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123-474: The Broken Jug follows the story of a judge who presides over a trial where he has to settle the question of who had broken a jug in the room of a young woman late one night, while himself acting highly suspiciously both before and throughout the whole trial. Adam, the judge of the small town of Huisum in the Netherlands, is found dressing a wound on his leg by his secretary Licht, when Licht enters Adam's home in

246-536: A 3D printer . The Ponseti method is widely used and highly effective under the age of two. The French method involves realignment, taping, and long-term home exercises and night splinting. It is also effective but outcomes vary and rely on heavy involvement of caregivers. Generally, the Ponseti method is preferred. Another technique, the Kite method, does not appear to be as effective. In about 20% of cases, additional surgery

369-467: A democratisation process, and periods of rapid economic growth. Indonesia consists of thousands of distinct native ethnic groups and hundreds of linguistic groups, with Javanese being the largest. A shared identity has developed with the motto " Bhinneka Tunggal Ika " ("Unity in Diversity" literally , "many, yet one"), defined by a national language , cultural diversity, religious pluralism within

492-526: A special autonomous status ( otonomi khusus ) from the central government. Aceh, a conservative Islamic territory , has the right to create some aspects of an independent legal system implementing sharia . Yogyakarta is the only pre-colonial monarchy legally recognised within Indonesia, with the positions of governor and vice governor being prioritised for the reigning Sultan of Yogyakarta and Duke of Pakualaman , respectively. The six Papuan provinces are

615-449: A Muslim-majority population, and a history of colonialism and rebellion against it. A developing country , Indonesia is classified a newly industrialized country , with its economy the world's 16th-largest by nominal GDP and the 7th-largest by PPP . It is the world's third-largest democracy, a regional power , and is considered a middle power in global affairs. The country is a member of several multilateral organisations, including

738-456: A dividing line ( Wallace Line ) between the distribution of Indonesia's Asian and Australasian species. It runs roughly north–south along the edge of the Sunda Shelf, between Kalimantan and Sulawesi, and along the deep Lombok Strait , between Lombok and Bali. Flora and fauna on the west of the line are generally Asian, while east from Lombok is increasingly Australian until the tipping point at

861-491: A dramatic impact on the quality of life . The exact cause is usually not identified. Both genetic and environmental factors are believed to be involved. There are two main types of congenital clubfoot: idiopathic (80% of cases) and secondary clubfoot (20% of cases). The idiopathic congenital clubfoot is a multifactorial condition that includes environmental, vascular, positional, and genetic factors. There appears to be hereditary component for this birth defect given that

984-700: A legislature ( DPRD Kabupaten/Kota ). The third level are the districts ( kecamatan , distrik in Papua , or kapanewon and kemantren in Yogyakarta ), and the fourth are the villages (either desa , kelurahan , kampung , nagari in West Sumatra , or gampong in Aceh ). The village is the lowest level of government administration. It is divided into several community groups ( rukun warga , RW), which are further divided into neighbourhood groups ( rukun tetangga , RT). In Java,

1107-482: A longer term target to further increase the coverage of its marine protected areas to 10% of its territorial waters, or 31 million hectares. Indonesia is a republic with a presidential system. Following the fall of the New Order in 1998, political and governmental structures have undergone sweeping reforms, with four constitutional amendments revamping the executive, legislative and judicial branches. Chief among them

1230-405: A look at Adam's court. Licht also tells Adam that a judge in a neighboring town has tried to commit suicide after Walter found problems at the court. Additionally, today is court day, and no one can find Adam's wig , with Adam's maidservant insisting that Adam arrived home without the wig late last evening. When Walter arrives, he insists that Adam immediately start the day's trial. The parties are

1353-401: A major contributor to non-adherence. Relapses are managed by repeating the casting process. Relapsed feet may also require additional, more extensive surgeries and have a reduced chance of achieving subsequent correction. Furthermore, research has revealed the possibility of overcorrection after use of the Ponseti method. Another reason for recurrence is a congenital muscle imbalance between

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1476-476: A military career, leaving the obvious career of the Church . In clubfoot, feet are rotated inward and downward . The affected foot and leg may be smaller than the other, while in about half of cases, clubfoot affects both feet. Most of the time clubfoot is not associated with other problems. Clubfoot can be diagnosed by ultrasound of the fetus in more than 60% of cases. The earliest week of gestation in which

1599-446: A mold can be made to fabricate a custom AFO brace. The new cast is left in place until the AFO is available. When the cast is removed, the AFO is worn to prevent the foot from returning to the old position. For feet with partial correction of deformity with non-operative treatment, surgery may be less extensive and may involve only the posterior part of the foot and ankle. This might be called

1722-488: A posterior release. This is done through a smaller incision and may involve releasing only the posterior capsule of the ankle and subtalar joints, along with lengthening the Achilles tendon. Surgery leaves residual scar tissue and typically there is more stiffness and weakness than with nonsurgical treatment. As the foot grows, there is potential for asymmetric growth that can result in recurrence of foot deformity that can affect

1845-471: A range of sea and coastal ecosystems, including beaches , dunes, estuaries, mangroves, coral reefs, seagrass beds, coastal mudflats, tidal flats, algal beds, and small island ecosystems. Indonesia is one of the Coral Triangle countries with the world's most enormous diversity of coral reef fish , with more than 1,650 species in eastern Indonesia only. British naturalist Alfred Russel Wallace described

1968-509: A wealth of Asian fauna. Large species such as the Sumatran tiger , rhinoceros, orangutan, Asian elephant , and leopard were once abundant as far east as Bali, but numbers and distribution have dwindled drastically. Having been long separated from the continental landmasses, Sulawesi, Nusa Tenggara, and Maluku have developed their unique flora and fauna. Papua was part of the Australian landmass and

