DOCSLIB.ORG

Sarah Balaam Thesis

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Sarah Balaam Thesis ALCOHOL USE AND ASSOCIATED HEALTH BEHAVIOURS OF WOMEN WHO HAVE BEEN TREATED FOR BREAST CANCER Sarah Balaam BHthSc(Nut&Diet)(Hons1), APD Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy School of Nursing Faculty of Health Institute of Health and Biomedical Innovation (IHBI) Queensland University of Technology 2019 Alcohol use and associated health behaviours of women who have been treated for breast cancer i Keywords Alcohol consumption, breast cancer, health behaviours, health promotion, precede-proceed model, predisposing, reinforcing, enabling, survivorship. ii Alcohol use and associated health behaviours of women who have been treated for breast cancer Abstract Background Breast cancer is the most commonly diagnosed cancer in Australian women (Australian Institute of Health and Welfare & Australasian Association of Cancer Registries, 2017). Fortunately, advances in screening, early detection, and diagnosis, together with more effective treatments, are associated with recently-improved survival rates for these women, despite increased incidence (Potter, Collins, Brown, & Hure, 2014; Rock et al., 2012; World Cancer Research Fund/American Institute for Cancer Research, 2007). Better survival is clearly a positive outcome for this growing population; however, survival is also associated with negative outcomes, such as an increased risk of secondary primary cancers (Pollard, Eakin, Vardy, & Hawkes, 2009), co-morbidities (Eakin et al., 2007; Eakin et al., 2006; Pollard et al., 2009; Rock, Byers, et al., 2013), and the debilitating long-term effects of cancer treatment. Alcohol is a known carcinogen, with direct links to breast cancer development (Brooks, 2011; World Cancer Research Fund International/American Institute for Cancer Research, 2017a). Alcohol consumption after treatment for breast cancer amplifies the risk of secondary cancers (Rock, Byers, et al., 2013), adverse treatment-related effects (Gallicchio et al., 2015; Lydon et al., 2016; Mitchell & Woods, 2015; Smith, Gallicchio, Miller, Zacur, & Flaws, 2016; Tipples & Robinson, 2011), and comorbidities (Campbell et al., 2012; Rock, Byers, et al., 2013), while potentially increasing the risk of recurrence (Brooks, 2011; Kwan et al., 2013; Rock et al., 2012; Tan, Barber, & Shields, 2006; Winstanley et al., 2011). For example, the relative risk of breast cancer recurrence is increased by 20% for postmenopausal women who regularly consume more than three alcoholic drinks per week (Kwan et al., 2013). Unfortunately, national and international alcohol-related guidelines in this context are confusing, in that there is no consensus as to how many grams of alcohol constitute a standard drink (International Center for Alcohol Policies, 2007a) and there is little agreement regarding the precise intake that protects health (Winstanley et al., 2011). Adding to this ambiguity, the amount of alcohol consumed and the reasons for alcohol intake among the growing Australian population of women who Alcohol use and associated health behaviours of women who have been treated for breast cancer iii have been treated for breast cancer are largely unknown. However, the evidence indicates, that alcohol consumption is a chronic disease risk factor that can and should be modified to enhance the health of this cohort. Aims The aim of this PhD study was to determine the predisposing, enabling, and reinforcing factors associated with alcohol consumption in women previously treated for breast cancer. The objectives were to: 1) quantify alcohol consumption in women who have been treated for breast cancer compared to guidelines and Australian norms, 2) investigate the decision-making and psychosocial processes associated with alcohol consumption in this cohort and to highlight any physical or psychosocial outcomes associated with alcohol use, and 3) determine whether a tailored e-health lifestyle intervention changed alcohol-related health behaviours. Methods An independent component of the Women’s Wellness after Cancer Program (WWACP) (D. J. Anderson, McGuire, & Porter-Steele, 2014; D. J. Anderson et al., 2017), this PhD project utilised mixed methods. Study 1 of the PhD project combined secondary analysis of quantitative alcohol-related and socio-demographic data from the randomised controlled WWACP trial (N = 269). Study 2 comprised the collection and analysis of qualitative alcohol-related data from a sub-set of seventeen WWACP intervention and control participants. Results Quantitative analysis of 269 female breast cancer participants (N = 269, n = 138 intervention, n = 131 control) provided the following results. The baseline alcohol intake pattern (frequency, quantity, type, and place) of participants reflected that of women in the general Australian