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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]

The study of subjective democratic legitimacy from a citizens' perspective has become an important strand of research in political science. Echoing the well‐known distinction between 'input‐oriented' and 'output‐oriented' legitimacy, the scientific debate on this topic has coined two opposed views. Some scholars find that citizens have a strong and intrinsic preference for meaningful participation in collective decision making. But others argue, to the contrary, that citizens prefer 'stealth democracy' because they care mainly about the substance of decisions, but much less about the procedures leading to them. In this article, citizens' preferences regarding democratic governance are explored, focusing on their evaluations of a public policy according to criteria related to various legitimacy dimensions, as well as on the (tense) relationship among them. Data from a population‐based conjoint experiment conducted in eight metropolitan areas in France, Germany, Switzerland and the United Kingdom is used. By analysing 5,000 respondents' preferences for different governance arrangements, which were randomly varied with respect to their input, throughput and output quality as well as their scope of authority, light is shed on the relative importance of different aspects of democratic governance. It is found, first, that output evaluations are the most important driver for citizens' choice of a governance arrangement; second, consistent positive effects of criteria of input and throughput legitimacy that operate largely independent of output evaluations can be discerned; and third, democratic input, but not democratic throughput, is considered somewhat more important when a governance body holds a high level of formal authority. These findings run counter to a central tenet of the 'stealth democracy' argument. While they indeed suggest that political actors and institutions can gain legitimacy primarily through the provision of 'good output', citizens' demand for input and throughput do not seem to be conditioned by the quality of output as advocates of stealth democratic theory suggest. Democratic input and throughput remain important secondary features of democratic governance. [ABSTRACT FROM AUTHOR]

As nationally mixed people have parents born in different countries, they can potentially identify with multiple national reference groups, allowing the researcher to study national identification processes. The analysis of approximately one hundred people of nationally mixed background living in France, Germany, and the United Kingdom highlights different registers of identification. There are important differences in how nationally mixed people articulate them, which leads to the identification of different national repertoires of identification. In France, a strong French national identity was emphasized, whereas German national identity seems more fragile because it depends mainly on cultural socialization. In the United Kingdom, non-national identities are developed in a context where the national community is not clearly defined, while ethnicity is publicly recognized. The register and repertoire of identification concepts thus allow the researcher to analyse identity discourses and then explain national differences through international comparison. [ABSTRACT FROM AUTHOR]

Treatment with new and/or innovative drugs with uncertain safety and efficacy profile is associated with substantial ethical concerns. The main objective of this paper is to present guidance on the use of such drugs contained in: (i) major international codes and guidelines pertaining to medical ethics and biomedical research; (ii) national codes of medical ethics and professional conduct of the USA, Canada, Australia, New Zealand, the UK, Ireland, France and Germany. Out of the four international codes and guidelines analysed, only the Declaration of Helsinki addresses the question of the use of unproven drugs. Among national codes, only two (USA and New Zealand) explicitly allow for use of new or innovative drugs. Moreover, treatment with unproven drugs seems to be permissible under the French code, though this is not stated explicitly. The remaining codes do not contain any articles on the use of new and innovative drugs. An update of existing articles, as well as the addition of new guidelines to the codes, should be considered in view of the rapid pace of development and introduction to clinical practice of new drugs. This work is relevant to innovative off-label applications of approved drugs and expanded access to investigational drugs., (© 2018 The British Pharmacological Society.)