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Background: Surviving a stroke poses a social and economic impact that requires the care system to be reformulated and the patient to be addressed in a comprehensive approach. Purpose: This study aims to investigate if there is a relationship between functional activities performed before the stroke, patients' clinical and hospitalization data, and functionality and quality of life measures in the first 6 months after the stroke. Methods: This study used a prospective cohort of 92 patients. We investigated sociodemographic and clinical data, the modified Rankin Scale (mRS), and the Frenchay Activities Index (FAI) during hospitalization. The Barthel Index (BI) and EuroQol-5D (EQ-5D) were applied at the following time points: 30 days (T1), 90 days (T2), and 180 days (T3) following postictal state. Statistical analysis was conducted using Spearman's coefficient, Friedman's non-parametric test, and multiple linear regression models. Results: No correlation was found between FAI, BI, and EQ-5D average scores. Severe patients, patients with comorbidities, and patients with extended hospital stays showed lower BI and EQ-5D scores □in the follow-up. BI and EQ-5D scores increased. Conclusion: This research found no relationship between activities performed before the stroke and functionalities and quality of life after the stroke, but comorbidities and extended hospital stay were associated with worse outcomes.

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OBJECTIVES: to build, validate and verify the reliability of the Scale of knowledge about sexuality of people with spinal cord injury for nursing students. METHODS: a methodological study, following the steps: 1) Construction based on literature review; 2) Validation of the content with calculation of the Content Validity Index and the Modified Kappa Coefficient; 3) Pre-test with Nursing students; and 4) Measurement of reliability by internal consistency (Cronbach's alpha). RESULTS: the first version of the instrument presented 13 items. After validation, the items received values above 0.80 and 0.76 for the Content Validity Index and Modified Kappa Coefficient, and it was suggested to separate three items to contemplate gender-specific aspects. After pre-testing, it was recommended that the writing of two items be revised. The final scale, with 16 items, showed Cronbach's alpha equal to 0.93. CONCLUSIONS: the constructed scale presented valid content and proved to be reliable for application with nursing students.

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Nursing history is marked by stigmas of gender, race and class. Nowadays, this scenario is evidenced by the social disqualification of the profession and biomedical and male supremacy. Nevertheless, the profession has the potential to change this paradigm with an intersectional approach. The current study aims to understand how the relationships of gender, feminism and empowerment are experienced by nursing students at a Brazilian public university. This is a qualitative study, exploratory-explanatory, with the application of interviews with nursing students in their five years of training. The chosen method of analysis was the Discourse of the Collective Subject based on the central ideas categorized after the interviews: (a) Profession-female and stigmatized due to its historical construction influenced by religiosity and moral; (b) Formation-far from gender relations by the perpetuation of stereotypes; and (c) Perspectives-empowerment of the profession if close to the feminist movement. The students' discourse alert to the historical reflexes of oppressive ideological mechanisms of women and nursing in their ongoing professional training, claiming transversal learning spaces for the critical expansion of gender awareness and consequent empowerment of nursing in a feminist and intersectional perspective.

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ABSTRACT Objectives: to build, validate and verify the reliability of the Scale of knowledge about sexuality of people with spinal cord injury for nursing students. Methods: a methodological study, following the steps: 1) Construction based on literature review; 2) Validation of the content with calculation of the Content Validity Index and the Modified Kappa Coefficient; 3) Pre-test with Nursing students; and 4) Measurement of reliability by internal consistency (Cronbach's alpha). Results: the first version of the instrument presented 13 items. After validation, the items received values above 0.80 and 0.76 for the Content Validity Index and Modified Kappa Coefficient, and it was suggested to separate three items to contemplate gender-specific aspects. After pre-testing, it was recommended that the writing of two items be revised. The final scale, with 16 items, showed Cronbach's alpha equal to 0.93. Conclusions: the constructed scale presented valid content and proved to be reliable for application with nursing students.

