1,720,979 research outputs found
Variations in arterial supply via the external and internal carotid arteries to the bony orbit and eyeball in full-term fetuses, infants, children, adolescents, and adults – a South African perspective
Get PDFThe anatomy of the orbital region is of great importance for many highly specialised clinical disciplines such as ophthalmology, maxillofacial surgery, and neurosurgery. The main source of arterial blood supply to the orbital region is by the ophthalmic artery, a branch of the internal carotid artery, and to a lesser extent by the anastomotic patterns which are formed through the external carotid artery. A range of arterial variations which may be developmental in origin, or which may develop due to pathologies later in life, may affect the ophthalmic artery in terms of its origin, course, and branching. If clinicians are not aware of the variations occurring in this region, the eye of the patient may be at risk of injury during invasive procedures, which may lead to partial or complete visual loss. Up until the present time, there have been only a few cadaveric studies that revealed some of the variant patterns and the overall frequencies of the recorded anastomotic patterns for the orbital blood supply. Whilst the anatomical variations are known, the frequencies of variations in the population are not. Furthermore, no published data exists regarding the variations in the orbital blood supply in a South African population. Therefore, the aim of this study was to investigate the orbital vascular supply within the South Africans of different age groups, to document and describe any variations in anastomotic patterns and record their frequencies. The current study was conducted through dissections of bodies in the Department of Human Biology, University of Cape Town, and patients' angiograms from Groote Schuur Hospital. The angiograms included data obtained from other hospitals within the Cape Town area and were reviewed retrospectively. The dissection sample included six full term fetuses and 63 adults, and the angiograms accounted for 870 individuals. The ophthalmic artery was studied from the point of origin from the internal carotid artery and its course in relation to the optic nerve, and both sides were compared to note any similarities or differences. Statistical analyses were performed to record the frequencies of the patterns of variations and to note whether there were any associations between sex, age, sidedness, and these variations. The results revealed statistically significant associations between age and sex for the patterns of variation. Several variations were noted in the current study. Among the novel findings were those in the origin of the ophthalmic artery from the internal carotid artery, whereby a lateral and inferior origin were recorded in both samples (dissected bodies and angiograms). In addition, it was noted that the ophthalmic artery may take origin from the A2 segment of the anterior cerebral artery, which is also a novel finding. This study, therefore, adds significantly to the current body of knowledge regarding the patterns of arterial supply to the ophthalmic region in a South African sample
The role of the arterial glycocalyx in sphingosine-1- phosphate induced cardioprotection in the isolated heart of the Wistar rat
Get PDFBackground: Ischemic heart diseases (IHD) are a leading cause of death among cardiovascular diseases. Unfortunately, the myocardial damage due to ischemia in IHD may be worsened by reperfusion therapy, a phenomenon called ischemic-reperfusion (I/R) injury. Coronary vascular damage is a key feature of I/R injury. Among the coronary vascular structures, the endothelial glycocalyx is a delicate polysaccharide and protein-rich layer that plays an important role in the regulation of vascular permeability, and is easily damaged during I/R. Sphingosine-1-phosphate (S1P) is a membrane phospholipid metabolite that has been shown to protect the heart against I/R. It has also been shown to regulate the synthesis of glycocalyx, but its effects on coronary endothelial glycocalyx damage and possible mechanism during I/R are unknown. Therefore, we hypothesized that S1P-induced cardioprotection is mediated by modulation of the glycocalyx during I/R in the isolated rat heart. Methods: Isolated male Wistar hearts were perfused on a Langendorff system with Krebs-Henseleit buffer via retrograde perfusion at constant temperature and pressure. The hearts were stabilized and pre-treated with S1P (10 nM for 7 minutes) before