A DISSERTATION SUBMITTED TO THE FACULTY OF MEDICINE, UNIVERSITY OF THE WITWATERSRAND, JOHANNESBURG, FR THE DEGREE OF MASTER OF SCIENCE IN MEDICINE. / The influence of iron on the outcome of various infections have been extensively reviewed. Clinical observations suggests that iron deficiency may be protective against malaria. Various researchers have shown that certain iron chelators blocked the proliferation of plasmodium falciparum in vitro and in vivo. (Abbreviation abstract) / Andrew Chakane 2018

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Medicine in Emergency Medicine. Johannesburg, March, 2016 / Objectives: The aim of the current research was to determine the perception and experience of different emergency department occupational groups regarding workplace violence in the past 12 months and to determine the effect that it had on them in two government hospitals in Johannesburg, South Africa. Materials and Methods: The current research was a cross sectional, retrospective qualitative survey. Results: Eighty-six surveys (43%) out of the distributed 200 questionnaires were returned. Five surveys were unfilled leaving 81 surveys (40.5%) that are included in the analysis. Psychological violence was experienced by 73 % (n=51) of the participants while physical violence was experienced by 34.2% (n=27). Patients were the perpetrators of 61% and 67.9% of psychological and physical violence against staff members, respectively. Friends and family members who accompanied patients in the emergency department accounted for 27.4% psychological violence while this same set of people caused 17.3% of physical violence. Ninety-one percent of the participants reported that they did not receive any training courses on how to handle workplace violence incidents. Medical staff (doctors and nurses) were found to be at an increased risk to psychological violence. Conclusions: Workplace violence was commonly experienced by ED staff members. Majority of the incidents were in the form of psychological violence; however, a considerable percentage of the participants experienced physical violent incidents. Most of the violent incidents experienced were perceived to be preventable by majority of participants. This research supports the need for practical training and education of the ED staff members, on how to prevent and deal with issues related to ED WPV. / MT2016

A thesis submitted to the Faculty of Engineering, University of the Witwatersrand, Johannesburg, in fulfillnent of the requirements for the degree of Doctor of Philosophy, 1992 / The self-heating of coal is a problem which concerns the mining industry not only in South Africa, but also in many other countries. This thesis deals with the contouring of spontaneous combustion liabilities (WITS-ERAC index values) of different seams at the Durban Navigation Colliery and the relationship between the WITS-EHAC index values and the properties of the coal samples. In the determination of the spontaneous combustion liabilities 58 different coal samples were tested with an ignition-temperature test apparatus, crossing-point temperature tests and differential thermal analysis were conducted simultaneously. [Abbreviated abstract. Open document to view full version] / MT2017

A thesis submitted to the Faculty of Science University of the Witwatersrand Johannesburg in fulfillment for the requirements of the degree of Master of Science. 14 May 2015. / Peptidomimetic compounds have been shown to exhibit both anti-HIV and anti-malarial activity. A multicomponent reaction was used to create a library of peptidomimetic compounds with an α-hydroxy-β-amino acid unit. The Passerini reaction between an aldehyde, carboxylic acid and isocyanide was used to prepare compounds containing both ester and amide functionalities. These compounds were then subjected to a deprotection-acyl migration strategy giving rise to the target compounds. This approach, known as the Passerini Amine Deprotection Acyl Migration (PADAM) sequence was successfully used to create a library of novel peptidomimetic compounds. From this library, 22 compounds were tested for activity against HIV and malaria. The Passerini reaction gives rise to a product containing a new stereogenic centre, and as the starting aldehyde used (N-Boc-phenylalaninal) has a stereogenic centre, the products were isolated as a mixture of diastereomers. Our research was also focused on finding ways of influencing the stereoselectivity of the reaction and the separation of the resulting diastereomers. The diastereomeric ratio of the Passerini products was found to be approximately 2:1 for all the reactions performed. This ratio could be modified slightly when using certain carboxylic acids and isocyanides that were either very bulky or had a stereogenic centre. Attempts to enzymatically resolve the diastereomeric products were not successful after trials using a library of 25 lipase enzymes. However, use of preparative HPLC enabled the successful separation of most of the diastereomeric mixtures, affording compounds with high purity. X-ray crystallography enabled us to identify the major diastereomers as having the R,S configuration, whilst the minor diastereomers had the S,S configuration at the two stereogenic centres. A possible explanation for the observed stereoselectivity is based on the Felkin-Anh chelation control model. It suggests that mono-protected amino aldehydes follow a chelation controlled mechanism in nucleophilic addition reactions. Chelation occurs, albeit in the form of hydrogen bonding, between the NH and carbonyl oxygen. The library of compounds was tested for activity against both HIV-1 and malaria. Only three compounds showed moderate activity against the malaria parasite, inhibiting parasitic growth by 37-42% at 5 μM respectively. Significantly, all of the active compounds contained an adamantyl moiety. Unfortunately no anti-HIV activity was seen for any of the compounds tested in the HIV-assay.

