Atividade antioxidante de fucanas e galactanas extraídas de algas marinhas

Studies made with polysaccharides of seaweed have demonstrated that these present important biological and pharmacological activities. These composites had presented "scavenging" activity of free radicals, which is important in the mediation of the inflammatory process and in the pathology of diverse disease. Recently, this "scavenging" property has taken some researches to evaluate the antioxidant capacity from various polysaccharides. Considering the limited research with polysaccharides and knowing its largely employed by the pharmaceutical and foodstuffs industries, we have objective to verify the actions from fucans and galactans as antioxidants. The fucans are found in brown seaweed and the galactans (carrageenans) in red seaweed. The fucans were obtained from seaweed Padina gymnospora (F0.5 e F1.1 fractions), common to our coastline and one another fucan, fucoidan, was of origin commercial and extracted from seaweed Fucus vesiculosus. The λ, κ e ι carrageenans were also of origin commercial. The antioxidant activities were tested in superoxide and hydroxyl systems to generated free radicals and for the inhibition of the lipid peroxidation. The results obtained to inhibition of formation the superoxide radicals demonstrated that all polysaccharides presented scavenging activity of superoxide radicals. The fucoidan, F0.5 and F1.1 fractions presented IC50 of 0.058; 0.243 and 0.243 mg/mL, respectively, while IC50 of the λ, κ and ι carrageenans were 0.046; 0.112 and 0.332 mg/mL, respectively. The results to inhibition of formation the hydroxyl radicals demonstrated that all sample had low effect in the inhibition of the formation of these radicals, except the F0.5. For these radicals the IC50 were 0.157 and 0.353 mg/mL to the fucoidan and F1.1, respectively and 0.357; 0.335 and 0.281 mg/mL to λ, κ and ι carrageenans, respectively. All the samples were capacity to inhibition the peroxidation, it present the IC50 of 1.250; 2.753 and 2.341 mg/mL to fucoidan, F0.5 and F1.1, respectively. Already the λ, κ and ι carrageenans presented the IC50 of 2.697; 0.323 and 0.830 mg/mL, respectively. With these findings, we conclude that polysaccharides used in this study presented activity antioxidant, and that fucoidan and the λ carrageenan show a significant "scavenging" activity for the radicals superoxide and the κ carrageenan a significant inhibitory activity for the lipid peroxidation

Estudo sobre a influência do massará no processo de formação de salitre em rebocos na região de Teresina - PI

This work had to verify the influence of massará, while mortar component, in the process of formation of saltpeter in cementitious plaster walls of buildings. The massará is a ceramic material, texture areno usually found in large volumes argillaceous sediments in Teresina, Piaui State capital, which is associated with the Portland cement mortar form for fixing and finishing in construction. Saltpeter or flowering is a pathology that happens in gypsum wallboard, which invariably reaction between soluble salts present in materials, water and oxygen. This pathology, supposedly credited to massará caused its use to suffer significant reduction in the market of the buildings. Verify this situation with particular scientific rigor is part of the proposal of this work. Grading tests Were performed, consistency limits (LL, LP and IP), determination of potential hydrogen, capacity Exchange (CTC), electrical conductivity (EC), x-ray fluorescence (FRX) and x-ray diffraction (DRX). Massará analysed samples in number six, including sample plastering salitrado presented potential hydrogen medium 5.7 in water and 5.2 on KCl n and electrical conductivity (EC), equal to zero. These results pointed to the affirmative that massará is a material that does not provide salinity content that can be taken into consideration. It is therefore concluded that the material analyzed not competing, at least with respect to the presence of soluble salts, for the formation of saltpeter

Biologia reprodutiva da |Tainha, Mugil curema valencientes, 1836 (osteichthyes: mugilidade) nas águas costeiras do Rio Grande do Norte

