The psychology of health and well-being in mass gatherings: A review and a research agenda

Connecting to Community: A Social Identity Approach to Neighborhood Mental Health

ACADEMIC ABSTRACT

Integrative theorizing is needed to advance our understanding of the relationship between where a person lives and their mental health. To this end, we introduce a social identity model that provides an integrated explanation of the ways in which social-psychological processes mediate and moderate the links between neighborhood and mental health. In developing this model, we first review existing models that are derived primarily from a resource-availability perspective informed by research in social epidemiology, health geography, and urban sociology. Building on these, the social identity model implicates neighborhood identification in four key pathways between residents' local environment and their mental health. We review a wealth of recent research that supports this model and which speaks to its capacity to integrate and extend insights from established models. We also explore the implications of the social identity approach for policy and intervention.

PUBLIC ABSTRACT

We need to understand the connection between where people live and their mental health better than we do. This article helps us do this by presenting an integrated model of the way that social and psychological factors affect the relationship between someone's neighborhood and their mental health. This model builds on insights from social epidemiology, health geography, and urban sociology. Its distinct and novel contribution is to point to the importance of four pathways through which neighborhood identification shapes residents' mental health. A large body of recent research supports this model and highlights its potential to integrate and expand upon existing theories. We also discuss how our model can inform policies and interventions that seek to improve mental health outcomes in communities.

Why We Gather: A New Look, Empirically Documented, at Émile Durkheim's Theory of Collective Assemblies and Collective Effervescence

For Durkheim, individuals' survival and well-being rest on cultural resources and social belonging that must be revived periodically in collective assemblies. Durkheim's concern was to clarify how these assemblies achieve this revitalization. An intensive examination of primitive religions led him to identify successive levels of engagement experienced by participants and to develop explanatory principles relevant to all types of collective gatherings. Durkheim's conception is widely referred to nowadays. However, the question of its empirical status remains open. We extracted from his text his main statements and translated them into research questions. We then examined each question in relation to current theories and findings. In particular, we relied on the plethora of recent cognitive and social-psychology studies that document conditions of reduced self-other differentiation. Abundant data support that each successive moment of collective assemblies contributes to blurring this differentiation. Ample support also exists that because shared emotions are increasingly amplified in collective context, they can fuel high-intensity experiences. Moreover, recent studies of self-transcendent emotions can account for the self-transformative effects described by Durkheim at the climax of collective assemblies. In conclusion, this century-old model is remarkably supported by recent results, mostly collected in experimental settings.

Psychosocial interventions and strategies to support young people at mass gathering events: a scoping review

OBJECTIVES

To improve health and safety outcomes at mass gathering events (MGEs) for young attendees, it is essential to understand the psychosocial factors that may influence behaviour so that the implementation of support strategies before, during and after MGEs can be developed to enhance outcomes. This review identifies the psychosocial outcomes that may occur at MGEs, including social connection, substance use, risky behaviours and psychological distress and examines what interventions have been implemented to target these outcomes.

STUDY DESIGN

Scoping review.

METHODS

This study examined MGE psychosocial interventions with predominantly youth attendees was conducted using the Preferred Reporting Items of Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines. Papers were collected from the databases CINAHL, MEDLINE, Embase and PsycINFO. Titles and abstracts were scanned for relevance, followed by a full-text screening. Information relevant to the research question was extracted from papers meeting the inclusion criteria.

RESULTS

Twenty-six papers met the inclusion criteria. The psychosocial factors that were most studied included social influence, social interactions and psychological stressors, which lead to behaviours such as excessive alcohol consumption, drug taking, risky casual sex and risk taking amongst psychological factors of young attendees. Effective interventions implemented before or during MGEs, such as alcohol-free zones, antidrinking campaigns, psychoeducation and disapproval from parents with regard to drinking alcohol, showed promise in reducing harms.

CONCLUSION

Psychosocial interventions have the potential to reduce harms and enhance well-being for young people attending MGEs. This review has identified gaps and opportunities in the current literature with regard to psychosocial interventions and strategies to support young people at MGEs and makes recommendations to support the development and refinement of evidence-based interventions aimed at young MGE attendees.

