Introdução: A Síndrome dos Ovários Policísticos (SOP) é uma doença que acomete de 5 a 10% das mulheres. A SOP tem sido relacionada em alguns estudos à disfunção sexual, ao aumento da ansiedade e depressão e à redução da qualidade de vida. Essas alterações podem estar relacionadas às alterações fenotípicas da SOP como o aumento do peso e das circunferências de quadril e cintura resultantes do hiperandrogenismo. A alteração no estilo de vida, principalmente envolvendo a prática de exercícios físicos, tem sido relevante na melhora das condições de saúde. Até o momento, há poucos estudos avaliando os efeitos do treinamento físico aeróbio sobre a função sexual em mulheres com SOP. Objetivo: Avaliar o efeito do treinamento físico aeróbico na função sexual de mulheres com a Síndrome dos Ovários Policísticos. Métodos: Trata-se de um ensaio clínico controlado com alocação aleatória e randomização estratificada pelo índice de massa corporal (IMC) em 3 grupos paralelos: grupo treinamento aeróbio contínuo (GAC), grupo treinamento aeróbio intermitente (GAI) e grupo controle sem treinamento (GC), sendo GAC com 23 voluntárias, o GAI com 22 voluntárias e o GC com 24 voluntárias. As avaliações ocorreram antes e após o período de 16 semanas de intervenção do treinamento físico aeróbio ou de observação no grupo controle. Foi realizada dosagem plasmática de testosterona, antes e após a intervenção. A função sexual, o risco de ansiedade e depressão e a qualidade de vida foram avaliados respectivamente, por meio dos questionários validados para o Português: Índice de Função Sexual Feminina (IFSF), Escala de Ansiedade e Depressão Hospitalar (HAD), e Questionário de Qualidade de Vida - SF-36. Resultados: Houve diferença significante na RCQ no grupo GAI (p = 0.047) e redução nos níveis de testosterona nos grupos GAC (p < 0.01) e GAI (p = 0.04). Na avaliação do IFSF no GC não houve qualquer alteração antes e após as 16 semanas. Contudo no GAC ocorreu aumento nos escores IFSF total (p = 0.048), satisfação (p = 0.049) e dor (p = 0.03). No GAI foram observados aumentos nos escores: IFSF total (p < 0.01), desejo (p < 0.01), excitação (p < 0.01), lubrificação (p < 0.01), orgasmo (p < 0.01) e satisfação (p = 0.02). Já na avaliação do questionário HAD observou- se diminuição tanto na ansiedade (p = 0.01) e (p < 0.01), quanto na depressão (p < 0.01) e (p = 0.02) nos grupos GAC e GAI respectivamente. Com relação ao SF-36 no GAC foram identificados aumento do escores: aspectos físicos (p = 0.01); estado geral de saúde (p = 0.02); vitalidade (p < 0.01); aspectos sociais (p < 0.01); aspectos emocionais (p = 0.03) e saúde mental (p < 0.01). No GAI houve elevação dos escores: capacidade funcional (p < 0.01); estado geral de saúde (p < 0.01); vitalidade (p < 0.01); aspectos sociais (p < 0.01); aspectos emocionais (p = 0.03) e saúde mental (p < 0.01). Conclusão: Ambos os protocolos de treinamento físico aeróbio foram eficazes na melhora da função sexual, ansiedade e depressão e qualidade de vida, observando maior efetividade no treinamento físico aeróbio intermitente. / Introduction: Polycystic Ovarian Syndrome (PCOS) is a disease that affects 5 to 10% of women. PCOS has been linked in some studies to sexual dysfunction, increased anxiety and depression, and reduced quality of life. These changes may be related to phenotypic changes in PCOS such as increased weight and hip and waist circumferences resulting from hyperandrogenism. The change in lifestyle, mainly involving the practice of physical exercises, has been relevant in improving health conditions. To date, there are few studies evaluating the effects of aerobic exercise training on sexual function in women with PCOS. Objective: To evaluate the effect of aerobic physical training on the sexual function of women with Polycystic Ovarian Syndrome. Methods: This is a controlled clinical trial with random allocation and randomization stratified by body mass index (BMI) in 3 parallel groups: continuous aerobic training group (GAC), intermittent aerobic training group (GAI) and control group without training (GC), GAC with 23 volunteers, GAI with 22 volunteers and GC with 24 volunteers. Evaluations occurred before and after the 16-week intervention period of aerobic or observational physical training in the control group. Testosterone plasma levels were measured before and after the intervention. Sexual function, risk of anxiety and depression, and quality of life were evaluated, respectively, using validated questionnaires for Portuguese: Female Sexual