inducing 20 minutes of global ischemia, followed by 60 minutes reperfusion. Functional parameters were recorded throughout the protocol, including left ventricular developed pressure (LVDP), left ventricular end diastolic pressure (LVEDP), heart rate (HR) and coronary flow (CF). Ventricular infarct size was measured by using triphenyltetrazolium chloride stain. Coronary net filtration rate (NFR) was calculated as a ratio of the amount of transudate to CF. Cardiac edema was assessed by calculating the heart wet/dry weight ratio and histologically quantifying size of the interstitial compartment. The shedding of the glycocalyx was estimated by measuring the release of the glycocalyx component syndecan-1 in the coronary effluent using enzyme-linked immunosorbent assay (ELISA) and determining relative syndecan-1 staining intensity between groups in immuno-stained wax sections of perfusion-fixed hearts. In addition, the histo-morphology of the myocardium was assessed using hematoxylin and eosin staining. Results: The cardiac performance was depressed after I/R, as was reflected by decreased LVDP (P=0.02 vs. control), and an increased LVEDP (P<0.0001 vs. control). I/R also significantly increased infarct size (P=0.04 vs. control). Treatment with S1P before I/R significantly decreased infarct size (P=0.01 vs. I/R), but did not improve the post-ischemic decrease in LVDP or stabilize the LVEDP, and had no effect on CF. I/R significantly increased release of syndecan-1 in the coronary effluent (P=0.0002 vs. control). Immunohistochemically-stained imaging also revealed syndecan-1 staining intensity was significantly decreased or absent in ischemic hearts (P≤0.001 vs. control). Pretreatment with S1P had neither effect on syndecan-1 level in the coronary effluent nor on the intensity of syndecan-1 signal in immuno-stained sections (P=n.s vs. I/R). Histological analysis of cardiac edema revealed an increase in the extracellular area in ischemic hearts compared to the control hearts (P≤0.001 vs. control), and S1P treatment decreased the extracellular area (P≤0.01 I/R+S1P vs. I/R). The NFR, and heart wet/dry ratio were not significantly different post-reperfusion between the groups and S1P had no effect on these parameters. Conclusion: This study showed that pretreatment with S1P protects the heart against I/R injury, as was indicated by the decreased infarct size, and decreased extracellular cardiac edema. S1P had no effect on hemodynamic performance or the shedding of syndecan-1. These results suggest that S1P-induced cardioprotection is not mediated by protection of the glycocalyx via stabilization of syndecan-1. However, it is possible that S1P may stabilize other minor glycocalyx components which were not measured in this study, such as heparan sulphate and hyaluronic acid. This is the first study that evaluated syndecan-1 in the cardiac effluent of the isolated heart of rats with global ischemia, and the study opens up prospects for further investigation of the role of the glycocalyx in other models of I/R injury, such as the more clinically-relevant regional ischemia disease model
Investigating the integrity of the vasculature and structural relationships of pericytes, astrocytes and the endothelial glycocalyx in an ex vivo hyperglycaemic rat retinal model
Get PDFBackground: Diabetes mellitus-induced retinopathy is the leading cause of adult-onset blindness. The retinopathy is characterised by the degeneration of the retinal microvascular and neural components that form the blood retinal barrier (BRB), and is due to diabetic metabolic derangements such as hyperglycaemia. The cellular components of the BRB include endothelial cells, pericytes and the glial cells (mainly astrocytes), which together maintain the integrity and barrier function of the retinal vasculature. However, there is limited data regarding the interconnecting biochemical pathways that lead to pericyte loss, astrocyte degeneration, and endothelial dysfunction as well as the thinning of the glycocalyx in the retinal vasculature of diabetics. As such, the underlying mechanism of how hyperglycaemia induces retinal damage is not fully understood, particularly at the early stages of the disease. Aim and Objectives: To establish and validate an ex vivo rat retinal model and use a multiimmunolabelled approach on the retina to study the effects of hyperglycaemia on the vasculature and cellular components of the BRB, including effect of time and the retinal preparation type. Methods: Eyes of euthanised Wistar and Sprague-Dawley adult rats (n = 68) were enucleated and the retinae were either dissected out (explant) or kept in situ after removal of the anterior segment, lens and vitreous (eyecup). Retinae were superfused continuously (for 1-, 2- or 3 hours) in a chamber with oxygenated Krebs-Henseleit buffer containing either physiological glucose (5.5 mmol/L; control group) or high glucose (25 mmol/L; hyperglycaemic group). For longer incubation (48 hours), explants were cultured in Dulbecco's Modified Eagle Medium containing the above glucose concentrations. Retinae were multi-immunolabelled to identify pericytes, astrocytes and the glycocalyx protein syndecan-1 with anti-neuron-glial 2 antigen (NG2), anti-glial fibrillary acidic protein (GFAP), and anti-syndecan-1 antibodies respectively. Retinal blood vessels were detected with FITC-conjugated lycopersicon esculentum (Tomato) lectin. Fluorescent signals were detected using confocal microscopy imaging where Z-stack images were randomly sampled from the mid-peripheral retina. Images were analysed using Image J software. Additionally, western blotting was used to determine the abundance of syndecan-1 and heat shock proteins in the rat retina. P value < 0.05 was considered statistically significant. Results: Retinal blood vessels, pericytes and astrocytes showed normal morphology in both explant and eyecup of normoglycaemia retinae, with no difference in fluorescence intensity between explant and eyecup preparations at each time point (1-3 hours). Similarly, there was no change in the vascular-associated syndecan-1 signal intensity over time. However, the syndecan-1 intensity was generally weak and localised mainly to the retinal arteries and their branches, but rarely in capillaries and was unevenly distributed throughout the entire retina in both retinal preparation types. Under hyperglycaemia, at the 3-hour time point of perfusion, the vessel width was reduced in the eyecup group, the neuron glial 2 (NG2) fluorescence intensity on pericytes was diminished with a noticeable reduction in number of pericyte nuclei bulge in the lower vascular bed in the explant and eyecup groups. Although the area coverage and fluorescence signal intensity of astrocytes did not change, retraction of astrocyte processes and signs of cellular disintegration were more evident in the hyperglycaemic eyecup group compared to that in the explant group. Syndecan-1 signal intensity was raised in hyperglycaemia compared to controls in the eyecup group. The preliminary investigation on retinae cultured for 48 hours showed signs of fragmentation and morphological deterioration of the BRB, which included narrowing of blood vessels, loss of pericytes and disintegration of astrocytes, especially in the hyperglycaemic group. Syndecan-1 signal intensity was also lower in the hyperglycaemic groups compared to the control groups cultured for 48 hours . Syndecan1 protein abundance in the 3-hour superfused retina using western blotting was significantly higher in the hyperglycaemic group than in control. Heat shock proteins showed higher expression in hyperglycaemic rat retina compared to the normoglycaemic group. Conclusion: This study validated the suitability of the ex vivo rat retinal model to study the components of the BRB. The study revealed that there is no significant difference between the retinal preparations (explants vs eyecup) and that the BRB is still structurally intact up to 3 hours in normoglycaemic conditions. The subtle morphological changes of the BRB (blood vessels, pericytes and astrocytes) induced by hyperglycaemia which were more apparent in the lower vascular layers,suggests that this ex vivo model is suitable to study the early pathogenesis of diabetic retinopathy. Furthermore, this study showed that syndecan-1 levels were affected by hyperglycaemia ex vivo, and that this occurred prior to morphological changes to the other BRB structures, thus supporting the notion that syndecan-1 plays a role in the pathophysiology of DR. Preliminary data suggest that heat shock proteins may play a role in response to hyperglycemia-induced oxidative stress
Riglyne vir die skep van 'n kultuursensitiewe leerkonteks