2091-569: Is US$ 15,835, while nominal per capita GDP is US$ 5,108. Services are the economy's largest sector and account for 43.4% of GDP (2018), followed by industry (39.7%) and agriculture (12.8%). Since 2009, it has employed more people than other sectors, accounting for 47.7% of the total labour force, followed by agriculture (30.2%) and industry (21.9%). Over time, the structure of the economy has changed considerably. Historically, it has been weighted heavily towards agriculture, reflecting both its stage of economic development and government policies in

2214-426: Is a Posteromedial Release (PMR) surgery. This is done through an incision across the medial side of the foot and ankle, that extends posteriorly, and sometimes around to the lateral side of the foot. In this procedure, it is typically necessary to release (cut) or lengthen the plantar fascia, several tendons, and joint capsules/ligaments. Typically, the important structures are exposed and then sequentially released until

2337-624: Is a founding member of the Association of Southeast Asian Nations ( ASEAN ) and the East Asia Summit . In common with most of the Muslim world , Indonesia does not have diplomatic relations with Israel and has actively supported Palestine . However, observers have pointed out that Indonesia has ties with Israel, albeit discreetly. Indonesia has been a member of the United Nations since 1950 and

2460-517: Is affected, there is a 33% chance the other one will be as well. Mutations in genes involved in muscle development are risk factors for clubfoot, specifically those encoding the muscle contractile complex ( MYH3 , TPM2 , TNNT3 , TNNI2 and MYH8 ). These can cause congenital contractures, including clubfoot, in distal arthrogryposis (DA) syndromes. Clubfoot can also be present in people with genetic conditions such as Loeys–Dietz syndrome and Ehlers–Danlos syndrome . Genetic mapping and

2583-506: Is another screening option to identify high-risk pregnancies for aneuploidy and it is not diagnostic. The incidence of chromosomal abnormalities in fetuses with prenatal diagnosis of clubfoot is relatively low. Overall, fetal ultrasound should be performed with a prenatal diagnosis of clubfoot in order to classify the condition as either complex or isolated because of the significant differences in rates of chromosomal abnormalities and outcomes between these two groups. If one identical twin

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2706-404: Is believed to have caused a global volcanic winter and cooling of the climate and subsequently led to a genetic bottleneck in human evolution, though this is still in debate. The 1815 eruption of Mount Tambora and the 1883 eruption of Krakatoa were among the largest in recorded history. The former caused 92,000 deaths and created an umbrella of volcanic ash that spread and blanketed parts of

2829-467: Is born. More testing and imaging is typically not needed, unless there is concern for other associated conditions. Treatment is usually with some combination of the Ponseti method and French method. The Ponseti method involves a combination of casting , Achilles tendon release, and bracing. There are many commercial braces as well as an open-source hardware brace that can be made for about US$ 11 with

2952-410: Is convicted and shall go to jail for his insubordination against the court. Eve now exclaims that it was Adam who was in her room last night and who broke the jug while fleeing. An enraged Ruprecht attacks Adam, who flees the court room unharmed. Walter ensures Ruprecht that his conviction will be overturned, Ruprecht and Eve reconcile and their parents approve of their wedding. In 1937 a German film of

3075-524: Is elected for a five-year term, as are the party-aligned members of the DPR and the non-partisan DPD. Beginning with the 2015 local elections , elections for governors and mayors have occurred on the same date. In 2014, the Constitutional Court ruled that legislative and presidential elections would be held simultaneously, starting in 2019. Indonesia has several levels of subdivisions. The first level are

3198-403: Is generally below average in both regional and global context. Indonesia has one of the world's fastest deforestation rates. In 2020, forests covered approximately 49.1% of the country's land area, down from 87% in 1950. Since the 1970s, log production, various plantations and agriculture have been responsible for much of the deforestation in Indonesia . Most recently, it has been driven by

3321-718: Is highly unstable, making it a site of numerous volcanoes and frequent earthquakes. It lies on the Pacific Ring of Fire , where the Indo-Australian Plate and the Pacific Plate are pushed under the Eurasian Plate , where they melt at about 100 kilometres (62 miles) deep. A string of volcanoes runs through Sumatra, Java , Bali and Nusa Tenggara , and then to the Banda Islands of Maluku to northeastern Sulawesi . Of

3444-495: Is home to a unique fauna and flora closely related to that of Australia, including over 600 bird species. Indonesia is second only to Australia in terms of total endemic species, with 36% of its 1,531 species of bird and 39% of its 515 species of mammal being endemic. Indonesia harbours 83% of Southeast Asia's old-growth forest , and the highest amount of forest carbon in the region. Tropical seas surround Indonesia's 80,000 kilometres (50,000 miles) of coastline. The country has

3567-591: Is now Taiwan. They arrived in the archipelago around 2,000 BCE and confined the native Melanesians to the far eastern regions as they spread east. Ideal agricultural conditions and the mastering of wet-field rice cultivation as early as the eighth century BCE allowed villages, towns, and small kingdoms to flourish by the first century CE. The archipelago's strategic sea-lane position fostered inter-island and international trade, including with Indian kingdoms and Chinese dynasties, from several centuries BCE. Trade has since fundamentally shaped Indonesian history. From

3690-447: Is required after initial treatment. The Ponseti method corrects clubfoot over the course of several stages. The Ponseti method is highly effective with short-term success rates of 90%. However, anywhere from 14% to 41% of children experience a recurrence of the deformity, with as many as 56% requiring an additional surgery beyond the 10 year mark. The most common reason for this is inadequate adherence to bracing, such as not wearing

3813-544: Is some policy recognition of OECMs but no national mechanism for reporting them. There are 55 national parks in Indonesia, of which 9 are predominantly marine . Of these 6 are World Heritage Sites , such as the Tropical Rainforest Heritage of Sumatra that includes three parks. Seven national parks are part of the World Network of Biosphere Reserves and 5 are wetlands of international importance under

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3936-403: Is the Ponseti method , which is divided into two phases: 1) correcting of foot position and 2) casting at repeated weekly intervals. If the clubfoot deformity does not improve by the end of the casting phase, an Achilles tendon tenotomy can be performed. The procedure consists of a small posterior skin incision through which the tendon cut is made. In order to maintain the correct position of

