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ABSTRACT

       IN October 1918, the world was still fighting World War I. Although the end of hostilities was near, news censorship remained. Therefore, it was left to the noncombatant country of Spain to report that civilians in many places were becoming ill and dying at an alarming rate. These circumstances gave rise to the name by which the disease would forever be known—the Spanish flu or widely known as Influenza.

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Crosby writes: “All the physicians of 1918 were participants in the greatest failure of medical science in the twentieth century or, if absolute numbers of dead are the measure, of all time.” Lest the blame be placed entirely on the medical profession, Barry makes this point: “Back then scientists fully comprehended the threat’s magnitude, knew how to cure much secondary bacterial pneumonia, and gave public-health advice that would have saved tens of thousands of American lives. Politicians ignored that advice.”

Now, the existence of a new epidemic recently known as the Avian Flu is again plaguing the world. Medical experts are once again alarmed as to how the said disease could be fought and might as well be prevented especially with regards to its attack on the elderly. In this regard, this paper shall examine the possibilities of developing a certain medical program that could help in the prevention of the Avian Flu attack towards the elderly specifically located in Hong Kong.

Primary Health Care

Prevention of the Avian Flu on the Elderly in Hong Kong

Background of the Health Issue

Background of the Study

            The Avian Flu is a type of Influenza that is mainly focused on the A virus that causes the said original disease. Most often than not, the said virus infects birds such as chickens and ducks. However, medical reports have noted that the first human infected with the Avian influenza is located in Hong Kong. As it started in the said country, the disease already began to plague the entire Asian Region in 1997. Mainly, the said illness attacks the poultries; however, as the disease transfer continues to rise, human patients are also reported to be rising.

Objectives of the Program

            The program to be formulated in this paper aims to create ways by which the Avian Flu could be prevented especially on its effects on the old-aged patients. As known to many, the resistance of the aging body has lesser strength of avoiding viruses from the environment that may directly destroy their health system. Hence, the program that would be presented in this paper would allow the medical experts to realize the measures that they have to take especially when dealing with old aged patients who are infected by the Avian Virus.

Further more, the said program aims to help the public realize their own responsibility with regards the said health issue. As known through medical researches The Avian Flu s mostly found on poultry products. Hence, a high level of caution is supposed to be placed with regards the ability of the public to avoid food stocks that are infected with the said virus. The program that would be presented herein aims to answer the said precautionary need.

Outline of the Program

Assessment of the subjects or respondents to be studied
Creating the program based on the needs that were known through the preformed assessment [Planning]
·         Educating the society regarding the disease, its causes, its symptoms and its prevention

·         Examining the environment of the society being studied and helping them clean up the surroundings to be able to control the possible spreading of the disease.

·         Creating a program that would regularly check the development of the said society with regards to their knowledge of the disease and the preventive measures that they take to be able to answer the growing need of giving extra attention to the elderly.

Implementation of the program
Implementing the program requires rigid effort. The willingness of the researcher, as well as the group involved in the implementation of the said program is highly needed. Hence, determination to help the society, especially the older ones to realize the importance of the program should be well identified and applied by the researcher.
Evaluation
·         After implementing the program, the results should be evaluated as to how far it has affected the health habits of the patients or the target population. Doing s would help the researcher realize that there may be some certain sectors of the program that must be changed or reconstructed to be able to meet the specific needs of the target benefactors of the program.

Significance of the Study

            As mentioned earlier, the Avian Flu is a growing dilemma in the health systems in Asia. Hence, studying its effects and evaluating the main reasons why the elderly are at high risk in suffering from the said disease, would increase the awareness of the society as well as the medical experts regarding the facts behind the illness in focus. Aside form this, the program that would be created herein shall be a big help towards the process of prevention and precautionary measures that medical experts already take into consideration regarding the said health issue.

Limitations

            Since the target location of the study is based on a faraway country such as Hong Kong, this research would be mainly based upon online researches from the Internet as well as from legitimate books that discuss the mentioned issue on Avian Flu in Hong Kong. Aside from this, some interview questions and survey formats shall be sent to online respondents. Hence, an actual observation of the Hong Kong environment and the impact of the Avian Flu towards the elderly population of the said country would not be performed although the said process would prove to be much helpful for this research.

Conclusion

            The fact that it is a social concern; the more that researches such as this is needed for the advancement of the medical precautions that are already taken by experts and community groups with regards the Avian Flu in Hong Kong.

