Submitted by Gilvan Almeida (gilvan.almeida@icict.fiocruz.br) on 2016-09-26T14:06:05Z No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 129.pdf: 974270 bytes, checksum: 98c49e2bbdfe576c955ed7b0d2d6dc63 (MD5) / Approved for entry into archive by Barata Manoel (msbarata@coc.fiocruz.br) on 2016-10-25T14:37:59Z (GMT) No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 129.pdf: 974270 bytes, checksum: 98c49e2bbdfe576c955ed7b0d2d6dc63 (MD5) / Made available in DSpace on 2016-10-25T14:37:59Z (GMT). No. of bitstreams: 2 license.txt: 1748 bytes, checksum: 8a4605be74aa9ea9d79846c1fba20a33 (MD5) 129.pdf: 974270 bytes, checksum: 98c49e2bbdfe576c955ed7b0d2d6dc63 (MD5) Previous issue date: 2011 / Fundação Oswaldo Cruz. Casa de Oswaldo Cruz. Rio de Janeiro, RJ, Brasil. / A proposta desta tese é mostrar como o contexto social da escravidão influenciou os saberes e práticas médicas nas primeiras décadas do Império brasileiro. A pesquisa dos escritos médicos produzidos entre 1830 e 1850 tornou possível perceber a presença significativa dos escravos no cotidiano daquela profissão ora como pacientes, ora como objeto de estudos. Esta produção textual encarnava o discurso médico do período e era disseminada através de artigos dos periódicos médicos ligados à Academia Imperial de Medicina. A construção deste conhecimento era feita a partir da experiência prática que os estudantes e médicos tinham com os doentes, sobretudo nas enfermarias da Santa Casa de Misericórdia. Assim é possível estabelecer uma ligação entre a escravidão e o aprendizado e treinamento médico a partir do estudo dos textos produzidos no conjunto de instituições responsáveis pela institucionalização da medicina na Corte. Desta forma, é possível defender a hipótese de que em uma sociedade escravista como o Rio de Janeiro, certamente o escravo era objeto de preocupação dos médicos, seja como paciente, seja como objeto de experimentos de novos tratamentos ou para o treinamento dos estudantes de medicina. / This thesis aims to prove how the slave system had influence upon medical knowledge and its practices, at the beginning of the Brazilian Empire. Medical texts, written between 1830 and 1850, make evident that the slaves were present in the professional current activities, or as accessible bodies or as patients. These writings represented medical discourse and were published in periodicals related to the Imperial Academy of Medicine. Practical training at the Santa Casa da Misericórdia’s infirmaries was essential for students and doctors to acquire and to produce knowledge. Therefore, the intensive reading of medical texts make possible to establish connections between slavery and medical learning. Then the hypothesis proposed is that in a society based on slave labor, such as Rio de Janeiro in the 19th century, the salve body is always present in medical practice and theory. Slaves could be doctors’ patients or even their material for experiments and their object for testing new treatments.