4059-542: Is the delegation of power and authority to various regional entities while remaining a unitary state . The President of Indonesia is the head of state and head of government , commander-in-chief of the Indonesian National Armed Forces ( Tentara Nasional Indonesia , TNI), and the director of domestic governance, policy-making, and foreign affairs. The president may serve a maximum of two consecutive five-year terms. The highest representative body at

4182-429: Is the most common congenital malformation of the foot with an incidence of 1 per 1000 births. In approximately 50% of cases, clubfoot affects both feet, but it can present unilaterally causing one leg or foot to be shorter than the other. Most of the time, it is not associated with other problems. Without appropriate treatment, the foot deformity will persist and lead to pain and impaired ability to walk, which can have

4305-639: The Netherlands East Indies ( Nederlandsch Oost Indië ), popularly Indië ; the East ( de Oost ); and Insulinde . After 1900, Indonesia became more common in academic circles outside the Netherlands, and native nationalist groups adopted it for political expression. Adolf Bastian of the University of Berlin popularized the name through his book Indonesien oder die Inseln des Malayischen Archipels, 1884–1894 . The first native scholar to use

4428-426: The 2006 Yogyakarta earthquake . Indonesia's size, tropical climate, and archipelagic geography support one of the world's highest levels of biodiversity , and it is among the 17 megadiverse countries identified by Conservation International . Its flora and fauna are a mixture of Asian and Australasian species. The Sunda Shelf islands (Sumatra, Java, Borneo, and Bali) were once linked to mainland Asia and have

4551-623: The Army (TNI–AD), Navy (TNI–AL, which includes Marine Corps ), and Air Force (TNI–AU). The army has about 400,000 active-duty personnel. Defence spending in the national budget was 0.7% of gross domestic product (GDP) in 2018, with controversial involvement of military-owned commercial interests and foundations. The Armed Forces were formed during the Indonesian National Revolution when it undertook guerrilla warfare along with informal militia. Since then, territorial lines have formed

4674-491: The Bali myna , Sumatran orangutan , and Javan rhinoceros . Some academics describe the deforestation and other environmental destruction in the country as an ecocide . As of 2023, the government of Indonesia has gazetted 21.3% of the country's land as protected areas , with the intention of developing a new protected area strategy in line with global post-2020 framework . The country also has 411 marine reserves , or 9% of

4797-586: The Constitutional Court ( Mahkamah Konstitusi ) which listens to constitutional and political matters, and the Religious Court ( Pengadilan Agama ), which deals with codified Islamic Personal Law ( sharia ) cases. Additionally, the Judicial Commission ( Komisi Yudisial ) monitors the performance of judges. Since 1999, Indonesia has had a multi-party system. In all legislative elections since

4920-462: The Consumer Price Index have contributed to strong economic growth in recent years. From 2007 to 2019, annual growth accelerated to between 4% and 6% due to improvements in the banking sector and domestic consumption, helping Indonesia weather the 2008–2009 Great Recession , and regain in 2011 the investment grade rating it had lost in 1997. As of 2019 , 9.41% of the population lived below

5043-491: The Indian and Pacific oceans. It consists of over 17,000 islands , including Sumatra , Java , Sulawesi , and parts of Borneo and New Guinea . Indonesia is the world's largest archipelagic state and the 14th-largest country by area , at 1,904,569 square kilometres (735,358 square miles). With over 280 million people, Indonesia is the world's fourth-most-populous country and the most populous Muslim-majority country . Java,

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5166-671: The Indian subcontinent . Over the centuries, local rulers assimilated foreign influences, leading to the flourishing of Hindu and Buddhist kingdoms. Sunni traders and Sufi scholars later brought Islam , and European powers fought one another to monopolise trade in the Spice Islands of Maluku during the Age of Discovery . Following three and a half centuries of Dutch colonialism , Indonesia secured its independence after World War II . Indonesia's history has since been turbulent, with challenges posed by natural disasters, corruption, separatism,

5289-602: The Japanese invasion and occupation ended Dutch rule and encouraged the independence movement. Two days after the surrender of Japan in August 1945, influential nationalist leaders Sukarno and Mohammad Hatta issued the Proclamation of Indonesian Independence . Sukarno, Hatta, and Sutan Sjahrir were appointed president, vice-president, and prime minister, respectively. The Netherlands attempted to re-establish their rule. In

5412-698: The Maluku Islands . Dutch and British traders followed. In 1602, the Dutch established the Dutch East India Company ( Verenigde Oostindische Compagnie ; VOC) and became the dominant European power for almost 200 years. The VOC was dissolved in 1799 following bankruptcy, and the Netherlands established the Dutch East Indies as a nationalised colony. For most of the colonial period , Dutch control over

5535-536: The Prosperous Justice Party (PKS). The first general election was held in 1955 to elect members of the DPR and the Constitutional Assembly ( Konstituante ). The most recent elections in 2019 resulted in nine political parties in the DPR, with a parliamentary threshold of 4% of the national vote. At the national level, Indonesians did not elect a president until 2004. Since then, the president

5658-520: The Ramsar convention . Around 9% of the Indonesia surface are national parks. As of 2012 Indonesia had over 100 marine protected areas covering an area of 15.7 million ha, of which 32 where managed by the Ministry of Forestry while the rest where managed by local governments. In 2009 the president Susilo Bambang Yudhoyono declared a target of reaching 20 million hectares by 2020. In 2010 Indonesia also set out

5781-683: The UNHRC have raised the issue of human rights abuses committed by Indonesian troops in Papua such as extrajudicial killings and forced disappearances. Past engagements of the army include the conflict against the Netherlands over the Dutch New Guinea , the opposition to the British -sponsored creation of Malaysia (" Konfrontasi "), the mass killings of the Indonesian Communist Party (PKI), and

