<p>HIV and AIDS are disease conditions that have led to high mortality rates in Southern Africa since the late 1970s. The socio-economic system has led to the unequal spread of resources&rsquo / and vulnerability and exposure to HIV is more prevalent in poorer communities. The added burden of life stresses cause for many to be isolated and stigmatised and are often not equipped with the necessary support and coping skills to deal with the magnitude of these circumstances. There is a high prevalence of mental disorders and especially depression amongst individuals infected with either HIV or AIDS. Research shows that stressful life events can impact HIV course progression and impacts the QoL of those infected with HIV or AIDS. Given the social and psychological context of HIV and AIDS, the aim of the study was to examine the relationship between depression and QoL in a sample of adults diagnosed with HIV or AIDS. This quantitative, cross-sectional study used the Becks Depression Inventory II (BDI II) and the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), to measure the variables concerned. This battery of&nbsp / questionnaires was administered to a purposive sample of adult individuals diagnosed with HIV or AIDS residing in a previously disadvantaged area in the Cape Metropole region. Using SPSS,&nbsp / data was analysed and descriptive and inferential statistics were conducted. The study found that there were more women than men with HIV or AIDS that were found to be depressed (mild, moderate and severe depression). Furthermore, the depressive state increased when the progression of the disease increased. There were generally no significant differences in the QoL&nbsp / experienced within various areas of life and overall life satisfaction experienced. However, the QoL experienced in work was lower. There was a significant relationship between the depressed state and QoL and life satisfaction experienced in household duties and tasks. The contribution of this study includes informing the larger research project, with regards to future treatment&nbsp / regimes. It will update statistics on the prevalence of depression and QoL of adults diagnosed with HIV or AIDS in the area. This study is framed within a biopsychosocial model and is&nbsp / theoretically underpinned by Beck&rsquo / s theory of depression. Key words: HIV, AIDS, adults, depression, quality of life (QoL), Beck Depression Inventory II (BDI II), Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), Antiretrovirals (ARV&rsquo / s), prevalence data, correlations.</p>

Background: Cardiac Rehabilitation (CR) has been shown to be effective in reducing mortality and morbidity in Coronary Heart Disease (CHD). There is a limited amount of research that evaluates the impact of menu-based CR, in patients with Acute Coronary Syndrome with Low Troponin levels (ACSLT). Aim: This thesis contains a feasibility study and an exploratory study. The feasibility study aimed to examine the feasibility of a Randomised Controlled Trial (RCT) which would test the impact of a menu-based CR programme, on individuals diagnosed with ACSLT, against standard care. This feasibility study included staff views. The exploratory study aimed to explore the impact that ACSLT and CR can have on this client group. Method: The feasibility study was a repeated measures case-control trial of menu-based CR based on the theoretical framework of the Common Sense Model of Self-Regulation (CSM), using a range of health assessments. The areas assessed included misconceptions, symptoms, anxiety, depression and Health Related Quality of Life (HRQoL). In addition, focus groups were held with both ward and specialist CR staff to seek their views on the feasibility of a RCT of menu-based CR for ACSLT. The exploratory study consisted of description and analysis of the data that had been collected from the participants over the two year period as above. In addition it included qualitative data that had been collected during interviews with the participants. Findings: Participants (n=33) were recruited from cardiology wards following an admission with ACSLT. They were assessed at baseline (T1), nine months (T3) and 24 months (T4). Twenty-five participants completed the studies. The feasibility study was successful in its aim of testing the CR intervention and protocols for a further RCT. The intervention was acceptable to the participants and to the specialist staff, although the ward staff did not see the need for a RCT. The measures used, with the exception of the self-reporting measures, were suitable and provided a wide range of data that could be utilised in a RCT. However the changes to diagnostic categories meant that a RCT would no longer be feasible. The exploratory study found that both groups were similar on a range of baseline demographic and clinical factors. There was a tendency to benefit within the exploratory study which favoured the intervention. An additional finding from the exploratory study was the degree of uncertainty experienced by the participants, within the context of a changing political and clinical landscape. Discussion and conclusions: The studies presented in this thesis add to our knowledge by highlighting some of the difficulties in designing a RCT of menu-based CR in a specific subgroup of CHD and by presenting outcome data for a small group of participants that have not previously been studied within the literature. This data suggests that there was a tendency to benefit for the intervention that requires further study. Implications for practice: Patients with ACSLT are now being included in CR programmes due to the changes within the diagnostic criteria. Clinicians have little understanding of the impact of CR on this group of patients, or what type of interventions would work best. Large RCT’s will however be problematic and this thesis has highlighted that further work is required to explore how CR can best improve the well-being of individuals with ACSLT.

