Innovative STRoke Interactive Virtual thErapy (STRIVE) online platform for community-dwelling stroke survivors: a randomised controlled trial protocol

Introduction: The STRoke Interactive Virtual thErapy (STRIVE) intervention provides community-dwelling stroke survivors access to individualised, remotely supervised progressive exercise training via an online platform. This trial aims to determine the clinical efficacy of the STRIVE intervention and its effect on brain activity in community-dwelling stroke survivors.Methods and analysis: In a multisite, assessor-blinded randomised controlled trial, 60 stroke survivors >3 months poststroke with mild-to-moderate upper extremity impairment will be recruited and equally randomised by location (Melbourne, Victoria or Launceston, Tasmania) to receive 8 weeks of virtual therapy (VT) at a local exercise training facility or usual care. Participants allocated to VT will perform 3–5 upper limb exercises individualised to their impairment severity and preference, while participants allocated to usual care will be asked to maintain their usual daily activities. The primary outcome measures will be upper limb motor function and impairment, which will be assessed using the Action Research Arm Test and Upper Extremity Fugl-Meyer, respectively. Secondary outcome measures include upper extremity function and spasticity, as measured by the box and block test and Modified AshworthScale, respectively, and task-related changes in bilateral sensorimotor cortex haemodynamics during hand reaching and wrist extension movements as measured by functional near-infrared spectroscopy. Quality of life will be measured using the Euro-Quality of Life-5 Dimension-5 Level Scale, and the Motor Activity Log-28 will be used to measure use of the hemiparetic arm. All measures will be assessed at baseline and immediately postintervention

Pengaruh Pengetahuan dan Sikap terhadap Kesiapsiagaan Masyarakat dalam Menghadapi Bencana Banjir di Desa Perkebunan Bukit Lawang Kecamatan Bahorok Tahun 2011

Flood preparedness will show the existence of attitudes and knowledge in the face of disaster and became an important part, especially in areas frequently hit by floods as the village of Perkebunan Bukit Lawang. flooding potentially occurred in the village of Perkebunan Bukit Lawang as in 2004. This is because the nature of the slope of the Bahorok River basin as  well as the many people who cut down trees around the river and a lot of activity in near the river. The purpose of this study to analyze the influence of knowledge and attitudes towards community preparedness in the face of catastrophic flooding in the village of Bukit Lawang district Bahorok Plantation. This type of research is analytical research using explanatory approach. The population in this study were all heads of families in the village of Perkebunan Bukit Lawang in 2011, amounting to 740 people to the sample amounted to 89 people drawn at random proportional sampling. Data obtained through interviews using questionnaires, were analyzed with multiple logistic regression. The results showed that statistically there is the influence of knowledge and attitudes towards community preparedness in the face of catastrophic floods in the village of Perkebunan Bukit Lawang in 2011 Variable attitude householders provide the most impact to the value of β coefficient (21.623). Necessary improvement of environmental health, so people are not too exploit nature for his life and eventually destroying the forest. Moreover, given counseling about preparedness in facing the potential hazards that arise in the area, such as floods. In addition, local governments are also expected to create policies that support the implementation of the conservation of protected forests and the prevention of forest destruction in order to prevent the emergence of flood disaster

Concurrent transcranial direct current stimulation and progressive resistance training in Parkinson's disease: Study protocol for a randomised controlled trial