Submitted by Luciana Ferreira (lucgeral@gmail.com) on 2018-07-18T11:17:54Z No. of bitstreams: 2 Tese - Luciana Alves de Oliveira - 2018.pdf: 1552159 bytes, checksum: 445d2c7e768d673821fe5ddce56e33eb (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Approved for entry into archive by Luciana Ferreira (lucgeral@gmail.com) on 2018-07-18T11:48:18Z (GMT) No. of bitstreams: 2 Tese - Luciana Alves de Oliveira - 2018.pdf: 1552159 bytes, checksum: 445d2c7e768d673821fe5ddce56e33eb (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) / Made available in DSpace on 2018-07-18T11:48:18Z (GMT). No. of bitstreams: 2 Tese - Luciana Alves de Oliveira - 2018.pdf: 1552159 bytes, checksum: 445d2c7e768d673821fe5ddce56e33eb (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2018-07-06 / The vulnerability on researches involving human being includes the reduction or impairment of individual’s self-determination ability. Several circumstances may determine the vulnerability situation. International regulations and consensus around ethics research are not enough to ensure respect for research participants and to prevent any harms arising from research. Research in hospitals has peculiarities about the health-disease process. This research sough to identify the research patient-participant situations of vulnerability occurring concomitantly with their treatment in a hospital in Goiânia-GO; and to analyze the meanings of vulnerability attributed by the actors involved in the context of research development in a hospital in Goiânia-GO. This was a qualitative approach of an ethnomethodology research based on Foucault's theoretical framework. Semi-structured interviews were conducted with 15 patients and 15 health professionals at a public hospital in Goiânia-GO. Three categories emerged from the interviews: "Changed lives", "Professional training" and "The ideal place". The results evidenced the tendency of the participants to understand the research as something positive that will bring important contributions for treatment, allowing the hope of the cure. The participants recognized the hospital as the ideal place to seek healing. However there were situations of weaknesses, such as the health care system itself and the communication between health professionals and patients. This suggests that the power existing in these relations still reiterates the maintenance of hierarchy and fragilities, affecting the exercise of autonomy by the patient. Thus, the speeches expressed and showed how power is established in that place, as well as the communication itself. Even not all participants perceived the weaknesses present in the research field, which amplifies the dimensions of the vulnerabilities. It is possible to conclude that the senses of vulnerability in this context cover the changes in the lives of those patients-participants, the process of training of the professionals and, also, the experience of the routines in that hospital considered reference for the treatment. / A vulnerabilidade em pesquisas envolvendo humanos compreende a redução ou impedimento da capacidade de autodeterminação do indivíduo. Vários fatores podem influenciar o estado e/ou a condição de vulnerabilidade. Regulamentações e consensosinternacionais sobre ética em pesquisa vigentes não são suficientes para garantir o respeito aos participantes de pesquisa e nem impedir malefícios decorrentes de pesquisas. Pesquisas em hospitais apresentam peculiaridades inerentes ao processo saúde-doença. Objetivos: identificar as situações de vulnerabilidade do paciente/participante de pesquisa presentes na realização de pesquisas concomitantemente ao tratamento em um hospital de Goiânia-GO; e analisar os sentidos de vulnerabilidade atribuídos pelos atores envolvidos no contexto do desenvolvimento de pesquisas em um hospital de Goiânia-GO. Estudo de abordagem qualitativa do tipo etnometodologia adotando o significado como conceito central da investigação. Algumas análises foram fundamentadas no pensamento de Foucault. Foram realizadas entrevistas semiestruturadas com 15 pacientes e 15 profissionais de saúde de um hospital da rede pública de saúde de Goiânia-GO. Três categorias emergiram das entrevistas realizadas: “Vidas alteradas”, “Formação profissional” e “O local ideal”. Os resultados evidenciaram a tendência dos participantes em vislumbrar a pesquisa como algo positivo que trará importantes contribuições no tratamento, permitindo esperança da cura. Os participantes reconheceram o hospital como o local ideal para buscar a cura. Todavia, nele estavam presentes situações de fragilidades, como o próprio sistema de atendimento à saúde e a comunicação entre profissionais de saúde e pacientes. Isto sugere que o poder existente nessas relações ainda reitera a manutenção da hierarquia e fragilidades, afetando o exercício da autonomia pelo paciente. Assim, os discursos expressaram e evidenciaram como o poder se estabelece naquele local, bem como a própria comunicação. Nem todos os participantes percebem as fragilidades que entrelaçam o cenário da pesquisa, o que amplia as dimensões das vulnerabilidades presentes. Concluímos que os sentidos de vulnerabilidade nesse contexto abrangem as modificações nas vidas daqueles pacientes, o processo de formação dos profissionais e, ainda, a vivência das rotinas naquele hospital considerado referência para o tratamento.

No description available.

