Exploring the Pathways Between Transformative Group Experiences and Identity Fusion.

A growing body of evidence suggests that two distinct forms of group alignment are possible: identification and fusion (the former asserts that group and personal identity are distinct, while the latter asserts group and personal identities are functionally equivalent and mutually reinforcing). Among highly fused individuals, group identity taps directly into personal agency and so any attack on the group is perceived as a personal attack and motivates a willingness to fight and possibly even die as a defensive response. As such, identity fusion is relevant in explaining violent extremism, including suicidal terrorist attacks. Identity fusion is theorized to arise as a result from experiences which are (1) perceived as shared and (2) transformative, however evidence for this relationship remains limited. Here, we present a pre-registered study in which we examine the role of transformativeness and perceived sharedness of group-defining events in generating identity fusion. We find that both of these factors are predictive of identity fusion but that the relationship with transformativeness was more consistent than perceived sharedness across analyses in a sample of Indonesian Muslims

Re-Emergence of Crimean-Congo Hemorrhagic Fever Virus in Central Africa

Crimean-Congo hemorrhagic fever virus (CCHFV) is transmitted to humans through tick-bite or contact with infected blood or tissues from livestock, the main vertebrate hosts in a peri-domestic natural cycle. With numerous outbreaks, a high case fatality rate (3%–30%) and a high risk for nosocomial transmission, CCHFV became a public health concern in Europe and Asia. However virus surveillance in Africa is difficult due to the limited sanitary facilities. Especially, CCHFV occurrence in Central Africa is very poorly described and seems highly in contrast with the temperate to dry environments to which the virus is usually associated with. We described a single human infection that occurred in Democratic Republic of the Congo after nearly 50 years of absence. The phylogenetic analysis suggests that CCHFV enzootic circulation in the area is still ongoing despite the absence of notification, and thus reinforces the need for the medical workers and authorities to be aware of the outbreak risk. The source of infection seemed associated with a forest environment while no link with the usual agro-pastoral risk factors could be identified. More accurate ecological data about CCHFV enzootic cycle are required to assess the risk of emergence in developing countries subjected to deforestation

Multiple Crimean-Congo Hemorrhagic Fever Virus Strains Are Associated with Disease Outbreaks in Sudan, 2008–2009

The tick-borne virus which causes the disease Crimean-Congo hemorrhagic fever (CCHF) is known to be widely distributed throughout much of Africa, Southern Europe, the Middle East, Central Asia, and Southern Russia. Humans contract the virus from contact with infected people, infected animals (which do not show symptoms), and from the bite of infected ticks. CCHF was recently recognized in the Sudan when several hospital staff and patients died from the disease in a rural hospital. The genetic analysis of viruses associated with the 2008 and 2009 outbreaks shows that several CCHF viral strains currently circulate and cause human outbreaks in the Sudan, highlighting CCHF virus as an emerging pathogen. The Sudanese strains are similar to others circulating in Africa, indicating movement of virus over large distances with introduction and disease outbreaks in rural areas possible. Understanding the epidemiology of zoonotic diseases such as CCHF is especially important in the Sudan given the large numbers of livestock in the country, and their importance to the economy and rural communities. It is imperative that hospital staff consider CCHF as a possible disease agent, since they are at a high risk of contracting the disease, especially in hospitals with limited medical supplies

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

The role of religious fundamentalism and tightness-looseness in promoting collective narcissism and extreme group behavior

The present study aims to understand the roles of religious fundamentalism and collective narcissism in predicting extreme behavior. It was hypothesized that religious fundamentalism may enhance collective narcissism and that this would in turn increase the tendency to endorse extreme behavior. It was also anticipated that perceptions of social tightness would moderate the indirect effect of religious fundamentalism on extreme behavior through collective narcissism. To test the hypotheses, we collected data from 787 members of Islamic religious groups in Indonesia (male = 457, female = 325); ages ranged from 17 to 52 (M = 25.14, SD = 8.49). Supporting the hypotheses, our findings demonstrated the validity of the expected pathways, confirming that it is important to consider the role of collective narcissism and tightness-looseness when studying relationships between religious fundamentalism and extreme behavior. Our findings demonstrate that when religious fundamentalists are able to see their cultural values in a loose way or more dynamics, they may become less narcissistic collective and less support for extreme behaviors

The role of religious fundamentalism and tightness-looseness in promoting collective narcissism and extreme group behavior

The present study aims to understand the roles of religious fundamentalism and collective narcissism in predicting extreme behavior. It was hypothesized that religious fundamentalism may enhance collective narcissism and that this would in turn increase the tendency to endorse extreme behavior. It was also anticipated that perceptions of social tightness would moderate the indirect effect of religious fundamentalism on extreme behavior through collective narcissism. To test the hypotheses, we collected data from 787 members of Islamic religious groups in Indonesia (male = 457, female = 325); ages ranged from 17 to 52 (M = 25.14, SD = 8.49). Supporting the hypotheses, our findings demonstrated the validity of the expected pathways, confirming that it is important to consider the role of collective narcissism and tightness-looseness when studying relationships between religious fundamentalism and extreme behavior. Our findings demonstrate that when religious fundamentalists are able to see their cultural values in a loose way or more dynamics, they may become less narcissistic collective and less support for extreme behaviors