The marine fish white mullet, Mugil curema Valenciennes, 1836 (Osteichthyes: Mugilidae) exhibits a wide geographical distribution, being common in the Brazilian coast and is an important component of the artisanal fisheries. The objective of this study was to investigate the reproductive biology of M. curema in the coastal waters of Rio Grande do Norte. Fish samples were captured on a monthly basis during August, 2008 to July, 2009. The fish specimens were numbered, weighed, measured, dissected and their gonads were removed, weighed, their sex and gonadal development were identified. The length-weight relationship was determined for males and females. The sex ratio, the size at first gonadal maturation and gonadosomatic index (GSI) were calculated and ovarian development was investigated using macroscopic and histological techniques. The fecundity, spawning type and the reproductive period of the species were determined. A total of 366 specimens (186 males and 180 females) were captured. The sex ratio was 1:1 and the females were heavier than males. The estimated values of the angular coefficient for both sexes suggest that the species has isometric growth. The size at which 50% of the population began the process of maturation was 25.9 cm of total length for grouped sex. The macroscopic characteristics of the ovaries showed four stages of development: immature, maturing, mature and spent. However, the microscopic characteristics of the ovaries showed five stages of development: immature, early maturing, late maturing, mature and spent. The development of oocytes indicated five phases: Chromatin-nucleolus (phase I), initial perinucleolar (phase II), final perinuclear (phase II), formation of vitelline vesicle or yolk (phase III), vitellogenic (phase IV) and complete vitellogenesis (phase V). The species has a prolonged spawning period, with two peaks coinciding with the rainy season.

Avaliação bioquímica e hostológica de fígado de ratas wistar diabéticas e tratadas com tamoxifeno

Tamoxifen (TX), a drug used in the treatment of breast cancer, may cause hepatic changes in some patients. The consequences of its use on the liver tissues of rats with or without diabetes mellitus (DM) have not been fully explored. The purpose of this multidisciplinary study was to evaluate the correlation between plasma hepatic enzyme levels and the presence of iron overload in the hepatic tissue of female Wistar rats with or without streptozotocin-induced DM and using TX. Female rats were studied in control groups: C-0 (non-drug users), C-V (sorbitol vehicle only) and C-TX (using TX). DM (diabetic non-drug users) and DM-TX (diabetics using TX) were the test groups. Sixty days after induced DM, blood samples were collected for glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST) alkaline phosphatase (ALP) and bilirubin measures. Hepatic fragments were processed and stained with hematoxylin and eosin (H&E), Masson s trichrome, Perls. The hepatic iron content was quantified by atomic absorption spectrometry. AST, ALT and ALP levels were significantly elevated in the DM and DM-TX groups, with unchanged bilirubin levels. Liver iron overload using Perls stain and atomic absorption spectrometry were observed exclusively in groups C-TX and DM-TX. There was positive correlation between AST, ALT and ALP levels and microscopic hepatic siderosis intensity in group DM-TX. In conclusion, TX administration is associated with liver siderosis in diabetic and non-diabetic rats. In addition, TX induced liver iron overload with unaltered hepatic function in 2 non-diabetic rats and may be a useful tool for investigating the biological control of iron metabolism

Efeito do sildenafil na lesão renal por isquemia-reperfusão em ratos

A lesão renal causada pelo processo isquemia-reperfusão ocorre em várias intervenções cirúrgicas, como transplantes de rins, cirurgias vasculares renais e na nefrectomia parcial. Devido ao processo isquêmico, ocorre disfunção do órgão e morte celular. Com o objetivo de avaliar o efeito do sildenafil, em ratos, administrado previamente à isquemia renal e reperfusão, em avaliações cintilográficas e histopatológicas, foram utilizados vinte e quatro ratos Wistar, aleatoriamente distribuídos em dois grupos. Os animais receberam 0,1 ml IV 99mTecnécio-Etilenodicisteína, realizando-se a cintilografia renal inicial e, em seguida, foram submetidos à laparotomia, provocando-se isquemia no rim esquerdo, com oclusão da artéria renal, durante 1 hora, com posterior reperfusão. Os animais do grupo sildenafil receberam previamente 1mg/kg de sildenafil via oral, 60 minutos antes da isquemia. O grupo controle recebeu somente solução salina. Após a isquemia e reperfusão, metade dos animais de cada grupo foi avaliada com 24 horas e a outra metade, com sete dias, com nova cintilografia renal. Após eutanásia, com superdose de anestésico, os rins foram retirados e submetidos a exame histopatológico. Empregou-se avaliação estatística com o teste t de Student e com teste não-paramétrico de Mann-Whitney. Foi observado no rim esquerdo do grupo controle um déficit funcional nas imagens cintilográficas, após sete dias, comparativamente ao respectivo estudo cintilográfico inicial (p<0,05). Nos rins esquerdos dos animais do grupo controle (24 horas pós-isquemia), ocorreu um maior grau de necrose celular quando comparados ao grupo tratado com o sildenafil (p<0,05). A cintilografia e a histopatologia demonstraram que o sildenafil exerceu ação protetora dos rins, após episódio de isquemia-reperfusão renal normotérmica. Deve ressaltar-se o x caráter interdisciplinar desta tese, que contou com a participação ativa de profissionais das áreas de cirurgia, medicina nuclear, urologia, patologia e estatística