A thesis completed by published work, Submitted to the School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, in fulfilment of the requirements for the degree of Doctor of Philosophy Johannesburg, South Africa December 2016. / Introduction With the largest epidemic in the world, the consequences of human immunodeficiency virus (HIV) in South Africa extend far beyond its disease burden. In fact, patterns of HIV-related infection and mortality in South Africa still reflect social cleavages and inequalities. Similarly, poverty-related issues such as poor education, unemployment and subsequent low socio-economic status, rural residence and inadequate access to health care are all implicated in human papillomavirus (HPV) associated cervical cancer-related mortality (of which South Africa also has the highest globally). Despite the knowledge of reproductive functions and sexuality being poor among adolescents in South Africa, the majority commence their sexual activity early with an estimated national average of 15 years for girls and 14 years for boys. Further, many South African adolescents engage in sexual risk-taking behaviours including concurrent partners and unprotected sexual acts that considerably increase their vulnerability to sexually transmitted infections including HIV and HPV. In recognising the unique health needs of adolescents in South Africa, the national government has already pin-pointed school health services as a strategic arm of primary health care re-engineering. The aim of this body of work is to elaborate on restructuring of adolescent health care by introducing the HIV and HPV vaccine concomitantly in South Africa via a school-based sexual and reproductive health service. Methodology Data from four studies were analysed and are presented in three published and two unpublished papers. The first study evaluated the synergism between HIV and HPV in the South African context and formed the basis of the literature review. The second study considered HIV vaccine implementation alone. The third study assessed dual HIV and HPV vaccine strategies among females and the final study compared the dual vaccination strategy against recognised biomedical HIV prevention interventions. The studies evaluated the implementation of a hypothetical HIV vaccine and the bivalent HPV vaccine both individually and in combination when administered to school-going adolescents in South Africa. The health outcomes and the cost-effectiveness of these strategies were assessed. Assumptions were made regarding the hypothetical HIV vaccine (based on HIV vaccine studies conducted to date) including a coverage rate of 60% (uncertainty range: 30-70%), vaccine efficacy of 50% (uncertainty range: 30-70%) and vaccine price per dose of US$ 12 (uncertainty range: US$ 3-24). The uncertainty ranges were tested in the sensitivity analysis. Mortality statistics, disease transition parameters (for the individual diseases and the models representing joint disease) and HPV vaccine characteristics were drawn from the South African literature. The joint effectiveness of the dual vaccine strategy was considered multiplicative. Nine year old adolescents attending South African schools in 2012 were eligible for the intervention (vaccination) that was introduced opportunistically as part of the national health initiative introducing school-based sexual and reproductive health services. The learners were targeted prior to their reported sexual debut. The HIV vaccine was considered against the comparator of HIV counselling and testing (HCT) and the national roll-out of antiretroviral therapy (ART) that constituted the standard of care in South Africa. The HPV vaccine was modelled as prevention against HPV-related cervical cancer and pre-cancerous HPV-related cervical states. The health service provider (provider) perspective was adopted and the cohort was modelled through a lifetime horizon of 70 years with annual cycles. The economic costs and health outcomes were discounted at 3% with an uncertainty range between 0% and 6% assessed. Cost valuations were for 2012 and costs were adjusted to this common year. The quality-adjusted life year (QALY) was used as the outcome measure of health related quality of life and was used to calculate the incremental cost-effectiveness ratio (ICER) of the comparator against the vaccination interventions. The core model was a semi-Markov simulation with annual cycles. The study population entered the model HIV and HPV disease free and were exposed to the risk of acquiring each disease annually. The model structure was parameterised drawing from South African data available in the literature. One-way sensitivity analyses evaluated the impact of single assumptions on cost and outcomes. Probabilistic sensitivity analysis (PSA) with a bootstrapping technique explored the uncertainty in the model and evaluated the robustness of the results. The PSA data generated determined if the intervention fell below the willingness-to-pay (WTP) threshold. As South Africa does not have a pre-defined WTP threshold, the