RESUMEN Objetivos: construir, validar y verificar confiabilidad de Escala de conocimiento sobre sexualidad de personas con lesión medular para estudiantes de Enfermería. Métodos: estudio metodológico, siguiendo las etapas: 1) Construcción basada en revisión de la literatura; 2) Validez de contenido con cálculo del Índice de Validez de Contenido y Coeficiente Kappa Modificado; 3) Pretest con estudiantes de Enfermería; y 4) Medida de confiabilidad por consistencia interna (alfa de Cronbach). Resultados: la primera versión del instrumento presentó 13 ítems. Posterior validación, estos recibieron valores arriba de 0,80 y 0,76 para el Índice de Validez de Contenido y Coeficiente Kappa Modificado, y sugerido separar tres ítems para contemplar aspectos específicos del sexo. Posterior pretest, recomendado la revisión de la escrita de dos ítems. La escala final, con 16 ítems, presentó alfa de Cronbach igual a 0,93. Conclusiones: la escala construida presentó contenido válido y se mostró confiable para aplicación con estudiantes de Enfermería.

RESUMO Objetivos: construir, validar e verificar a confiabilidade da Escala de conhecimento sobre sexualidade de pessoas com lesão medular para estudantes de Enfermagem. Métodos: estudo metodológico, seguindo as etapas: 1) Construção baseada em revisão da literatura; 2) Validação do conteúdo com cálculo do Índice de Validade de Conteúdo e do Coeficiente Kappa Modificado; 3) Pré-teste com estudantes de Enfermagem; e 4) Medida da confiabilidade pela consistência interna (alfa de Cronbach). Resultados: a primeira versão do instrumento apresentou 13 itens. Após validação, os itens receberam valores acima de 0,80 e 0,76 para o Índice de Validade de Conteúdo e Coeficiente Kappa Modificado, e sugeriu-se separar três itens para contemplar aspectos específicos do sexo. Após pré-teste, recomendou-se a revisão da escrita de dois itens. A escala final, com 16 itens, apresentou alfa de Cronbach igual a 0,93. Conclusões: a escala construída apresentou conteúdo válido e mostrou-se confiável para aplicação com estudantes de Enfermagem.

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ABSTRACT: BACKGROUND: The sexuality of people with spinal cord injury (SCI) is a subject often neglected by healthcare professionals because of their lack of knowledge or understanding of how to proceed in this context. Different teaching strategies can be used to fill this knowledge gap, such as clinical simulation and peer-assisted learning. This study evaluates the effects of an educational intervention on nursing students' knowledge acquisition about the sexuality of individuals with SCI and on the students' self-confidence and satisfaction with the experience. METHODS: Quasi-experimental, pretest-posttest design was conducted with nursing students (N = 54). The intervention was the application by a senior-level nursing student of 2 scenarios of high-fidelity clinical simulation. The primary outcome was the knowledge about the sexuality of people with SCI. The secondary outcome was the satisfaction and self-confidence in learning. We performed descriptive and inferential statistics and built multiple linear regression models. RESULTS: The effect of the intervention on knowledge acquisition ranged from the mean of 1.26 in the pretest to 3.10 in the posttest. The means in the scores of satisfaction and self-confidence were considered excellent and correlated with knowledge acquisition. Previous attendance of a class on SCI positively interfered in the scale of knowledge acquisition. CONCLUSION: We verified an effect size ranging from medium to large magnitude for knowledge acquisition, and great satisfaction and self-confidence in learning through the use of simulated experience and peer-assisted learning.

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OBJECTIVE: The aim of the study was to develop the conceptual and operational definitions for the defining characteristics of each nursing diagnosis related to self-care deficits of patients with stroke and to validate these definitions with experts. METHODS: This was a methodological study. The definitions were evaluated by 32 specialists and analyzed using binomial testing. RESULTS: All the defining characteristics analyzed were statistically significant (p < .05); three indicators showed agreement at a level lower than the ideal (<0.85). CONCLUSION: The definitions achieved validity for measuring self-care deficit for bathing, toileting, dressing, and eating. IMPLICATIONS FOR NURSING PRACTICE: These defining characteristics of each nursing diagnosis related to self-care deficits may enable more accurate assessment, driving relevant and individualized action plans in rehabilitation.