Get PDFM.Cur. (Professional Nursing)The purpose of this study is to describe the guidelines for creating a cultural sensitive learning context. In present- day South Africa the learning accompanist is faced with the challenge to create a didactic situation which accommodates the cultural diversity of students. In the dynamic interactive relationship between the learning accompanist and the student, the student has the right to be treated with respect and human dignity. This right can only be respected if the learning accompaniment takes place from a cultural- sensitive perspective. The paradigmatic perspective that guides this research is described by means of metatheoretlcal, theoretical and methodological assumptions. The Nursing Theory for the Whole Person was used as meta- theoretical assumption. the theoretical assumptions were set from the Nursing Theory for the Whole Person. the U Model vir begeleide selfstudie .. (Klopper 1994) and Chrisman's (1991) .. Cultural Sensitive Nursing Care u. The methodological assumptions of the study are based on Botes" research model (1992) implying a functional approach to practice of science. The experience of the learning accompanists and students in a multicultural learning context was explored and supported by literature. From this data statements were generated indiVidually for phase I and phase II of the research. Eight statements were generated from each phase. In chapter four the conceptual framework is described from concepts of phases I and II and relevant national and international literature. With the description of the conceptual framework main concepts and related concepts were determined analytically. A total of nineteen statements were generated from the main and related concepts. A total of thirty five statements were generated from phases I and II and the conceptual framework. The guidelines for creating a cultural- sensitive didactic situation were inferred by means of deductive and inductive reasoning from these statements. The guidelines focus on the actions a learning accompanist should carry out within a multicultural didactic situation in order to carry create a cultural- sensitive didactic situation. The unique contribution of this research arises from the description of a multicultural didactic situation of nursing within the constructivist learning perspective
Evaluation of new postharvest fungicides for the control of Phytophthora brown rot
Get PDFThesis (MScAgric)--Stellenbosch University, 2020.ENGLISH ABSTRACT: Brown rot is a citrus postharvest disease caused by Phytophthora spp. during continuous wet
conditions. Fruit closest to the soil surface in the orchard are usually infected when
the infecting propagules present are splashed upward during irrigation or rain. When infections on
fruit are still in early development, it may go unnoticed when fruit are harvested. Infections
develop further after harvest and can infect other fruit while in storage or transit. In the
current study, the efficacy of actives azoxystrobin, fludioxonil and potassium phosphite was tested
for the control of postharvest Phytophthora brown rot on citrus, as there is currently
nothing registered for the management of this disease in South Africa.
The fungicide sensitivities of 121 Phytophthora nicotianae isolates belonging to either a
previously unexposed population or previously possibly exposed population, were tested for against
the strobilurin azoxystrobin, based on the growth of mycelium. The mycelial growth on corn meal
agar (CMA) amended with azoxystrobin at 0-, 0.25-, 0.5-, 1-, 10-, 100-, and 2000 µg/ml with the
addition of 100 µg/ml salicylhydroxamic acid (SHAM), to inhibit the alternative respiration route,
was measured after 7 days. The addition of SHAM did not have a significant effect on the growth of
mycelia. CMA was also amended with the phenylpyrrole fludioxonil at 0-, 1-, 100-, 1000-, and 10 000
µg/ml. The effective concentration for 50% reduction of mycelial growth (EC50) for azoxystrobin
ranged from 0.01 to 0.46 µg/ml for both populations and the EC90 ranged from 4.28 to 84.85 µg/ml
for both populations. Fludioxonil sensitivity had a much wider range and higher EC values. The EC50
for both populations ranged from 3.10 to 1613.52 µg/ml and the EC90 values were 1090.50 to 9929
µg/ml.
Subsequently, curative and protective actions of aqueous postharvest dip treatments, were
carried out with the use of azoxystrobin at 1125 µg/ml and fludioxonil at 598 µg/ml. With the in
vivo trials, potassium phosphite was added as an additional treatment at 1500 µg/ml. These trials
were repeated on three fruit types namely lemons, oranges and mandarins and at four time
intervals. The data clearly showed that with all three fungicides, the curative efficacy
is excellent when treatments occurred up to 12 hrs after inoculation. Azoxystrobin and potassium
phosphite exhibited excellent protective activity up to 48 hrs between treatment and inoculation.
