Profile of anxiolytic consumption by patients seen in a basic pharmacy

Introduction: Mental disorders are more and more frequent. In Brazil, primary care makes possible the population's first encounter with mental care, having medicines as one of the main therapeutic applied resources, which are made available in different ways, including the municipal primary pharmacy. Psychotropic drugs, such as anxiolytics, act on these mental disorders, improving the quality of life and providing freedom to the individual, however, their use irrationally and for a prolonged period of time causes harm to those who use them. Objective: To know the aspects surrounding the consumption of anxiolytic drugs, as well as to identify individual and collective characteristics of the participants that lead to their use. Methodology: Cross-sectional descriptive research with a quali-quantitative approach, carried out with prescriptions that contained anxiolytics and questionnaires answered by patients treated at the basic pharmacy in the city of Flores - PE. Results: The female gender, age group over 41 years, low education, presence of children and marriage were related to the increase in the use of anxiolytics, in addition, the emergence of effects caused by treatment abandonment, interactions regarding the use of plants or more of a drug with anxiolytics and the errors of gifts in prescriptions had high rates. Conclusion: The delineation of the profile of individuals who use anxiolytics as therapy provides the creation of policies at specific groups in order to reduce the therapy with them, in addition, knowledge of the main errors in prescriptions and the presence of interactions ensures a better treatment success.

家族信託基礎構造與遺囑信託爭議問題研究──以福祉型信託內涵為核心開展

「福祉型信託」（Welfare Trusts）為家族治理（Family Governance）、家族事業所有權（Family Property Business Ownership）、家族財產事業經營管理（Family Property Business Management）所組成之「家族信託」（Family Trust）核心，具有民事信託與商業信託之雙面性，且非僅僅為單純之財產管理制度，而係「財產管理運用、活用以及傳承」機能之最大程度展現，以完整支援信託利益享有者包括生活及財產管理全盤支援架構建立之身心照護。有鑑於此，本文以我國信託法主要繼受之日本「信託法」法制規範及其相關學理與實務發展為比較法對象，以福祉型信託為核心，對家族信託與遺囑信託進行研究。首先，家族信託制度之建置上，須考量其與消費者權益調和、裁量信託使用界線與合理分配、共益定性、第三人介入之限制、責任信託之搭配。其次，針對永續傳承、連續受益人、特留分、目的信託與特定目的信託、「閉鎖性公司＋自益信託」架構等家族信託爭議問題，提出研究對策。再者，家族信託法制尚未完整建立前，應以前述福祉型信託為核心之家族信託為基礎，對信託行為與方法解釋與修正、受益人權益確保、遺囑信託受託催告、法院選任遺囑信託受託人、遺囑信託委託人之繼承人、替代遺囑信託等議題進行解析，俾使我國遺囑信託功能確實發揮與家族信託內涵相互搭配。最後，從家族信託架構下之委託人與受託人角色與功能，提出本文之結論與建議。<br />&ldquo;Welfare trust&rdquo;is the core of a family trust composed of family governance, family property business ownership, and family property business management. It has duality of civil trust and commercial trust in that it is not only a pure property management system, but also the maximum demonstration of the function of property management application, utilization, and inheritance to support the physical and mental care of the trust beneficiaries which include the establishment of a comprehensive support structure for life and a thorough property management. In the establishment of the family trust system, this article firstly argues that it is necessary to consider the coordination with consumer rights, discretionary trust boundaries and reasonable distribution, common benefits, restrictions on third party intervention, and liability trust. Secondly, this article puts forward the research results on the controversial issues of family trust such as perpetual inheritance, continuous beneficiaries, legally reserved portion, purpose trusts and special purpose trusts, and&ldquo;closed company with self-benefit trust&rdquo;structure. Furthermore, before the establishment of a complete family trust legal structure, it is important to analyze the combination of testamentary trust and family trust, interpretation and amendment of trust behaviors and methods to ensure the rights and interests of the beneficiaries, and the appointment the trustee of the testamentary trust by the court, the successor of the settlor of the testamentary trust, and alternative testamentary trust (trust with successive beneficiaries). Finally, the article provides conclusions and suggestions from the perspective of the settlor and the trustee of trust.<br />

Influence of Self-Esteem of Middle School Students for Mental Care on Academic Achievement: Based on the Mediation Effect of GRIT and Academic Enthusiasm

The purpose of this study is to identify how self-esteem of middle school students for mental care influences their academic achievement and to verify the mediation effect of GRIT on academic enthusiasm. Data of 2590 first graders in middle school from the Kora Children and Youth Panel Survey 2019 was used to support this study. Data analysis was performed by using SPSS21.0, AMOS22.0, and PROCESS macro program. The results are as follows. Comparison of the model fits of each full mediation model and partial mediation model with χ2 showed that the full mediation model was more suitable for this study. In more detail, the influence of self-esteem on GRIT and the influence of GRIT on academic enthusiasm were significantly positive. Lastly, the study identified that there was a mediation effect between self-esteem and academic achievement through GRIT and academic enthusiasm. It indicates that self-esteem is the key to improve academic achievement and that specific programs should be supplemented in order to enhance self-esteem, GRIT, and academic enthusiasm.