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OBJECTIVE: To identify and eliminate steps that do not add value for customers in the disinfection center. METHOD: We applied the Lean tool: Value Flow Map, using the concepts of gemba and kaizen in the work process of the disinfection unit for ventilatory care materials, aiming at improving such process. After performing a training with the team on the Lean concepts described above, applying the Value Flow Map in the gemba, analyzing the opportunities for improvement, and approving the changes, the Value Flow Map of the future state was devised and changes were implemented. RESULT: The time of the disinfection process was reduced in 2h37 and the financial resources required also decreased, in R$ 809.08/month. CONCLUSION: The application of Lean concepts presented positive results for the elimination of wastages in the disinfection center.

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INTRODUCTION: Arts-based knowledge translation (ABKT) strategies represent an innovative approach to disseminate results of qualitative studies, especially to tackle social issues, such as stigma and prejudice, due to knowledge gaps. Epilepsy affects 1% of the world population and brings a strong psychosocial impact to the patient, family members, and caregivers. People with epilepsy have difficulties to establish social relationships due to stigma. METHODS: In this study, we narrate the construction of an aerial and contemporary dance based on the results of a qualitative study with patients with epilepsy, their families, and health professionals, called "'Dialogue with Emotions' to overcome barriers and to improve quality of life in epilepsy". Under the ABKT classification, this study is defined as a strategy of subjective key messages, which are presented as active performances (contemporary dance and aerial acrobacies). RESULTS: In this sense, the choreography called "Perspective" presented elements that relate to suffering, pain, fear, social isolation, followed by mutual support, resilience, adaptation, and happiness. Through its scenic poetry and acrobatics combined with special lighting effect and soundtrack, this choreography represents the potential to overcome suffering and experience happiness if people embrace a different perspective over epilepsy. CONCLUSION: This presentation conveyed perceptions on epilepsy in a way to create an experience for its audience. It represented an opportunity to stimulate reflection, discussion, and knowledge construction between members of the academy, as well as patients and caregivers. Thus, this artistic presentation was able to promote discussions about epilepsy, disseminating research results, promoting empathy and compassion.

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ABSTRACT Objective: To identify and eliminate steps that do not add value for customers in the disinfection center. Method: We applied the Lean tool: Value Flow Map, using the concepts of gemba and kaizen in the work process of the disinfection unit for ventilatory care materials, aiming at improving such process. After performing a training with the team on the Lean concepts described above, applying the Value Flow Map in the gemba, analyzing the opportunities for improvement, and approving the changes, the Value Flow Map of the future state was devised and changes were implemented. Result: The time of the disinfection process was reduced in 2h37 and the financial resources required also decreased, in R$ 809.08/month. Conclusion: The application of Lean concepts presented positive results for the elimination of wastages in the disinfection center.

RESUMEN Objetivo: identificar y eliminar los pasos que no agregan valor para los clientes en el centro de desinfección. Método: aplicamos la herramienta Lean: mapa de la cadena de valor, conceptos de gemba y kaizen, en el proceso de trabajo de la unidad de desinfección para materiales de asistencia ventilatoria con el objetivo de mejorar el proceso. Después de realizar una capacitación con el equipo sobre los conceptos Lean descritos anteriormente, aplicamos el Mapa de la cadena de valor en el gemba, analizamos las oportunidades de mejora y aprobamos los cambios; se diseñó el Mapa de la cadena de valor del estado futuro y se implementaron los cambios. Resultado: el tiempo del proceso de desinfección se redujo en dos horas y treinta y siete minutos, y los recursos financieros requeridos también disminuyeron en R$ 809,08/mes. Conclusión: la aplicación de los conceptos Lean presentó resultados positivos para la eliminación de desperdicios en el centro de desinfección.