An overall trend that was seen with all three fruit types, was that the longer the fungicide was
present on the fruit, the better the protective activity. The nesting data clearly demonstrated
that only azoxystrobin amended wax significantly reduced brown rot from spreading to the
healthy fruit, when compared to the control.
With this study, it could be seen that all three fungicides, with their different actives, have the
potential to effectively manage postharvest brown rot. Considering that azoxystrobin and
fludioxonil are already registered on citrus for the postharvest use of Penicillium management, and potassium phosphite that are registered as a preharvest Phytophthora treatment, this study indicate that they will also provide added protection against Phytophthora brown rot.AFRIKAANSE OPSOMMING: Bruin vrot is ‘n sitrus na-oes siekte wat veroorsaak word deur Phytophthora spesies gedurende aanhoudende nat toestande. Die vrugte naaste aan die grond oppervlakte in boorde word gewoonlik geïnfekteer wanneer die infekterende propagules opwaarts gespat word tydens besproeiing of wanneer dit reën. Wanneer infeksie op vrugte nog in vroeë ontwikkeling is, kan dié vrugte ongesiens geoes word en ander vrugte tydens die stoor daarvan, of tydens vervoer, infekteer. Die huidige studie toets die effektiwiteit van aktiewes asoksistrobien, fludioxonil en kaliumfosfiet vir die beheer van na-oes Phytophthora bruin vrot op sitrus, aangesien daar tans niks geregistreer is vir die beheer van hierdie siekte in Suid-Afrika nie.
Die swamdoder sensitiwiteit van 121 Phytophthora nicotianae isolate wat behoort aan nie-blootgestelde- en moontlik blootgestelde populasies, was gebaseer op die groei van die miselium. Die miselium groei op mieliemeel agar (MMA) met die byvoeging van die strobilurien asoksistrobien teen 0-, 0.25-, 0.5-, 1-, 10-, 100-, en 2000 μg/ml en addisioneel 100 μg/ml salisielhidroksamiensuur (SHAM), om alternatiewe respirasie roetes the inhibeer, was gemeet na sewe dae. Die byvoeging van SHAM het geen betekenisvolle effek gehad op die miselium se groei nie. KMA was ook bygevoeg met die finielpirool fludioxonil teen 0-, 1-, 100-, 1000-, en 10 000 μg/ml. Die effektiewe konsentrasie om die miselium se groei met 50% te verminder (EC50) was vir asoksiestrobien tussen 0.01 en 0.46 μg/ml vir beide populasies en die EC90 was tussen 4.28 en 84.85 μg/ml vir beide populasies. Fludioxonil sensitiwiteit het ‘n veel wyer reeks en hoër EC waardes gehad. Die EC50 vir beide populasies was tussen 3.10 en 1613.52 μg/ml en die EC90 waardes was tussen 1090.50 en 9929 μg/ml.
Gevolglik was die genesende en beskermde aksies getoets met die gebruik van ‘n na-oes doop en was uitgevoer met asoksiestrobien teen 1125 μg/ml en fludioxonil teen 598 μg/ml. Met die in vivo proewe was kalium fosfiet teen 1500 μg/ml bygevoeg. Hierdie proewe was getoets op drie vrug tipes, naamlik suurlemoene, lemoene en mandaryne en teen vier tyd intervalle. Die data wys duidelik dat al drie swamdoders goeie genesende aksies het wanneer behandeling plaasvind tot en met 12 ure na inokulasie. Asoksietrobien en kalium fosfiet het goeie beskermende effektiwiteit gewys tot en met 48 uur tussen behandeling en inokulasie. ‘n Algehele tendens wat opgemerk was met al drie vrug tipes, was dat hoe langer die swamdoder teenwoordig was op die vrug voor inokulasie, hoe beter was die beskermende effek van die swamdoder. Die voorkoming van oordrag data het gedemonstreer dat net asoksiestrobien wat in waks bygevoeg was, het die verspreiding van bruin vrot na gesonde vrugte betekenisvol verminder het, as dit met die kontrole vergelyk was.