5904-483: The Weber Line . In his 1869 book, The Malay Archipelago , Wallace described numerous species unique to the area. The region of islands between his line and New Guinea is now termed Wallacea . Indonesia's large and growing population and rapid industrialisation present serious environmental issues . They are often given a lower priority due to high poverty levels and weak, under-resourced governance. Problems include

6027-672: The invasion of East Timor , the latter having been Indonesia's most massive military operation. Indonesia has a mixed economy in which the private sector and government play vital roles. As the only G20 member state in Southeast Asia, the country has the largest economy in the region and is classified as a newly industrialised country . Per a 2023 estimate, it is the world's 16th largest economy by nominal GDP and 7th in terms of GDP at PPP , estimated to be US$ 1.417 trillion and US$ 4.393 trillion, respectively. Per capita GDP in PPP

6150-436: The palm oil industry, which has been criticised for its environmental impact and displacement of local communities. The situation has made Indonesia the world's largest forest-based emitter of greenhouse gases. It also threatens the survival of indigenous and endemic species. The International Union for Conservation of Nature (IUCN) identified 140 species of mammals as threatened and 15 as critically endangered, including

6273-436: The provinces , which have a legislature ( Dewan Perwakilan Rakyat Daerah , DPRD) and an elected governor . A total of 38 provinces have been established from the original eight in 1945, the most recent change being the split of Southwest Papua from the province of West Papua in 2022. The second level are the regencies ( kabupaten ) and cities ( kota ), led by regents ( bupati ) and mayors ( walikota ), respectively, and

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6396-410: The tropical rainforest climate found on every large island of Indonesia. Cooler climate types exist in mountainous regions that are 1,300 to 1,500 metres (4,300 to 4,900 feet) above sea level. The oceanic climate (Köppen Cfb ) prevails in highland areas adjacent to rainforest climates, with uniform precipitation year-round. In highland areas near the tropical monsoon and tropical savanna climates ,

6519-531: The 11th and 12th week of gestation. Intrinsic factors Clubfoot can be diagnosed prenatally as early as 13 weeks of gestation via ultrasound. According to the Society of Maternal-Fetal Medicine, a diagnostic testing for genetic causes is recommended when clubfoot is diagnosed prenatally. If prenatal screening is suspicious for aneuploidy, karyotype analysis or chromosomal microarray (CMA) may be performed. However, if patients decline diagnostic testing, Cell-Free DNA

6642-413: The 1950s and 1960s to promote agricultural self-sufficiency. A gradual process of industrialisation and urbanisation began in the late 1960s and accelerated in the 1980s as falling oil prices saw the government focus on diversifying away from oil exports and towards manufactured exports. This development continued throughout the 1980s and into the next decade despite the 1990 oil price shock , during which

6765-411: The 400 volcanoes, around 130 are active. Between 1972 and 1991, there were 29 volcanic eruptions, mostly on Java. Volcanic ash has made agricultural conditions unpredictable in some areas. However, it has also resulted in fertile soils, a factor in historically sustaining the high population densities of Java and Bali. A massive supervolcano erupted at present-day Lake Toba around 70,000 BCE. It

6888-620: The Cold War. Numerous attempts by the United States and the Soviet Union , and China to some degree, culminated in the 1965 coup attempt and subsequent upheaval that led to a reorientation of foreign policy. Quiet alignment with the Western world while maintaining a non-aligned stance has characterised Indonesia's foreign policy since then. Today, it maintains close relations with its neighbours and

7011-541: The GDP rose at an average rate of 7.1%. As a result, the official poverty rate fell from 60% to 15%. Trade barriers reduction from the mid-1980s made the economy more globally integrated. The growth ended with the 1997 Asian financial crisis that severely impacted the economy, including a 13.1% real GDP contraction in 1998 and a 78% inflation. The economy reached its low point in mid-1999 with only 0.8% real GDP growth. Relatively steady inflation and an increase in GDP deflator and

7134-504: The Philippines , Australia , Palau , and India . Despite its large population and densely populated regions, Indonesia has vast areas of wilderness that support one of the world's highest levels of biodiversity . The Indonesian archipelago has been a valuable region for trade since at least the seventh century, when Sumatra's Srivijaya and later Java's Majapahit kingdoms engaged in commerce with entities from mainland China and

7257-510: The Philippines, Palau, and Australia. At 4,884 metres (16,024 ft), Puncak Jaya is Indonesia's highest peak, and Lake Toba in Sumatra is the largest lake, with an area of 1,145 km (442 sq mi). Indonesia's largest rivers are in Kalimantan and New Guinea and include Kapuas , Barito , Mamberamo , Sepik and Mahakam . They serve as communication and transport links between

7380-470: The Ponseti method which uses rigid casts and braces, the French method uses tape which allows for some motion in the feet. Despite its goal to avoid surgery, the success rate varies and surgery may still be necessary. The Ponseti method is generally preferred over the French method. If non-operative treatments are unsuccessful or achieve incomplete correction of the deformity, surgery is sometimes needed. Surgery

7503-488: The UN) scattered over both sides of the equator, around 6,000 of which are inhabited. The largest are Sumatra , Java , Borneo (shared with Brunei and Malaysia), Sulawesi , and New Guinea (shared with Papua New Guinea). Indonesia shares land borders with Malaysia on Borneo and Sebatik , Papua New Guinea on the island of New Guinea, East Timor on the island of Timor , and maritime borders with Singapore, Malaysia, Vietnam,

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7626-581: The United Nations, World Trade Organization , G20 , and a founding member of the Non-Aligned Movement , Association of Southeast Asian Nations , East Asia Summit , D-8 , APEC , and the Organisation of Islamic Cooperation . The name Indonesia derives from the Greek words Indos ( Ἰνδός ) and nesos ( νῆσος ), meaning "Indian islands". The name dates back to the 19th century, far predating