Function Index (IFSF), Hospital Anxiety and Depression Scale (HAD), and Questionnaire Quality of Life - SF-36. Results: There was a significant difference in WHR in the GAI group (p = 0.047) and reduction in testosterone levels in the groups GAC (p <0.01) and GAI (p = 0.04). In the evaluation of IFSF in the CG there was no change before and after 16 weeks. However, in GAC, there was an increase in total IFSF (p = 0.048), satisfaction (p = 0.049) and pain (p = 0.03). GAI showed increases in scores: total IFSF (p <0.01), desire (p <0.01), excitation (p <0.01), lubrication (p <0.01), orgasm (p <0.01) and satisfaction (p = 0.02). In the evaluation of the HAD questionnaire, both anxiety (p = 0.01) and (p <0.01) and depression (p <0.01) and (p = 0.02) in the GAC and GAI groups respectively. Regarding the SF-36 in the GAC was identified increase of the scores: physical aspects (p = 0.01); general health status (p = 0.02); vitality (p <0.01); social aspects (p <0.01); emotional aspects (p = 0.03) and mental health (p <0.01). In GAI there was elevation of the scores: functional capacity (p <0.01); general health status (p <0.01); vitality (p <0.01); social aspects (p <0.01); emotional aspects (p = 0.03) and mental health (p <0.01). Conclusion: Both aerobic physical training protocols were effective in improving sexual function, anxiety and depression and quality of life, observing greater effectiveness in intermittent aerobic physical training.

Magister Artium (Social Work) - MA(SW) / The burden of HIV disease is concentrated in sub-Saharan Africa and South Africa (SA) is particularly affected. Whilst there have been many studies conducted on the biomedical and socio-psychological aspects of HIV and AIDS, insufficient attention has been paid to the quality of life of those infected with the virus. The primary purpose of this study was to determine the predictors of quality of life enjoyment and satisfaction (Q-LES) of individuals living with HIV and or AIDS and those on anti-retroviral treatment or being prepared for it. Further, the study determined the relationship between psychological distress and Q-LES of HIV positive individuals because psychological distress is reported to contribute substantially to the burden of the disease in sub-Saharan Africa, including SA. This quantitative study used a battery of questionnaires administered to 121 participants in an out-patient clinic setting. The main hypothesis tested in this study is: psychological distress is a strong predictor of Q-LES. The Hospital Anxiety and Depression Scale (HADS) was used to screen for psychological distress and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) to assess the various components of QoL. A purposive sampling strategy was used to recruit participants into the study. Data analysis included descriptive and inferential statistics using SPSS to test the hypothesis. Of the total sample (N=121), 74% were females. The study found that a large proportion (49.5%) of the sample within the age group 25-49 years old had significant presence of psychological distress. Those not on ART yet were significantly affected (66%). The relationship between Q-LES subscales and psychological distress was significant (p< 0.01). The results show that psychological distress was significantly prevalent among HIV positive individuals and it was the strongest predictor of Q-LES among the study participants. Modifying the current psychological intervention programmes, in the public health clinics, for individuals vi infected with the HI virus will assist in improving the current health outcomes and also help to achieve better Quality of Life outcomes.

Vestibular schwannoma is one of the most common tumors found in a cerebellopontine angle. Despite tumor's benignity, there are many cases that are indicated for a surgical resection. Frequently postoperative symptoms described by patients and also by literature are hearing loss, vertigo, tinnitus and weakness or numbness of face. Our work wants to show also other factors which can be damaging for patient life. We talk about postoperative headache and anxiety or depression disorders. The aim of the study will be describe these symptoms, try to find the corelations between them and determine the impact on quality of life. In our survey, patients one year after vestibular schwannoma resection recieve convenient questionnaires to fill. The questionnaires will be focused on headache disability, anxiety and depression, vestibular dysfunction and perception of quality of life.

