Kirjallisuuskatsaus fysioterapiamenetelmien vaikuttavuudesta lannerangan välilevytyrän konservatiivisessa hoidossa

Opinnäytetyön tarkoituksena oli tehdä kirjallisuuskatsaus, joka selvittää uusimman ja luotettavan tutkimustiedon perusteella fysioterapiamenetelmien vaikuttavuutta lannerangan välilevytyrän hoi-dossa. Opinnäytetyössämme keskityimme käsittelemään aihetta fysioterapian näkökulmasta mutta myös muita tieteenaloja sivuttiin. Opinnäytetyömme tavoite on pyrkiä selvittämään mahdollisimman ajankohtaisen ja luotettavan tutkimustiedon pohjalta, mitä tuloksellisia fysioterapiamenetelmiä lannerangan välilevytyrän konservatiivisessa hoidossa on käytettävissä. Toimeksiantajanamme toimii Kuopion OMT- Keskus OY, jonka työntekijöille tämä työ on suunnattu. Tavoitteena oli tukea heidän työtään luotettavan ja ajan tasalla olevan kirjallisuuskatsauksen muodossa. Käytimme tutkimusmenetelmänä kirjallisuuskatsausta, joka eteni systemaattisesti. Käytimme tie-donhaussa Cinahl-tietokantaa. Viimeisen haun teimme syyskuussa 2011. Kirjallisuuskatsauk-seemme valitsimme 12 tutkimusta, jotka on julkaistu vuosina 2005- 2011. Valitsemissamme tutkimuksissa käsiteltiin fysioterapian menetelmiä lannerangan välilevytyrän konservatiivisessa hoidossa. Näitä menetelmiä olivat terapeuttinen harjoittelu, manuaalinen terapia sekä fysikaaliset hoidot. Tutkimuksista saatiin kohtalaista näyttöä lannerankaa stabiloivien- ja eks-tensioharjoitteiden sekä vetohoidon vaikuttavuudesta. Lisäksi saatiin heikkoa näyttöä fysikaalisista hoidoista sekä manipuloinnista. Näillä menetelmillä pystyttiin lieventämään lannerangan välilevyty-rästä aiheutuvaa kipua ja parantamaan toiminnallisuutta. Jatkossa aiheesta tulisi tehdä lisää kor-kealaatuisia tutkimuksia, jotta voitaisiin luotettavasti osoittaa hoitomenetelmien vaikuttavuus.The purpose of this study was to make a literature review, and to find the latest and the most relia-ble scientific data on the effectiveness of physiotherapy modalities in conservative treatment of lumbar disc herniation. On the process, we focused to address this issue from the perspective of physiotherapy, but other disciplines were also covered. The objective of our thesis was to produce current and research evidence based information about physiotherapy modalities which are used in conservative treatment of lumbar disc herniation. Kuopio OMT Centre Ltd was our employer and our thesis was directed for their employees. The aim was to support their work with a reliable and up-to-date literature review. We used literature review as a research method, which proceeded systematically. In research we used the Cinahl database. We did the last search in September 2011. We chose 12 studies into our literature review. These studies were published between the years 2005-2011. Studies that we used addressed physiotherapy methods in conservative treatment of lumbar disc herniation. These methods were therapeutic exercise, manual therapy and physical therapy. Stud-ies found moderate evidence about the effectiveness of lumbar stabilizing- and extension exercises and about the effectiveness of traction. Studies found also weak evidence about the effectiveness of physical therapy as well as manipulation. These methods were able to alleviate the pain caused by lumbar disc herniation and improve functionality. More high quality trials are needed in the future in order to reliably demonstrate the effectiveness of physiotherapy treatments

Guided Imagery to Improve Mental Health in Cancer Patients with Chemotherapy: Literature Review

Aims: The purpose of this study was to review the research literature related to the use of Guided imagery on the mental health of cancer patients undergoing chemotherapy. Methods: The design of this review is a literature review. Five quantitative experimental articles and RCTs were obtained from the database: PubMed, Proquest, Clinicalkey nursing, Science Direct, with the criteria of experimental articles providing guided imagery interventions for chemotherapy patients, published 2011-2021, in English and Indonesian. Results: The findings of this review article were guided imagery intervention, two articles combined PMR relaxation, and three articles carried out guided imagery with deep breath relaxation. The duration of guided imagery differed in some studies from 15 minutes to 30 minutes with various sessions either supervised or conducted independently with compact disc (CD) recordings. The results of the findings that guided imagery can reduce mental health problems such as stress, anxiety and depression experienced by cancer patients undergoing chemotherapy. Conclusion: Guided imagery is a practical, easy, and simple action that can be taken to reduce mental health problems in cancer patients with chemotherapy

Towards understanding the dynamics of the bar/bulge region in our Galaxy

I review some of the work on bars which is closely linked to the bar/bulge system in our Galaxy. Several independent studies, using totally independent methods, come to the same results about the 3D structure of a bar, i.e., that a bar is composed of a vertically thick inner part and a vertically thin outer part. I give examples of this from simulations and substantiate the discussion with input from orbital structure analysis and from observations. The thick part has a considerably shorter radial extent than the thin part. I then see how this applies to our Galaxy, where two bars have been reported, the COBE/DIRBE bar and the Long bar. Comparing their extents and making the reasonable and necessary assumption that our Galaxy has properties similar to those of other galaxies of similar type, leads to the conclusion that these two bars can not form a standard double bar system. I then discuss arguments in favour of the two bars being simply different parts of the same bar, the COBE/DIRBE bar being the thick inner part and the Long bar being the thin outer part of this bar. I also very briefly discuss some related new results. I first consider bar formation and evolution in disc galaxies with a gaseous component - including star formation, feedback and evolution - and a triaxial halo. Then I consider bar formation in a fully cosmological context using hydrodynamical LCDM simulations, where the host galaxies grow, accrete matter and significantly evolve during the formation and evolution of the bar.Comment: 6 pages, 3 figures, invited talk at "Assembling the Puzzle of the Milky Way" conference, April 17-22 2011, Grand Bornan

Accretion by the Galaxy

Cosmology requires at least half of the baryons in the Universe to be in the intergalactic medium, much of which is believed to form hot coronae around galaxies. Star-forming galaxies must be accreting from their coronae. HI observations of external galaxies show that they have HI halos associated with star formation. These halos are naturally modelled as ensembles of clouds driven up by supernova bubbles. These models can fit the data successfully only if clouds exchange mass and momentum with the corona. As a cloud orbits, it is ablated and forms a turbulent wake where cold high-metallicity gas mixes with hot coronal gas causing the prompt cooling of the latter. As a consequence the total mass of HI increases. This model has recently been used to model the Leiden-Argentina-Bonn survey of Galactic HI. The values of the model's parameters that are required to model NGC 891, NGC 2403 and our Galaxy show a remarkable degree of consistency, despite the very different natures of the two external galaxies and the dramatic difference in the nature of the data for our Galaxy and the external galaxies. The parameter values are also consistent with hydrodynamical simulations of the ablation of individual clouds. The model predicts that a galaxy that loses its cool-gas disc for instance through a major merger cannot reform it from its corona; it can return to steady star formation only if it can capture a large body of cool gas, for example by accreting a gas-rich dwarf. Thus the model explains how major mergers can make galaxies "red and dead."Comment: Invited review at "Assembling the Puzzle of the Milky Way", Grand Bornand, April 2011; 6 page