<p>Uvod: Traumatsko o&scaron;tećenje mozga (TOM) nastaje usled dejstva spolja&scaron;nje mehničke sile na kranijum i endokranijalni sadržaj, koje se karakteri&scaron;e privremenim ili trajnim neurolo&scaron;kim o&scaron;tećenjem, funkcionalnom onesposobljeno&scaron;ću ili psihosocijalnom neprilagođeno&scaron;ću. Blago TOM je najče&scaron;će i čini između 70% i 90% svih povređenih sa TOM. Postoji veliki broj definicija ovog kliničkog entiteta, ali gotovo sve sadrže Glazgov koma skor 13-15, poremećaj stanja svesti u različitom trajanju, te posttraumatsku amneziju kao odrednice koje defini&scaron;u blago TOM. Najveći broj povređenih sa blagim TOM ima dobru prognozu i potpunu rezoluciju tegoba u kratkom vremenskom periodu nakon povređivanja, bez medicinski relevantnih posledica. Međutim, jedna grupa povređenih koja navodi nagla&scaron;enije i dugotrajnije tegobe koje mogu imati uticaja na ukupno zdravstveno stanje i kvalitet života. U savremenom naučnoistraživačkom radu aktuelni su poku&scaron;aji da se primenom novih dijagnostičkih metoda, detaljnim praćenjem povređenih i primenom neuropsiholo&scaron;kih testova objektivizuju ove tvrdnje, kako bi se pacijenti sa povi&scaron;enim rizikom od nastanka dugotrajnih tegoba pravovremeno identifikovali i kako bi se mogao sprovesti adekvatan tretman. Cilj: Cilj ove studije je da se utvrditi da li postoji korelacija između kliničkih i radiolo&scaron;kih simptoma i znakova i rezultata neuropsiholo&scaron;kog testiranja kod povređenih sa blagim traumatskim o&scaron;tećenjem mozga, kao i da se utvrdi da li neki od od kliničkih simptoma i znakova mogu biti pouzdan prediktor pojave perzistentnih neuropsiholo&scaron;kih posledica, i koja je priroda moždanih o&scaron;tećenja koja mogu biti u njihovoj osnovi. Materijal i metode: Sprovedeno istraživanje je u celosti bilo kliničko, prospektivno, i obuhvatilo je 64 povređena sa blagim TOM koji su u periodu od 2012. do 2015. godine hospitalizovani na Klinici za neurohirurgiju Kliničkog centra Vojvodine u Novom Sadu. Pre prijema je svim ispitanicima načinjen pregled endokranijuma kompjuterizovanom tomografijom (CT) koji nije prikazivao znakove traumatskih o&scaron;tećenja kranijuma niti endokranijalnog sadržaja. U toku hospitalizacije kod povređenih su praćeni i beleženi relevantni klinički parametri. U prvih 72 sata od povređivanja je kod 37 ispitanika načinjen pregled endokranijuma magnetnom rezonancom (MRI). Kod 25 ispitanika je načinjeno neuropsiholo&scaron;ko ispitivanje baterijom neuropsiholo&scaron;kih testova mesec dana nakon povređivanja i 6-9 meseci nakon povređivanja. Rezultati su uno&scaron;eni u bazu podataka i nakon toga statistički analizirani. Rezultati: U analiziranoj grupi od 64 povređena sa blagim TOM kod 37 ispitanika (58%) je načinjen MRI pregled endokranijuma, a pozitivan nalaz u smislu postojanja traumom izazvanih o&scaron;tećenja moždanog parenhima pronađen je kod 17 ispitanika (46%). Najsenzitivnije MRI sekvence su SWI i T2* kojima se otkrivaju veoma diskretni depoziti razgradnih produkata krvi. Povređeni sa pozitivnim MRI nalazom imaju lo&scaron;ije postignuće na rekogniciji liste B Rejovog testa verbalnog učenja u odnosu na povređene iz grupe bez intrakranijalne traumatske lezije. Rezultati neuropsiholo&scaron;kih testova ukazuju na pobolj&scaron;anje rezultata između prvog i drugog testiranja u pogledu egzekutivnih i govornih funkcija u ispitivanoj grupi. U ostalim ispitivanim kognitivnim aspektima nije pronađena značajna razlika među navedenim grupama Zaključak: TOM predstavlja jedan od najvećih savremenih medicinskih izazova koji se nameće zbog svoje visoke incidence, dijagnostičkih i terapijskih problema, ali i potencijalno lo&scaron;eg ishoda i visokih tro&scaron;kova rehabilitacije i resocijalizacije povređenih. Rezultati studije se mogu iskoristiti za bolje razumevanje blagog TOM u smislu lak&scaron;eg re&scaron;avanja dijagnostičkih dilema, kreiranje efikasnijih dijagnostičkih protokola i preciznije procene ishoda nakon povređivanja ove vrste.