Objective: Soft tissue sarcomas (STS) and gastrointestinal stromal tumours (GIST) are a group of rare malignant tumours with a high and heterogenous disease burden. As evidence is scarce, we analysed the prevalence of increased emotional distress and identified distress‐associated factors in these patients. - Methods: The PROSa‐study (Burden and medical care of sarcoma) was conducted between 2017 and 2020 in 39 study centres. Cross‐sectional data from adult STS and GIST patients were analysed. Distress was measured with the Patient Health Questionnaire (PHQ‐4). The relation of socioeconomic and clinical factors with distress was explored in adjusted logistic regression models. - Results: Among 897 patients, 17% reported elevated anxiety and 19% reported depression. Unemployed patients (odds ratio [OR] 6.6; 95% CI 2.9–15.0), and those with a disability pension (OR 3.1; 95% CI 1.9–5.0) were more likely to experience distress compared to employed patients. Also, patients with a disability pass had higher odds of increased distress than those without (OR 1.8; 95% CI 1.2–2.7). Lowest distress was observed in patients 2 to <5 years and ≥5 years after diagnosis (comparison: <6 months) (OR 0.4; 95% CI 0.2–0.6) and (0.3; 95% CI 0.2–0.6). Patients with thoracic STS (vs. lower limbs) had twice the odds to experience distress(OR2.0;95%CI 1.1–3.6). Distress was seen almost twice as often in patients with progressive disease (vs. complete remission) (OR 1.7; 95% CI 1.1–2.8). - Conclusion: The prevalence of elevated distress in STS and GIST patients is high. In unemployed patients, in those with a disability pension and in newly diagnosed patients a noticeable increase was observed. Clinicians should be aware of these factors and consider the social aspects of the disease.

Theoretischer Hintergrund: Aktuelle Studien zeigen spezifische Zusammenhänge von peripartalen psychischen Störungen und kindlichen Entwicklungsauffälligkeiten. Fragestellung: Haben Kinder von Müttern mit einer peripartalen Angst- oder depressiven Störung ein erhöhtes Risiko für (visuo–)‌motorische, sprachliche und kognitive Entwicklungsauffälligkeiten? Methode: In der prospektiven MARI-Studie (N = 306) wurden peripartale psychische Störungen mit dem CIDI-V in jedem Schwangerschaftstrimester sowie 2, 4 und 16 Monate nach der Geburt erhoben. Die kindliche Entwicklung wurde mit dem Neuropsychologischen Entwicklungs-Screening im Alter von 4 (N = 263) und 16 Monaten (N = 241) erfasst. Ergebnisse: Maternale depressive Störungen vor der Schwangerschaft waren negativ mit der visuellen Entwicklung (4 Monate; OR = 3.3) und der Haltungs- und Bewegungssteuerung (16 Monate; OR = 4.4) des Kindes assoziiert. Diskussion: Entwicklungsauffälligkeiten könnten u. a. durch ein verändertes Interaktionsverhalten (z. B. weniger Blickkontakt/Ermutigung) betroffener Mütter begründet sein. / Theoretical background: Anxiety and depressive disorders are among the most prevalent perinatal disorders, and specific associations with child development have to be distinguished to derive early targeted interventions. Objective: Are children of mothers with peripartum anxiety or depressive disorder at increased risk for (visuo–)‌motor, language, and cognitive developmental abnormalities? Method: In this prospective-longitudinal MARI study, N = 306 women were examined three time during pregnancy and at 2, 4, and 16 months after delivery using the Composite International Diagnostic Interview for Women (CIDI-V) to assess their anxiety and depressive disorders. Child development was assessed at 4 (N = 263) and 16 months postpartum (N = 241) using a standardized development test (Neuropsychologisches Entwicklungs-Screening, NES). Results: Maternal depressive disorders prior to pregnancy were associated with infant visual development at 4 months (OR = 3.3) and motor development at 16 months (OR = 4.4) postpartum. The results remained stable after adjustment for preterm delivery and perceived maternal social support. Discussion and conclusion: Developmental adversities in infants of mothers with prior depressive disorders might be explained by altered mother-child interaction (e. g., less eye contact, less engagement). Early identification of expectant mothers with a history of depressive disorders is crucial for early targeted intervention. Further studies are needed to examine the mechanisms of transmission to derive innovative approaches for prevention.