This dissertation examines the legal position relating to the participation of children in research, especially in HIV preventive clinical research in South Africa. HIV/AIDS presents a real threat to humanity and particularly to the welfare of children. The participation of children in this type of trials is therefore vital. Children, as vulnerable participants, must also be protected from harm resulting from research. The study also considers the nature of HIV preventive clinical research, pointing to the inconsistencies in the legislation governing children’s participation in HIV preventive vaccine trials. The dissertation concludes that the question of the participation of children in HIV preventive clinical research poses many challenges, as the position in the South African law and relevant ethical guidelines are inconsistent and contradictory. The study recommends in the final instance that the relevant statutory provisions and ethical guidelines be harmonised in order to clear up the inconsistencies. / Jurisprudence / LL.M. (Legal Aspects of HIV/AIDS)

Thesis (DPhil)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Human participant research raises a conflict between medical progress as a societal good and the protection of participants as an individual good. Prior to 1960 the discretionary authority for the protection of participants resided in the hands of individual investigators. However, a wave of research atrocities from Tuskegee in 1932 to the Beecher expose in 1966 stimulated a change to a principle based system of regulation. Research Ethics Committees (RECs) and Institutional Review Boards (IRBs) were henceforth charged with the responsibility of human participant protection. Since 1966, this system of research review was established internationally and at one institution in South Africa. In 1997, placebo-controlled HIV vertical transmission trials in a number of developing countries including South Africa raised unprecedented controversy in research ethics internationally and nationally. In 2000, the fraudulent breast cancer trials conducted by Dr Bezwoda at Baragwanath Hospital drew international attention to research ethics in South Africa. However, the events that called into question the efficiency of the system of ethical review most poignantly were the recent deaths of volunteers in research at centres of excellence in the United States. It was charged that if there were deficiencies in the research ethics review system in developed countries, these were more likely to be present in developing countries. Around the same time the Interim National Health Research Ethics Committee (INHREC) was established in South Africa to explore and regulate the ethical review system in South Africa. Cognisant of these issues, the current study was undertaken to establish the various structural, procedural and substantive ethical challenges facing justifiable and ethical review of research in South Africa. A combination of conceptualphilosophical reflection and empirical research was employed in this dissertation. The empirical work employed both quantitative and qualitative research methodology. The quantitative survey explored the composition of RECs reviewing clinical trials research in South Africa with an emphasis on committee composition and structure as well as the review process. The qualitative research was conducted using semi-structured interviews of ten REC Chairpersons in South Africa to explore complex substantive issues like informed consent, standards of care and participant remuneration, inter alia. While the review system in South Africa is functioning at a reasonable level, there is wide variation from one REC to the next. RECs are geographically distant and function in isolation without opportunity to communicate and share ideas. Amongst institutional RECs, there is a stark contrast between historically disadvantaged institutions and historically advantaged institutions. REC membership, ten years into democracy remains white male dominated. Community representation is inadequate. Most RECs are dominated by scientists and clinicians. The review process is widely variable with delays in review ranging from ten days to ten weeks. Procedural and bureaucratic demands impact on the ability of REC members to engage in debate on important substantive ethics issues like standards of care, informed consent and participant remuneration. Research ethics training and educational needs vary widely across the country. Serious attention must be paid to the way in which RECs are constituted in South Africa. Restructuring of RECs with a view to improving representation in terms of race, gender and religion must be prioritized. There is a need for community representation and non-scientific membership to be explored. RECs in South Africa need to revisit the question of whether they should be conducting both scientific and ethics review or ethics review alone. The review process requires a paradigm shift in emphasis from adverse event reporting to monitoring, from informed consent forms to a culturally relevant informed consent process. Aparadigm shift is indicated to shift the focus from informed consent to a more comprehensive review framework. Policies regarding standards of care and participant remuneration must be clarified and articulated. Although the role of RECs in human participant protection has been questioned, it is clear that in the vast majority of cases, they are fulfilling an important role. Their function could certainly be enhanced. This is being facilitated by training programs and an electronic newsletter. However, responsibility for human participant protection does not reside in the domain of the REC