BACKGROUND: Parkinson\u27s disease (PD) results from a loss of dopamine in the brain, leading to movement dysfunctions such as bradykinesia, postural instability, resting tremor and muscle rigidity. Furthermore, dopamine deficiency in PD has been shown to result in maladaptive plasticity of the primary motor cortex (M1). Progressive resistance training (PRT) is a popular intervention in PD that improves muscular strength and results in clinically significant improvements on the Unified Parkinson\u27s Disease Rating Scale (UPDRS). In separate studies, the application of anodal transcranial direct current stimulation (a-tDCS) to the M1 has been shown to improve motor function in PD; however, the combined use of tDCS and PRT has not been investigated. METHODS/DESIGN: We propose a 6-week, double-blind randomised controlled trial combining M1 tDCS and PRT of the lower body in participants (n&thinsp;=&thinsp;42) with moderate PD (Hoehn and Yahr scale score 2-4). Supervised lower body PRT combined with functional balance tasks will be performed three times per week with concurrent a-tDCS delivered at 2 mA for 20 minutes (a-tDCS group) or with sham tDCS (sham group). Control participants will receive standard care (control group). Outcome measures will include functional strength, gait speed and variability, balance, neurophysiological function at rest and during movement execution, and the UPDRS motor subscale, measured at baseline, 3 weeks (during), 6 weeks (post), and 9 weeks (retention). Ethical approval has been granted by the Deakin University Human Research Ethics Committee (project number 2015-014), and the trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12615001241527). DISCUSSION: This will be the first randomised controlled trial to combine PRT and a-tDCS targeting balance and gait in people with PD. The study will elucidate the functional, clinical and neurophysiological outcomes of combined PRT and a-tDCS. It is hypothesised that combined PRT and a-tDCS will significantly improve lower limb strength, postural sway, gait speed and stride variability compared with PRT with sham tDCS. Further, we hypothesise that pre-frontal cortex activation during dual-task cognitive and gait/balance activities will be reduced, and that M1 excitability and inhibition will be augmented, following the combined PRT and a-tDCS intervention. <br /

Using non-invasive transcranial stimulation to improve motor and cognitive function in Parkinson's disease: A systematic review and meta-analysis

Parkinson\u27s disease (PD) is a neurodegenerative disorder affecting motor and cognitive abilities. There is no cure for PD, therefore identifying safe therapies to alleviate symptoms remains a priority. This meta-analysis quantified the effectiveness of repetitive transcranial magnetic stimulation (rTMS) and transcranial electrical stimulation (TES) to improve motor and cognitive dysfunction in PD. PubMed, EMBASE, Web of Science, Google Scholar, Scopus, Library of Congress and Cochrane library were searched. 24 rTMS and 9 TES studies (n&thinsp;=&thinsp;33) with a sham control group were included for analyses. The Physiotherapy Evidence Database and Cochrane Risk of Bias showed high quality (7.5/10) and low bias with included studies respectively. Our results showed an overall positive effect in favour of rTMS (SMD&thinsp;=&thinsp;0.394, CI [0.106&ndash;0.683], p&thinsp;=&thinsp;0.007) and TES (SMD&thinsp;=&thinsp;0.611, CI [0.188&ndash;1.035], p&thinsp;=&thinsp;0.005) compared with sham stimulation on motor function, with no significant differences detected between rTMS and TES (Q [1]&thinsp;=&thinsp;0.69, p&thinsp;=&thinsp;0.406). Neither rTMS nor TES improved cognition. No effects for stimulation parameters on motor or cognitive function were observed. To enhance the clinical utility of non-invasive brain stimulation (NBS), individual prescription of stimulation parameters based upon symptomology and resting excitability state should be a priority of future research

Performance of Fat-tailed Rams Fed Complete Feed Based Oil Palm Fronds

The aim of this experiment was to evaluate the performance of fat-tailed rams fed complete feedbased oil palm fronds (OPF). This experiment was arranged in Completely Randomized Design (CRD)with 5 treatments and 4 replications i.e. 0, 25, 50, 75 and 100% of OPF substituting fields grass incomplete feed for A, B, C, D and E treatments, respectively. Twenty fat-tailed rams were fed twice at08.00 and 14.00 with pellet of complete feed for 4 months. The result of this experiment showed thatOPF significantly influenced nutrient consumption, average daily gain (ADG) and feed efficiency ratio(FER). Oil palm fronds significantly affected (P<0.05) fat-tailed rams's dry matter intake (DMI), organicmatter intake (OMI), crude protein intake (CPI), ADG and FER. The highest DMI, OMI, CPI, ADG, andFER of fat-tailed rams was in C treatment and significantly different from the others. It was concludedthat C treatment was the best treatment which can give the best fat-tailed rams performance. The OPFcan be used to replace the field grass as feed up to 75% proportion in complete feed and could increasethe performance and productivity of fat-tailed rams