Gross Domestic Product (GDP) per capita (for 2012) was used as a proxy in accordance with the World Health Organization’s Guide to Cost-Effective Analysis. Additionally, benchmark interventions were used in the final comparison study as a measure of cost-effectiveness. Ethical approval for the study was obtained from the Human Research Ethics Committee (Medical) of the University of the Witwatersrand. Findings The second study explored the implementation of the HIV vaccine on an individual and national, programmatic level. The simultaneous implementation of HIV vaccination services with current HIV management programmes would be cost-effective, even at relatively higher vaccine cost. At base vaccine cost of US$ 12, the ICER was US$ 43 per QALY gained, with improved ICER values yielded at lower vaccine costs. The ICER was sensitive to the duration of vaccine-mediated protection and to variations in the vaccine efficacy. Data from this work demonstrate that vaccines offering longer duration of protection and at lower cost would result in improved ICER values. Assessing this HIV vaccine model on a national programmatic level, yielded an ICER of US$ 5 per life-year gained (LYG) (95% CI US$ 3-12) compared with the comparator. This fell considerably below the national WTP threshold of cost-effectiveness. This also translated to an 11% increase in per capita costs from US$ 80 to US$ 89. National implementation of this intervention could potentially result in an estimated cumulative gain of 24 million years of life (95% CI 8–34 million years) among those adolescents aged between 10-19 years that were vaccinated. The 10 year absolute risk reduction projected by HIV vaccine implementation was 0.42% for HIV incidence and 0.41% for HIV mortality. The ICER was sensitive to the HIV vaccine efficacy, coverage and vaccine pricing in the sensitivity analysis. The third study assessed the impact of dual HIV and HPV implementation strategies. Programmes that involved the dual vaccine strategy were assessed as cost-saving. ICER values were sensitive to the HIV vaccine cost. The dual vaccine strategy resulted in 10 year absolute risk reductions in HIV incidence (5.24%), dual mortality (1.21%) and a reduction in HPV incidence (0.39%) compared with no vaccination. Importantly, the reduction in HIV incidence rate and dual mortality rate in the dual vaccine strategy exceeded the reductions noted with the use of the HIV vaccine alone. All scenarios assessed with the dual vaccine strategy were cost-effective. Lower vaccine prices and reduced discount rates were associated with improved ICER outcomes. The final study compared the biomedical interventions of oral pre-exposure prophylaxis (PrEP), voluntary medical male circumcision (VMMC) and the scaling-up of ART coverage against the vaccine strategies. When compared with other biomedical HIV prevention interventions, the dual vaccination intervention was the most cost-effective strategy (US$ 7 per QALY gained) and averted 29% of new HIV infections. VMMC (US$ 30 per QALY gained) proved more cost-effective than HIV vaccination alone (US$ 93 per QALY gained), though VMMC averted 6% more new infections than the HIV vaccine. PrEP interventions were the least cost-effective. Combined dual vaccination and VMMC strategies represent the only dominant intervention. Strategies involving oral PrEP were the least cost-effective. Conclusion The findings of this thesis have implications for school-based adolescent health care and HIV- and HPV-related disease prevention among adolescents, a highly susceptible population. The cost-effectiveness of the dual HIV and HPV vaccine strategy was demonstrated, and the improved health outcomes associated with the interventions quantified. Proposals were suggested regarding possible combinations of HIV prevention interventions that could yield the favourable health outcomes with the most efficient use of financial resources. Several important areas for future research were identified to shed light on improving adolescent health care and for optimising HIV prevention strategies. These include integrating HIV and HPV services as part of the re-engineering of primary health care in South Africa, and then formulating economic evaluations of HIV/HPV prevention strategies targeting adolescents specifically. Further, more effective methods of collecting data on socially marginalised populations such as young people need to be explored. Another vital research area is the discussion and implementation of existing school health documents with the ideals embodied in the school health programme envisaged under the National Health Insurance restructuring. Once these are integrated, the cost implication of the combined programmes need to be assessed. / MT2017

