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The winding path that led to the creation of Indonesia's modern province of Kepulauan Riau (Kepri) has deep historical roots, and the ramifications are still being played out. In 1997, more than twenty years ago, a collection of articles under the title of Riau in Transition was published in a special issue of the journal of the Royal Netherlands Institute of Southeast Asian and Caribbean Studies (Chou and Derks 1997). At that time Riau was the sixth largest of Indonesia's twenty-six provinces, extending from the foothills of Sumatra's Bukit Barisan to the Natuna islands in the South China Sea, with a land area covering 94,562 km2 and a larger sea surface of around 235,000 km2. It was further distinguished by its geographical separation. On the one hand was mainland Riau (Riau daratan) on the Sumatran side of the Melaka Straits, together with its offshore islands; on the other, insular Riau (Riau kepulauan), which included around 2,000 islands stretching from the Riau-Lingga archipelagos to the South China Sea. My contribution to this collection focused on the period from the sixteenth to the late twentieth century, giving particular attention to Riau-Johor, reconstituted after Melaka's conquest by the Portuguese in 1511, and its relationship with Malay areas along the east coast of Sumatra. Tracking the uneasiness that characterized the daratan-kepulauanassociation over nearly 500 years, I argued that despite the widespread perception of Riau as a Malay domain, the promotion of a sense of unity and commonality between mainland and island would be no easy task (Andaya 1997, p. 505). But when the final proofs went to press, there was no indication that the fall of the Soeharto regime and the subsequent demands for reformasi were around the corner. Nor could one then foresee the ripple effects of the regional autonomy law, which finally took effect in 2001, or that the rising tensions in the daratan-kepulauan marriage would reach such a point that divorce seemed the only solution. Under extreme pressure from island representatives, Jakarta eventually agreed to the creation of a new province of “island Riau”. In 2002, only five years after Riau in Transition appeared, President Megawati Sukarnoputri signed the document that formally separated kepulauan Riau from the daratan.
Despite evidence to the contrary, many practitioners continue to inappropriately screen for and treat bacteria in the urine of clinically asymptomatic patients. The purpose of this study was to evaluate the impact of a new order set on the number of urine culture performed, antibiotic days of therapy (DOT), catheter-associated urinary tract infections (CAUTI), and associated financial impact.
A quasi-experimental before-and-after intervention.
We conducted this study at 5 Catholic Health Initiative (CHI) hospitals in Texas that use the same electronic health record (EHR) system.
The study populations included adult patients who had urine culture performed from June 2017 to June 2019.
The intervention (implemented June 25, 2018) was the addition of a new order set in the electronic health record that required practitioners to choose an indication for the type of urine study. The primary outcome was number of urine cultures performed adjusted for the number of total patient days.
Following implementation of the new order set, the number of urine cultures performed among the 5 sites decreased from 1,175.8 tests per 10,000 patient days before the intervention to 701.4 after the intervention (40.4% reduction; P < .01). Antibiotic DOT for patients with a urinary tract infection indication decreased from 102.5 to 86.9 per 1,000 patient days (15.2% reduction; P < .01). The CAUTI standardized infection ratio was 1.0 before the intervention and 0.8 after the intervention (P = .23). The estimated yearly savings following the intervention was US$535,181.
The addition of a new order set resulted in decreases in the number of urine cultures performed and the antibiotic DOT, as well as substantial financial savings.
Drawing on a landscape analysis of existing data-sharing initiatives, in-depth interviews with expert stakeholders, and public deliberations with community advisory panels across the U.S., we describe features of the evolving medical information commons (MIC). We identify participant-centricity and trustworthiness as the most important features of an MIC and discuss the implications for those seeking to create a sustainable, useful, and widely available collection of linked resources for research and other purposes.
