Made available in DSpace on 2016-04-27T16:33:24Z (GMT). No. of bitstreams: 1 Maria Angelica Pedra Minhoto.pdf: 1912582 bytes, checksum: e8bde3d0245c340522e4a2340ee1dba8 (MD5) Previous issue date: 2007-07-24 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The object of this research is the admission examination for secondary education. In Brazil, it was established in 1931 and was used during 40 years to elect pupils to gymnasium. The analysis ranges between 1931 and 1945. The work aims at identifying: the social origin of pupils selected to secondary education, in Sao Paulo city; the variations on their performances at school; if such variations keep relation with social origin factors; if the exam results permit anticipate the students performance; the characteristics of the previous trajectory of the students that were successful in the exam; if the subjects covered by the exam produce any effect on primary education curriculum; the relation between the exam legal changes and the gymnasium social composition. The theoretical bases are: 1) David Hamilton s distinction between schooling and others institutionalized forms of education, and the different forms of schooling; 2) Norbert Elias effort to link the individual patterns of behavior and the structural changes of the society; and 3) Fritz Ringer s conceptual framework developed to study the European systems of secondary education, during the last three centuries. The empirical research collected data from the files of five educational institutions. The main results are: the social composition of secondary education in Sao Paulo was not restricted to the so called elite; the exam was inefficient to produce prognostics; the exam was not efficient to restrain the demand for secondary education; the social function of the exam was to legitimize a pattern of selection and to disguise the existence barriers in elementary education institutions; the selected social mobility of part of the students appeared as a sort of demonstration-effect , stimulating the demand for secondary education in Brazil; the legal regulation of the exam did not produce significant changes in the gymnasium social composition; the different strategies adopted by the private sector to circumvent the legal framework showed the limits of the Brazilian State both as a repressive agency and as a development inducer in the field of education / O objeto de estudo desta pesquisa é o exame de admissão ao ginásio, instituído em nível nacional em 1931 e utilizado por 40 anos consecutivos para a seleção de alunos ao ensino secundário. A análise do objeto circunscreve-se aos anos 1931 e 1945. A pesquisa visava a identificar: a origem social dos alunos selecionados pelo exame, na cidade de São Paulo; as variações em seu percurso ginasial; se tais variações guardam relação com fatores de origem social; se os resultados obtidos no exame indicam de maneira eficiente o desempenho escolar futuro; as características que marcam a progressão dos estudos entre os níveis elementar e secundário; se os conteúdos e a forma do exame exercem algum efeito na conformação do currículo e da clientela do ensino primário paulistano; e se existe alguma relação entre as mudanças nas prescrições legais do exame e a composição social do ginásio. Os referentes teóricos que orientam as análises são os estudos desenvolvidos por: 1) David Hamilton, que distingue, na longa duração, a escolarização de outras formas institucionalizadas de educação e as diferentes formas assumidas pela escolarização; 2) Norbert Elias, que evidencia, também na longa duração, as correlações entre alterações da estrutura de comportamento individual e as mudanças estruturais da sociedade; e 3) Fritz Ringer, cuja base conceitual foi concebida para analisar os sistemas europeus de educação secundária entre os séculos XVIII e XX. O levantamento das informações foi realizado no período de 2004 a 2006 em arquivos de cinco instituições de ensino, localizadas em São Paulo, que permanecem em funcionamento até hoje, e se limita a uma amostra de três coortes. Os resultados indicam que: a composição social do ensino secundário paulistano não esteve restrita à chamada elite; o exame foi ineficiente para produzir prognósticos; o exame não funcionou eficazmente para conter a demanda por educação secundária, infirmando parte da literatura especializada, que via nessa meta a função manifesta do exame; a função latente do exame, no entanto, foi a de legitimar um padrão específico de recrutamento e camuflar a existência de barreiras institucionais no ensino elementar; a mobilidade ascendente, ainda que seletiva, de indivíduos ou de segmentos da população propiciada pelo acesso ao secundário serviu como efeito-demonstração para o crescimento da demanda por escolarização secundária; a regulamentação jurídica do exame não produziu alterações significativas na composição social do ginásio e as estratégias desenvolvidas pelas instituições privadas para contornar sistematicamente esses regulamentos permite entrever limites ao papel repressivo e interventor do Estado da época

Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2017-09-29T12:32:34Z No. of bitstreams: 1 Nathalia Martins Melati.pdf: 3955036 bytes, checksum: 40e64456ecd4c032541c15796ba9b1f9 (MD5) / Made available in DSpace on 2017-09-29T12:32:34Z (GMT). No. of bitstreams: 1 Nathalia Martins Melati.pdf: 3955036 bytes, checksum: 40e64456ecd4c032541c15796ba9b1f9 (MD5) Previous issue date: 2017-09-21 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / This dissertation comprises a study linked to the Reading, Writing and Teaching of Portuguese Language research line and conducts an analysis of the writing proposal of the National High School Examination (Enem), as well as its design and fundamentals, so that it understands which way the teaching of basic components of Rhetoric in the classroom can collaborate with the work of the Portuguese Language teacher in the development of the competences evaluated by the writing test of Enem. For this, this dissertation was based on bibliographical research about Brazilian education, the notion of competence and rhetorical acts. The analysis was carried out from the rhetorical reading of Enem's writing tests from 2009 to 2016 with the purpose of drawing the profile of the speaker, the auditorium and the rhetorical genre required by the evaluation. From this conceptualization, a rhetorical exercise of text production was proposed, with an emphasis on rhetorical invention and disposition, based on the essay writing of Enem 2016. Finally, this research concludes that the teaching of basic rhetorical components can productively collaborate in for the development of the skills required by the Enem writing test. Thus, competence I is contemplated during elocution, since a discourse that respects grammatical rules has more argumentative force. Competency II is developed in so far as Rhetoric encourages the student to seek arguments in all the common places available to the speaker. Competence III is directly related to the rhetorical invention and, therefore, the rhetorical exercise in the classroom makes possible its adequate development. Likewise, competence IV is developed from the disposition exercise, since the creation of the draft of the text is fundamental to the understanding of the importance of the relation between the arguments. Finally, competence V is not fully developed through Rhetoric, but benefited, since the exercise of the production of deliberative discourse presupposes a reflection about the society in which the speaker is inserted / Esta dissertação compreende um estudo vinculado à linha de pesquisa Leitura, Escrita e Ensino de Língua Portuguesa e realiza uma análise da proposta de redação do Exame Nacional do Ensino Médio (Enem), bem como da sua concepção e dos seus fundamentos, para que compreenda de que maneira o ensino dos componentes básicos da Retórica, em sala de aula, pode colaborar com o trabalho do professor de Língua Portuguesa no desenvolvimento das competências avaliadas pela prova de redação do Enem. Para tanto, esta dissertação foi embasada em pesquisa bibliográfica acerca da educação brasileira, da noção de competência e dos atos retóricos. A análise foi realizada a partir da leitura retórica das provas de redação do Enem de 2009 até 2016 com o objetivo de traçar o perfil do orador, do auditório e do gênero retórico exigidos pela avaliação. A partir dessa conceituação, foi proposto um exercício retórico de produção de texto, com ênfase na invenção e disposição retóricas, a partir da prova de redação do Enem 2016. Por fim, esta pesquisa conclui que o ensino de componentes básicos da Retórica pode colaborar de forma produtiva para o desenvolvimento das competências exigidas pela prova de redação do Enem. Dessa forma, a competência I é contemplada durante a elocução, uma vez que um discurso que respeite às regras gramaticais possui mais força argumentativa. A competência II é desenvolvida na medida em que a Retórica incentiva que o aluno busque argumentos em todos os lugares-comuns disponíveis ao orador. A competência III está diretamente relacionada à invenção retórica e, portanto, o exercício retórico em sala de aula possibilita o seu desenvolvimento adequado. Da mesma forma, a competência IV é desenvolvida a partir do exercício de disposição, uma vez que a criação do esboço do texto é fundamental para a compreensão da importância da relação entre os argumentos. Por fim, a competência V não é plenamente desenvolvida por meio da Retórica, porém beneficiada, já que o exercício de produção do discurso deliberativo pressupõe uma reflexão acerca da sociedade em que o orador está inserido