alone. A collective responsibility shared by researchers, institutions, research ethics committees, sponsors and participants is integral to human participant protection and the generation of new, valid and relevant scientific knowledge. / AFRIKAANSE OPSOMMING: Navorsing op menslike subjekte gee aanleiding tot ‘n konflik tussen mediese vooruitgang as ‘n voordeel vir die samelewing en die beskerming van deelnemers as iets waarby die individu direkte belang het. Voor 1960 het die diskresionêre gesag vir die beskerming van deelnemers by die individuele navorsers berus. ‘n Golf van navorsingsvergrype, van Tuskegee in 1932 tot die Beecher onthulling in 1966, het egter veranderinge in die rigting van ‘n stelsel van beginsel-gebaseerde regulasie gestimuleer. Navorsingsetiekkomitees (NEKs) en Institusionele Beoordelings- en toesigrade (IBRs) is gevolglik belas met die verantwoordelikheid om toe te sien dat mense wat deelneem, sover moontlik beskerm word. Sedert 1966 is hierdie stelsel van navorsingshersiening en -toesig internasionaal tot stand gebring – ook, aanvanklik, by een instansie in Suid-Afrika. In 1997 het plasebo-beheerde HIV-vertikale oordrag-proewe in ‘n aantal ontwikkelende lande, insluitend Suid-Afrika, tot ongekende kontroversie op die terrein van navorsingsetiek aanleiding gee, internasionaal en nasionaal. In 2000 het die bedrog met borskankerproewe, uitgevoer deur dr Bezwoda by Baragwanath Hospitaal, internasionale aandag op navorsing in Suid-Afrika gevestig. Hierdie gebeure het egter die effektiwiteit van die stelsel van etiese toesig in Suid-Afrika en elders in die wêreld bevraagteken. Die mees kommerwekkende onlangse insident was die dood van navorsingsvrywilligers by sentra van uitmuntendheid in die Verenigde State. Daar is beweer dat as daar tekortkominge in die navorsingsetiektoesigsisteem in ontwikkelende lande is, daar ‘n groter moontlikheid bestaan dat dit ook (en moontlik meer) in ontwikkelende lande voorkom. Ongeveer dieselfde tyd is die Interim Nasionale Gesondheidsnavorsings-etiekkomitee (INGNEK) [Interim National HealthResearch Ethics Committee (INHREC)] in Suid-Afrika gestig om die etiekoorsigstelsel in Suid-Afrika te ondersoek en te reguleer. Met dit in gedagte is die huidige studie onderneem om die verskillende strukturele-, prosedurele- en substantiewe etiese uitdagings wat regverdigbare en etiese oorsig van en toesig oor navorsing in Suid-Afrika in die gesig staar, vas te stel. Daar is van ‘n kombinasie van konseptuele, filosofiese refleksie en empiriese navorsing in hierdie proefskrif gebruik gemaak. Die empiriese werk maak gebruik van sowel kwantitatiewe as kwalitatiewe navorsingsmetodes. Die kwantitatiewe opname bestudeer die samestelling van NEKs wat toesig hou oor kliniese proewe in Suid-Afrika, met die klem op komiteesamestelling, -struktuur en die toesigproses. Die kwalitatiewe navorsing is gedoen met behulp van van semi-gestruktureerde onderhoude van tien NEK-voorsitters in Suid-Afrika om die komplekse substantiewe aspekte, soos onder andere ingeligte toestemming, standaard van versorging en deelnemervergoeding, te ondersoek. Terwyl die etiek-toesigstelsel in Suid-Afriks op ‘n redelike vlak funksioneer, is daar ‘n groot verskil tussen verskillende NEKs. NEKs is geografies verspreid en funksioneer dikwels in isolasie sonder ‘n geleentheid om te kommunikeer en idees te deel. Ten opsigte van die institusionele NEKs bestaan daar ‘n duidelike kontras tussen histories benadeelde instansies en histories bevoordeelde instansies. NEK-lidmaatskap word, tien jaar na demokrasie, steeds gedomineer deur blanke mans. Gemeenskapsverteenwoordiging is onvoldoende. Die meerderheid NEKs word gedomineer deur wetenskaplikes en klinici. Die toesig- en hersieningsprosesse in die verskillende komitees verskil grootliks, met vertragings wat wissel van 10 dae to 10 weke. Prosedurele- en burokratiese vereistes het ‘n impak op die vermoëns van NEK-lede om by debatte oor belangrike substantiewe etiese aangeleenthede betrokke te raak, soos byvoorbeeld die standaard van versorging, ingeligte toestemming en deelnemervergoeding. Opleiding en opvoedkundige behoeftes verskil wyd oor die land.Ernstige aandag moet geskenk word aan die wyse waarop NEKs in Suid-Afrika saamgestel is. Herstrukturering van NEKs met ‘n visie op verbeterde verteenwoordiging in terme van ras, geslag en geloof is ‘n prioriteitsvereiste. Gemeenskapsverteenwoordiging en lidmaatskap van nie-wetenskaplikes moet verder ondersoek word. NEKs in Suid-Afrika moet die vraag of hulle sowel wetenskaplike- as etiektoesig moet uitvoer, of sl slégs etiektoesig, opnuut ondersoek. Die nasiensproses vereis ‘n paradigmaskuif, vanaf ‘n klem op rapportering van gebeurtenisse, na monitering van ingeligte toestemmingsvorms sowel as na ‘n kultureel toepaslike ingeligte toestemmingsproses. ’n Paradigmaskuif is noodsaaklik ten einde die fokus te verskuif vanaf ingeligte toestemming na ‘n meer omvattende toesig- en nasiensraamwerk. Beleid rakende standaard van versorging en deelnemervergoeding moet verduidelik en geartikuleer word. Alhoewel die rol van NEKs in die beskerming van menslike deelnemers aan navorsing bevraagteken word, is dit duidelik dat NEKs in die meerderheid van gevalle wel ‘n belangrike rol vervul. Hul funksie kan natuurlik uitgebrei word. Dit sal gefasiliteer word deur opleidingsprogramme en ‘n elektroniese nuusbrief. Verantwoordelikheid vir die beskerming van mense wat deelneem aan navorsing berus egter nie uitsluitlik by NEKs nie. ‘n Kollektiewe verantwoordelikheid, gedeel deur navorsers, instellings, navorsingsetiekkomitees, borge en deelnemers is ‘n integrale vereiste vir hierdie beskerming sowel as vir die verwerwing van nuwe, geldige en relevante wetenskaplike kennis.