Subjective Exercise Experience and Group Cohesion among Chinese Participating in Square Dance: A Moderated Mediation Model of Years of Participation and Gender

(1) Background: This study aimed to explore the relationship between years of participation, subjective exercise experience, and group cohesion among gender-specific square dance practitioners. (2) Methods: The Subjective Exercise Experience Questionnaire (SEEQ) and Group Environment Questionnaire (GEQ) were used to evaluate Subjective Exercise Experience (SEE) and group cohesion (GC). An analysis was conducted on 130 Chinese (63 males and 67 females) using multiple group analysis within a structural equation model. (3) Results: (a) The positive aspects of Subjective Exercise Experience (SEE) and Positive Well-Being (PWB), had a strongly positive effect on GC in both groups. The negative aspects of SEE, Psychological Fatigue (PF), and Psychological Distress (PD), had negative effects on GC. (b) Only for the male group was there an indirect effect of participation years on the association between SEE and GC in the model (a × b = 0.062, 95% CI [0.001, 0.181]; standard error (SE) = 0.062, p = 0.048). (c) The significant differences between paths coefficients were noticed in the association of years of participation with SEE (t = -2.043) and GC (t = -1.962). (4) Conclusion: Based on these results, gender differences in terms of the partial mediating role of adherence in the relationship of SEE and GC were presented for future research, fitness popularization, and society.

Participação política e potência de agir: a produção de saúde ético-política em ocupações estudantis paulistas

Resumo Os anos de 2015 e 2016 foram marcados politicamente por movimentos de ocupações estudantis pelo Brasil, os quais pautavam a defesa da educação pública e tiveram a autogestão como grande marca organizativa. Este artigo objetiva abordar os processos de produção de potência de agir e saúde ético-política ocorridos durante ocupações estudantis paulistas nos anos de 2015 e 2016. O corpus de pesquisa foi construído por meio de entrevistas, grupos focais e observações participantes com estudantes de quatro cidades: São Paulo, Ribeirão Preto, Catanduva e Barretos. A partir da análise do material, evidencia-se que apesar de os participantes terem sido submetidos a processos de diminuição de potência de agir e a sofrimento ético-político durante os movimentos, lutaram em prol de ideais coletivos, partilha de identidades sociais, humor, espaços lúdicos etc.

The Effects of Social Identity and Emotional Connection on Subjective Well-Being in Times of the COVID-19 Pandemic for a Spanish Sample

This study analyzes whether the degree of social identity and the degree of emotional connection influence the subjective well-being of individuals that participated in collective acts of support for health personnel fighting against the COVID-19 pandemic. Our sample was composed of 810 participants who resided in Spain (339 women and 471 men) with an average age of 34.22 (SD = 12.56). All of them frequently participated in the acts of support that took place each day of the lockdown decreed by the National Government on 14 March 2020. The results show that the greater identification with the group (the country) and the greater the emotional connection, the higher the scores obtained in subjective well-being. The results also show that emotional connection had a positive effect on emotional subjective well-being, mediated by the social identity activated in the collective act. The results are interpreted from the perspective of social identity that highlights the role played by social identity in influencing health and subjective well-being.

Mass Gathering Medicine in Soccer Leagues: A Review and Creation of the SALEM Tool

Potential risks for public health incidents, outbreaks, and casualties are inferred at association football events, especially if event organizers have not taken appropriate preventative measures. This review explores the potential risks imposed by mass gathering (MG) football events, with particular emphasis on tools and methodologies to manage the risks of football MG events. Effective planning and implementation of MGs along with the mitigation of risks related to people’s health require special attention to all potential threats, especially in frequent and recurring MG events such as football leagues. The well-being of all participants can be compromised by ignoring a single risk. Healthcare systems should cooperate with all stakeholders and organizations who are involved in MG management and response. Provision of services during MG or a disaster must be performed by trained personnel or entities that have full access to available resources in accessible publicly known locations at the MG event site. Several MG assessment tools were developed worldwide; however, to adapt to the Saudi context, SALEM tool was developed to provide a guide for MG planning and assessment. SALEM assesses the risks of MG events with scores that help to categorize the risk of MG events by offering recommendations for required resources.