Submitted by Joana Azevedo (joanad@id.uff.br) on 2017-08-24T17:09:46Z No. of bitstreams: 1 DISSERT José Antonio dos Santos Martins.pdf: 2220571 bytes, checksum: d2a8c0ae3c3c50da3e560e214a0093ab (MD5) / Approved for entry into archive by Biblioteca da Escola de Engenharia (bee@ndc.uff.br) on 2017-08-29T15:56:42Z (GMT) No. of bitstreams: 1 DISSERT José Antonio dos Santos Martins.pdf: 2220571 bytes, checksum: d2a8c0ae3c3c50da3e560e214a0093ab (MD5) / Made available in DSpace on 2017-08-29T15:56:42Z (GMT). No. of bitstreams: 1 DISSERT José Antonio dos Santos Martins.pdf: 2220571 bytes, checksum: d2a8c0ae3c3c50da3e560e214a0093ab (MD5) Previous issue date: 2016-09-08 / Nos dias atuais, a presença do cirurgião-dentista especialista em Odontologia do Trabalho se faz necessária e de fundamental importância no ambiente laboral das diversas classes de trabalhadores, com o intuito de atuar favoravelmente sobre a saúde destes, através da identificação de potenciais riscos a ela e, também, pela necessidade de se educar o trabalhador para que ele mesmo seja o melhor promotor da saúde na empresa. Neste sentido a Odontologia do Trabalho visa à busca permanente da compatibilidade entre a atividade laboral e a preservação da saúde bucal do trabalhador e, sob a ótica da gestão, a Odontologia do Trabalho difere das atividades comumente praticadas no consultório, exatamente por não mais caracterizar uma relação simples entre Dentista-cliente. Dentro deste contexto o objetivo desta pesquisa é analisar a contribuição dos exames periódicos odontológicos na manutenção da saúde bucal dos servidores do Instituto de Engenharia Nuclear (IEN), através da avaliação do prontuário de saúde bucal do Conselho Federal de Odontologia (CFO). Como metodologia, foi realizada uma revisão da literatura que fundamentou a pesquisa de campo que visa mapear a percepção de 30 (trinta) especialistas em odontologia do trabalho sobre o protocolo utilizado durante os exames periódicos odontológicos do IEN, através da aplicação de um questionário. Nos resultados da pesquisa, observa-se que todos os respondentes possuem mais de 10 (dez) anos de experiência profissional, e os itens que julgaram mais importantes nas investigações clínicas foram as doenças cardiovasculares, hematológicas, transmissíveis e as hepáticas. Além disso, foi atribuída também uma importância alta na realização dos exames clínico e radiológico. Sendo assim, conclui-se com as respostas obtidas, que a aplicabilidade e eficiência dos exames periódicos odontológicos são de grande valor para a saúde dos servidores do IEN. Desse modo, tem-se a expectativa de que este trabalho auxilie na conscientização sobre saúde bucal com os trabalhadores, buscando-se relacionar os riscos ocupacionais com as doenças manifestadas na cavidade bucal e contribuindo essencialmente para a manutenção da saúde bucal dos servidores do IEN. / Nowadays, the work of Surgeon Dentist specialized on Occupational Odontology, it is more essential than ever, being extremely necessary in the labor of many work classes, acting in favor over the health of the employees, by the identification of potential risks associated to their labors and also by the need to educate the employee in order to make himself the best promoter of health in their companies. With this main goal, the occupational odontology aims the constant searching of the compatibility between the labor activity and the preservation of the worker´s oral health and under the management point of view, what makes the activities from this professional different from the usual activities practiced in a dentist office, not being an ordinary relation between client and dentist. Inside this context, the goal of this research it is analyze the contribution of dental periodical examinations in the oral health maintenance of the workers from Nuclear Engineering Institute (IEN), through an evaluation of the oral dental health record from Federal Council of Dentistry (CFO). As methodology, a literature review was made to substantiate the field research that aims to map the perception of 30 (thirty) dentistry experts on the protocol used for the periodic dental checks from IEN, applying a survey. The results of the research, it is observed that all respondents have more than 10 (ten) years of professional experience and the items that they judged more relevant in clinical investigations were: cardiovascular, hematologic, assignable and liver diseases. In addition, it was also given a high importance of performing the clinical and radiological examinations. Thus, its concluded with the answers that the applicability and efficiency of dental periodic examinations have a great value for the health of IEN employees. In this way, it is hoped this research helps the awareness of the employers regarding oral health, seeking to relate occupational hazards with the diseases that emerged from the oral cavity and essentially contributing for the maintenance of oral health from IEN´s workers.

