The Adult Transition Challenge of Autistic Individuals and the Way Ahead

Autism is a life-long neurodevelopmental condition characterized by difficulties in social communication, restricted and repetitive behaviors, and sensory processing issues. In India, there is a huge question mark regarding autistic individuals after they transition into adulthood, more specifically in housing and work options. In this chapter, beginning from the general considerations for upbringing of an autistic individual, attention is given to the need for future planning of autistic adults, more specifically in residential options. Some of the major residential centres are described followed by projections on establishing residential facilities. Following this, examples of life skills training, employment, and inclusion initiatives taking place in India are mentioned. Finally, research directions and other expectations aimed at increasing support for parents and siblings and also improving the lives of individuals on spectrum are discussed.

Asumispalvelujen hankinnan kehykset

Artikkelissa tarkastellaan, millaisia tavoitteita kunnalliset tilaajat asettavat asumispalveluille. Millaisia tilaamisen viitekehyksiä on tunnistettavissa asumispalvelujen tilaajien teemahaastattelujen perusteella? Analyysin tuloksena tunnistetaan kolme kehystä: julkishallinnollinen vahvan ohjauksen, tuotteistukseen ohjaava ja markkinaehtoinen vahvan ohjauksen kehys. Kehyksiä yhdistää se, ettei hankintaosaamiseen sisälly riittävää ymmärrystä tilattavista palveluista ja tuotteista. Tilaajien tavoitteiden saavuttaminen edellyttäisi asiantuntemuksen uutta jäsentämistä. Palvelun käyttäjien itsenäisen asumisen ja elämän sekä henkilöstön asumisen tuen asiantuntemusta tarvitaan palvelujen tilaamisessa ja näin ollen myös sosiaali- ja terveydenhuollon uudistuksessa – esimerkiksi artikkelissa luonnostellun neljännen, yhteistoiminnallisen kehyksen mukaisesti. Kilpailutus ei ole toimiva väline asumispalvelujen tilaamisessa. Sen merkitystä palvelujen laadun, kustannustehokkuuden ja tuloksellisuuden saavuttamisessa on yliarvioitu. Kilpailutus ei ole suoraan vaikuttanut palvelujen laadun eikä palvelujen käyttäjien aseman kohentumiseen, mihin yhteistoiminnallinen kehys antaa uusia mahdollisuuksia. Avainasemassa on tilaajien aloitteellisuus. Julkisen ohjauksen tehtävänä on velvoittaa kaikkia asianosaisryhmiä tyydyttävään yhteistoimintaan. Abstract Frameworks of Commissioning Residential Facilities for Mental Health and Drug Service Users. In Search of a Collaborative Framework This article analyzes the goals that commissioners of residential facilities for mental health and drug service users try to achieve. Are there specific frameworks of commissioning which can be recognized from analysis of interviews with commissioners? The research material used in this analysis is based on field work in three different parts of Finland. The article recognizes three frameworks of public steering: a strong traditional commissioning; a new model for commodification of services and a strong market based commissioning. The critical common denominator of these frameworks is that the commissioners do not have adequate understanding of the services and the contexts of service provision which they are obliged to commission and purchase. To achieve the goals set by the commissioners, a new model of collaborative framework is duly required – this framework puts stronger emphasis on the expertises of users and ground floor staff. The commissioners play a key role in forming new alliances between private and other service providers, the ground floor staff, the service users and other stakeholders. Keywords: commissioning, housing services for mental health and drug service users, collaborative framework

Loneliness, Coping Strategies and Perceived Social Support among Students of Public Universities in Malaysia during the Covid-19 MCO

The unprecedented COVID-19 pandemic had prompted many governments to enforce lockdown to prevent the virus from spreading. In Malaysia, a series of Movement Control Orders (MCO) were introduced starting March 18, 2020. As a result, many people’s lives were affected, including university students. These affected students had to stay in their campus residential facilities, isolated from family, relatives and friends, which could lead to the feeling of loneliness. This study aims to explore the phenomenon among students stranded on campus during MCO periods. Approximately 243 students from several public universities were surveyed using Google form. Results from the 210 usable responses showed that most of these students experienced moderate loneliness and often used coping approaches like acceptance, positive interpretation, active coping, and active solitude. Friends seemed to be a more immediate source to seek for support in times of isolation. Correlation results suggested that social support availability is negatively associated with student loneliness experience, and positively related with student coping strategies. Specifically, the availability of support from friends and significant others may minimize loneliness experience.

DAMPAK PEMBIAYAAN INVESTASI DENGAN UTANG DAN JAMINAN DARI MODAL SENDIRI (Case Study PT Agung Podomoro Land Tbk)

This study aims to recommend decision making related to the use of debt in corporate financing. This study took data from PT Agung Podomoro Land Tbk. In addition to developing, the company also plays a role in providing modern residential facilities. This study focuses on the financing structure between debt and equity. The results of the study become an important study to see the company's performance through the LTDER ratio with the use of 2017-2019 data. The results of the study found that there was a large percentage of debt financing carried out by companies from 2017 to 2019. This condition indicates that debt financing makes a greater contribution than own capital to funding and business growth. Keywords: Financing, Long-Term Debt, Equity

Nursing Students Visiting People with Dementia Online during COVID-19: A Qualitative Study