population and was similar to other breast cancer cohorts. Binary logistic regression modelling identified significant differences between non-drinkers and drinkers. Participants in this cohort who consumed alcohol at baseline were highly educated (p = .017), current or past smokers (p = .008), and reported better quality of life scores in the social and family wellbeing domain (p = .009). Significant findings that related to the odds of moving to a higher level of alcohol intake, assessed using ordinal logistic regression, were associated with being a current or past smoker (p = .004), greater physical activity levels (p = .049), and iv Alcohol use and associated health behaviours of women who have been treated for breast cancer better quality of life overall (p = .045). There was no quantifiable change to alcohol intake following participation in the WWACP intervention. Qualitative findings from the 17 sub-study participants indicated that, overall, participants viewed alcohol consumption favourably. Australian social norms and a family history of alcohol use appeared to influence pre-cancer behaviours and beliefs, and predisposed alcohol-related behaviours after diagnosis. Other predisposing factors identified in this phase of the study included age, tobacco use, health-related quality of life, physical activity, baseline knowledge, exposure to alcohol education, and socially-mediated beliefs about alcohol. WWACP-related behaviour change enablers identified in this cohort related to the WWACP intervention content, timing, and delivery method. The factors that reinforced change included the physical consequences of alcohol consumption and partner support. The qualitative data also suggested that alcohol intake changed during diagnosis, treatment, and into the period of survivorship, and was influenced by participation in the WWACP intervention. The data also suggested that health professionals provided inconsistent education about alcohol, and participants had varying levels of receptivity to education, depending on their position on the cancer trajectory. This resulted in some critical knowledge deficiencies and little knowledge among participants about the risk factors attendant on alcohol consumption before and after cancer treatment. Conclusions This PhD study makes a significant contribution to the currently sparse evidence base regarding alcohol consumption in Australia’s growing population of women who have received treatment for breast cancer. The study provides insights into the predisposing, enabling, and reinforcing factors that shape alcohol consumption. It also provides grounds for further research into interventions that target these behaviours to reduce the potential harms from alcohol consumption after breast cancer treatment. Alcohol use and associated health behaviours of women who have been treated for breast cancer v vi Alcohol use and associated health behaviours of women who have been treated for breast cancer Table of Contents Keywords .................................................................................................................................. ii Abstract .................................................................................................................................... iii Table of Contents .................................................................................................................... vii List of Figures ........................................................................................................................... x List of Tables ........................................................................................................................... xi List of Abbreviations .............................................................................................................. xii Statement of Original Authorship .......................................................................................... xiv PhD Supervisors ..................................................................................................................... xv Acknowledgements ............................................................................................................... xvi Chapter 1: Introduction ....................................................................................... 1 1.1 Context of the research project ........................................................................................ 1 1.2 Background ..................................................................................................................... 3 1.3 Study aim and research questions ................................................................................... 5 1.4 Design and methods overview .......................................................................................