No description available.

Le principe d’individualisation de la sanction pénale constitue, aujourd’hui, la pierre angulaire du droit pénal et de la procédure pénale française. Toutefois, un courant de pensée contemporain issu du mouvement américain Law and Economics a émergé progressivement en France. Celui-ci serait le seul à pouvoir apporter une réponse pertinente aux questions juridiques contemporaines, en se fondant sur le pragmatisme et l’efficacité. Cette logique a d’abord investi la procédure pénale, mais le droit de la peine n’y échappe pas. L’efficacité d’une mesure renvoie à un objectif atteint, c’est-à-dire l’absence de réitération d’infractions. Alors, comment l’individualisation de la peine peut-elle permettre d’accroître l’efficacité de la sanction pénale ? En effet, celle-ci doit permettre de rendre la peine équitable pour lui donner du sens. Ainsi, les différents législateurs n’ont eu de cesse de diversifier les mesures pouvant être prononcées par le juge, afin d’accompagner les délinquants et de les ramener à la vie collective. La doctrine considère qu’une peine est plus efficace lorsque le délinquant participe à la mesure ; il est donc possible d’en développer de nouvelles, qui permettront de responsabiliser le délinquant, en s’inspirant des mesures de justice restaurative, et en modifiant le prononcé de la peine. La césure du procès pénal permettrait ainsi de se diriger vers une peine juste, équitable et à la fois individualisée. / The principle of individualization of the punishment establishes, today, the cornerstone of the criminal law and the French criminal procedure. However, a contemporary current of thought from the American movement Law and Economics emerged gradually in France. This current would be the only one able to bring a relevant answer to the contemporary legal issues, basing itself on pragmatism and efficiency. This logic first invested the criminal procedure but the right of the punishment doesn’t escape it. The efficiency of a measure sends back to a reached objective, that is the absence of repetitive offenses. Then, how the sentencing according to the characteristics of the offender can allow to increase the efficiency of the punishment? Indeed, it shall allow the punishment to be fair and to give it meaning. For that purpose, the various legislators never stopped diversifying the measures which can be rendered by the judge to accompany offenders and bring them back in community life. This doctrine considers that a punishment is more effective when the offender takes part in the measure. It is therefore possible to develop new measures allowing to give offenders responsibilities, taking inspiration in measures of restorative justice, and to modify the render of the punishment. The césure of the penal trial would allow to head for a just punishment, fair and personalized.