Evaluasi Pelaksanaan RANHAM 2004-2009 dan Rencana Ratifikasi Optional Protocol To The Convention Against Torture (CAT) dalam RANHAM 2004-2009 dan Perencanaan RANHAM 2010-2014

Dalam rangka mengevaluasi kepatuhan (comply) Pemerintah Indonesia dalam menjalankan United Nations Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (UNCAT) yang telah dirati kasi dengan UU No 5 1998, Kemitraan merasa perlu mengadakan kajian ini karena alasan-alasan berikut: (i) Secara hukum Indonesia wajib menjalankan UNCAT karena telah mengikatkan diri pada Konvensi tersebut sejak tahun 1998, sehingga semua pasal-pasal UNCAT (kecuali pasal 20 karena Indonesia mengecualikan diri) bersifat wajib atau legally binding untuk melaksanakannya. (ii) Indonesia belum sepenuhnya mengintegrasikan UNCAT dalam sejumlah peraturan Perundang-undangan nasional sehingga perlu dicermati secara khusus. (iii) Rencana Aksi Nasional Hak Asasi Manusia (RANHAM) 1998-2003 dan RANHAM 2004-2009 dirasa masih memiliki kekosongan substansi dan pelaksanaannya belum konsisten dengan apa yang dituangkan dalam ke dua RANHAM tersebut. Berdasarkan alan-alasan di atas dan makin maraknya pelanggaran HAM yang terjadi di Indonesia, Kemitraan dengan bantuan dana dari Uni Eropa mencoba mengevaluasi secara komprehensive pelaksanaan RANHAM 2004-2009 dan melihat kemungkinan rencana rati kasi Optional Protocol UNCAT yang telah disepakati oleh Majelis Umum PBB pada tanggal 18 Desember 2002 dan telah enter into force pada tanggal 22 Juni 2006. Disamping itu, kajian ini juga memberikan masukan bagi Perencanaan RANHAM 2010-2014

KEWENANGAN HAKIM MELAKSANAKAN MEDIASI PADA PERKARA ISTBAT NIKAH DALAM RANGKA PENYELESAIAN PERCERAIAN

Salah satu alasan pengajuan istbat nikah menurut KHI adalah karena adanya perkawinan dalam rangka penyelesaian perceraian. Persoalannya adalah di satu sisi istbat nikah bukanlah perkara yang wajib dimediasi, di sisi lain perkara perceraian menjadi salah satu perkara yang wajib dimediasi. Penelitian bertujuan untuk menganalisis apakah hakim berwenang melakukan mediasi terhadap istbat nikah dengan alasan perceraian dan bagaimana perspektif asas peradilan cepat serta biaya ringan dalam mengadili perkata istbat nikah dalam rangka penyelesaian perceraian. Kajian menggunakan metode penelitian hukum yuridis empiris. Data primer diperoleh melalui wawancara dengan hakim dan advokat. Bahan hukum primer yang digunakan terdiri dari UU Perkawinan, KHI dan Perma Nomor 1 Tahun 2016. Analisis data dilakukan secara kualitatif dengan pendekatan konseptual. Hasil penelitian menunjukkan bahwa hakim berwenang melaksanakan mediasi dalam perkara istbat nikah dalam rangka penyelesaian perceraian. Perkara pokok dari istbat nikah dalam rangka perceraian adalah perceraiannya sehingga menurut Perma Nomor 1 Tahun 2016 dapat dilaksanakan mediasi karena perkara perceraian merupakan salah satu kasus yang dapat dimediasikan oleh hakim. Permohonan isbat nikah dalam rangka penyelesaian perceraian mengakomodir asas peradilan sederhana, cepat dan biaya ringan karena tidak memerlukan pembuktian yang sulit. Pembuktian dapat dilakukan sekaligus dengan menghadirkan saksi yang menyaksikan terpenuhinya rukun dan syarat sah perkawinan menurut hukum Islam serta&nbsp; telah terjadinya perselisihan secara terus menerus di antara pasangan suami isteri