anthologists are more relevant to this literature than literary study´ (Biersteker and Plane 1989:451). It is encouraging to see, however, that in recent years more and more scholars, like Mlamali (1980), Fiedel and Shariff (1986), Biersteker (1991) and Mbele (1996), to mention but a few, address issues of artistic design in their critical appraisals of Kiswahili literary works. This article is a modest attempt to follow their example by looking at Utenzi wa Shujaka as an object of design; how the poet has used the technical instruments of verbal craftsmanshjp in his bid to elicit an aesthetic response from his audience.