Despite Christianity's position as a minority faith in most Asian countries, the remarkable expansion of Pentecostalism-Charismatic (P/C) Christianity in recent years has encouraged observers to regard it as a ‘new’ religious movement. Using the Sidang Injil Borneo, Malaysia, and the Bethel Church of Indonesia as examples, this chapter employs the concept of ‘glocalization’ to examine how P/C Christianity has been marketed to Indonesian and Malaysian clientele in ways that maintain a global style of evangelism while stressing local roots. The emphasis on charismatic preaching and healing has exercised a strong cultural appeal and provided a basis for the subsequent growth of P/C congregations. An increased presence in urban centres also owes much to communication through social media and to a technologically sophisticated worship style perceived as emblematic of a new religious modernity. At the same time, these case studies suggest that the presentation of Christianity as simultaneously national and cosmopolitan contains inherent tensions, and that ‘local’ elements are receding as global influences become increasingly dominant.
Keywords: Pentecostalism, Charismatic Christianity, marketing, glocalisation, Sidang Injil Borneo, Gereja Bethel Indonesia
In the non-Western world, the contemporary revitalization and expansion of Pentecostalism, a movement within Christianity that stresses a believer's personal encounter with God through the Holy Spirit, is an unprecedented phenomenon. This development is of particular interest because Pentecostalism itself is not a ‘new’ religion. While its formal origins are generally traced to revival meetings held in Azusa Street in Los Angeles in 1906, antecedents can be found in Christian renewal movements in the late nineteenth century. The name is derived from the Greek Pentekostas , which in Jewish tradition refers to the ritual held seven weeks after Passover. The Pentecostal movement takes its inspiration from the biblical description of events on the Day of Pentecost that followed the death and resurrection of Christ as described in Acts 2. A group of disciples were gathered together for prayer when the sound of a mighty wind engulfed the entire house. ‘And they were all filled with the Holy Spirit and began to speak with other tongues, as the Spirit gave them utterance’. The conviction that the Holy Spirit can once more descend in all its power is thus central to Pentecostal theology.
The economic, political, strategic and cultural dynamism in Southeast Asia has gained added relevance in recent years with the spectacular rise of giant economies in East and South Asia. This has drawn greater attention to the region and to the enhanced role it now plays in international relations and global economics.
The sustained effort made by Southeast Asian nations since 1967 towards a peaceful and gradual integration of their economies has had indubitable success, and perhaps as a consequence of this, most of these countries are undergoing deep political and social changes domestically and are constructing innovative solutions to meet new international challenges. Big Power tensions continue to be played out in the neighbourhood despite the tradition of neutrality exercised by the Association of Southeast Asian Nations (ASEAN).
The Trends in Southeast Asia series acts as a platform for serious analyses by selected authors who are experts in their fields. It is aimed at encouraging policymakers and scholars to contemplate the diversity and dynamism of this exciting region.
It is difficult for students of contemporary Malaysia to write dispassionately about the institution of monarchy in a country where the Malay rulers have been protected from criticism, where they have been so embedded in Malay culture, and where they are perceived as guardians of Malay rights and of the Islamic faith. Yet in a world in which royalty is increasingly seen as anachronistic, Malaysia's nine sultans occupy a special place. Not only do they constitute almost a quarter of the world's monarchies, they continue to exercise considerable influence in Malaysia's political life. More particularly, over the last two decades a growing public disenchantment with the dishonesty and self-interest of politicians has led many Malaysians to look to the sultans as an alternative source of leadership. To a considerable degree this has been encouraged by the rulers themselves, alienated by the limitations on royal privileges imposed during the earlier regime of the current Prime Minister Mahathir Mohamad and by the depth of corruption in the government of Najib Razak as revealed by the 1MDB scandal. In October 2015, after the domestic inquiry was halted by Najib's dismissal of the attorney general, the Conference of Rulers issued a joint statement calling for a revival of the investigation and “stern action” against those incriminated. Two years later, the government's unabashed politicization of Islam prompted another royal warning about the deepening of racial and religious divides.3 On the other hand, it has sometimes been difficult for individual rulers to take the moral high ground; in Pahang, Najib's home state, 1MDB disclosures indicate that the sultan received large sums of money taken directly from development funds.