Intervenção dietoterápica em portadores de lipodistrofia generalizada congênita do Rio Grande do Norte

Congenital generalized lipodystrophy is a rare genetic disease with autosomal recessive inheritance characterized by the generalized absence of subcutaneous adipose tissue and insulin resistance. The aim of our study was to determine the profile of patients with congenital generalized lipodystrophy (Berardinelli-Seip syndrome) through their clinical history, eating habits, and socioeconomic and cultural aspects; assess food consumption and nutritional status of the study group; propose and evaluate a diet therapy model associated to oral supplementation with zinc to help in the control and prevention of metabolic complications associated to the pathology. Initial assessment of food consumption indicated a voracious appetite in all the patients studied. The introduction of zinc reduced appetite, contributing to patient adherence to the food plan proposed. It was also observed that the proposed diet contributed mainly to glycidic control, specifically with respect to HbA1c. The nutritional status of the patients investigated was adequate in terms of body mass index (BMI), arm muscle circumference (AMC), arm muscle area AMA, but triceps skinfold (TSF) indicated serious malnutrition. Our study is unique in the literature and provides important information to the field of nutrition and to individuals with this pathology. Furthermore, it contemplates the interdisciplinary and multidisciplinary requirements of the Postgraduate Program in Health Sciences of the Federal University of Rio Grande do Norte (UFRN), Natal, Brazil

Rastreamento populacional para Doença de Gaucher em Tabuleiro do Norte-CE

Background. Gaucher Disease (GD) is a hereditary lysosomal storage disorder characterized by the accumulation of glucosylceramide, mainly in the cells of the reticuloendothelial system, due to a deficiency of the enzyme acid β-glucosidase (GBA). Diagnosis is usually based on measurement of GBA activity in peripheral leukocytes. The purpose of this study was to evaluate the ability of screening for GBA and chitotriosidase activity using Dried Blood Spots on Filter Paper (DBS-FP) to identify individuals at high risk for GD in high-risk populations such as that of Tabuleiro do Norte, a small town in Northeastern Brazil. Methods. Between June 1, 2007 and May 31, 2008, 740 consented residents and descendants of traditional families from Tabuleiro do Norte were submitted to screening with DBS-FP. Subjects with GBA activity <2.19 nmol/h/mL were referred to analysis of GBA and chitotriosidase activity in peripheral leukocytes and in plasma, respectively. Subjects at highest risk for GD (GBA activity in peripheral leukocytes <5.6 nmol/h/mg protein) were submitted to molecular analysis to confirm diagnosis. Results. Screening with DBS-FP identified 135 subjects (18.2%) with GBA activity <2.19 nmol/h/mL, 131 of whom remained in the study. In 10 of these (7.6%), GBA activity in leukocytes was 2.6 5.5 nmol/h/mg protein. Subsequent molecular analysis confirmed 6 cases of heterozygosity and 4 normals for GD. Conclusion. DBS-FP assay was shown to be an effective initial GD screening strategy for high-prevalence populations in developing regions. Diagnosis could not be established from GBA activity in leukocytes alone, but required confirmation with molecular analysis

Biodistribuição do pertecnetato de sódio (Na99mTcO4) em ratos submetidos à ressecção extensa de intestino delgado