Load more

Recommended publications
  • The Relationship Between Alcohol Drinking Patterns and Sleep Duration Among Black and White Men and Women in the United States
    International Journal of Environmental Research and Public Health Article The Relationship between Alcohol Drinking Patterns and Sleep Duration among Black and White Men and Women in the United States Chandra L. Jackson 1,*, Symielle A. Gaston 1 ID , Rui Liu 2, Kenneth Mukamal 3,4 and Eric B. Rimm 4,5,6 1 Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, 111 TW Alexander Drive, Research Triangle Park, NC 27709, USA; [email protected] 2 Social & Scientific Systems, Inc., Research Triangle Park, NC 27703, USA; [email protected] 3 Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA; [email protected] 4 Nutrition Department, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA; [email protected] 5 Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA 6 Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02215, USA * Correspondence: [email protected]; Tel.: +1-984-287-3701; Fax: +1-301-480-3290 Received: 22 January 2018; Accepted: 2 March 2018; Published: 20 March 2018 Abstract: In the United States, racial minorities generally experience poorer cardiovascular health compared to whites, and differences in alcohol consumption and sleep could contribute to these disparities. With a nationally representative sample of 187,950 adults in the National Health Interview Survey from 2004 to 2015, we examined the relationship between alcohol-drinking patterns and sleep duration/quality by race and sex.
    [Show full text]
  • Public Health Annual Report 2016/17
    Our STORY about alcohol St Helens Public Health Annual Report 2016/17 contents Foreword 3 Chapter 1 - St.Helens - Our Story 5 Chapter 2 - Drinking Prayer 6 Chapter 3 - Alcohol Culture in St.Helens 7 - Michelle’s Story 8 - Dave’s Story 9 Chapter 4 - Tackling Alcohol Harm 10 - Healthy Living 12 - Pharmacy 13 - GP 14 - Hospital A&E 15 - Police 16 Chapter 5 - Adults 17 - A Father’s Story, by John 18 - A Daughter’s Story, by Emma 19 - Behind the Scenes at the Recovery Centre 20 - Ways to Work Scheme 22 - Engaging People in Services 23 Chapter 6 - Children and Families 24 - A Mother’s Story, by Jane 25 - Alcohol and Pregnancy 26 - Footsteps Family Support 27 - Sam’s Story 28 Chapter 7 - Conclusion 29 Chapter 8 - Acknowledgements 30 Chapter 9 - What do you Think? 31 “This Public Health Annual Report tells the story of developments that we have made in tackling alcohol harm.” Foreword ‘Our Story about Alcohol’ is my first resonate with people in St.Helens which reflected Public Health Annual Report for the needs but also highlighted the good work that St.Helens and my aim was to highlight is happening to support people. We are only at the start of a journey that St.Helens is going on, working the issue from the people’s perspective. together with people to tackle the alcohol harm in I must thank those who have invested their time to the Borough. describe how alcohol has personally affected them Alcohol is a priority for the St.Helens People’s or described how it impacts on their life.
    [Show full text]
  • Cognitive Mechanisms Underlying the Link Between Anxiety, Health Behaviors, and Illness Outcomes: Commentary on a Special Issue
    Cognitive Therapy and Research (2019) 43:131–138 https://doi.org/10.1007/s10608-019-09999-6 ORIGINAL ARTICLE Cognitive Mechanisms Underlying the Link Between Anxiety, Health Behaviors, and Illness Outcomes: Commentary on a Special Issue Aliza T. Stein1 · Slaton Z. Freeman1 · Jasper A. J. Smits1 Published online: 28 January 2019 © Springer Science+Business Media, LLC, part of Springer Nature 2019 Abstract This commentary synthesizes research examining cognitive mechanisms underlying the links between anxiety, health behav- iors, and illness outcomes. We provide a brief summary of contributions to this special issue and review common themes and methodological limitations. Notably, a number of related constructs emerged as amplification factors, increasing vulnerability to psychopathology and maladaptive health behaviors. These include anxiety sensitivity, distress and discomfort intolerance, emotion regulation, health literacy, and repetitive negative thinking. Finally, we discuss clinical implications, and conclude with suggestions for further research in this area. Keywords Anxiety · Health behaviors · Transdiagnostic Introduction (Yamaoka and Tango 2005). Despite these advances, there are still large knowledge gaps and extensive unmet needs Many of the most common and serious medical conditions where effective and targeted behavioral interventions could affecting people in developed countries have strong behavio- enhance health outcomes. In order to maximize the impact ral determinants (Prather et al. 2017; Schroeder 2007). These of behavioral interventions, a better understanding of the include disorders such as heart disease, stroke, cancer, and underlying, yet malleable, processes that contribute to risk diabetes, many of which share common behavioral risk fac- and maintenance of these problems is needed. In particular, tors, such as smoking, alcohol use, poor diet, sedentary life- a greater understanding of targets that cut across physical style, and obesity.
