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      Worry experienced during the 2015 Middle East Respiratory Syndrome (MERS) pandemic in Korea

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          Abstract

          Background

          Korea failed in its risk communication during the early stage of the Middle East Respiratory Syndrome (MERS) outbreak; consequently, it faced difficulties in managing MERS, while disease-related worry increased. Disease-related worry can help disease prevention and management, but can also have a detrimental effect. This study measured the overall level of disease-related worry during the MERS outbreak period in Korea and the influencing factors and levels of disease-related worry during key outbreak periods.

          Methods

          The cross-sectional survey included 1,000 adults who resided in Korea. An ordinal logistic regression was performed for the overall level of MERS-related worry, and influencing factors of worry were analyzed. A reliability test was performed on the levels of MERS-related worry during key outbreak periods.

          Results

          The overall level of MERS-related worry was 2.44. Multivariate analysis revealed that women and respondents w very poor subjective health status had higher levels of worry. Respondents with very high stress in daily life had higher levels of worry than those who reported having little stress. The reliability test results on MERS-related worry scores during key outbreak periods showed consistent scores during each period.

          Conclusion

          Level of worry increased in cases having higher perceived susceptibility and greater trust in informal information, while initial stage of outbreak was closely associated with that at later stages. These findings suggest the importance of managing the level of worry by providing timely and accurate disease-related information during the initial stage of disease outbreak.

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          Most cited references13

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          Anxiety, worry and cognitive risk estimate in relation to protective behaviors during the 2009 influenza A/H1N1 pandemic in Hong Kong: ten cross-sectional surveys

          Background Few studies have investigated associations between psychological and behavioral indices throughout a major epidemic. This study was aimed to compare the strength of associations between different cognitive and affective measures of risk and self-reported protective behaviors in a series of ten cross-sectional surveys conducted throughout the first wave of influenza A/H1N1 pandemic. Methods All surveys were conducted using questionnaire-based telephone interviews, with random digit dialing to recruit adults from the general population. Measures of anxiety and worry (affective) and perceived risk (cognitive) regarding A/H1N1 were made in 10 serial surveys. Multivariate logistic regression models were used to estimate the cognitive/affective-behavioral associations in each survey while multilevel logistic models were conducted to estimate the average effects of each cognitive/affective measure on adoption of protective behaviors throughout the ten surveys. Results Excepting state anxiety, other affective measures including “anticipated worry”, “experienced worry” and “current worry” specific to A/H1N1 risk were consistently and strongly associated with adoption of protective behaviors across different survey periods. However, the cognitive-behavioral associations were weaker and inconsistent across the ten surveys. Perceived A/H1N1 severity relative to SARS had stronger associations with adoption of protective behaviors in the late epidemic periods than in the early epidemic periods. Conclusion Risk-specific worries appear to be significantly associated with the adoption of protective behaviors at different epidemic stages, whereas cognitive measures may become more important in understanding people’s behavioral responses later in epidemics. Future epidemic-related psycho-behavioral research should include more affective-loaded measures of risk.
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            Awareness, attitudes, and practices related to the swine influenza pandemic among the Saudi public

            Background During an infectious disease outbreak, it is critical to learn as much as possible about the concerns, knowledge, attitudes, and behavior of the public. Such information can be crucial to the improvement of communication efforts by public health officials and clinicians. The aim of this study was to identify awareness, attitudes, and practices related to influenza A (H1N1) among the Saudi public. Methods A cross-sectional study of 1,548 adult subjects recruited from various shopping malls in Riyadh and Jeddah was conducted. All of the subjects were interviewed using a questionnaire that tested their knowledge, attitudes, and use of precautionary measures in relation to the H1N1 influenza pandemic. Results More than half (54.3%, 840/1548) of the participants showed high concern, 43.7%(677/1548) showed a low level of knowledge, and 60.8%(941/1548) had taken minimal or no precautionary measures. After adjusting for other variables, education level was the only significant predictor of the level of concern (p < 0.001), while greater precautionary measures were taken by participants who were male (p < 0.001), older (p = 0.047), better educated (p = 0.04), and more knowledgeable (p < 0.001). More than one-third (38.3%) of participants were not convinced that the MOH reports about the disease were true, and only 16.1% of the participants reported receiving information from health providers. Conclusions High concern did not translate into a higher compliance with precautionary recommendations, possibly due to the low level of knowledge about the disease among the public. Frequent communication between physicians and the public is recommended to help dispel myths about the disease and to spread better information about the role that the public can play in limiting the spread of the disease.
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              Pattern transitions in spatial epidemics: Mechanisms and emergent properties

              Infectious diseases are a threat to human health and a hindrance to societal development. Consequently, the spread of diseases in both time and space has been widely studied, revealing the different types of spatial patterns. Transitions between patterns are an emergent property in spatial epidemics that can serve as a potential trend indicator of disease spread. Despite the usefulness of such an indicator, attempts to systematize the topic of pattern transitions have been few and far between. We present a mini-review on pattern transitions in spatial epidemics, describing the types of transitions and their underlying mechanisms. We show that pattern transitions relate to the complexity of spatial epidemics by, for example, being accompanied with phenomena such as coherence resonance and cyclic evolution. The results presented herein provide valuable insights into disease prevention and control, and may even be applicable outside epidemiology, including other branches of medical science, ecology, quantitative finance, and elsewhere.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                8 March 2017
                2017
                : 12
                : 3
                : e0173234
                Affiliations
                [1 ]Department of Infectious Disease, Research Center of Infectious and Environmental Disease, Armed forces medical research institute, Daejeon, South Korea
                [2 ]Department of Health Policy and Management, College of Medicine, Seoul National University, Seoul, South Korea
                [3 ]Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, South Korea
                Shanxi University, CHINA
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                • Conceptualization: JSL.

                • Data curation: JSL JSR.

                • Formal analysis: JSR.

                • Funding acquisition: JSL.

                • Investigation: JSL JSR.

                • Methodology: JSR JSL SCK.

                • Project administration: JSL.

                • Supervision: JSL.

                • Validation: JSR SCK.

                • Visualization: JSR.

                • Writing – original draft: JSR.

                • Writing – review & editing: HMJ JSL.

                Article
                PONE-D-16-28628
                10.1371/journal.pone.0173234
                5342218
                28273131
                114f67f1-582c-4055-a3f1-be41a36df8b9
                © 2017 Ro et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 12 August 2016
                : 19 February 2017
                Page count
                Figures: 1, Tables: 4, Pages: 10
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100003625, Ministry of Health and Welfare;
                Award Recipient :
                Ministry of Health and Welfare (Republic of Korea) has supported J-SL, grant numbers: none, URLs: http://www.mohw.go.kr/eng/index.jsp. The Funder had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Infectious Diseases
                Infectious Disease Control
                Medicine and Health Sciences
                Infectious Diseases
                Viral Diseases
                Influenza
                Social Sciences
                Sociology
                Education
                Schools
                Medicine and Health Sciences
                Pulmonology
                Respiratory Infections
                Medicine and Health Sciences
                Epidemiology
                Infectious Disease Epidemiology
                Medicine and Health Sciences
                Infectious Diseases
                Infectious Disease Epidemiology
                Biology and Life Sciences
                Zoology
                Animal Diseases
                Animal Influenza
                Swine Influenza
                Medicine and Health Sciences
                Infectious Diseases
                Zoonoses
                Swine Influenza
                Engineering and Technology
                Management Engineering
                Risk Management
                Insurance
                People and Places
                Geographical Locations
                Asia
                Korea
                Custom metadata
                The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the Supporting Information files.

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