Massive resection of the small intestine results in short bowel syndrome with anti-absorptive effect and repercussions on the metabolism. Morphologic and functional evaluation may be necessary in order to control wrapped organs. Scintigraphy an examination with little invading and no biologic damage can be used. The purpose were to assess the biodistribution of sodium pertecnetate in organs of rats subjected to massive resection of the small intestine, the intestinal adaptation of the remnant intestinal mucosa and weight curve evaluation in the postoperative period. Twenty-one Wistar rats were randomly allocated into three groups (n = 7). The operated group named short bowel (SB) after anesthetized was subjected to massive resection of the small intestine; the control group (C), and sham group (SHAM). On the 30th postoperative day, 0.l mL of sodium pertechnetate was injected into the venous orbital plexus. After 30 minutes, the rats were killed with an overdose of anesthetic, and fragments of the liver, spleen, pancreas, stomach, duodenum, small intestine, thyroid, lung, heart, kidney, bladder, muscle, femur and brain were harvested. The percentage of radioactivity per gram of tissue (%ATI/g) was determined using Gama Counter WizardTM 1470, PerkinElmer to all samples. Biopsies of 3 cm remaining jejunum were removed to histological analyses. Analysis of variance (ANOVA) and the Tukey test for multiple comparisons were used, considering p<0.05 as significant. The study had the participation of some departments and laboratories, as Nucleus of Experimental Surgery, Department of Surgery, Laboratory of Radiobiology, Department of Pathology and Service of Nuclear Medicine, certifying the character of a multidisciplinary research. The results were no significant differences in %ATI/g of the sodium pertechnetate in the organs of the groups studied (p>0.05). An increase in the weight of the SB rats was observed after the second postoperative week. The jejunal mucosal thickness of the SB rats was significantly greater than that of C and sham rats (p<0.05. The biodistribution of sodium pertechnetate was not affected by massive intestinal resection in rats. An adaptive response by the intestinal mucosa probably contributed to the reversion of weight loss and the biodistribution of sodium pertechnetate was not affected by the surgery

Acurácia do teste de labirinto no rastreamento de déficits cognitivos em idosos

This study intended to evaluate the maze test accuracy in cognitive deficit screening in elderly with or without neuropsychological pathology. The sample included 40 healthy young (18-25 years old; mean- 21 ± 1.6), 40 healthy old (60-77 years old; mean- 67 ± 5.1) and 18 patients with probable diagnosis of Alzheimer s disease initial stage (52-90 years old; mean- 78 ± 9.2). Data analysis was made using Anova with Tukey s post hoc, multiple linear regression analysis and ROC curve analysis. According to Tukey s test Alzheimer patients spent more time (46843 ± 37926 ms) to execute the test than healthy young (5482 ± 2873 ms; p= 0.0001) and elderly (17978 ± 13700; p= 0.0001); healthy young executed test n lower time (p= 0.035). According to the regression analysis of age, education level and cognitive performance of the three groups, the cognitive performance was the predictor of the execution time. When analyzing young and elderly only age was the predictor and the cognitive performance was the only factor to influence the test of old aged healthy and patients. The ROC curve analysis indicated 72% accuracy for young and elderly and 36% for healthy and elderly patients. The maze execution time represented a better balance between sensibility (75%) and the specificity (61%) was near 13575 ms, indicating that those subjects that execute the maze in a time higher to this value may show cognitive deficit related to the executive function. According to the results it is suggested that the maze test used in this study shows a good accuracy in the cognitive deficit tracking and may discriminate age changes

Ações de detecção precoce do câncer de mama realizadas por profissionais da estratégia saúde da família

This study is an exploratory descriptive study with a quantitative approach. The objective was to identify the actions for the early detection of breast cancer conducted by the health professionals of the Family Health Strategy in the Trairi region of the State of Rio Grande do Norte, Brazil. The research was conducted in nine municipalities of the region. Data were collected by means of a questionnaire with 52 Family Health Strategy professionals, 30 nurses and 22 physicians, that work in the region. Analysis was conducted using descriptive statistics. The results were organized and discussed in three areas: Knowledge about the early detection of breast cancer; Actions for early detection detection of breast cancer, and Difficulties experienced in the screening actions for breast cancer. The results indicate that these professionals (100%) have knowledge of the signs and symptoms of breast cancer and that the majority (96,2%) conduct screening actions in accordance with the recommendations of the Ministry of Health. However, a considerable number (55,8%) of these professionals encounters difficulties while conducting the screening procedures in his work setting. The difficulties varied from those of a personal nature to those of access to the procedure, such as the unavailability of sufficient quotas of screening exams. We conclude that the majority of health professionals execute the screening actions for breast cancer in their work settings according to the recommendations of the Ministry of Health, even though they encounter difficulties in the conclusion of the mammography and ultrasound exams, essential procedures in the early detection of breast cancer. We understand that these professionals demonstrate knowledge of secondary prevention even though they do not execute all the actions necessary for early detection primarily because they are impeded by the blockage of access to exam quotas. We conclude that, in spite of the difficulties experienced, the procedures for the early detection of breast cancer are being executed by the majority of the Family Health Strategy professionals in the Trairí region, specifically the clinical examination of the breast, orientation of breast self examination, requests for mammography and ultra sound examinations. Measures are needed that can mediate the difficulties, that will permit the realization of secondary prevention procedures with the population at risk in the region. We suggest training and actualization courses on the complete screening process that includes a wide discussion of the new legislation that provides the mammography exam for women over 40 years. We believe that the acquisition of such a work perspective for the early detection of breast cancer, along with knowledge of health vigilance and of breast cancer, will enhance integral health care of women that constitutes an aim of the nurse and the family health team