A Atenção Domiciliar (AD) é uma modalidade de assistência que deve ser concebida como a capacidade de mobilizar, articular e colocar em prática conhecimentos, habilidades e atitudes necessárias ao desempenho efetivo das competências dos enfermeiros. Em se tratando do risco de infecção as pesquisas nessa área são escassas no Brasil, principalmente na perspectiva das ações preventivas. O estudo representa uma contribuição para com a atenção domiciliar, no que concerne às competências do enfermeiro em atuar nos fatores de risco para infecção e, assim, avançar nas diretrizes de prevenção e controle da infecção. Trata-se de um estudo de natureza quase-experimental considerando a primeira etapa e, pesquisa metodológica na construção das diretrizes. Utilizou-se como referencial teórico os princípios de Durand (2000) e, a avaliação de consenso foi subsidiada na técnica Delphi. O cenário envolveu as Unidades Básicas de Saúde do município de Teresina - PI. Os participantes foram divididos em dois grupos sendo um com 19 enfermeiros atuantes nas equipes da ESF e, o outro grupo com 15 pesquisadores/enfermeiros recrutados pelo método snow-ball (representando as quatro diferentes regiões do País). Para a organização dos dados utilizou-se o software Alceste 4.8, e a análise estatística descritiva foi ordenada em quartis. A lista de competências, referente à primeira rodada da Técnica Delphi totalizou 48 itens, sendo 26 classificadas como competências gerais e 22 específicas. Na segunda rodada, exclui-se apenas um item após análise de concordância entre os sujeitos. E, na terceira rodada foram mantidas as 47 competências, das quais as classificaram em três dimensões: conhecimentos, habilidades e atitudes. Esta organização tomou como base o referencial teórico, bem como as justificativas dos participantes. Dessa forma, 61 competências foram identificadas quando analisadas a luz do referencial teórico, e, articulada as praticas de prevenção e controle da infecção no ambiente domiciliar. Observa-se que, embora de modos heterogêneos, o conceito de competência para a prevenção da infecção tem sido apropriado de modo fértil pelos enfermeiros. Por fim, os resultados desse estudo mostram a relevância da atuação dos enfermeiros no manejo dos riscos de infecção, na manutenção do ambiente domiciliar biologicamente seguro, e no enfrentamento dos desafios da utilização de políticas públicas direcionadas para esse foco. Conclui-se que as práticas de prevenção e controle da infecção na atenção domiciliar são competências fundamentais reconhecidas pelos enfermeiros e, precisam ser incrementadas na formação em Enfermagem. / Home Care (AD) is a form of assistance that should be conceived as the ability to mobilize, articulate and apply knowledge, skills and attitudes necessary for the effective performance of the competences of nurses. In what concerns the risk of infection, research in this area is scarce in Brazil, especially in the perspective of preventive actions. This study represents a contribution to home care, in relation to the skills of nurses to act on risk factors for infection and thus advance the guidelines for prevention and control of infections. This is a study of quasi-experimental nature and, considering the second step in constructing the guidelines, a methodological research. Durand (2000) principles were used as theoretical references and the consensus evaluation was supported in Delphi techniques. The scenario involved Basic Health Units in the city of Teresina - PI. The subjects were divided into two groups being the first with 19 nurses working in the ESF teams for at least two years. The second group was attended by 15 researcher nurses who were recruited by the snow-ball method, until the establishment of a network representing four different regions of the country. For data organization Alceste4.8 software, and statistical, descriptive analysis sorted in quartiles were utilized. The list of skills on the first round of the Delphi totaled 48 items, with 26 classified as general and 22 specific competence. In the second round, after the analysis of agreement among subjects one competence was excluded, for not reaching the level of consensus determined. And in the third and final round of the Delphi technique were maintained 47 skills from the analysis of consensus, which were divided among the three dimensions, namely: knowledge, skills and attitudes. This organization was based on the theoretical reference as well as the justifications of the subjects, as a result, 61 competences were developed. The respective items were analyzed in light of the theoretical references, and we proceeded to the recovery of such knowledge, skills and attitudes for the prevention and control of infection in home environment. It is observed that although in heterogeneous ways, the concept of competence for the prevention of infection has been appropriated in a fertile way by nurses. Finally, the results of this study show the importance of the role of nurses in the management of the risks of infection, the maintenance of biologically safe home environment and in facing the challenges to contribute to the formulation and use of public policies directed to this focus. We conclude that the practices of prevention and infection control in home care are a core competence recognized by nurses and needs to be improved in Nursing graduation.