Mass gatherings: a review of the scope for meningococcal vaccination in the Indian context

The risk of meningococcal transmission is increased with crowding and prolonged close proximity between people. There have been numerous invasive meningococcal disease (IMD) outbreaks associated with mass gatherings and other overcrowded situations, including cramped accommodation, such as student and military housing, and refugee camps. In these conditions, IMD outbreaks predominantly affect adolescents and young adults. In this narrative review, we examine the situation in India, where the burden of IMD-related complications is significant but the reported background incidence of IMD is low. However, active surveillance for meningococcal disease is suboptimal and laboratory confirmation of meningococcal strain is near absent, especially in non-outbreak periods. IMD risk factors are prevalent, including frequent mass gatherings and overcrowding combined with a demographically young population. Since overcrowded situations are generally unavoidable, the way forward relies on preventive measures. More widespread meningococcal vaccination and strengthened disease surveillance are likely to be key to this approach.

Re-opening live events and large venues after Covid-19 'lockdown': Behavioural risks and their mitigations

This article reviews the behavioural risks and possible mitigations for re-opening large venues for sports and music events when Covid-19 infection rates and hospitalizations begin to decline. We describe the key variables that we suggest will affect public behaviour relevant to the spread of the virus, drawing upon four sources: (1) relevant evidence and recommendations from the Scientific Pandemic Influenza Group on Behaviours produced for the Scientific Advisory Group for Emergencies (SAGE); (2) research evidence from non-pandemic conditions; (3) research on behaviour during the pandemic; and (4) relevant theory. We first outline some basic risks and a framework for understanding collective behaviour at live events. We then survey some trends in UK public behaviour observed over 2020 and how these might interact with the opening of live events and venues. We present a range of mitigation strategies, based on the framework for collective behaviour and on what is known about non-pharmaceutical (i.e. behavioural) interventions in relation to Covid-19.

INCREASING TREND OF BRAND CONSUMPTION AND ITS EFFECTS ON YOUTH’S SOCIAL IDENTITY

Purpose of the Study: The present research examined the effects of brand consumption on the social identity of youth. Methodology: In this study, the researcher used a quantitative research approach; and survey research method was used, the questionnaire was used as a tool of data collection. A sample of 385 students was chosen by using a convenient sampling technique. In this study, researchers used SPSS for data analysis. Principal Findings: The findings show that brand consumption has a positive relationship with social identity. Major findings show that brand consumption has negative relation with the overall well-being of respondents. Findings also show that the main purchased item was apparel brands. Applications of the study: This study can be helpful in better understanding of youth’s attitude towards brands consumption and its effects on their social identity. Novelty/Originality of this study: People make their choices every day and consumer studies seek to know these choices. Differentiating brand consumption as a real phenomenon, this research aims to examine the increasing trend of brand consumption and its effects on youth’s social identity. Despite of the increasing demand for luxury brand products in the modern era, a few types of research have been concluded to find out the link between luxury brands consumption and youth social identity. To better understand the brand consumption’s effect on youth’s social identity; this research inspected the social identity of youth in details.

Mass meets mosh: Exploring healthcare professionals' perspectives on social identity processes and health risks at a religious pilgrimage and music festivals

RATIONALE

The field of mass gathering medicine has tended to focus on physical factors in the aggravation and mitigation of health risks in mass gatherings to the neglect of psychosocial factors.

OBJECTIVES

This study sought to explore perspectives of healthcare professionals (HCPs) on (1) implications of social identity processes for mass gathering-associated health risks; and (2) how social identity processes can be drawn on to inform and improve healthcare practices and interventions targeted at mitigating health risks in mass gatherings.