The elections of May 2018 (GE14) brought a new coalition government to power under the banner of Pakatan Harapan, currently led by Dr Mahathir Mohamad, the erstwhile nemesis of the sultans. It is not yet clear whether Pakatan Harapan leaders will be able to set aside a baggage of resentment towards royal privilege and form a solid working relationship with the sultans at both state and national levels. Mahathir's supporters claim that he is a changed man, while the sultans, energized by what one observer has called “monarchical activism” are in a far stronger position than they were in the 1980s and 1990s.
• Although Dr Mahathir Mohamad's earlier government (1981–2003) limited the powers and privileges of Malaysia's nine hereditary rulers, the political influence that they could exercise was still evident in the “Perak Crisis” of 2009, which also generated public debate about royal rights.
• In recent years, public wariness in Malaysia about politicians has helped the rulers present themselves as alternative sources of authority. “Monarchical activism” has been especially evident in the state of Perak, dating from 1984 when Sultan Azlan Muhibbuddin Shah, who was until then Malaysia's Lord President, was installed as the thirty-fourth ruler. In 2014, he was succeeded by his eldest son, Sultan Nazrin Muizzuddin Shah.
• Sultan Nazrin Shah has presented himself as a modern, educated and approachable ruler who consistently endorses the rule of law and is aware that public support for the monarch is highly dependent on meeting expectations in regard to ethical conduct and good governance.
• This paper argues that although Sultan Azlan Shah and Sultan Nazrin Shah have embraced the idea of a “new” Malaysian monarchy that actively responds to changing political and social contexts, two issues with especial relevance to the situation today can be tracked through the history of Perak's royal line since its inception in the sixteenth century. The first, arguably now of lesser importance, concerns royal succession. The second issue, still highly important, involves the ruler's relationships with non-royal officials and with elected representatives and the public at large.
Although Dr. Mahathir Mohamad's earlier government (1981–2003) limited the powers and privileges of Malaysia's nine hereditary rulers, the political influence that they could exercise was still evident in the "Perak Crisis" of 2009, which also generated public debate about royal rights. In recent years, public wariness in Malaysia about politicians has helped the rulers present themselves as alternative sources of authority. "Monarchical activism" has been especially evident in the state of Perak, dating from 1984 when Sultan Azlan Muhibbuddin Shah, who was until then Malaysia's Lord President, was installed as the thirty-fourth ruler. In 2014, he was succeeded by his eldest son, Sultan Nazrin Muizzuddin Shah. Sultan Nazrin Shah has presented himself as a modern, educated and approachable ruler who consistently endorses the rule of law and is aware that public support for the monarch is highly dependent on meeting expectations in regard to ethical conduct and good governance. This paper argues that although Sultan Azlan Shah and Sultan Nazrin Shah have embraced the idea of a "new" Malaysian monarchy that actively responds to changing political and social contexts, two issues with especial relevance to the situation today can be tracked through the history of Perak's royal line since its inception in the sixteenth century. The first, arguably now of lesser importance, concerns royal succession. The second issue, still highly important, involves the ruler's relationships with non-royal officials and with elected representatives and the public at large.
This article discusses the changing spirit world of maritime communities in Southeast Asia by differentiating ‘oceans’ from ‘seas’ and by linking historical evidence to modern anthropological studies. Since the lives of seagoing peoples are fraught with unpredictability, propitiation of local sea spirits was a traditional means of ensuring good fortune and protection. As long-distance voyages expanded in the early modern period, the global reach of the world religions, extending beyond familiar seas into the more extensive ocean environment, held out particular appeal. Not only were the gods, deities and saints attached to larger religious systems themselves ocean travellers; in contrast to the unpredictability of indigenous spirits, they were always amenable to requests for help, even when the suppliant was far from home waters. At the same time, as world religions were incorporated into indigenous cosmologies, maritime peoples gained greater agency in negotiating relationships with the local spirits that still wield power in Southeast Asian seas.