A ocorrência de úlcera por pressão (UPP) nos pacientes atendidos nos serviços de saúde é um problema significante tanto para os indivíduos como para os familiares e instituições do mundo todo. Os pacientes com restrição de mobilidade são os que têm maior risco. A assistência domiciliária pode contribuir com o atendimento humanizado na promoção da saúde e prevenção da doença assim como para orientar e acompanhar os cuidadores domiciliares no atendimento das necessidades dos pacientes com condições crônicas que estão sujeitos a complicações como a UPP. Este estudo é do tipo descritivo e quantitativo e teve como objetivos identificar nos pacientes em assistência domiciliária em um Distrito de Saúde, as características sóciodemográficas e clínicas, o escore de risco para a UPP pela escala de Braden; a prevalência de pacientes com UPP; as características da lesão e as medidas utilizadas para prevenção e tratamento. A população foi 47 pacientes, com 76,7% na faixa etária de 60 a 80 anos, 51% do sexo feminino, 42,5% casados, 85% de cor branca; predominância de escolaridade no nível fundamental 1 incompleto; 48,9% recebiam entre 3 a 5 salários mínimos; 91,5% pacientes eram dependentes de cuidadores. As morbidades mais freqüentes foram as doenças do sistema circulatório (63,8%) e do sistema nervoso (48,9%). Para 48,9% dos pacientes a restrição da mobilidade ocorreu em decorrência da própria doença. O escore médio da Escala de Braden foi 17, mínimo 10 e máximo 23 e os idosos tinham escores mais baixos. Nove pacientes tinham UPP (prevalência 19,1%). A localização anatômica de maior freqüência foi a região do trocânter do fêmur (29,4%) e a região dos calcâneos (23,5%). Quanto a classificação das UPP, o maior percentual (35,3%) encontrado foi no estágio I e 29,4% no estágio IV. Quanto ao tempo da lesão, 58,8% das UPP haviam surgido há 4 meses. Quanto a dimensão, mais de 40% das lesões tinham mais de 8 cm2 . Em referência às características do leito das feridas, 11 apresentavam mostravam sinais de cicatrização e 6 apresentavam esfacelo ou necrose. Embora 70% da população tivesse risco para UPP a grande maioria não utilizava as medidas básicas para prevenção da UPP. Em relação ao tratamento 29,4% citaram o uso de pomadas com antibióticos, medida desnecessária e contra-indicada; 35,3% citaram o uso de coberturas industrializadas e em 4 úlceras, foram utilizados produtos sem qualquer evidência como hipoglós, óleo de amendoim e talco. Considerando as características de cada paciente que apresentou a UPP como a idade, morbidade referida e escore da Escala de Braden é possível compreender que os fatores agiram sinergisticamente para o desenvolvimento da lesão e que as medidas que poderiam diminuir o impacto do excesso de pressão como a redução do tempo em uma mesma posição e o uso de colchão adequado não foram utilizadas com freqüência. A articulação entre os níveis de atenção à saúde é fundamental para esta população para possibilitar o atendimento integral e contínuo. A construção de redes de apoio entre a família, comunidade e serviços poderá facilitar a resolução dos problemas encontrados. / The occurrence of pressure ulcers (PU) in patients seen at health services is a significant issue for the individuals as well as for their families and institutions across the world. Patients with restricted mobility are those at the highest risk. Home care should contribute with humanized care in health promotion and disease prevention, as well as with the process of instructing and following home caregivers in their meeting the needs of patients with chronic conditions subject to complications like pressure ulcers. The objectives of this descriptive quantitative study were to identify the sociodemographic and clinical characteristics of home care patients in a health district, as well as their risk score for PU according to the Braden scale; the prevalence of patients with PU; the characteristics of the wound, and the measures used for prevention and treatment. The population consisted of 47 patients, with 76.7% in the age range of 60 to 80 years, 51% were women, 42.5% were married, and 85% were white. Most patients had incomplete fundamental studies, 48.9% received between 3 and 5 minimum salaries, and 91.5% were dependent on their caregivers. The most common morbidities were circulatory system (63.8%) and nervous system (48.9%) diseases. The mobility of 48.9% of patients was restricted due to the disease itself. The average score on the Braden Scale was 17 (minimum 10 and maximum 23), and the elderly had the lowest scores. Nine patients had PU (19.1% prevalence). The most frequent anatomic location