The coronavirus disease 2019 (COVID-19) crisis has impacted the daily routines of students, people living with dementia, and their care partners. Social distancing results in fewer interpersonal interactions and enjoyable activities which makes life more challenging for those living with dementia. The purposes of this multiple case study were to understand how nursing students, people with dementia, and care partners (a) describe online visits between nursing students and people with dementia during stay-at-home directives in response to COVID-19 and (b) the perceived visit benefits. Nursing students participated in online visits to socially engage with their mentor (person living with dementia). During the visits it was anticipated that care partners would enjoy a brief respite. After 12 visits, investigators completed one-to-one online interviews with students (n = 10), care partners (n = 8) and mentors (n = 8). All cases reported a positive experience, perceptions of the conversations, improved social connection and meaning and purpose, mentor’s enhanced cognition and planned future connections. Relationships were formed between students, people with dementia, and care partners during online visits, an activity that might be implemented outside of a crisis to prevent social isolation across generations. Future efforts to engage people with dementia in residential facilities should be formally integrated into the care plan and staff dedicated to help with technology assigned.

Clinical and psychosocial profile of persons with mental illness living in non-hospital residential facilities in a district in Kerala, India: A cross-sectional survey

Background: Clinical and psychosocial profiles of persons living with mental illness (PMI) in non-hospital settings in India have not been adequately studied. Aim: This study describes the profile of PMI living in non-hospital settings by focussing on variables like functioning and social networks. Method: Residents of all available residential facilities in one district area were surveyed and descriptive data was obtained. Socio occupational functioning was assessed using the Social and Occupational Functioning Scale (SOFS) and social network was measured by modified Lubben Social Network Scale-6 (LSNS-6). Results: A total of nine centres housing 491 residents (7–128) were surveyed via field visits. The mean age of the residents was 49 ± 14.0 years. Fifty per cent of them were never married, 22% were separated or widowed. Almost half of the people had psychotic disorders, while diagnosis could not be delineated in a quarter of the population. Almost half the people reached the facilities with the help of their families, while 40% were brought by police or volunteers who found them wandering. Impairment in socio-occupational functioning was only mild in 90% of residents, while 60% did not contact relatives or friends in the past 3 months. Conclusion: PMI living in non-hospital residential facilities were on average in their middle age and were deficient in marital bonds and other social support. They had reached the centres with the help of extended family or by police/volunteers who rescued them from wandering status. Nevertheless, most of them had only mild to moderate levels of impairment, and their functional capacity was good for independent living in the community with support. Hence, newer models of supported housing that provide greater community reintegration, like independent shared housing within regular neighbourhoods, can be tried. In persons with residual family ties, providing continuous community-based support may help re-establish family integration.

Wpływ zmiany pełnionych funkcji na fizjonomię portu w Ustce

Celem artykułu jest przedstawienie wpływu zmiany funkcji pełnionych przez port w Ustce na jego fizjonomię. Analiza funkcjonalna dotyczy głównie okresu 2016-2019. Natomiast analizę fizjonomii przeprowadzono dla 2021 r. Stwierdzono, że podstawowa dla portów funkcja przeładunkowa jest w Ustce pełniona w minimalnym stopniu. Funkcja turystyki morskiej jest realizowana w stopniu niewystarczającym (brak mariny jachtowej), a żeglugi pasażerskiej nie jest realizowana. Port pełni nadal funkcję rybołówstwa i wędkarstwa rekreacyjnego, ale w stopniu mniejszym, niż w przeszłości. Działalność produkcyjna na terenie portu nie jest już prowadzona, chociaż w przeszłości była realizowana na dużą skalę. Istnieje szansa, że w porcie rozwinie się funkcja związana z konserwacją i eksploatacją farm wiatrowych. Obecnie w porcie rozwijają się silnie funkcja turystyczna (gastronomia, hotele itd.) oraz mieszkaniowa. Wprowadzenie tej ostatniej funkcji do portu uznano za błąd. Zmiany funkcji powodują zmiany w fizjonomii portu. Znikają obiekty przemysłowe i przeładunkowe, a na ich miejsce pojawiają się obiekty z funkcją hotelową i gastronomiczną oraz mieszkaniowe, aczkolwiek zmiany te zachodzą z dużym opóźnieniem. The impact of changes in the performed functions on the physiognomy of the port in Ustka The aim of the article is to present the impact of changes in the functions performed by the port in Ustka on its physiognomy. The functional analysis mainly covers the period of 2016-2019, while the analysis of the physiognomy was conducted for 2021. It was found that the basic trans-shipment function is played to a minimum extent in Ustka. The function of sea tourism is insufficiently realized (no yacht marina), and the function of passenger shipping is not performed. The function of recreational fishing and angling is still performed by the port, but to a lesser extent than in the past. There is no longer any production activity in the port area, although in the past it was carried out on a large scale. There is a chance that the port will develop a function related to the maintenance and operation of wind farms. On the other hand, the tourist function (gastronomy, hotels, etc.) and housing are strongly developing in the port. Introducing the latter function into the port was considered a mistake. Changes in functions result in changes to the port physiognomy. Industrial and trans-shipment facilities are disappearing and replaced with hotel, catering and residential facilities. However, these changes are long delayed.