    [Show full text]
  • Sleeping Problems in Chinese Illicit Drug Dependent Subjects
    Tang et al. BMC Psychiatry (2015) 15:28 DOI 10.1186/s12888-015-0409-x RESEARCH ARTICLE Open Access Sleeping problems in Chinese illicit drug dependent subjects Jinsong Tang1, Yanhui Liao1*, Haoyu He1, Qijian Deng1, Guanbai Zhang1,2, Chang Qi1, Hangtao Cui1,3, Bin Jiao1,4, Mei Yang1,5, Zhijuan Feng1, Xiaogang Chen1, Wei Hao1 and Tieqiao Liu1,6,7* Abstract Background: Illicit drug use/dependence has been recognized as a major problem. Clinical studies demonstrate that poor sleep quality is associated with increased frequency of drug use and relapse. However, few studies have addressed the issue of sleep quality among illicit drug dependent subjects. Methods: This cross-sectional study explored sleep quality in drug dependent subjects in China. We studied 2178 illicit drug dependent subjects from drug rehabilitation centres in Changsha and 2236 non-drug-using subjects, all of whom completed the self-report Pittsburgh Sleep Quality Index (PSQI). Results: We found that the prevalence of sleep disturbance was much higher in drug users (68.5%, PSQI >5; specifically, 80.24% in heroin users, 54.16% in methamphetamine users and 81.98% in ketamine users with PSQI >5) than non-users (26.4%, PSQI >5). Drug users had approximately twice the sleep latency than nondrug users (37.7 minutes V.S 18.4 minutes). Although drug users and non-users reported similar sleep duration (about 7.4 hours), drug users showed poorer subjective sleep quality and habitual sleep efficiency. They reported more sleep disturbance and need for sleep medications, more daytime dysfunction and poorer subjective sleep quality compared with nondrug users.
    [Show full text]
  • Sleep and Alcohol Use in Women
    FOCUS ON Alcohol Res. 2020;40(2):13 • https://doi.org/10.35946/arcr.v40.2.13 Published: 16 July 2020 SLEEP AND ALCOHOL USE IN WOMEN Sarah M. Inkelis,1 Brant P. Hasler,2 and Fiona C. Baker3 1Joint Doctoral Program in Clinical Psychology, San Diego State University and University of California San Diego, San Diego, California 2Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 3Center for Health Sciences, SRI International, Menlo Park, California; School of Physiology, University of the Witwatersrand, Johannesburg, South Africa Sleep disturbance is common among individuals with alcohol use disorder (AUD). Insomnia not only is a pathway toward alcohol consumption but also is related to increased risk of relapse, psychosocial impairment, decreased quality of life, and suicidal ideation in individuals with AUD. Few studies examining sleep disturbance and alcohol use have explored how this relationship differs between men and women. Historically, studies of AUD have included few, if any, women in their samples. However, women are increasingly consuming alcohol at an earlier age and at higher rates, and the effect of alcohol on women’s mental and physical health is expected to rise. This narrative review consolidates findings from studies that have reported the effects of acute and chronic alcohol use on sleep among women. Additional research is needed to investigate sex differences in this area. Such research should consider the modifying effects of age, lifetime alcohol use, and psychiatric co-occurrence,
    [Show full text]
  • Alcohol ‘ a Whole Population Approach’