7749-461: The archipelago and made much of the Northern Hemisphere without summer in 1816 . The latter produced the loudest sound in recorded history and caused 36,000 deaths due to the eruption itself and the resulting tsunamis, with significant additional effects around the world years after the event. Recent catastrophic disasters due to seismic activity include the 2004 Indian Ocean earthquake and

7872-562: The archipelago was tenuous. Dutch forces were engaged continuously in quelling rebellions on and off Java. The influence of local leaders such as Prince Diponegoro in central Java, Imam Bonjol in central Sumatra, Pattimura in Maluku , and the Aceh War weakened the Dutch and tied up the colonial military forces. Only in the early 20th century did Dutch dominance extend to what was to become Indonesia's current boundaries. During World War II,

7995-473: The basis of all TNI branches' structure, aimed at maintaining domestic stability and deterring foreign threats. The military has possessed a strong political influence since its founding, which peaked during the New Order . Political reforms in 1998 included the removal of the TNI's formal representation from the legislature. Nevertheless, its political influence remains, albeit at a reduced level. Since independence,

8118-573: The beginning of the Indonesian National Revolution , the Dutch recognised Indonesian independence in the face of international pressure in December 1949, following the Dutch–Indonesian Round Table Conference . Despite political, social, and sectarian divisions, Indonesians found unity in their fight for independence. As president, Sukarno moved Indonesia from democracy towards authoritarianism and maintained power by balancing

8241-399: The brace properly, not keeping it on for the recommended length of time, or not using it every day. Children who do not follow proper bracing protocol have up to seven times higher recurrence rates than those who follow bracing protocol, as the muscles around the foot can pull it back into the abnormal position. Low parental education level and failure to understand the importance of bracing is

8364-417: The child is over four years of age (many doctors prefer to wait until after seven years old), this can be addressed with a surgery to transfer the tibialis anterior tendon from its medial attachment (on the navicula ) to a more lateral position (on the lateral cuneiform ). The surgery requires general anesthesia and subsequent casting while the tendon heals, but it is a relatively minor surgery that re-balances

8487-454: The clubfoot deformity: Factors used to assess severity include the stiffness of the deformity (how much it can be corrected by manually manipulating the foot), the presence of skin creases at the arch and heel, and poor muscle consistency. Sometimes, it is possible to detect clubfoot before birth using ultrasound . Prenatal diagnosis by ultrasound can allow parents to learn more about this condition and plan ahead for treatment after their baby

8610-583: The condition appears in Egyptian paintings. Indian texts ( c.  1000 BC ) and Hippocrates ( c.  400 BC ) describe treatment. In 1823, Delpech presented a new procedure to treat the condition. The new method, known as tenotomy, involved the cutting of the Achilles tendon. The surgical procedure had complications such as infections. Talleyrand might have had a congenital clubfoot, which if his uncle did as well, could have been genetic. In any case, his handicap made him unable to follow his father into

8733-415: The condition is diagnosed with a high degree of confidence was the 12th and the latest was the 32nd. Not all patients were diagnosed at an early stage. In 29% of fetuses the first ultrasound examination failed to detect the deformity which subsequently became obvious at a later examination. Clubfoot was diagnosed between 12 and 23 weeks of gestation in 86% of children and between 24 and 32 weeks of gestation in

8856-499: The country hardest hit by the 1997 Asian financial crisis . It brought out popular discontent with the New Order's corruption and suppression of political opposition and ultimately ended Suharto's presidency. In 1999, East Timor seceded from Indonesia, following its 1975 invasion by Indonesia and a 25-year occupation marked by international condemnation of human rights abuses . Since 1998, democratic processes have been strengthened by enhancing regional autonomy and instituting

8979-456: The country has struggled to maintain unity against local insurgencies and separatist movements. Some, notably in Aceh and Papua , have led to an armed conflict and subsequent allegations of human rights abuses and brutality from all sides. The former was resolved peacefully in 2005, while the latter has continued amid a significant, albeit imperfect, implementation of regional autonomy laws. Reports from Amnesty , Human Rights Watch , and

9102-493: The country's first direct presidential election in 2004 . Political, economic and social instability, corruption, and instances of terrorism remained problems in the 2000s; however, the economy has performed strongly since 2007. Although relations among the diverse population are mostly harmonious, acute sectarian discontent and violence remain problematic in some areas. A political settlement to an armed separatist conflict in Aceh

9225-415: The country's total maritime area, and has set a target to increase this to 30% by 2045. However, a 2023 study suggested this target is not on track and that existing marine reserves are poorly managed. Around 390 marine areas are managed in some way by government bodies, communities, and other sectors, with potential for these to be considered other effective area-based conservation measures (OECMs). There

9348-432: The destruction of peatlands, large-scale illegal deforestation (causing extensive haze across parts of Southeast Asia ), over-exploitation of marine resources, air pollution, garbage management, and reliable water and wastewater services . These issues contribute to Indonesia's low ranking (number 116 out of 180 countries) in the 2020 Environmental Performance Index . The report also indicates that Indonesia's performance

9471-498: The development of models of the disease have improved understanding of developmental processes. Its inheritance pattern is explained as a heterogenous disorder using a polygenic threshold model. The PITX1 - TBX4 transcriptional pathway has become key to the study of clubfoot. PITX1 and TBX4 are uniquely expressed in the hind limb. Clubfoot is diagnosed through physical examination. Typically, babies are examined from head-to-toe shortly after they are born. There are four components of

9594-531: The dominant religion in Java and Sumatra by the end of the 16th century. For the most part, Islam overlaid and mixed with existing cultural and religious influences, which shaped the predominant form of Islam in Indonesia, particularly in Java. The first Europeans arrived in the archipelago in 1512, when Portuguese traders, led by Francisco Serrão , sought to monopolise the sources of nutmeg , cloves , and cubeb pepper in

9717-437: The etiology of clubfoot is most likely multifactorial. A meta-analysis and systematic review found that the most clinically relevant risk factors for clubfoot were family history, paternal and maternal smoking, maternal obesity, gestational diabetes, amniocentesis, and the use of selective serotonin re-uptake inhibitors (SSRIs). Many findings agree that "it is likely there is more than one different cause and at least in some cases