was the femur trochanter region (29.4%) and the calcaneus (23.5%). In terms of PU classification, the higher percentage (35.3%) found was in stage I, and 29.4% in stage IV. As for wound time, 58.8% of PU had appeared four months before. In terms of the wounds dimension, over 40% were bigger than 8 cm2. Regarding the characteristics of the wound beds, 11 presented signs of healing, and six presented slough or necrosis. Although 70% of the population were at risk of PU, the majority did not use any basic PU prevention measures. As for treatment, 29.4% stated using ointments with antibiotics, which is unnecessary and contraindicated. Other 35.3% reported using industrialized dressings, and products without any evidence were used on four ulcers, like hipoglós®, peanut oil, and talc. The characteristics of each patient with PU, like age, referred morbidity and score on the Braden Scale make clear that the factors act synergistically toward the development of the wound. In addition, this shows that measures that could reduce the impact from the excessive pressure, like reducing the time in the same position and using an appropriate mattress were not frequently used. The articulation between health care levels is essential for this population in order to make integral and continuous health care possible. Constructing support networks between families, the community, and services could facilitate solving the identified problems.

Tian, Yuanyuan. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2013. / Includes bibliographical references (leaves 101-124). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts also in Chinese.

Orientador: Ione Corrêa / Resumo: Introdução: A crescente introdução da mulher no mercado de trabalho levou crianças de até sete anos, a serem assistidas por creches. Entretanto, esses ambientes favorecem que crianças sejam acometidas por microrganismos com potencial infeccioso, em função da aglomeração e contato muito próximo, o que facilita a disseminação de microrganismos com potencial infeccioso a essas crianças, quando não estabelecidas medidas profiláticas. Objetivo: Avaliar aspectos relacionados à prevenção e controle da disseminação de microrganismos em creches. Método: Trata-se de uma revisão integrativa de literatura, que visa realizar síntese do conhecimento já produzido e permite a incorporação da aplicabilidade dos resultados dos estudos significativos na prática. Resultados: Os achados foram demonstrados e discutidos em cinco capítulos, dos quais os quatro primeiros correspondem à elaboração de artigos científicos, estando os mesmos de acordo com os padrões de formatação preconizados pelos periódicos selecionados e, o último corresponde à apresentação de um manual (e-book). Considerações finais: Esta revisão integrativa permitiu identificar os possíveis veículos disseminadores de microrganismos, fatores de risco, microrganismos e infecções mais recorrentes na assistência às crianças em creches, possibilitando elencar estratégias que visem prevenir e controlar os danos que poderão ser causados às crianças. / Abstract: Introduction: The increasing introduction of women into the labor market has led children up to seven years of age to be assisted by day-care centers. However, these environments favor that children be affected by microorganisms with infectious potential, due to the agglomeration and close contact, which facilitates the dissemination of microorganisms with infectious potential to these children, when not established prophylactic measures. Objective: To evaluate aspects related to prevention and control of dissemination of microorganisms in day care centers. Method: This is an integrative literature review, which aims to synthesize knowledge which has already been produced, and to lead to practical applicability of significant studies´ results. Results: The findings were demonstrated and discussed in five chapters, in a way that the first four approach the production of scientific articles, in accordance with the formatting standards recommended by each selected periodical; and the last corresponds to the presentation of a manual (e-book). Final considerations: This integrative review allowed the identification of possible disseminating vehicles for microorganisms, risk factors, microorganisms and more recurrent infections in the care of children in day care centers, making it possible to establish strategies to prevent and control the damages that may be caused to children. / Doutor

Cheung Ngai man Edmund. / "August 2000." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2000. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.