Identificação das condições gerais de conservação dos reservatórios integrantes do sistema de abastecimento de água de Natal

Infrastructure works are included in strategic areas for the social development. For that matter that all of the investments are very important for the social development. When the population has enough water and an acceptable quality, and it includes a wastewater gathering and its treatment, the whole society became less susceptible to the water diseases. Even the Water Supply and the Sewage depend for its perfect operation of reservoirs, or of the accumulation of water to provide the popular necessity, either due to retention or for the treatment wastewarer. These structures present very specific environmental conditions, because the microclimate created around them, like high environmental humidity and for the existence of many harmful substances for the concrete, such as chloride ions presents in water. The reservoir that compose the System of Water Supply of Natal were built between 1970s and 1980s, a period whom the technical and scientific community did not have in-depth studies about the reinforced concrete mechanism of deterioration. Therefore, these reservoirs have been suffered accelerated deterioration progress, and they have been shown many pathological manifestations strikingly visible. In front of all these problems this academic work aims to identify the generally conditions of conservation of all the reservoirs components of the Water Supply System of Natal. This academic work objectives to develop a recuperation plan for use in these reservoirs, in this academic work it was achieved all the survey of pathological manifestation existing in each reservoir. It was made with local visits, photographic recorders of all manifestations viii and realization of in loco tests. The other step consisted in a application of GDE/UnB metodolgy reformulated by Fonseca (2007). In the step of local visits in each reservoir it was evaluated carbonation depth, by spreading a phenolphthalein solution with 1% of concentration; evaluation of contamination of chlorides, by spreading silver nitrate solution with 1% of concentration, and evaluation of width cracks. After the conclusion of all the testings, it was established that all reservoir, studied in this academic work, have showed an advanced deteriorating condition. It´s presents prevalent pathological manifestations as unacceptable cracks, spots, efflorescence and reinforcement corrosion, and in some cases, chlorides contamination. After the conclusion of the testings and its concatenation it was able to implementing, using GDE/UnB methodology, the order of the restoration its service life and initial safety conditions

Desenvolvimento e avaliação de controladores preditivos baseados em modelos biliares