RESUMO Objetivo: identificar e eliminar as etapas que não agregam valor ao cliente na central de desinfecção. Método: foi aplicada a ferramenta Lean: Mapa de Fluxo de Valor, utilizando os conceitos Gemba e Kaizen no processo de trabalho da unidade de desinfecção de materiais para uso na assistência ventilatória com o intuito de melhorar o processo de trabalho. Foi realizada a capacitação da equipe em relação aos conceitos Lean descritos acima, foi aplicado o Mapa de Fluxo de Valor no Gemba, foram analisadas as oportunidades de melhoria e, após, aprovação das alterações, foi desenhado o Mapa de Fluxo de Valor do estado futuro e implementadas as mudanças. Resultado: obteve-se redução de tempo em 2h37 no processo de desinfecção e redução de recursos financeiros em R$ 809,08 reais/mês. Conclusão: a aplicação de conceitos Lean apresentou resultados positivos na eliminação de desperdícios na central de desinfecção.

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Reflexão sobre a criação e apresentação artística realizada na abertura do 67º Congresso Brasileiro de Enfermagem, em 2015, desenvolvida por equipe multiprofissional envolvendo alunos e profissionais das artes e enfermagem. Por meio de expressão artística e elementos circenses, retratou-se a história da enfermagem, iniciando pelo cuidado durante a guerra e estimulando os sentidos para o público “sonhar” e despertar para novas possibilidades do fazer enfermagem, ou seja, “novos caminhos” para a arte do cuidar, atendendo ao tema central do evento. Para criar esse espetáculo, utilizou-se a metodologia ativa das estratégias da Arts-based Knowledge Transfer por meio de oficinas, rodas de conversa, pesquisa bibliográfica e imagens. O resultado foi a construção de cinco cenas que provocaram reflexões nos expectadores sobre a história e a profissão com possibilidades de envolver a arte no saber fazer da enfermagem. Percebeu-se o potencial do espetáculo para fomentar discussões sobre as relações humanas na Enfermagem, promovendo a empatia, compaixão e a esperança. Estímulo para estudar, refletir e registrar sobre o processo de criação da beleza do ato de cuidar como pressupostos de um trabalho coletivo, do equilíbrio, colaboração e respeito à diversidade de disposições e interesses de cada profissional articulados para ações que se comprometam com a integralidade do cuidado.

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Introdução: Desde 2004, ano de fundação da Federação Brasileira de Epilepsia (Epibrasil), são realizadas reuniões anuais objetivando consolidar o apoio às associações de epilepsia, fortalecer o movimento e estabelecer metas de trabalho para o próximo ano. Neste ano, o Encontro Nacional foi realizado na Sede do Ministério Público de Rondônia, em Porto Velho, RO. Objetivo: Relatar os principais destaques do XIII Encontro e da XI Assembleia, ocorridos de 27 a 28 de março de 2015. Métodos: Registro descritivo dos eventos e análise qualitativa para compor o presente relato. Resultados: Estiveram presentes no evento representantes de 10 associações. As palestras abordaram temas em discussão na mídia, como o uso de canabidiol para o tratamento de epilepsia e a questão trabalhista, tendo sido ressaltada a dificuldade de inserção das pessoas com epilepsia no mercado de trabalho. Em consonância com as discussões do Encontro de 2014, manteve-se a ênfase na questão trabalhista, com o intuito de garantir às pessoas com epilepsia o acesso ao trabalho e a manutenção do emprego. Conclusão: A partir das discussões, delinearam-se as propostas com foco no próximo ano, especialmente no tema "Epilepsia e Trabalho", articulando diferentes setores da sociedade para promover a inclusão da pessoa com epilepsia...