METHODS

Semi-structured interviews, complemented by a brief survey, were conducted with 17 HCPs in the United Kingdom operating at a religious pilgrimage and music festivals.

RESULTS

The findings from a thematic analysis suggest that HCPs recognise that social identity processes involved in identity enactment in mass gatherings are implicated in health risks. HCPs also perceive value in drawing on social identity processes to inform and improve healthcare practices and interventions in mass gatherings. The findings from the survey corroborate the findings from the interviews.

CONCLUSION

Taken together, the research highlights avenues for future research and collaboration aimed at developing healthcare practices and interventions informed by the social identity approach for the management of health risks in mass gatherings.

The Combined Effect of Perceived COVID-19 Infection Risk at Work and Identification with Work Community with Psychosocial Wellbeing among Finnish Social Sector and Health Care Workers

It has been well documented that both risk perception and group identification are related to psychosocial well-being. However, their combined effect has rarely been analyzed. We examined the combined effect of perceived risk associated with COVID-19 infection at work and work community identification on psychosocial well-being (i.e., frequency of stress symptoms) among health care and social sector workers in Finland (N = 1279). Data were collected via an online questionnaire in June 2020 and analyses of covariance were conducted. Perceived COVID-19 infection risk at work was classified into high, medium and low risk. In total, 41% of participants reported a high risk. After all background variables were included, participants who reported high perceived infection risk and low work community identification reported stress symptoms more often than those who reported high perceived risk and high identification (p = 0.010). Similarly, the former differed significantly from all other comparison groups (medium and low risk, p < 0.001), being the most stressed. We found that perceived infection risk and work community identification were not related to each other. Our conclusion is that high work community identification can buffer employee stress when faced with a high perceived health risk. In the context of the COVID-19 pandemic, work organizations with a high infection risk should advance the possibility of employees’ identification with their work community.

Risk-Taking That Signals Trust Increases Social Identification

Abstract. Social identification predicts many important phenomena; however, its determinants have received comparably little research attention. We argue that people are more likely to socially identify with others who engage in risky behavior that implies trust than with those who act cautiously, and test this in four experiments with over 900 participants. The experiments found support for the hypotheses across diverse risk contexts – specifically, risk of physical injury, disease risk, and financial risk. These findings indicate that others’ risk taking can strengthen shared psychological group membership.

Perceived Emotional Synchrony in Collective Gatherings: Validation of a Short Scale and Proposition of an Integrative Measure

Over the past decade, there has been an increasing interest in the relationship between participation in collective gatherings and rituals and different important psychosocial variables and processes, such as social sharing of emotions, group cohesion, identity fusion, prosocial tendencies and behaviors, and well-being (e.g., Rimé, 2009; Xygalatas et al., 2013; Khan et al., 2015; Páez et al., 2015). These studies, coming from different lines of research, have proposed diverse explanatory mechanisms to explain the positive social and psychological effects of collective gatherings. In the present article, we focus on one of these mechanisms, known as collective effervescence, emotional communion, emotional entrainment, or perceived emotional synchrony (PES). First, we briefly discuss current conceptions of the emotional states and experience during collective gatherings and what they bring to the definition of PES. We close this point by proposing an integrative definition of PES. Second, structural validity of the original PES scale is examined. Third, incremental validity of PES is examined in two longitudinal studies, particularly with respect to well-being. Finally, we propose an integrative short form of the PES Scale, which measures antecedents and behavioral effects of collective effervescence.

Inequalities and identity processes in crises: Recommendations for facilitating safe response to the COVID-19 pandemic

Structural inequalities and identity processes are pivotal to understanding public response to COVID-19. We discuss how identity processes can be used to promote community-level support, safe normative behaviour, and increase compliance with guidance. However, we caution how government failure to account for structural inequalities can alienate vulnerable groups, inhibit groups from being able to follow guidance, and lead to the creation of new groups in response to illegitimate treatment. Moreover, we look ahead to the longitudinal impacts of inequalities during pandemics and advise government bodies should address identity-based inequalities to mitigate negative relations with the public and subsequent collective protest.