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

A melancolia em A Asa Esquerda do Anjo

O termo melancolia, como foi mostrado em todo o decorrer do nosso trabalho, principalmente no histórico da melancolia, é um termo, por excelência, escorregadio. De várias facetas, a melancolia pode vir a designar desde patologia, passando por inspiração filosófica, para desaguar num modo de ver a vida, como bem nos coloca Denílson Lopes em seu livro Nós os mortos: melancolia e neo Barroco (1999). A Asa Esquerda do Anjo (LUFT, 2005) é uma obra que já nos acompanha há algum tempo, pois desde a graduação estudamo-la. Em torno da protagonista, chamada de Gisela pela mãe e Guísela pela avó, circula toda a trama desse romance moderno. Tentamos visualizá-la nos três capítulos da dissertação. No primeiro, focalizamos a obra sob o aspecto de uma possível estética da melancolia, tendo por base teórica Marie Claude Lambotte (2000). Depois, elaboramos algumas linhas sobre as perdas da protagonista que do enredo emergem. Por fim, demonstramos Gisela pelo aspecto de múltiplas faces. Sabendo que uma obra literária é infinita em seus significados, cremos que A Asa Esquerda do Anjo (2005) suscita outras nuances. Isto nos dá a certeza que não é um texto acabado, finalizado. Estas nuances poderão ser estudadas, pesquisadas em uma outra oportunidade por nós ou por outros leitores de Luft. A fim de estudar a melancolia em Gisela, fundamentamos nossa dissertação com os estudos de Freud (1980) a respeito do tema. Este faz uma análise comparando a melancolia ao luto, para poder chegar, assim, a um denominador comum, já que o termo é flexível em seus significados. Freud e alguns outros autores no campo, tais como, Bataille (1980); Benjamin (1984); Erickson (2003); Klein (1971); Kristeva (1989); Lino (2004); Peres (2003); Santos (2005), Scliar (2003), pois, nos auxiliaram em nossas pesquisas e direcionaram melhor o nosso olhar sobre a obra. Acreditamos ter alcançado nosso objetivo estudar a obra A Asa Esquerda do Anjo (LLUFT, 2005) pelo foco da melancolia e suas nuances. Gisela é um personagem inacabado. Em seu discurso ela deixa isto bem nítido. Assim também, não buscamos respostas prontas, com teor de acabamento. O fechar da história está nas mãos do leitor. Mas, à medida que reiniciamos nova leitura, percebemos algo novo, que pode ser extraído da obra, do personagem, da trama. É neste abrir/fechar que a própria Gisela sussurra: Vem, vem, vem.... Ao chamar a todos nós, chama também para um novo caminhar com ela, em suas perturbações subjetivas e sua ausência de respostas. Ao aceitarmos este convite, fica difícil retornarmos pelo mesmo caminho de antes. É necessário, então, junto com este ser de papel, rever nossos passos, para, enfim, redimensionarmos nossa escrita acerca de nós mesmos e (por que não dizer?) do mundo que nos circunda

Da emergência da personagem social do homosexual à cultura gay: uma leitura a partir de Michel Foucault

This present research aims to understand the concept of homosexuality as a social creation that comes permeated by the discourses of sexuality devices. It discusses the issue of homosexuality with a focus on works of Michel Foucault, in special The History of Sexuality, where the author emphasizes that homosexuality as a social construct that manifests itself during the nineteenth century. From the Foucauldian discourse, it is proposed to understand and analyze the creation of the concept of homosexuality, which is built around the subordination of the individual as a social agent, or the creation of homosexuality does not refer to sexual intercourse between individuals of the same sex, but a social subject and the position it takes in society. So along with the birth of the homosexual individual, there is also the construction of the individual as a social subject, as being, homosexuality and homosexual subject are products of overlapping powerculture. When addressing this theme, it breaks the hegemony that seeks to characterize naturalized of sexuality and, consequently, homosexuality, born with the original speeches on medical and psychiatric couches, in which one perceives the role of power in the discourses deploying the truths aimed at sexuality. With this, there has been an argument that seeks to refute the eugenics that includes sexuality as something natural, instituting a homosexual as a guy born hostage to a bad genetic and abnormal who should be treated for their disease, and understand this individual as a product of social discourse

Grau de conhecimento de pacientes sobre o acidente vascular cerebral e a necessidade do uso de cartilha educativa para orientação fisioterapêutica

Stroke is a neurological dysfunction of vascular origin that causes physical impairments and disabilities. Brazil leads the statistics stroke mortality among Latin American countries, demonstrating still be a neglected disease in this country. The incidence is related to risk factors and still is great misinformation in our country about stroke, treatment and prophylaxis. The aim of this study was to assess the degree of knowledge about stroke and patients need to use educational booklet for physiotherapy. The sample consisted of 53 patients, 22 females and 31 males, mean age 56.2 ± 10.9 years. Patients were evaluated by completing questionnaires, observing the socio-demographic and clinical aspects, neurological assessment, functional assessment, knowledge of pathology and presenting educational booklet. The data were analyzed using the chi-square test. According to the results, it was observed that the patients had not enough knowledge about the terminology, complications and warning signs of stroke, were not aware and did not perform the proper positioning of the limb and transfers, however, were aware and performed the stretching maneuvers. This reveals the need to implement policies that lead to information about stroke population. Following discharge from outpatient physical therapy using educational booklets with guidelines on positioning, stretching exercises and transfer is important in functional rehabilitation and encouraging independence of the individual affected by stroke