Introduction: Since 2004, when the Brazilian Federation of Epilepsy (Epibrasil) was founded, annual meetings are held in order to consolidate support for epilepsy associations, aiming to strengthen the movement and establish working goals for the forthcoming year. This year, the National Meeting was held at the headquarters of the Public Ministry of Rondônia, in Porto Velho, RO. Objective: To report the main highlights of the XII National Meeting of Epibrasil, held on March 27th and 28th, 2014. Methods: Descriptive record of the events and qualitative analysis. Results and Discussion: In this meeting, there were representatives of 10 associations. Lectures covered topics discussed in the media, such as the use of cannabidiol for epilepsy treatment as well as labor issues with emphasis on difficulties faced by people with epilepsy to find and maintain jobs. Aligned with discussions during the last meeting, there was a special emphasis on labor issues, in order to ensure people with epilepsy access to work and job retention. Conclusion: Based in these discussions, proposals were drafted for the next year focusing especially on the topic "Epilepsy and Work", linking different sectors of society to promote the inclusion of people with epilepsy...

Introducción: Desde 2004, año de la fundación de la Federación Brasileña de Epilepsia (Epibrasil), son realizadas reuniones anuales con el objetivo de consolidar el apoyo a las asociaciones de epilepsia, fortalecer el movimiento y establecer metas de trabajo para el próximo año. Este año, el Encuentro Nacional se realizó en la Sede del Ministerio Público de Rondônia, en la ciudad de Porto Velho. Relatar los principales destaques del XIII Encuentro y de la XI Asamblea, ocurridos los días 27 y 28 de marzo de 2015. Métodos: Registro descriptivo de los eventos y análisis cualitativo para componer el presente relato. Resultados: Han estado presentes representantes de 10 asociaciones. Las conferencias abordaron temas en discusión en los medios, como el uso de cannabidiol para el tratamiento de epilepsia y la cuestión laboral, habiendo sido resaltada la dificultad de inserción de las personas con epilepsia en el mercado de trabajo. En consonancia con las discusiones en el Encuentro de 2014, se mantuvo el énfasis en la cuestión laboral, con el objetivo de asegurar a las personas con epilepsia el acceso al trabajo y el mantenimiento del empleo. Conclusión: A partir de las discusiones, fueron delineadas las propuestas en foco en el próximo año, en especial en el tema "Epilepsia y Trabajo", articulando diferentes sectores de la sociedad para promover la inclusión de la persona con epilepsia...

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Introdução: Com o objetivo de aumentar a conscientização sobre a Epilepsia na sociedade, a ASPE, o Instituto BRAINN (Instituto Brasileiro de Neurociência e Neurotecnologia - CEPID - Unicamp) e o Programa ABCérebro TV (http://www. abcerebro.tv/) promoveram a Semana Nacional e Latino-Americana para a Conscientização sobre a Epilepsia, entre os dias 9 a 13 de setembro. As atividades contaram com a participação de pacientes, alunos e professores da rede básica, profissionais da saúde e público em geral, assim como com a parceria da Prefeitura Municipal de Campinas. Objetivo: Relatar as principais atividades da Semana Nacional e Latino- Americana pela Conscientização sobre a Epilepsia, realizada entre os dias 9 a 13 de setembro de 2014. Métodos: Registro descritivo e fotográfico dos eventos para compor o presente relato. Resultados: A divulgação do evento e o estabelecimento da parceria com a rede pública de ensino básico permitiu a difusão de conhecimentos sobre Epilepsia tanto no meio acadêmico, quanto na sociedade. As atividades, com um caráter diversificado, foram capazes de promover a integração entre esses públicos, abrindo espaço para discussões, trocas e, principalmente, para quebrar o preconceito sobre a Epilepsia. Conclusão: A parceria entre a ASPE, uma organização não-governamental, o Instituto BRAINN, da pesquisa, e o canal de difusão e divulgação científica ABCérebro TV continuará a promover a divulgação sobre a Epilepsia para os mais diversos públicos,através das mídias sociais e dos eventos à comunidade, a partir de propostas de transformação social construídas em conjunto...