Met hierdie studie, kan daar gesien word dat al drie van die swamdoders, met hul verskillende aktiewes, effektief aangewend kan word vir na-oes bruin vrot beheer. Aangesien
asoksiestrobien en fludioxonil klaar in Suid-Afrika geregistreer is vir na-oes Penicillium beheer op sitrus, en kalium fosfiet vir voor-oes Phytophthora beheer, kan hierdie studie aandui dat die swamdoders addisionele beskerming bied teen na-oes Phytophthora bruin vrot.Master
Toward best management practices for the growth of the abalone Haliotis midae Linnaeus on a commercial South African abalone farm
No full textMagister Scientiae - MSc (Biodiversity and Conservation Biology)South Afric
Systematics of the non-geniculate coralline red algae from the South African south coast
Get PDFPhilosophiae Doctor - PhDThe aim of this study was to document the intertidal and shallow subtidal species of
non-geniculate coralline red algae from the South Africa south coast. The main emphasis of the study are encompassed in four research chapters and one concluding chapter focusing on: 1) the documentation of the non-geniculate coralline red algae occurring along the South Africa south coast; 2) revisiting the Leptophytum-Phymatolithon complex in order to resolve the taxonomic status of species previously ascribed to the genus Leptophytum from South African; 3) starting to prepare modern monographic accounts of the higher taxa; and 4) the
production of updated keys to all the currently recognised taxa of non-geniculate coralline algae for South Africa. Although nowhere near complete, here we present our findings and report on the current biodiversity status of the non-geniculate coralline red algae after a further four years of extensive sampling
Cold hardiness and carotenoid variation in western redcedar (Thuja plicata Donn ex. D. Don.): Implications for assisted migration for future climates
Get PDFWestern redcedar (Thuja plicata Donn ex D. Don; redcedar), an indeterminate conifer in the Cupressaceae family, is vulnerable to maladaptation in the face of climate change. Assisted gene flow is one mitigation strategy and involves human-mediated migration of populations, where the projected climate of the area of deployment matches the source climate of the population. Despite the overall projections of warmer temperatures globally, in British Columbia (B.C.), the risk of seasonal frost events will remain and therefore the potential for cold damage and mortality of redcedar exists if the newly migrated populations cannot withstand these freezing events. Knowledge of redcedar's ability to withstand freezing temperatures (cold hardiness) is therefore crucial. Redcedar, like many Cupressaceae species, produces and accumulates the purple-coloured carotenoid rhodoxanthin during the winter. This was hypothesized to be correlated with cold hardiness.
Assessment of variation in overall, fall and spring cold hardiness and associated rhodoxanthin concentrations were done through repeated, seasonal freeze testing of clonal grafts originating from across the range of redcedar, and seedling progeny from a subset of these clones. Cold damage was quantified using electrolyte leakage and rhodoxanthin concentrations were quantified using high performance liquid chromatography. Cold hardiness and rhodoxanthin were individually modelled using univariate and bivariate mixed effect models with clone/family as a random effect. Model outputs were compared to climatic variables associated with clonal origin to test for climatic relationships.
This study found genetic variation in cold hardiness of redcedar with weak climatic clines. This indicates that assisted gene flow of redcedar should be done on a case-by-case basis, with no need for a climatic threshold. Overall heritability of cold hardiness was 0.17 ± 0.03. Novel findings included the positive genetic correlation between fall and spring cold hardiness (0.55 ± 0.33); lack of reciprocal or parental effect for overall cold hardiness; and weak climatic relationships between cold hardiness and predominantly temperature, with the strongest correlation between number of frost-free days in January (0.38, p < 0.01) in the location of origin and cold hardiness.