    April 2017 Alcohol ‘ A Whole Population Approach’ Insert Names here: Whole Population – What is covered? Trends in prevalence, affordability and availability Alcohol & ill health (alcohol-related deaths) Attitudes & Values Social norms Societal costs Understanding alcohol units and guidance Drinking definitions Problematic Drinking Alcohol & ill health (wider impact) Stages of an Alcohol Brief Intervention (ABI) Screening Attitudes & Values? Alcohol Consumption UK (1900-2010) Litres of pure alcohol consumption per capita in the UK, 1900-2010 11 10 Beer Cider Wine Spirits RTDs 9 8 7 6 5 4 3 Litres of pure alcohol per head per alcohol pure of Litres 2 1 0 1900 1905 1910 1915 1920 1925 1930 1935 1940 1945 1950 1955 1960 1965 1970 1975 1980 1985 1990 1995 2000 2005 2010 Year Consumption – Sales – Impacts • UK has high levels of alcohol consumption in context of Europe. Scotland purchases 20% more alcohol than the rest of the UK (that gap once being as high as 25%) with an increase in sales in 2014-2015 MESAS data (2016) • In 2015 alcohol off-sales account for 74% of all sales in Scotland. Average price for off-sales alcohol is £0.52 per unit (with more than half being sold under this. Average price for on-sales is £1.74 per unit. MESAS (2016) • Mismatch between sales and reported consumption (from Scottish Health Survey) so highly likely that actual consumption is under-reported • Cost to Scotland for alcohol-related issues estimated at £3.6 billion* p.a. Costs to Aberdeen estimated to be around £120 million p.a. (2010, based on 2007 data
    [Show full text]
  • Sleep Throughout the Alcoholism Recovery Process
    ABSTRACT Title of Document: SLEEP THROUGHOUT THE ALCOHOLISM RECOVERY PROCESS: A MIXED METHODS EXAMINATION OF INDIVIDUALS' EXPERIENCES TRANSITIONING FROM AN INPATIENT RESEARCH FACILITY PROVIDING REHABILITATION TREATMENT TO THE COMMUNITY Alyssa Todaro Brooks, Doctor of Philosophy, 2015 Directed By: Dr. Kenneth Beck Department of Behavioral and Community Health Despite research establishing the relationship between sleep disturbances and alcohol use, there is no clear understanding or model for what occurs once individuals who seek inpatient alcoholism treatment are discharged from rehabilitation facilities and attempt to integrate back into their homes and communities. This study used a mixed methods approach to assess individuals’ perceptions of and experiences with sleep throughout the process of alcohol rehabilitation and to explore associations between sleep-related beliefs/behavior, sleep quality, and relapse. The Social Cognitive Theory (SCT), which posits that personal factors, the environment, and human behavior exert influence upon each other through reciprocal determinism, was used as the underlying theory for this study. Constructs from the SCT were measured directly in this study using both quantitative and qualitative approaches in a convergent parallel design to study the following aims: a) to assess perceptions of and experiences with sleep during alcohol rehabilitation, b) to describe sleep patterns, perceptions, and beliefs among individuals who are alcohol-dependent throughout the transition from a clinical research facility providing rehabilitation treatment back to the community, and c) to assess whether sleep- related beliefs and/or behavior are associated with sleep quality or alcohol relapse. Data were collected from a cohort of clinical research participants enrolled on an inpatient alcohol treatment protocol (n=32).