中醫按摩源起於遠古時代，早於殷商甲骨文卽有按摩輔助人員之記載，春秋戰國名醫扁鵲併用弟子按摩搶救瀕死患者，戰國秦漢時期《黃帝內經》並以「按龜之法」作為按摩從業人員考覈取材標準，唐朝太醫署按摩科設立官方按摩博士及助理制度；說明中醫按摩法制早已完備。雖自明朝起「按摩」始有「推拿」之稱，清朝並分為十二流派，但按摩推拿法制仍能綿衍不絕。 　　然正當亞洲各國紛紛建立中醫推拿業務法制並重視第三醫學之際，我國行政主管機關卻仍在原地踏步、裹足不前。造成「真正從事中醫推拿助理業務者，無正規學歷與證照考覈管理制度；真正合法醫事人員，卻不從事中醫推拿助理業務且無相關法律配套」之窘境。 綜觀我國憲法、大法官解釋及相關法律規範，並未明文限制人民從事中醫推拿助理之業務。故在就業平等原則下，人民當具有自由選擇為職業之工作權、具有平等接受就業服務及不受歧視之就業與執業機會平等。且各種療法(包括民俗療法)皆存在著風險，甚至已關乎人命問題；是以不論各種療法之風險高低，均應有在職訓練及證照考覈制度管制、相關從業人員身份立法，不應有差別待遇或階級區分。依釋字第666號葉百修大法官協同意見書解釋之精神觀之，行政主管機關應有效提出配套措施、在職訓練及證照考覈制度，實不得以中醫推拿助理所執行之業務非正統醫療、有害社會或不具社會價值為理由，禁止其特定業務活動，使人民得從事該活動之自由『排除於職業自由的保障範圍之外』，藉此淘空憲法所保障中醫推拿助理之工作權。 據此，本論文蒐集歸納歷代與當代中醫按摩推拿歷史及法制文獻；比較當前亞洲國家推拿業務法制與英德日中職業證照制度；分析憲法及現行法秩序下，中醫推拿助理職業自由之保障與限制；並從歷年法院相關實務見解、衛生署行政函釋爭議、立法院質詢改革要點，彙整並比較當前司法、行政及立法機關之見解與措施，並對利弊得失作出評析。最後，提出個人自擬「中醫推拿技術士考覈與管理辦法草案」、「中醫推拿師法草案」及短中長期具體建議，作為未來中醫推拿法制與助理考覈管理改革之重要參考方針。 關鍵字：中醫推拿助理、工作權、職業自由、證照考覈制度 / The Chinese massage originated in ancient times. At the Shang dynasty, the oracle- bone scriptures had already recorded a number of massage assistance personnel . At the Eastern Zhou dynasty, a famous country Chinese herb doctor "pian-chiueh" who rescued the dying with massage therapy by disciples . At the Warring States Period and Qin-Han dynasties , " Laws of pressing the turtle " as the massage employee's standard examination had already described by "Huangdi Neijing(Yellow Emperor's Canon of Medicine)". At the Tang dynasty , imperial government established the official massage doctor and assistant systems . So that Chinese massage system had long been a complete system since then . Althrough "massage" started "tueinar" of call since Ming dynasty, and which divided into twelve divisions at Qing dynasty; the systems of Chinese massage could be still transmitted for ever and ever. However, many Asian countries have established legitimate Chinese massage systems and paid much attention to the third medical science in succession ; but administrative organizations in our country still have hesitated whether to move forward or not.Therefore, those embarrassing situations caused a great deal of trouble to us that" those who engaged in Chinese massage assistants with no formal qualifications and licence examination systems; and those who engaged in legitimate medical personnel with no legal standards of Chinese massage". Taking a comprehensive view of our country Constitution , J .Y . interpretations and related laws,which don't explicitly limit any people engaged in traditional Chinese massage assistants. Therefore , under the principle of equality in employment , people have freely choice of jobs for the right to work as a career;whom have equal acceptance of employment service and free from discrimination of jobs. Various therapies(including folk remedies) all exist risks which even have been already close to human life problems. Based on a variety of treatments regardless of the level of risk,one should have job training, evaluation licence examination systems,the relevant legislation as employees;but should not be discrimination or class distinction. According to the coordination view of J .Y. interpretation NO. 666 by the Honorable Justice Pai- Hsiu Yeh , administrative organizations should put effective integration of on-the-job training and licence examination for Chinese massage assistants ; then those shouldn't forbid their particular business activity in which guaranteed by the Constitution by reason of non-medical, harmful or valueless to the society. Accordingly, this thesis summarized collection of ancient and contemporary history of Chinese massage and legal documents; compared the massage systems in a few Asian countries and occupational licence systems in England , Germany , Japan and China ; analyzed under the Constitution and existing legislation in order to comprehend guarantee and restriction of occupational freedoms for Chinese massage assistants . In addition , it made assessment of the advantages and disadvantages about the related views of judicial , executive and legislature's organs till now. Finally, it proposed the personal draft plans " ordinance draft for Chinese massage technician 's assessment and management " , " law draft for the Chinese massagist " and the short , medium , long term recommendations as important reform references for policy in the future. Key words : Chinese massage assistant , Right to work, Freedom of occupation , Licence examination system