9840-636: The executive branch. Reforms since 1998 have markedly increased its role in national governance, while the DPD is a new chamber for matters of regional management. Most civil disputes appear before the State Court ( Pengadilan Negeri ); appeals are heard before the High Court ( Pengadilan Tinggi ). The Supreme Court of Indonesia ( Mahkamah Agung ) is the highest level of the judicial branch and hears final cessation appeals and conducts case reviews. Other courts include

9963-691: The fall of the New Order , no political party has won an overall majority of seats. The Indonesian Democratic Party of Struggle (PDI-P) secured the most votes in the 2024 general election , becoming their third consecutive wins since 2014. Other notable parties include the Party of the Functional Groups ( Golkar ), the Great Indonesia Movement Party ( Gerindra ), the Democratic Party , and

10086-496: The feet's range of motion. Exercises may focus on strengthening the peroneal muscles , which is thought to contribute to long-term correction. After the two month mark, the frequency of physical therapy sessions can be weaned down to three times a week instead of daily, until the child reaches six months. After the conclusion of the physical therapy program, caregivers must continue performing exercises at home and splinting at night in order to maintain long-term correction. Compared to

10209-434: The foot can be brought to an appropriate plantigrade position. Specifically, it is important to bring the ankle to neutral, the heel into neutral, the midfoot aligned with the hindfoot (navicula aligned with the talus, and the cuboid aligned with the calcaneus). Once these joints can be aligned, thin wires are usually placed across these joints to hold them in the corrected position. These wires are temporary and left out through

10332-430: The foot, it is necessary to wear an orthopedic brace until 5 years of age. Initially, the brace is worn nearly continuously and then just at night. In about 20% of cases, further surgery is required. Treatment can be carried out by a range of healthcare providers and can generally be achieved in the developing world with few resources. Congenital clubfoot occurs in 1 to 4 of every 1,000 live births, making it one of

10455-409: The forefoot, midfoot, or hindfoot. Many patients do fine, but some require orthotics or additional surgeries. Long-term studies of adults with post-surgical clubfeet, especially those needing multiple surgeries, show that they may not fare as well in the long term. Some people may require additional surgeries as they age, though there is some dispute as to the effectiveness of such surgeries, in light of

10578-582: The formation of independent Indonesia. In 1850, George Windsor Earl , an English ethnologist , proposed the terms Indunesians —and, his preference, Malayunesians —for the inhabitants of the "Indian Archipelago or Malay Archipelago ". In the same publication, one of his students, James Richardson Logan , used Indonesia as a synonym for Indian Archipelago . Dutch academics writing in East Indies publications were reluctant to use Indonesia . They preferred Malay Archipelago ( Dutch : Maleische Archipel );

10701-438: The frequency of drought and food shortages (with an impact on precipitation and the patterns of wet and dry seasons, and thus Indonesia's agriculture system ) as well as numerous diseases and wildfires. Rising sea levels would also threaten most of Indonesia's population, who live in low-lying coastal areas. Impoverished communities would likely be affected the most by climate change. Tectonically , most of Indonesia's area

10824-495: The interiors of Kalimantan and Papua, and less in areas closer to Australia, such as Nusa Tenggara, which tends to be relatively dry. The almost uniformly warm waters that constitute 81% of Indonesia's area ensure that land temperatures remain relatively constant. Humidity is quite high, at between 70 and 90%. Winds are moderate and generally predictable, with monsoons usually blowing in from the south and east in May through October and from

10947-419: The island's river settlements. Indonesia lies along the equator, and its climate tends to be relatively even year-round. Indonesia has two seasons—a dry season and a wet season —with no extremes of summer or winter. For most parts of Indonesia, the dry season falls between May and October, while the wet season falls between November and April. Indonesia's climate is almost entirely tropical , dominated by

11070-463: The jug broken. She also claims that Eve had accused Ruprecht of breaking the jug. When it is Ruprecht's turn to testify, he explains that he secretly went to Eve's home and heard her talk with somebody in her room. He mentions that he suspected it to be a man called Lebrecht, who had previously shown interest in Eve. When Adam hears that Lebrecht is suspected, he eagerly requests that information to be noted in

11193-422: The morning. Licht also notices a large gash on Adam's face. Adam tells Licht that he received these wounds when he fell down after getting out of bed this morning and hit his head on the fireplace. Licht also comments on Adam's clubfoot . Licht informs Adam that Walter, a government inspector who travels through the country to inspect the finances and the proceedings of the town courts, will arrive this day to take

11316-676: The most common birth defects affecting the legs. About 80% of cases occur in developing countries where there is limited access to care. Clubfoot is more common in firstborn children and males. It is more common among Māori people , and less common among Chinese people. Birth prevalence of clubfoot varies between 0.51 and 2.03/1,000 live births in low and middle-income countries (LMICs). Clubfoot disproportionally affects those in LMICs. About 80% of those with clubfoot, or approximately 100,000 children per year as of 2018, are born in LMICs. Pharaohs Siptah and Tutankhamun had clubfeet, and

11439-463: The muscles of the foot without disturbing any joints. The French method is a conservative, non-operative method of clubfoot treatment that involves daily physical therapy for the first two months followed by thrice-weekly physical therapy for the next four months and continued home exercises following the conclusion of formal physical therapy. During each physical therapy session the feet are manipulated, stretched, then taped to maintain any gains made to

11562-500: The muscles that invert the ankle ( tibialis posterior and tibialis anterior muscles) and the muscles that evert the ankle ( peroneal muscles ). This imbalance is present in approximately 20% of infants successfully treated with the Ponseti casting method, and makes them more prone to recurrence. This relapse is usually treated with Ponseti casting and can be done multiple times before resorting to surgery. If after all non-surgical casting and bracing options have been exhausted, and when