Psychosocial Influences on Patient Presentations: Considerations for Research and Evaluation at Mass-Gathering Events

Aim:

This review discusses the need for consistency in mass-gathering research and evaluation from a psychosocial perspective.

Background:

Mass gatherings occur frequently throughout the world. Having an understanding of the complexities of mass gatherings is important to determine required health resources. Factors within the environmental, psychosocial, and biomedical domains influence the usage of health services at mass gatherings. A standardized approach to data collection is important to identify a consistent reporting standard for the psychosocial domain.

Method:

This research used an integrative literature review design. Manuscripts were collected using keyword searches from databases and journal content pages from 2003 through 2018. Data were analyzed and categorized using the existing minimum data set as a framework.

Results:

In total, 31 manuscripts met the inclusion criteria. The main variables identified were use of alcohol or drugs, crowd behavior, crowd mood, rationale, and length of stay.

Conclusion:

Upon interrogating the literature, the authors have determined that the variables fall under the categories of alcohol or drugs; maladaptive and adaptive behaviors; crowd behavior, crowd culture, and crowd mood; reason for attending event (motivation); duration; and crowd demographics. In collecting psychosocial data from mass gatherings, an agreed-upon set of variables that can be used to collect de-identified psychosocial variables for the purpose of making comparisons across societies for mass-gathering events (MGEs) would be invaluable to researchers and event clinicians.

Shared social identification in mass gatherings lowers health risk perceptions via lowered disgust

Previous research concerning mass gathering‐associated health risks has focused on physical factors while largely neglecting the role of psychological factors. The present research examined the effect of experiencing shared social identification on perceptions of susceptibility to health risks in mass gatherings. Participants in Study 1 were asked to either recall a crowd in which they shared a social identity with other crowd members or a crowd in which they did not. Participants subsequently completed measures assessing shared social identity, disgust, and health risk perceptions. Study 2 involved administering the same measures as part of a survey to participants who had recently attended a music festival. The results from both studies indicated that sharing a social identity lowered health risk perceptions; this effect was indirect and mediated via disgust. This highlights the importance of considering social identity processes in the design of health communication aimed at reducing mass gathering‐associated health risks.

Risks threatening the health of people participating in mass gatherings: A systematic review

CONTEXT

Mass gatherings (MGs) are established for different religious, social, political, cultural, and sport motivations. Many risks threaten the participants' health in MGs for different reasons. One duty of health-care system is to identify the risks and manage them to reduce the participants' injuries in MGs. This study aimed to identify and classify the risks threatening the health of participants in MGs and review related articles systematically.

SUBJECTS AND METHODS

In this study, we investigated electronic databases including Science Direct, PubMed, Ovid, ProQuest, Web of Science, Scopus, and Google Scholar. This systematic review investigated those health articles which studied MGs published after 2000. Keywords that were searched included (Mass gathering OR Crowd) AND (Assessment OR Evaluation) AND (Disaster OR Emergencies) AND (Injuries OR Stamped). The final full text articles were assessed qualitatively by STROBE article assessment checklist, and then the data extracted from the results of the articles were analyzed and reported.

RESULTS

Initially, a total of 1874 articles were found, qualitative exclusion and inclusion criteria were applied, and finally 29 full-text articles were selected for the analysis. More than forty health-related risks were recognized. In order to better understand the risks and use of the results more efficiently, the risks were classified and reported into the following five domains: environmental risks, individual risks, psychological risks, public health risks, and management risks.

CONCLUSION

Many risks threaten the health of participants in MGs. Recognizing and managing the risks are considered the primary and basic essentials of health sector for the better management of MGs.

Risk and protective factors for mental health at a youth mass gathering

BACKGROUND

Mass gatherings are well-documented for their public health risks; however, little research has examined their impact on mental health or focused on young people specifically. This study explores risk and protective factors for mental health at mass gatherings, with a particular focus on characterising attendees with high levels of psychological distress and risk taking.