近年來為配合重大建設之開發如設置科學園區、國立大學分部設校計畫等土地開發，政府機關多按區域計畫法第15條之2規定以申請開發許可方式辦理農地之變更使用。於是大批農地變更為建築用地、工業用地或特定目的事業用地使用之情形屢見不鮮。如此大型之開發案雖經整體規劃，但規劃過程中僅考量開發案基地內本身之條件，卻忽視對週遭之環境或相關計畫之協調與整合，以致於不僅造成農地大量流失外，亦對整體環境品質之維護造成嚴重影響。 目前非都市土地開發管理在實務操作的面向上，似呈現開發許可制度並未考慮區域計畫精神、制度設計未考慮層級、各層級計畫之間的指導或承接關係普遍存在欠缺適當的聯繫機制、個案變更審議過程中未與國土規劃相連結且易受到政治影響、涉及變更農地使用時僅針對個案審議未考量是否影響周邊環境、農業主管機關對於優良農地保護及審查機制不足、開發方式太縱容個案開發許可、僅有量之需求但無質之要求、民眾事先參與之管道欠缺等之缺點，均有待探討謀求解決之道。 本文以土地使用計畫審議之合理性為主軸，應用永續發展中環境、經濟和公平（environment, economy, and equity）三個E之概念與區域計畫法第15條之2於國土利用係屬適當而合理之原則，探討開發許可中，農牧用地變更審議之規範與執行情形及民眾參與之方式，並藉由對專家學者、當地居民、公部門與相關組織之深入訪談及個案綜合分析結果，加以檢視與研討，確認目前非都市土地農牧用地變更審議執行上遭遇之課題，最後針對各課題研提改善策略與配套措施，以供政府未來執行非都市土地農牧用地變更審議政策之參考，期能達到農地環境資源合理利用之目標。 / In recent years, for co-operating the development of significant construction, like establishment of science parks, the national university branch and so on, the Government applies for the development permission to change the farmland use according to article 15-2 in Regional Plan Act. Large quantities of farmland are often changed to construction land, industry land or special-purpose land. So large-scale land development cases are planned comprehensively, and conditions of developed land base are considered in the planning process. Actually, the coordination and conformity to the environment or related plan are neglected. This not only causes the massive lost farmland, but also influences maintenance of the overall environment quality seriously. At present, in the non-urban land development management in the practice operation, the spirit of regional plan is not considered in the development permission institution. The Government do not considered the levels in the institution design. It is short of the suitable link mechanism in the instruction or continuation between plans in various levels. In the examination process of land-change cases, the cases are not linked to the national land planning, and easily influenced by the political power. When involving the farmland conversion, only the case itself is examined, but the effects on the peripheral environment are not considered. The agricultural agency lacks the superior farmland protection and examination mechanism. In the development way, the Government too tolerates the case development permission, and only has demand of the quantity without request for the quality. Besides, public participation prior to examination process is lacked. Above shortcomings should be discussed and solved. This article takes the rationality of land use plan examination as the main axle. It applies the concepts of three Es including environment, economy, and equity in the sustainable development, and adopts the principle of suitable and reasonable national land use in article 15-2 in Regional Plan Act. It discusses the standards and the situations of examination in agricultural land conversion, and the way of public participation in development permission. According to the in-depth Interviews of experts, local residents, the government agency and related organization and the results of cases study, it inspects and confirms present layout problems of examination in agricultural land conversion of non-urban land. Finally, it proposes the improvement strategies and the coordinated measures for various problems to offer references to the governmental policy in the future for achieving the goal of the reasonable use of farmland environment resources.