Introduction: Aiming to increase awareness about epilepsy in society, the non-governmental organization called Assistência à Saúde do Paciente com Epilepsia (ASPE), the Brazilian Institute for Neuroscience and Neurotechnology (BRAINN - Unicamp) and the ABCérebro TV (http://www.abcerebro.tv/) promoted the National and Latin American week for Epilepsy awareness, from 9 to 13 September. Activities were attended by patients, students and teachers from the Public Education System, health professionals and the general public, with the support of the Campinas City Council and the University of Campinas. Objective: To describe the activities during the Latin American and National Week for Epilepsy Awareness, held from 9 to 13 September, 2014. Methods: Descriptive records and qualitative analysis. Results and Discussion: This event and the establishment of partnerships with the public basic education allowed knowledge dissemination about epilepsy in the academic environment as well as in the society. Activities with different approaches promoted an integration between these groups, opening paths for discussions and exchanges, contributing to decrease prejudice about Epilepsy. Conclusion: The partnership between ASPE, a non-governmental organization, the BRAINN and ABCérebro TV will continue to promote disclosure on Epilepsy for all audiences, through social media and community events, according to social transformationprojects proposed by this group...

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Introdução: O Movimento Nacional de Epilepsia foi marcado, em 2003, com o lançamento do Manifesto de Campinas, por ocasião do I Encontro Nacional de Associações e Grupos de apoio de Epilepsia, organizado e realizado pela ASPE (Assistência à Saúde de Pacientes com Epilepsia), executora oficial do Projeto Demonstrativo em Epilepsia no Brasil da OMS-ILAE-IBE. A partir da fundação da Federação Brasileira de Epilepsia (Epibrasil), em 2004, os representantes das associações afiliadas se reúnem anualmente para traçar metas e propostas. Neste ano, o Encontro Nacional foi realizado no Hotel Bourbon Cataratas, em Foz do IguaçuPR, concomitante ao 35o Congresso da Liga Brasileira de Epilepsia. Objetivo: Relatar os principais destaques do Encontro, ocorrido nos dias 4 e 5 de abril de 2014. Métodos: Registro descritivo dos eventos e análise qualitativa para compor o presente relato. Resultados: Das 15 associações afiliadas, 10 estiveram presentes. As discussões destacaram a importância do contexto cultural, condições trabalhistas e relações sociais que cercam as pessoas com epilepsia, a partir das quais foram elaboradas propostas para orientar as ações da nova diretoria (2014-2016) eleita no encontro. Conclusão: A nova diretoria continuará as ações voltadas para epilepsia com ênfase em políticas públicas, a partir das propostas construídas em conjunto...

Introduction: In 2003, the National Movement for Epilepsy was strengthened by the launch of the Manifesto of Campinas during the First National Meeting of Associations and Support Groups of Epilepsy, organized by ASPE (Assistência à Saúde de Pacientes com Epilepsia), official executor of the Demonstration Project on Epilepsy in Brazil under the auspice of WHO-ILAE- IBE. Since the foundation of the Brazilian Federation of Epilepsy (Epibrasil) in 2004, association representatives meet once a year to establish goals and proposals. This year, the National Meeting was held at the Hotel Bourbon Cataratas, Foz do Iguaçu, PR, concomitant to the 35th Congress of the Brazilian League of Epilepsy. Objective: To report highlights of the XII National Meeting of the EPIBRASIL, held on the April, 4rd and 5th, 2014. Methods: Descriptive records and qualitative analysis. Results and Discussion: Out of the 15 member associations, 10 attended. Discussion sessions highlighted the importance of cultural context, community work conditions and social relations around the person with Epilepsy. These topics guided the construction of proposals to define actions for the new board (2014-2016), elected during this meeting. Conclusion: The newboard will continue actions for Epilepsy with emphasis on public policies from the proposals built together...