METHOD

Data collection was conducted in situ at "Schoolies", an annual informal week-long mass gathering of approximately 30,000 Australian school leavers. Participants were 812 attendees of Schoolies on the Gold Coast in 2015 or 2016 (74% aged 17 years old).

RESULTS

In both years, attendee mental health was found to be significantly better than population norms for their age peers. Identification with the mass gathering predicted better mental health, and this relationship became stronger across the course of the mass gathering. Attendees with high levels of psychological distress were more likely to be male, socially isolated, impulsive, and in a friendship group where risk taking was normative.

CONCLUSIONS

Mass gatherings may have a net benefit for attendee mental health, especially for those attendees who are subjectively committed to the event. However, a vulnerable subgroup of attendees requires targeted mental health support.

Perception of risk as a mediator between personality and perception of health: test of a model

Background

This research article addresses the relationships among personality, risk perception, and health perception. The personality construct has been one of the main topics of research in psychology throughout history and is understood as the set of traits or cognitive, affective and behavioral characteristics that an individual possesses. Important relationships have been found that show the impact of personality on people’s health as well as the impact of health conditions on the configuration of personality. This research investigates the perception of risk as a mediating trait between personality and perception of health.

Materials and methods

To achieve this, a cross-sectional study was conducted in which 398 Colombians from all regions of the country were evaluated. The NEO Five Factor Inventory (NEO-FFI), The General Health Questionnaire (GHQ-12) and Health Risk Perception Test (HRPT) tests were used.

Results

The data were analyzed with multiple regression and path analysis. The findings using multiple regression show that neuroticism and the personal meaning of risk affect the perception of health; however, using path analysis, model fit with the proposed model was not achieved with no mediator effect of perception of risk.

Conclusion

It is necessary to focus on relationships between neuroticism and perception of health in future research.

From the "Madding Crowd" to mass gatherings-religion, sport, culture and public health

Human behavior has long engaged in collective behavior assembling in crowds. The Christian pilgrimage to the Holy Land has been recorded since the 4th century, while the Hajj, Islam's great pilgrimage, has existed for fourteen centuries, of which a body of literature devoted to the travelogues of the Hajj has been recorded for over ten centuries. Football is a sport played worldwide by more than 1.5 million teams and in 300,000 clubs. Most however play outside of the officially organized sphere: more than 4 percent of the global population plays football, including 270 million amateur players.

Assembling for specific events is a uniquely human behavior, though the formal study of crowds did not begin until the mid-Twentieth Century. Today Mass Gathering Medicine focuses on the public health challenges to hosting events attended by a large enough number of people, at a specific site, for a defined period of time, likely to strain both the planning and response to the mass gathering of a community, state, or nation. All of us can recall attending a mass gathering, whether it be watching one's favorite rock group in performance or assembling for religious pilgrimage. Certainly, the event itself is transporting and transforming and the unison of behaviors and activities can be enormously enriching, uplifting and overwhelming, just as much as they may be at times dangerous and high risk. This review seeks to draw contrasts and comparisons between sporting gatherings and religious gatherings with a chief focus on Hajj, among the largest of all mass gatherings today. We will find there are some powerful similarities as well as stark differences. Each bequeaths a legacy which can inform the other and, as we make our observations, we join with you and the legions of other investigators who continue to remain fascinated and enthralled by mass gatherings which are among the most beloved and beholden events of modern humanity.

Ritual experimental: ¿Humanizando a los inmigrantes o prejuicio utilitario en Europa?

A menudo los inmigrantes y refugiados son representados a través de formas deshumanizantes o como una ganancia económica para los países receptores. Este hecho, sumado a la situación sociopolítica europea actual, puede aumentar los niveles de infrahumanización que sufren las minorías objeto de prejuicio. En este estudio, se propuso reducir la infrahumanización hacia la población magrebí a través de una actividad ritualizada, manipulando la información que los participantes utilizaban. Los resultados indicaron que la participación fue diferente según las condiciones y que se redujo la infrahumanización. Además, los participantes que utilizaron información utilitarista humanizaban cuando percibían una ganancia económica, mientras que también aumentaban sus niveles de prejuicio. Los resultados se discuten en términos de rituales colectivos y efectos duales de la información utilitarista.