Water in many different forms and contexts is of central significance in Southeast Asia, and these differences are reflected in the vast range of spirits and deities. Despite wide variation, the most obvious distinction is between spirits associated with fresh and salt water. Those linked to water associated with fertility are typically regarded as female and sympathetic to human requests for assistance. By contrast, the spirits who inhabit turbulent river waters and patrol the shorelines may be male, female, or only vaguely gendered. Although they can be capricious and sometimes cruel, they are nonetheless amenable to individual or communal supplication. The same ambiguity is exemplified by the sea spirits, who extend rewards to those they favour but inflict harsh punishments when their anger is aroused. Yet regardless of their nature or the place with which they were associated, the ‘power base’ of indigenous spirits was always locally concentrated. The limitations in their reach help explain the appeal of cosmologies that extended across a much larger area, and even across the entire globe. The accompanying conceptualization of new and benevolent beings is especially evident in the maritime environment. Here human activity is male-dominated, and the male divinities and saints associated with supra-local belief systems might appear to be the natural guardians of mariners. Even so, culturally entrenched ideas of connections between water and maternal care facilitated the adoption of female deities as protectors of ocean-going voyagers.
The latter part of the eighteenth and the first decades of the nineteenth century witnessed significant shifts in local and global power relationships that characterize the closing phase of the early modern period in Southeast Asia. On the mainland, Siam, Myanmar, and a newly unified Vietnam all seemed on course to maintain a trajectory of administrative and cultural consolidation. By the 1830s, however, the balance of power was already weighted in favor of advancing European economic interests, notably those of Britain. The Dutch had been steadily overtaken by British maritime superiority in technology, cartography, and shipbuilding, and the Fourth Anglo–Dutch War (1780–4) brought to an end the VOC monopoly of trade in Malay–Indonesian waters. On 31 December 1799 the affairs of the now bankrupt Company were assumed by the new Batavian Republic, formed after the invasion of the Netherlands by Napoleonic forces in 1795. Although the Netherlands was no longer a global power, it was able to maintain its position in the Indonesian archipelago through the Anglo–Dutch Treaty of 1824, by which its territorial stake in Southeast Asia was acknowledged.
Britain’s maritime dominance in Asia was confirmed by its expanding territorial control in India and the establishment of the new free trade ports of Penang (1786) and Singapore (1819). In 1826, following their victory in the first of three Anglo–Burmese Wars, the British also forced Myanmar to make significant territorial and monetary concessions. The British saw their primary European rival as the French, whose involvement in Vietnam was fueled by missionary and nationalist ambitions that envisioned more active involvement in Asia, especially in China. Although the mainland Southeast Asian states continued to send tribute to China, the Qing dynasty’s inability to withstand unrelenting European pressure was already evident. The poverty and bleak future that confronted so many Chinese peasants was reflected in the ever-growing numbers of migrants who flocked to Southeast Asia carrying hopes of improving their lives.
Written by two experienced teachers with a long history of research, this textbook provides students with a detailed overview of developments in early modern Southeast Asia, when the region became tightly integrated into the world economy because of international demand for its unique forest and sea products. Proceeding chronologically, each chapter covers a specific time frame in which Southeast Asia is located in a global context. A discussion of general features that distinguish the period under discussion is followed by a detailed account of the various sub-regions. Students will be shown the ways in which local societies adapted to new religious and political ideas and responded to far-reaching economic changes. Particular attention is given to lesser-known societies that inhabited the seas, the forests, and the uplands, and to the role of the geographical environment in shaping the region's history. The authoritative yet accessible narrative features maps, illustrations, and timelines to support student learning. A major contribution to the field, this text is essential reading for students and specialists in Asian studies and early modern world history.