11685-511: The name was Ki Hajar Dewantara when in 1913, he established a press bureau in the Netherlands, Indonesisch Pers-bureau . Fossilised remains of Homo erectus , popularly known as the " Java Man ", suggest the Indonesian archipelago was inhabited two million to 500,000 years ago. Homo sapiens reached the region around 43,000 BCE. Austronesian peoples , who form the majority of the modern population, migrated to Southeast Asia from what

11808-625: The national level is the People's Consultative Assembly ( Majelis Permusyawaratan Rakyat , MPR). Its main functions are supporting and amending the constitution, inaugurating and impeaching the president, and formalising broad outlines of state policy. The MPR comprises two houses; the People's Representative Council ( Dewan Perwakilan Rakyat , DPR), with 575 members, and the Regional Representative Council ( Dewan Perwakilan Daerah , DPD), with 136. The DPR passes legislation and monitors

11931-550: The north and west in November through April. Typhoons and large-scale storms pose little hazard to mariners; significant dangers come from swift currents in channels, such as the Lombok and Sape straits. Several studies consider Indonesia to be at severe risk from the projected effects of climate change . These include unreduced emissions resulting in an average temperature rise of around 1 °C (2 °F) by mid-century, raising

12054-425: The only ones where the indigenous people have privileges in their local government. Indonesia maintains 132 diplomatic missions abroad, including 95 embassies. The country adheres to what it calls a "free and active" foreign policy, seeking a role in regional affairs in proportion to its size and location but avoiding involvement in conflicts among other countries. Indonesia was a significant battleground during

12177-484: The opposing forces of the military , political Islam, and the increasingly powerful Communist Party of Indonesia (PKI). Tensions between the military and the PKI culminated in an attempted coup in 1965. The army, led by Major General Suharto , countered by instigating a violent anti-communist purge that killed between 500,000 and one million people and incarcerated roughly a million more in concentration camps . The PKI

12300-537: The person's community. In the 2024 series The Penguin, Oswald Cobb, the main character, has a club foot that causes his to walk with a limp. The main character of the animated series, Waynehead (1996), based on creator Damon Wayan's childhood, had a large foot brace due to his club foot. Indonesia Indonesia , officially the Republic of Indonesia , is a country in Southeast Asia and Oceania , between

12423-779: The phenotype may occur as a result of a threshold effect of different factors acting together." The most commonly associated conditions are distal arthrogryposis or myelomeningocele . The factors contributing to the development of clubfoot can be categorized as extrinsic and intrinsic factors. Extrinsic factors Factors that can influence the positioning of the fetal foot in utero include oligohydramnios, breech presentation, Müllerian anomalies, multiple gestation, amniotic band sequence, or amniocentesis at <15 weeks of gestation. In cases that impede normal growth and position for longstanding period of times, clubfoot can be accompanied with other deformations and may be associated with developmental hip dysplasia. The theory of fetal growth arrest

12546-435: The plaintiff Marthe, a widowed farmer who is there with her daughter Eve and the defendant, Ruprecht, Eve's fiancé together with his father, Veit. Before the trial Eve tries to speak to Ruprecht, who rejects her and calls her a harlot. Adam also speaks to the parties before the trial, especially Eve, seemingly trying to influence her testimony. Walter admonishes Adam and requests him to start the official trial immediately. When

12669-517: The play, setting it in a famine-stricken Irish village. It had its first production in Dublin in 1994. In Indonesia , Studiklub Teater Bandung (STB) produced adaption by Suyatna Anirun with Indonesian title "Jambangan yang Pecah" in 1982. [REDACTED] Media related to The Broken Jug at Wikimedia Commons Clubfoot Clubfoot is a congenital or acquired defect where one or both feet are rotated inward and downward . Congenital clubfoot

12792-544: The poverty line, and the official open unemployment rate was 5.28%. During the first year of the global COVID-19 pandemic , the economy suffered its first recession since the 1997 crisis but recovered in the following year. Indonesia has abundant natural resources. Its primary industries are fishing, petroleum, timber, paper products, cotton cloth, tourism, petroleum mining, natural gas, bauxite, coal, and tin. Its main agricultural products are rice, coconuts, soybeans, bananas, coffee, tea, palm, rubber, and sugar cane. Indonesia

12915-533: The prevalence of scar tissue present from earlier surgeries. Despite effective treatments, children in LMICs face many barriers such as limited access to equipment (specifically casting materials and abduction braces), shortages of healthcare professionals , and low education levels and socioeconomic status amongst caregivers and families. These factors make it difficult to detect and diagnose children with clubfoot, connect them to care, and train their caregivers to follow

13038-420: The proper treatment and return for follow-up visits. It is estimated that only 15% of those diagnosed with clubfoot receive treatment. In an effort to reduce the burden of clubfoot in LMICs, there have been initiatives to improve early diagnosis, organize high-volume Ponseti casting centers, utilize mid-level practitioners and non-physician health workers, engage families in care, and provide local follow-up in

13161-491: The protocol. Ruprecht says that he broke down the door, entered the room and saw someone flee through the window. He was able to hit the fleeing man twice over the head with a broken off door handle but could not identify the person. He also admits that he is not absolutely sure if it was him or the fleeing man who broke the jug in the chaos. When it is Eve's turn, Adam again talks to her, seemingly trying to influence her testimony. Walter again admonishes him. Eve testifies that it

13284-437: The remaining 14%. Without treatment the foot remains deformed and people walk on the sides or tops of their feet, which can cause calluses, foot infections, trouble fitting into shoes, pain, difficulty walking, and disability. Hypotheses about the precise cause of clubfoot vary. However, research has found that genetics, environmental factors or a combination of both are associated with this condition. Evidence suggests that