    [Show full text]
  • Zerohack Zer0pwn Youranonnews Yevgeniy Anikin Yes Men
    Zerohack Zer0Pwn YourAnonNews Yevgeniy Anikin Yes Men YamaTough Xtreme x-Leader xenu xen0nymous www.oem.com.mx www.nytimes.com/pages/world/asia/index.html www.informador.com.mx www.futuregov.asia www.cronica.com.mx www.asiapacificsecuritymagazine.com Worm Wolfy Withdrawal* WillyFoReal Wikileaks IRC 88.80.16.13/9999 IRC Channel WikiLeaks WiiSpellWhy whitekidney Wells Fargo weed WallRoad w0rmware Vulnerability Vladislav Khorokhorin Visa Inc. Virus Virgin Islands "Viewpointe Archive Services, LLC" Versability Verizon Venezuela Vegas Vatican City USB US Trust US Bankcorp Uruguay Uran0n unusedcrayon United Kingdom UnicormCr3w unfittoprint unelected.org UndisclosedAnon Ukraine UGNazi ua_musti_1905 U.S. Bankcorp TYLER Turkey trosec113 Trojan Horse Trojan Trivette TriCk Tribalzer0 Transnistria transaction Traitor traffic court Tradecraft Trade Secrets "Total System Services, Inc." Topiary Top Secret Tom Stracener TibitXimer Thumb Drive Thomson Reuters TheWikiBoat thepeoplescause the_infecti0n The Unknowns The UnderTaker The Syrian electronic army The Jokerhack Thailand ThaCosmo th3j35t3r testeux1 TEST Telecomix TehWongZ Teddy Bigglesworth TeaMp0isoN TeamHav0k Team Ghost Shell Team Digi7al tdl4 taxes TARP tango down Tampa Tammy Shapiro Taiwan Tabu T0x1c t0wN T.A.R.P. Syrian Electronic Army syndiv Symantec Corporation Switzerland Swingers Club SWIFT Sweden Swan SwaggSec Swagg Security "SunGard Data Systems, Inc." Stuxnet Stringer Streamroller Stole* Sterlok SteelAnne st0rm SQLi Spyware Spying Spydevilz Spy Camera Sposed Spook Spoofing Splendide
    [Show full text]
  • Gender Differences in the Bidirectional Relationship Between Alcohol Consumption and Sleeplessness
    Rognmo et al. BMC Public Health (2019) 19:444 https://doi.org/10.1186/s12889-019-6801-6 RESEARCHARTICLE Open Access Gender differences in the bidirectional relationship between alcohol consumption and sleeplessness: the Tromsø study Kamilla Rognmo* , Svein Bergvik, Jan Harald Rosenvinge, Katja Lovise Bratlid and Oddgeir Friborg Abstract Background: The degree to which the relationship between alcohol use and sleeplessness is unidirectional or reciprocal is unclear due to great variation among the results of previous studies. The aim of the present study was to investigate if the relationship between alcohol use and sleeplessness is bidirectional by exploring how the change in and stability of alcohol use were related to sleeplessness, and vice versa, how the change in and stability of sleeplessness were related to alcohol use, in a longitudinal study spanning 13 years. Method: Data were collected from 9941 adults who participated in two waves (T1: 1994–1995, and T2: 2007–2008) of the Tromsø Study, a Norwegian general population health study. Alcohol use was measured by questions asking about the frequency of drinking, amounts of alcohol normally consumed and the frequency of binge drinking, whereas sleeplessness was measured by one item asking about the frequency of experiencing sleeplessness. Variables representing change in and stability of consumption of alcohol and sleeplessness from T1 to T2 were created. Logistic regression analyses, stratified by gender, were used to analyze the data. Results: Men reporting stable high (OR = 2.11, p. < .001) or increasing (OR =1.94,p. < .01) consumption of alcohol from T1 to T2 had a significantly higher risk of reporting sleeplessness at T2.
