Search

Evidence is accumulating of the negative impact of the COVID‐19 pandemic and related public health measures on mental health. In this emergent field, there has been little research into the role of risk perception on depressive symptoms and the contribution of health‐care resources to model risk perception and mental health. The aim of this paper is to describe the relationship between individual‐level perception of risk and depression, controlling for a set of confounders and for country‐level heterogeneity. A cross‐sectional and observational online survey was conducted using a non‐probability snowball sampling technique. We use data on 11,340 respondents, living in six European countries (Italy, Sweden, United Kingdom, France, Poland, Czech Republic) who completed survey questionnaires during the first months of the pandemic. We used a fixed‐effect approach, which included individual and macro‐level variables. The findings suggest that a high proportion of people suffering from depression and heightened risk perception is positively associated with reporting depressive symptoms, even if this relationship varies significantly between countries. Moreover, the association is moderated by contextual factors including health‐care expenditure as a percentage of Gross Domestic Product, hospital beds for acute care, and number of medical specialists per head of population. Investment in health care offers a concrete means of protecting the mental health of a population living under pandemic restrictions. [ABSTRACT FROM AUTHOR]

This paper assesses the coverage probability of commonly used confidence intervals for the standardized mortality ratio (SMR) when death certificates are missing. It also proposes alternative confidence interval approaches with coverage probabilities close to .95. In epidemiology, the SMR is an important measure of risk of disease mortality (or incidence) to compare a specific group to a reference population. The appropriate confidence interval for the SMR is crucial, especially when the SMR is close to 1.0 and the statistical significance of the risk needs to be determined. There are several ways to calculate confidence intervals, depending on a study characteristics (ie, studies with small number of deaths, studies with small counts, aggregate SMRs based on several countries or time periods, and studies with missing death certificates). This paper summarizes the most commonly used confidence intervals and newly applies several existing approaches not previously used for SMR confidence intervals. The coverage probability and length of the different confidence intervals are assessed using a simulation study and different scenarios. The performance of the confidence intervals for the lung cancer SMR and all other cancer SMR is also assessed using the dataset of French and Czech uranium miners. Finally, the most appropriate confidence intervals to use under different study scenarios are recommended. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]