A Meta-Analytic Review of Social Identification and Health in Organizational Contexts

We provide a meta-analytical review examining two decades of work on the relationship between individuals’ social identifications and health in organizations (102 effect sizes, k = 58, N = 19,799). Results reveal a mean-weighted positive association between organizational identification and health ( r = .21, T = .14). Analysis identified a positive relationship for both workgroup ( r = .21) and organizational identification ( r = .21), and in studies using longitudinal/experimental ( r = .13) and cross-sectional designs ( r = .22). The relationship is stronger (a) for indicators of the presence of well-being ( r = .27) than absence of stress ( r = .18), (b) for psychological ( r = .23) than physical health ( r = .16), (c) to the extent that identification is shared among group members, and (d) as the proportion of female participants in a sample decreases. Overall, results indicate that social identifications in organizations are positively associated with health but that there is also substantial variation in effect size strength. We discuss implications for theory and practice and outline a roadmap for future research.

Travelers to the FIFA world cup 2014 in Brazil: Health risks related to mass gatherings/sports events and implications for the Summer Olympic Games in Rio de Janeiro in 2016

BACKGROUND

Health threats during mass gatherings, such as the FIFA world cup 2014 differ from traditional health risks. The influence of event type, demographics of attendees and environmental conditions are still not fully understood.

METHODS

An observational, prospective case-control survey conducted at the Frankfurt international airport in Germany on 544 travelers to the FIFA world cup 2014 and 432 regular travelers to Brazil departing after the end of the world cup.

RESULTS

Travelers to the FIFA world cup 2014 were predominantly male whereas the gender distribution in the control group was more balanced. The majority in both groups obtained insect bites and sunburns as environmental risk factors. Every third traveler suffered from diarrheal complaints in both groups, whereas the proportion of travelers with flu-like symptoms was higher in the case group. Travelers to the FIFA world cup 2014 indicated alcohol intake and sexual contacts outside of a relationship more frequently than travelers in the control group.

CONCLUSIONS

The additional health risks of travelers to sporting events as the FIFA world cup 2014 should be addressed in addition to traditional health threats in pre-travel counseling for the Summer Olympic Games 2016 in Brazil.

Core disgust is attenuated by ingroup relations

We present the first experimental evidence to our knowledge that ingroup relations attenuate core disgust and that this helps explain the ability of groups to coact. In study 1, 45 student participants smelled a sweaty t-shirt bearing the logo of another university, with either their student identity (ingroup condition), their specific university identity (outgroup condition), or their personal identity (interpersonal condition) made salient. Self-reported disgust was lower in the ingroup condition than in the other conditions, and disgust mediated the relationship between condition and willingness to interact with target. In study 2, 90 student participants smelled a sweaty target t-shirt bearing either the logo of their own university, another university, or no logo, with either their student identity or their specific university identity made salient. Walking time to wash hands and pumps of soap indicated that disgust was lower where the relationship between participant and target was ingroup rather than outgroup or ambivalent (no logo).

Adding a psychological dimension to mass gatherings medicine

Mass gatherings pose distinctive challenges for medicine. One neglected aspect of this is that the behaviour of people participating in such events is different from the behaviour they exhibit in their everyday lives. This paper seeks to describe a social psychological perspective on the processes shaping people's behaviour at mass gatherings and to explore how these are relevant for an understanding of the processes impacting on the transmission of infection. It is inadequate to conceptualize mass gatherings as simply an aggregate of a large number of individuals. Rather, those present may conceptualize themselves in terms of a collective with a shared group identity. Thinking of oneself and others as members of a collective changes one's behaviour. First, one behaves in terms of one's understanding of the norms associated with the group. Second, the relationships between group members become more trusting and supportive. Understanding these two behavioural changes is key to understanding how and why mass gathering participants may behave in ways that make them more or less vulnerable to infection transmission. Implications for health education interventions are discussed.