All findings related to rhodoxanthin were novel. Rhodoxanthin varied with family/provenance and season with heritabilities of 0.30 ± 0.09 in fall, 0.42 ± 0.09 in winter and 0.28 ± 0.09 in spring. Winter and spring rhodoxanthin concentrations were phenotypically correlated (0.50, p < 0.01) and genetically correlated (0.76 ± 0.14). Surprisingly, rhodoxanthin was not detected in clonal grafts of redcedar in any season. Results also indicate that rhodoxanthin cannot be used to estimate cold hardiness. The absence of rhodoxanthin in the clonal grafts compared to the seedlings suggests that plant age impacts rhodoxanthin accumulation.Graduate2021-12-1
Systematics of the non-geniculate coralline red algae from the South African south coast
No full textPhilosophiae Doctor - PhDThe aim of this study was to document the intertidal and shallow subtidal species of
non-geniculate coralline red algae from the South Africa south coast. The main emphasis of the study are encompassed in four research chapters and one concluding chapter focusing on: 1) the documentation of the non-geniculate coralline red algae occurring along the South Africa south coast; 2) revisiting the Leptophytum-Phymatolithon complex in order to resolve the taxonomic status of species previously ascribed to the genus Leptophytum from South African; 3) starting to prepare modern monographic accounts of the higher taxa; and 4) the
production of updated keys to all the currently recognised taxa of non-geniculate coralline algae for South Africa. Although nowhere near complete, here we present our findings and report on the current biodiversity status of the non-geniculate coralline red algae after a further four years of extensive sampling
Early screening for the post intensive care syndrome in a tertiary ICU follow-up clinic in the Eastern Cape
Get PDFThe Post ICU Syndrome (PICS) is defined as a constellation of new or worsened impairments in physical, cognitive, and/or psychological health which persist after critical care discharge. These deficits are more related to the patients’ intensive care unit (ICU) stay rather than to their original ICU admission diagnosis. Between 25-50% of critical care survivors suffer from PICS. There is a paucity of research on PICS in South Africa (SA). The primary objective of this study is to describe the incidence and co-occurrence of PICS symptoms, as well as the changes in instrumental activities of daily living and life roles in ICU survivors.The study was conducted in a multidisciplinary tertiary ICU in the Eastern Cape. Inclusion criteria were respiratory support for ≥ 48 hours, or a shocked state, and/or organ failure requiring ICU stay for 48 hours. Patients were assessed at six weeks and six months after hospital discharge. Physical impairment was measured by the six-minute walk test and ICU-acquired weakness by the Medical Research Council scale. Instrumental activities of daily living score and employment/educational status were determined. The Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised questionnaires were used as screening tools for significant psychological symptoms. Screening for neurocognitive impairment was performed with the NeuroScreen application and compared to a matched control group. The Short Form-36 Health-Related Quality of Life questionnaire (HRQOL) was used to determine quality of life at baseline and study visits. 107 patients, half of whom had COVID-19, completed the six-month follow-up. Six months after hospital discharge, six out of ten patients were affected by PICS, five out of every ten suffered from physical impairment, four out of every ten reported significant psychological symptoms, with three out of every ten affected by both. Three out of ten experienced significant chronic pain. Overall, six out of every ten patients experienced significant psychological symptoms at either one or both study visits. Only one in ten had psychological symptoms in isolation at six months. Six out of every ten patients reported a significantly lower health-related quality of life at six months as compared to their baseline. Three out of every ten patients had not returned to their previous remunerative work, studying or home making. Neurocognitive impairment in this cohort was not verified, and this may have been due to the selection of the control group. However, there was a significant improvement in neurocognitive functioning from the six-week to the six-month study visits. Only 15% of patients received rehabilitation therapy after hospital discharge. Female sex, a higher co-morbidity score and an admission diagnosis of trauma were predictors of PICS symptoms. COVID-19 was not found to be associated with a higher incidence of PICS.Thesis (D.Phil) -- Faculty of Health Science, School of Behavioural & Lifestyle Sciences, 202
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