Thesis (doctoral)-Freie Universität, Berlin, 2004. / Includes bibliographical references (p. 350-399) and index.

This dissertation examines the legal position relating to the participation of children in research, especially in HIV preventive clinical research in South Africa. HIV/AIDS presents a real threat to humanity and particularly to the welfare of children. The participation of children in this type of trials is therefore vital. Children, as vulnerable participants, must also be protected from harm resulting from research. The study also considers the nature of HIV preventive clinical research, pointing to the inconsistencies in the legislation governing children’s participation in HIV preventive vaccine trials. The dissertation concludes that the question of the participation of children in HIV preventive clinical research poses many challenges, as the position in the South African law and relevant ethical guidelines are inconsistent and contradictory. The study recommends in the final instance that the relevant statutory provisions and ethical guidelines be harmonised in order to clear up the inconsistencies. / Jurisprudence / LL.M. (Legal Aspects of HIV/AIDS)

A thesis submitted to the faculty of Engineering, University of the Witwatersrand, Johannesburg , in fulfillment of the requirements for the degree of Doctor of Philosophy. Johannesburg, November 1994 / Organ function is often characterised using imaging techniques. In particular a tracer is often used which does not react with tissue, is low in concentration, follows body fluid flows and is distinguishable from the observed system and thus measurable. These requirements ensure linear characteristics of the tracer. In this thesis, these linear characteristics are used to develop a generalised mathematical theory to determine organ function from imaged tracer experiments. The theory is based on anatomical and physiological information for single and multiple input organs. [Abbreviated Abstract. Open document to view full version] / MT2018

<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>

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.