What Hinders Victims from Reporting Sexual Violence: A Qualitative Study with Police Officers, Prosecutors, and Judges in Hungary

While rape historically remains underreported all over the globe, and criminal justice factors contribute to this problem, we investigate unique circumstances that might influence reporting inclinations by Hungarian victims of sexual violence. Among other possible factors, victim-blaming, institutional desensitization, and a lack of trust in the criminal justice system and in the community are discussed. The in-depth interviews (n = 22) with law enforcement and criminal justice professionals conducted in 2018 in Hungary reveal roots of underreporting in the complexities of the criminal justice system: there is a failure to prioritize victims’ needs—mental care services, physical and privacy protection—and a focus instead on solely providing legal justice. The further deficits that can be found among professionals’ attitudes and behaviors in the courtroom are products of the following: a lack of standardized protocols in addressing the needs of victims; a dearth of technical and evidence-based knowledge and training; a lack of supervision and trauma-informed services to practitioners; high caseloads; a focus on the goal of high conviction rates; not providing open communication toward victims; and a shortage of standardized protocols in dealing with victims.

A Comparative Study of Perceived Stress and Anxiety, among Patients with Bipolar Affective Disorder, and the General Population, during COVID-19 Pandemic, Conducted in Government Hospital for Mental Care, Visakhapatnam

BACKGROUND Generally during pandemic, mental health needs are largely neglected and patients with psychiatric illness are given less medical care as majority of the health professionals are involved in acute management of the pandemic. In this study we wanted to determine the difference between stress and anxiety in patients with bipolar affective disorder (BPAD) and the general population. METHODS It was a cross sectional study and convenient sampling was used. The study was conducted in Government Hospital for Mental Care, Visakhapatnam. The study included 60 participants of whom 30 participants are patients with bipolar affective disorder who were currently in remission and 30 participants were from general population and were evaluated using semi structured proforma for sociodemographic data and perceived stress scale to assess perceived stress, Hamilton anxiety rating scale to assess anxiety. Results were analyzed statistically. RESULTS The results showed statistically significant difference in severity of perceived stress and anxiety among patients with bipolar affective disorder and the general population. CONCLUSIONS Our study results re-emphasize the fact that there should be an increased awareness about patients with psychiatric illness like bipolar affective disorder as targets for care with regular psychiatric intervention during Covid-19 pandemic. With our study, we want to re-iterate the fact that patients with psychiatric illness experience exacerbation of symptoms during infectious disease epidemic. Patients diagnosed with bipolar affective disorder can also have comorbid anxiety disorder, even after treating the mood disorder episode. Residual anxiety may persist and in times of infectious diseases epidemic, these anxiety symptoms will exacerbate leading to poor quality of life and non-compliance to medication. With our study we want to recommend that proper care and regular follow-up schedules have to be formulated by mental health professionals and mental health institutions to reduce and prevent exacerbation of symptoms and improve treatment compliance which in turn helps in preventing relapse of bipolar affective disorder. KEYWORDS Bipolar Affective Disorder, Perceived Stress, Anxiety, Covid-19

A Prospective Evaluation of Structures and Processes Associated with the Quality of Mental Health Care in the Kingdom of Saudi Arabia

<b><i>Introduction:</i></b> Quality of care is important for improving outcomes of service users in inpatient mental health settings. There is a lack of research investigating the predictors of quality of mental health care and their relationship with service user outcomes, particularly in Saudi Arabia, despite the high priority given to this in the Kingdom of Saudi Arabia (KSA) national health strategy. <b><i>Objective:</i></b> This study investigates the factors associated with the quality of mental care and their relationship with service users’ outcomes, disability, disease, discomfort, and dissatisfaction, using Donabedian’s framework. <b><i>Methods:</i></b> A questionnaire survey was distributed to 176 nurses and 321 service users in an inpatient psychiatric hospital in Saudi Arabia. Data were gathered on structures (staff and service users’ characteristics) and processes (staff attitudes to mental illness, competency, and level of interaction with service users) linked to service users’ outcomes. <b><i>Results:</i></b> Multilevel modelling showed that service users’ characteristics, for example, age, marital status, employment status, educational level, area of residence, and diagnosis, significantly predicted disability. With 1 exception (unemployment), none of the service users’ characteristics was found to be a statistically significant predictor of disease, although educational level was found to be a significant predictor of discomfort and dissatisfaction. Age and years of experience were found to significantly predict service user disability among nurses, and years of experience was a significant predictor of users’ dissatisfaction. Nurses’ competence was found to be a statistically significant predictor of disability, while their attitudes to mental illness and their interactions with users did not significantly predict the latter’s outcomes. <b><i>Conclusions:</i></b> These findings suggest that factors other than those studied here have more currency in relation to quality of care in Saudi Arabia, despite these factors have been shown to relate to quality of care outside the KSA. A more detailed qualitative approach to better understand factors relevant to the quality of mental care in Saudi Arabia is reported by the authors in a concomitant article.

Uncertainty, Imagination, Hope and Utopia

During the early stages of the Covid-19 crisis, a center in Greece organized a volunteer team for mental care and empowerment. About 300 mental health professionals participated, running systemic Appreciative Inquiry empowerment tele-groups using appreciative tools and creative writing. They shared their dreams for the future in Dreamland, a Facebook group created specifically for them.