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A epilepsia é a doença neurológica crônica mais comum no mundo e afeta todas as idades, raças e classes sociais. Desde 2002, a Organização não Governamental (OnG) Assistência à Saúde de Pacientes com Epilepsia (ASPE) desenvolve ações de conscientização sobre epilepsia no Brasil, sendo ela a executora oficial do Projeto Demonstrativo sobre Epilepsia no Brasil parte integrante da Campanha Global "Epilepsia fora das Sombras" da Organização Mundial de Saúde, da Liga Internacional Contra Epilepsia e da Associação Mundial de Pacientes com Epilepsia (OMS/ILAE/IBE). Buscando ampliar as ações de divulgação para o ano de 2014, a ASPE em parceria com a Fundação Internacional Anita Kaufmann promoveu o Purple Day, celebrado no dia 26 de março, no Brasil. O Purple Day teve início em 2008 com a manifestação de uma menina de 9 anos, Cassidy Megan, de Nova Escócia, Canadá, com o objetivo de aumentar a conscientização sobre a epilepsia. A escolha do roxo remete à lavanda, a cor internacional da epilepsia, dado ao fato que a flor lavanda remete a um sentimento de isolamento, solidão, frequentemente vivenciado pelas pessoas com epilepsia. A presente carta tem por objetivo descrever à Cassidy Megan sobre as atividades realizadas no Purple Day...

Epilepsy is the most common chronic neurological disease worldwide and affects all ages, races and social classes. Since 2002, the nongovernmental organization (NGO) "Assistência à Saúde do Paciente com Epilepsia" (ASPE) undertakes activities to raise awareness about epilepsy in Brazil, as the official executor of Demonstrative Project on Epilepsy in Brazil, part of the World Health Organization Global Campaign "Epilepsy Out of Shadows", the International League Against Epilepsy and the International Bureau for Epilepsy (ILAE IBE WHO). To expand its actions on 2014, ASPE in partnership with the Anita Kaufmann Foundation promoted the Purple Day, celebrated on March 26th, in Brazil. The Purple Day began in 2008 with the initiative of a 9-year-old girl, Cassidy Megan of Nova Scotia, Canada, with the goal of raising awareness about epilepsy. The choice of purple refers to the color of lavender s, to the feeling of isolation linked to this flower, often experienced by people with epilepsy. This letter aims to describe directly to Cassidy Megan about the activities promoted on the Purple Day...

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BACKGROUND: A growing body of evidence supports the hypothesis that vitamin D is an important environmental factor in the etiology of T-cell-mediated autoimmune diseases such as multiple sclerosis (MS). AIM: The purpose of this study was exploring the mechanisms underlying the beneficial effect of vitamin D3 in encephalomyelitis (EAE). METHODS: We treated monophasic experimental autoimmune EAE, induced in Lewis rat, with vitamin D3 and adoptively transfer tolerogenic bone marrow-derived DCs generated in the presence of vitamin D3. RESULTS: This study provides evidence that the in vivo administration of vitamin D3, as well as the adoptive transfer of vitamin D3 -induced IDO(+) immature/tolerogenic dendritic cells, leads to a significant increase in the percentage of CD4(+) CD25(+) Foxp3(+) regulatory T cells in the lymph nodes in a rat model of MS, experimental autoimmune EAE. Concomitant with the increase in this cell population, there is a significant decrease in the number of autoreactive T cells in the central nervous system. Bone marrow-derived DCs cultivated in the presence of vitamin D3 present a tolerogenic profile with high IL-10, TNFα, and IDO expression and decreased MHC-II and CD80 expression. The adoptive transfer of IDO (+) DCs induces a significant increase in the percentage of CD4(+) CD25(+) Foxp3(+) T cells in the lymph nodes, comparable with vitamin D3 treatment. CONCLUSION: These mechanisms contribute actively to the generation of a microenvironment in the lymph nodes that suppresses the activation of encephalitogenic T cells, resulting in the downregulation of the inflammatory response in the central nervous system.

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