<p><p><strong>Bakgrund: </strong>Smärtor i ben är vanligt förekommande och neuropati (nervskada) är en orsak som troligen är underdiagnostiserad. Bimanuell (tvåhändig/tvåsidig) nervpalpation och känseltest med sporre har visat sig vara ganska tillförlitliga och enkla test för att hitta nervskada men har inte testats på friska individer.</p><p><strong>Syfte: </strong>Syftet var att undersöka om bimanuell nervpalpation i fossa poplitea framkallar smärta/obehag och om det finns skillnad mellan vänster och höger sida vid bimanuell undersökning med sporre på underben hos friska försökspersoner.</p><p><strong>Metod: </strong>Ett bimanuellt palpationstest av nervi tibialis och peroneus i fossa poplitea och även ett bimanuellt känseltest med sporre över dermatomen L4, L5 och S1 på underben genomfördes. Urvalet var ändamålsenligt och totalt deltog 37 försökspersoner. Åldersspannet var 20 till 57 och medianålder 23.</p><p><strong>Resultat: </strong>Vid palpationstestet hade intensiteten av smärta/obehag en median på 1 (variationsvidd 3) på den 11 gradiga skalan. En stor del skattade olika mellan sidorna i både palpationstestet (11 av 37) och känseltestet med sporre (25 av 37). Det var inte någon större skillnad mellan könen.</p><p><strong>Slutsats: </strong>När man utför dessa nervtester måste man ta hänsyn till att även friska individer ofta anger en liten sidoskillnad och inte alltid skattar noll vad gäller smärta/obehag. Det behövs dock fler studier för att bekräfta dessa resultat.</p></p> / <p><strong>Background: </strong>Leg pain is common and neuropathy (nerve disease) is one reason which probably is under diagnosed. Bimanual (bilateral) nerve palpation and sensory test with spurs has been shown to be quite reliable. Furthermore, the tests are straight forward detecting nerve disease but have not been tested on a healthy population.</p><p><strong>Purpose: </strong>The purpose was to investigate whether peripheral nerve palpation in fossa poplitea induces pain/discomfort, and if side difference exists in a sensibility test with spurs on the lower leg in healthy subjects.</p><p><strong>Method: </strong>A bimanual palpation test of the tibial and peroneal nerve in fossa poplitea and also a bimanual sensibility test with spurs of dermatome L4, L5 and S1 on the lower leg were carried out. In order to find healthy subjects a purposive sampling was made. A total of 37 subjects between 20 and 57 years with a median age of 23 participated in the study.</p><p><strong>Results: </strong>At the palpation test the intensity of pain/discomfort had a median of 1 (range 3) in the 11 degrees of pain scale. A large part estimated differences between the sides in both the palpation test (11 of 37) and the sensibility test with spur (25 of 37). There was no significant difference between the sexes.</p><p><strong>Conclusion: </strong>When performing these nerve tests it is important to keep in mind that even healthy individuals might perceive some pain/discomfort as well as side difference. However, we need more studies to confirm these results.</p>

Background: Vitamin D deficiency is a concern in the US. Association between vitamin D status and metabolic syndrome (MetS), insulin resistance (IR), and inflammation is unclear in children. Objective: The relationship between serum vitamin D and MetS, C-reactive protein (CRP), and Homeostatic Model Assessment-IR (HOMA-IR) was investigated. Design: Data from 3 cycles of National Health and Nutrition Examination Survey, 2001-2006 for 3700 (1820, boys; 1880, girls) children and adolescents, aged 12-17 y were used to assess prevalence of vitamin D deficiency (<20 ng>/mL) and association between serum vitamin D and prevalence of MetS, various components of MetS, CRP, and HOMA-IR using multivariate regression models. Results: Overall, prevalences of MetS and vitamin D deficiency were 6.1% and 30.5%, respectively. Prevalence of vitamin D deficiency was higher in girls (52%), blacks (74%), non-supplement users (50%), persons who were examined in winter (56%), and persons in the low poverty income ratio group (57%) compared to their counterparts. Serum vitamin D was inversely associated with waist circumference (P<0.001), systolic blood pressure (P=0.009), and HOMA-IR (P=0.003) and positively associated with HDL-cholesterol (P<0.001). Children with lowest serum vitamin D are at increased risk for MetS (P=0.04; OR 2.26; 95% CI: 1.11, 4.61). Serum vitamin D was not related to CRP (P<0.10). Conclusions: Children with poor vitamin D status are at increased risk for MetS and IR. Because of negative health outcomes associated with MetS and poor vitamin D status when existed individually or in combination, early detection and intervention of these conditions are paramount, especially in children.

Bakgrund: Smärtor i ben är vanligt förekommande och neuropati (nervskada) är en orsak som troligen är underdiagnostiserad. Bimanuell (tvåhändig/tvåsidig) nervpalpation och känseltest med sporre har visat sig vara ganska tillförlitliga och enkla test för att hitta nervskada men har inte testats på friska individer. Syfte: Syftet var att undersöka om bimanuell nervpalpation i fossa poplitea framkallar smärta/obehag och om det finns skillnad mellan vänster och höger sida vid bimanuell undersökning med sporre på underben hos friska försökspersoner. Metod: Ett bimanuellt palpationstest av nervi tibialis och peroneus i fossa poplitea och även ett bimanuellt känseltest med sporre över dermatomen L4, L5 och S1 på underben genomfördes. Urvalet var ändamålsenligt och totalt deltog 37 försökspersoner. Åldersspannet var 20 till 57 och medianålder 23. Resultat: Vid palpationstestet hade intensiteten av smärta/obehag en median på 1 (variationsvidd 3) på den 11 gradiga skalan. En stor del skattade olika mellan sidorna i både palpationstestet (11 av 37) och känseltestet med sporre (25 av 37). Det var inte någon större skillnad mellan könen. Slutsats: När man utför dessa nervtester måste man ta hänsyn till att även friska individer ofta anger en liten sidoskillnad och inte alltid skattar noll vad gäller smärta/obehag. Det behövs dock fler studier för att bekräfta dessa resultat. / Background: Leg pain is common and neuropathy (nerve disease) is one reason which probably is under diagnosed. Bimanual (bilateral) nerve palpation and sensory test with spurs has been shown to be quite reliable. Furthermore, the tests are straight forward detecting nerve disease but have not been tested on a healthy population. Purpose: The purpose was to investigate whether peripheral nerve palpation in fossa poplitea induces pain/discomfort, and if side difference exists in a sensibility test with spurs on the lower leg in healthy subjects. Method: A bimanual palpation test of the tibial and peroneal nerve in fossa poplitea and also a bimanual sensibility test with spurs of dermatome L4, L5 and S1 on the lower leg were carried out. In order to find healthy subjects a purposive sampling was made. A total of 37 subjects between 20 and 57 years with a median age of 23 participated in the study. Results: At the palpation test the intensity of pain/discomfort had a median of 1 (range 3) in the 11 degrees of pain scale. A large part estimated differences between the sides in both the palpation test (11 of 37) and the sensibility test with spur (25 of 37). There was no significant difference between the sexes. Conclusion: When performing these nerve tests it is important to keep in mind that even healthy individuals might perceive some pain/discomfort as well as side difference. However, we need more studies to confirm these results.