</p> / <p>Introduction: Traumatic brain injury (TBI) is a result of the influence of external mechanical forces on scull and endocranial structures which can produce temporarily or permanent neurological impairment, functional disability or psychosocial unconformity. Mild TBI is the most frequent form of TBI and represent between 70% and 90% of all TBI cases. There are several different definitions of mild TBI, but almost all of them contain Glasgow Coma Scale score 13-15, altered state of consciousness and different forms of amnesia as criteria for mild TBI diagnosis. Largest number of patients suffered mild TBI have good prognosis and complete resolution of symptoms in short period of time after injury, with out of any kind of sequeles. However, small group of patients report various symptoms and complaints which can last longer than is usual and seriously affect quality of life of this patients. Numerous researches has been conducted applying novel imaging technologies, long follow-up periods and neuropsychological testing in order to make these non-specific self-reported complaints as much objective as possible. The other reason is necessity of timely identification of patients in risk of developing long term complaints so they can be treated in a proper manner. Objective: The aim of this study was to determine is there correlation between clinical and radiological signs and symptoms and results of neuropsychological testing in patients with mild TBI. The aim also was to determine are there some clinical signs which can be reliable predictor of appearance of neuropsychological consequences and what is the nature of cerebral lesion suspected to be a cause of this consequences. Materials and methods: The research was clinical, completely prospective and included total of 64 patients with mild TBI who were hospitalized between 2012 and 2015 at Clinic for neurosurgery, Clinical Centre of Vojvodina in Novi Sad. All patients had computed tomography scan (CT) at the admission which failed to show any signs of trauma of cranial bones or endocranial content. During the first 72 hours after injury the magnetic resonance imaging (MRI) has been performed in 37 patients. 25 patients had neuropsychological testing one month and 6-9 months after injury. We entered results in database and after completion we performed statistical analysis. Results: In 37 of 64 patients (58%) MRI examination has been performed and in 46% of patients we found trauma induced small haemorrhagic and oedematous brain lesions. The most sensitive sequences in our protocol were SWI and T2* confirmed superb sensitivity in detection of small foci of blood. Patients with detected MRI abnormalities showed poorer accomplishment at recognition of list B of Ray Auditory Verbal Learning Test in comparison with group with no intracranial lesions. The results of neuropsychological testing showed significant improvement of executive and speech functions between two periods in time when tests have been administered. We found no other significant differences between analysed cognitive functions in this period in our group of patients. Conclusion: TBI is one of the most important contemporary medical problems due to his high incidence, diagnostics and therapy related issues, but also potentially poor outcome and high costs of rehabilitation. Results of this study can be used for better understanding of mild TBI in order to solve some diagnostic dilemma, create more efficient diagnostic protocols and facilitate more precise outcome assessment after mild TBI.</p>

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.