13407-604: The risk of developing congenital clubfoot is 25% when a first-degree relative is affected. In addition, if one identical twin is affected, there is a 33% chance the other one will be as well. The underlying mechanism involves disruption of the muscles or connective tissue of the lower leg, leading to joint contracture . Other abnormalities are associated 20% of the time, with the most common being distal arthrogryposis and myelomeningocele . The diagnosis may be made at birth by physical examination or before birth during an ultrasound exam. The most common initial treatment

13530-718: The same title was released with Emil Jannings in the lead. It is also a 1941 opera by Viktor Ullmann . In 1944 it was produced as a film in Mexico by German director Alfredo B. Crevenna under the title Adan, Eva y el diablo . In 1958, the Stratford Festival produced an adaptation by Donald Harron and directed by Michael Langham which toured in Canada and to the Phoenix Theatre in New York . The Irish author, John Banville , adapted

13653-450: The seventh century CE, the Srivijaya naval kingdom flourished due to trade and the influences of Hinduism and Buddhism . Between the eighth and tenth centuries CE, the agricultural Buddhist Sailendra and Hindu Mataram dynasties thrived and declined in inland Java, leaving grand religious monuments such as Sailendra's Borobudur and Mataram's Prambanan . The Hindu Majapahit kingdom

13776-414: The skin for removal after 3–4 weeks. Once the joints are aligned, tendons (typically the Achilles, posterior tibialis, and flexor halluces longus) are repaired at an appropriate length. The incision (or incisions) are closed with dissolvable sutures. The foot is then casted in the corrected position for 6–8 weeks. It is common to do a cast change with anesthesia after 3–4 weeks, so that pins can be removed and

13899-438: The subtropical highland climate (Köppen Cwb ) is more pronounced during dry season. Some regions, such as Kalimantan and Sumatra , experience only slight differences in rainfall and temperature between the seasons, whereas others, such as Nusa Tenggara, experience far more pronounced differences with droughts in the dry season and floods in the wet season. Rainfall varies across regions, with more in western Sumatra, Java, and

14022-413: The trial starts, an enraged Marthe accuses Ruprecht of having destroyed a water jug which was intricately painted and had rich family history and because of that had a large emotional value to her. Other people suggest that her disappointment of Ruprecht's treatment of Eve may also have something to do with her anger. Marthe claims that she found Ruprecht in Eve's room last night with the door broken down and

14145-633: The village ( desa ) is divided into smaller units called dusun or dukuh (hamlets), which are the same as RW. Following the implementation of regional autonomy measures in 2001, regencies and cities have become chief administrative units responsible for providing most government services. The village administration level is the most influential on a citizen's daily life and handles village or neighbourhood matters through an elected village head ( lurah or kepala desa ). Nine provinces—Aceh, Jakarta, Yogyakarta, Papua , Central Papua , Highland Papua , South Papua , Southwest Papua , and West Papua —are granted

14268-523: The world's most populous island , is home to more than half of the country's population. Indonesia is a presidential republic with an elected legislature . It has 38 provinces , of which nine have special autonomous status . The country's largest city, Jakarta , is the world's second-most-populous urban area . Indonesia shares land borders with Papua New Guinea , East Timor , and the eastern part of Malaysia , as well as maritime borders with Singapore , Peninsular Malaysia , Vietnam , Thailand ,

14391-656: Was a founding member of the Non-Aligned Movement (NAM) and the Organisation of Islamic Cooperation (OIC). Indonesia is a signatory to the ASEAN Free Trade Area agreement, the Cairns Group , the World Trade Organization (WTO), and a former member of OPEC . Indonesia has been a humanitarian and development aid recipient since 1967, and recently, the country established its first overseas aid programme in late 2019. Indonesia's Armed Forces (TNI) include

14514-575: Was achieved in 2005. Indonesia is the southernmost country in Asia. The country lies between latitudes 11°S and 6°N and longitudes 95°E and 141°E . A transcontinental country spanning Southeast Asia and Oceania, it is the world's largest archipelagic state , extending 5,120 kilometres (3,181 mi) from east to west and 1,760 kilometres (1,094 mi) from north to south. The country's Coordinating Ministry for Maritime and Investments Affairs says Indonesia has 17,504 islands (with 16,056 registered at

14637-450: Was blamed for the coup and effectively destroyed. Suharto capitalised on Sukarno's weakened position, and following a drawn-out power play with Sukarno , Suharto was appointed president in March 1968. His US-backed "New Order" administration encouraged foreign direct investment , which was a crucial factor in the subsequent three decades of substantial economic growth. Indonesia was

14760-401: Was founded in eastern Java in the late 13th century, and under Gajah Mada , its influence stretched over much of present-day Indonesia. This period is often referred to as the "Golden Age" in Indonesian history. The earliest evidence of Islamized populations in the archipelago dates to the 13th century in northern Sumatra . Other parts of the archipelago gradually adopted Islam, and it was

14883-420: Was more common prior to the widespread acceptance of the Ponseti method. The extent of surgery depends on the severity of the deformity. Usually, surgery is done at 9 to 12 months of age and the goal is to correct all the components of the clubfoot deformity at the time of surgery. For feet with the typical components of deformity (cavus, forefoot adductus, hindfoot varus, and ankle equinus), the typical procedure

15006-561: Was not Ruprecht who broke the jug but that she will not name the actual guilty person. During a pause in the proceedings, Adam tries to get Walter drunk. Then, Brigitte, a lodger in Marthe's house arrives with Licht and a wig in her hand. She states that she found the wig last night in Marthe's garden and that she and Licht found a club-footed trail in the fresh snow and both followed that trail to Adam's house. Walter asks Adam to come clean but Adam refuses and instead hands down his ruling: Ruprecht

15129-508: Was proposed by Von Volkmann in 1863, and has been verified by other authors since. According to this theory, intrinsic errors or environmental insults during gestation prevents the correction of an equinovarus to pronated foot. Other researchers hypothesize that clubfoot may derive from external insults during gestation. For example, a research study found an alarmingly high incidence of club foot and limb contractures associated with iatrogenic amniotic leakage caused by early amniocentesis between

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