    [Show full text]
  • Economic Evaluations of Interventions Aimed at the Prevention, Treatment
    original adicciones vol. xx, nº x · 2021 Economic evaluations of interventions aimed at the prevention, treatment and/or rehabilitation of alcohol-related disorders: a systematic review Evaluaciones económicas de intervenciones dirigidas a la prevención, tratamiento y/o rehabilitación de trastornos por consumo de alcohol: una revisión sistemática Marta Trapero-Bertran*, Dolors Gil-Doménech**, Ana Magdalena Vargas-Martínez***. * Basic Sciences Department. University Institute for Patient Care. Universitat Internacional de Catalunya (UIC Barcelona). ** Faculty of Economic and Social Sciences. Universitat Internacional de Catalunya (UIC Barcelona). *** Department of Nursing. Faculty of Nursing, Physiotherapy and Podiatry. Universidad de Sevilla (US). Universitat Internacional de Catalunya (UIC Barcelona). Abstract Resumen The aim of this systematic literature review is to identify economic El objetivo de esta revisión sistemática de la literatura es identificar eva- evaluations of programmes or interventions aimed at the prevention, luaciones económicas de programas o intervenciones dirigidas a la pre- treatment and rehabilitation of alcohol use disorders, as well as to vención, tratamiento y rehabilitación de trastornos por consumo de al- determine those types of programmes, treatments or interventions cohol, así como determinar aquellos tipos de programas, tratamientos that are efficient. The systematic literature review was conducted by o intervenciones que son eficientes. Se realizó una revisión sistemática searching the following databases: National Health Service Economic de la literatura mediante la búsqueda en las siguientes bases de datos: Evaluation Database (NHS EED), Health Technology Assessment National Health Service Economic Evaluation Database (NHS EED), (HTA), MEDLINE Ovid and PubMed. The search terms used were in Health Technology Assessment (HTA), MEDLINE Ovid and PubMed. English. No time restriction was applied.
    [Show full text]
  • Recommendation from the Scientific Committee on Occupational Exposure Limits for Cyanamide
    Recommendation from the Scientific Committee on Occupational Exposure Limits for Cyanamide SCOEL/SUM/100_rev September 2003 European Commission Employment, Social Affairs and Inclusion Recommendation from the Scientific Committee on Occupational Exposure Limits for cyanamide Table of Contents 1. Occurrence / Use ........................................................................................................................... 4 2. Health significance......................................................................................................................... 4 2.1. Metabolism and toxicokinetics..............................................................................................4 2.2. Acute toxicity ........................................................................................................................... 4 2.3. Sensitisation............................................................................................................................... 5 2.4. Toxicity after repeated exposure .......................................................................................... 5 2.5. Reproductive toxicity .............................................................................................................. 6 2.6. Genotoxicity ............................................................................................................................. 7 2.7. Carcinogenicity ......................................................................................................................
    [Show full text]
  • An Embedded Framework for Integrating Speed, Alcohol and Weight Monitoring in a Public Service Vehicle
    UNIVERSITY OF NAIROBI School of Computing and Informatics AN EMBEDDED FRAMEWORK FOR INTEGRATING SPEED, ALCOHOL AND WEIGHT MONITORING IN A PUBLIC SERVICE VEHICLE By Samue Karuga Mungai P52/64696/2013 Supervisor Dr Eng Lawrence Muchemi © June 2014 A research project submitted in partial fulfilment of requirements for the award of Master of Science degree in Computational Intelligence, School of Computing and Informatics, University of Nairobi DECLARATION This research project is my original work and has not been presented for a degree or any other award in any other university. Student Signature: Date: Name: Samuel Karuga Mungai Registration Number: P52/64696/2013 This project report has been submitted as a partial fulfilment of the requirements for award of the degree of Master of Science in Computational Intelligence with my approval as the University supervisor Supervisor Signature: Date: Name: Dr Eng Lawrence Muchemi ii | P a g e DEDICATION This work is dedicated to my mother, Monica Wangari Karuga, whose constant support enabled me to pursue my education, my father Hiram Mungai Kiarie, who passed on the love of reading and respect for education and has been instrumental in my life by providing a pillar that propelled us as a family. I also dedicate this work to my brother Stanley Kiarie, and my close friend Elizabeth Wakonyo. The two of them were a force behind this achievement, especially when balancing between education, work and family became unbearable. I also dedicate this work to my grandmother Lydia Wambui Karuga. This old lady made me believe in the power of possibilities especially if you take control of your life.
    [Show full text]