Situation of older women living at Slum area in Dhaka City of Bangladesh

The older section of the population is increasing much faster than the total population. Older women bear a disproportionately low status in every aspects of life in Bangladesh. They have less control over their family income and family decision making. The objective of this study was to find out the situation of older women living at slum area. This is a descriptive data where data were collected from Dhaka city Bangladesh in slum area. In Bangladesh many older people spend their lives in poverty and ill health which is major risk for the elderly population. Poverty and exclusion are the greatest threats to the wellbeing of older people. They passed their very basic QoL with no proper humanitarian support. The policy maker should take the proper steps for improving their QoL as well as think about their basic rights.

Does Family Decision-Making Power Improve Women’s Happiness?

It is almost a consensus that the stronger family decision-making power a woman has, the happier she will be. While using the China Family Panel Studies, this study reveals a long-overlooked fact that women’s control over more family decision-making power does not necessarily improve their happiness. The results of the ordinary least squares and ordinal logit model confirm this finding, and the propensity score matching method corroborates the conclusion. Heterogeneity analysis shows that among those women with less education and lower social status, the negative happiness effect of women’s family decision-making power is particularly significant. Women’s traditional attitudes and self-esteem are two important factors which hinder women’s family decision-making power from enhancing their happiness.

Barriers to accessing mental health services in The Gambia: patients’/family members’ perspectives

This paper concerns mental health services in The Gambia. It describes local concepts, experiences and knowledge about mental illness and the implications of such beliefs and attitudes for access to mental health services. A pretested questionnaire and interview guide were administered to a sample of patients/family members. Barriers to accessing mental health services were identified. These included beliefs about the causes of mental illness; family decision-making; the scarcity and high cost of services. Obtaining access to mental health services in The Gambia is currently challenging. Importantly, increased community and family education about the causes and treatment of mental illnesses will be required to address these issues.

The Family Decision Making Patterns of Children with Special Needs: a Sociology Study of the Family

This study aims to explain information about the patterns of family decision making for parents who have children with special needs in the city of Makassar. This type of research is descriptive qualitative. The results of the study show that parents are key figures who play a very important role in providing role models, guidance, and affection in the process of child development. The role of parents in the acceptance of children with special needs is very important. Parents are the best guides and helpers for the independence of children with special needs. The mother as one of the parents of children with special needs has an important role in understanding the needs and development of their children. This is related to the mother's acceptance of children with disabilities, which is shown in the attitude to face children. If parents lack understanding of children with special needs, it can result in a lack of attention and consider the child to be unlucky in the family. Parents are the determinants of a child's life before and after birth. Therefore, it is the responsibility of parents to fully accept the existence of their children and treat them equally in all aspects of life with children in general without any discriminatory attitude and to provide the widest possible opportunity for education.

Pilot Study to Implement a Resident and Family Decision Guide

In this first stage of an 8 state initiative designed to assist nursing homes in reducing unnecessary hospital readmissions, 16 nursing homes were identified and invited by CMS and state agency advisors to participate in the pilot study of the effects of intervention (use of the Guide). Selected facilities received an online orientation to the project and onsite visit from project team leadership prior to launch. Pre and post implementation data were uploaded to a secure section of the project website by the facilities. Three facilities withdrew due to change in top management and a fourth facility provided incomplete data resulting in data for analysis from 12 pilot facilities. Results show the average reduction in readmissions was 31.2% for the project period as compared with the 3-month pre-project period. This presentation will include facility reports of the effect of Guide use on resident and family decision making.

Abstract 14242: Homogeneous Fetal Access to Cardiac Care in a Heterogeneous State

Introduction: Timely prenatal diagnosis of congenital heart disease (CHD) allows for families to participate in complex decisions and plan for the care of their child. This study sought to investigate if the timing of the first fetal echocardiogram (FE) and the characteristics of fetal counseling were impacted by parental socioeconomic factors. Hypothesis: We hypothesized that the scheduling of initial FE would be delayed due to distance from hospital, rurality of maternal home and median income. Methods: We performed a retrospective chart review of all fetal patients referred to our institution from 1/1/17 to 12/31/18 with a diagnosis of CHD. We looked at the gestational age at the first FE, age of mother, zip code of residence, rurality index, distance from our hospital and maternal ethnicity. Counseling was evaluated based on documentation in the FE report regarding use of interpreter, time billed for counseling, individuals accompanying mother, and treatment option chosen. Results: 138 maternal-fetal dyads met inclusion criteria, 29 dyads had a diagnosis of single ventricle heart disease. The median gestational age (GA) at first FE was 24 weeks 4 days. The median income was $57,019 ($42,624-$83,695), and the median distance to the hospital was 51 miles (3.2-379.9miles). There was no difference in income, distance from hospital or rurality index and timing of first FE. There was no significant difference between maternal ethnicity and age of mother, GA at initial FE, number of follow-up FEs or family accompanying mother to the visit. There was no difference in maternal ethnicity and use of interpreter with time counseled. Patients who lived in rural areas did have increased counseling time (p<.05). Importantly, there was no difference between socioeconomic factors and ultimate parental choices (termination, palliative delivery or surgery). Conclusions: Oregon comprises a heterogeneous population from a large geographical catchment. While prenatal counseling and family decision making is multifaceted we demonstrated that dyads were referred from across the state and received care in a uniformly timely manner, and once at our center received consistent counseling despite differences in parental socioeconomic factors.

Diverse Perspectives on Transition to Adulthood Among Families: A Qualitative Exploration

Family engagement is an essential aspect of preparing for the transition to adulthood for youth with disabilities. The purpose of this study was threefold: (a) describe the supports historically marginalized families of students with disabilities draw upon, (b) understand family decision-making when engaging with schools and agencies, and (c) determine whether supports provided by a local Parent Training and Information Center (PTI) were perceived as effective for historically marginalized groups of families. The sample comprised 36 parents of children and adolescents with disabilities who participated in focus groups or interviews. A qualitative analysis revealed several interacting influences associated with family decision-making and advocacy as their children transitioned to adulthood. Implications for policy and practice toward addressing family engagement with schools and communities are described.