Background of the Introduction

Facts Related to the Health Issue

            Since the outbreak of the Avian Flu, which mainly started in the Asian regions, the said disease has been killing a number of patients who were infected by the said virus. The World Health Organization (WHO), despite of trying to control the outbreak has somewhat failed to fully control the spread of the virus. The table to follow shows the recent reports of the WHO agencies regarding the actual number of people infected by the virus:

Cumulative Number of Confirmed Human Cases

of Avian Influenza A/H5N1) Reported to WHO

29 November 2006

Country

2003
2004
2005
2006
Total
cases
deaths
cases
deaths
cases
deaths
cases
deaths
cases
deaths
Azerbaijan
0
0
0
0
0
0
8
5
8
5
Cambodia
0
0
0
0
4
4
2
2
6
6
China
1
1
0
0
8
5
12
8
21
14
Djibouti
0
0
0
0
0
0
1
0
1
0
Egypt
0
0
0
0
0
0
15
7
15
7
Indonesia
0
0
0
0
19
12
55
45
74
57
Iraq
0
0
0
0
0
0
3
2
3
2
Thailand
0
0
17
12
5
2
3
3
25
17
Turkey
0
0
0
0
0
0
12
4
12
4
Viet Nam
3
3
29
20
61
19
0
0
93
42
Total
4
4
46
32
97
42
111
76
258
154
* Total number of cases includes number of deaths.
WHO reports only laboratory-confirmed cases.

(SOURCE: WHO OMS. http://www.who.int/csr/disease/avian_influenza/country/cases_table_2006_11_29/en/index.html)

            With the observation of the table presented above, it could be noticed that the main target of the virus is the Asian region. Although not included in the recent reports, Hong Kong as mentioned earlier has been the location of the first human infected by the Avian Flu. Hence, this should be a sign that Hong Kong to should take precautions in dealing with the said illness and the possibility of its wider spread in the said country. Review of Current Hong Kong Health Services

            The actual outbreak of the Avian Flu in Hong Kong occurred in 1997. The said report has moved the medical groups of the said countries to take precaution on the preempted effects of the flu on the people of Hong Kong. Because of this, they have developed a vaccine that would help on the prevention of the infection of the Avian Flu especially towards children and the elderly.

Justifications of the Program

            As the program aims to hopefully develop the existing medical program in Hong Kong, the program that would be presented here would be duly based on the medical applications that are done on other countries experiencing the said health dilemma. Hence, through the effectiveness of the patterns being followed by the researcher, it would not be impossible to attain the best results from what is actually expected from the study.

Link to Primary Healthcare Principles

            The program to be presented highlights several healthcare principles such as the ones listed herein:

·         Educating the Public

Prevention is always better than cure. Hence, being educated about the necessary things that govern a certain health issue is the main key towards being aware and being able to prevent certain diseases from occurring.

·         Understanding The needs and health demands of the subjects

Since this study focuses on the elderly, it is important to specifically know the differences of their needs with regards to both the prevention and the medication of the disease.

·         Studying what the subjects really intend to have to be able to be given medication

Program Objectives

            As mentioned earlier, the program that would be formulated by the researcher with regards to this study has certain objectives pertaining to the expected results of the implementation of the program. And they are as follows:

·         To promote social education on the basic facts regarding the Avian Flu

·         To allow the public have a chance to redirect their activities towards a more preventive or precautionary measure towards the occurrence of an Avian flu epidemic in their community.

·         To bring about preventive and nutritional ways by which the society would be able to avoid the said illness.

·         To help the elderly become more aware of the food they eat and the way the meals they take re being prepared.

Having these objectives, the program that would be created is expected to bear

fine results especially regarding the healthful habits of the subjects to be studied.

Outline of the Essay

CHAPTER 1 Introduction

            Statement of the Problem

            Background of the Study

            Hypothesis

            Scope and Delimitations

            Definition of Terms

            Background Overview

CHAPTER 2 Literature Review

            The Health Issue

            The Needed Primary Healthcare

            On Prevention and Health Habits

CHAPTER 3 Methodology

            The Respondents

            The Instrument to be Used (Interview and Survey Questionnaires)

            Internal validity

            External Validity

            Statistical Techniques

CHAPTER 4 Data Presentation

CHAPTER 5 Discussion

CHAPTER 6 Summary, Conclusion and Recommendation

Literature Review

Health Issue

            According to the medical experts handling the Avian Flu cases in Hong Kong, the said medical problem has caused so much turmoil in the medical industries of the Asian countries. Furthermore, its infection towards humans has massively changed the entire medical practices of the said country. The reports that follow indicated the inoffensive attack of the said virus on Hong Kong’s Primary Healthcare Practices:

·  H5N1, Hong Kong, Special Administrative Region, 1997: Highly pathogenic avian influenza A (H5N1) infections occurred in both poultry and humans. This was the first time an avian influenza A virus transmission directly from birds to humans had been found. During this outbreak, 18 people were hospitalized and six of them died. To control the outbreak, authorities killed about 1.5 million chickens to remove the source of the virus. Scientists determined that the virus spread primarily from birds to humans, though rare person-to-person infection was noted.

·  H9N2, China and Hong Kong, Special Administrative Region, 1999: Low pathogenic avian influenza A (H9N2) virus infection was confirmed in two children and resulted in uncomplicated influenza-like illness. Both patients recovered, and no additional cases were confirmed. The source is unknown, but the evidence suggested that poultry was the source of infection and the main mode of transmission was from bird to human. However, the possibility of person-to-person transmission could not be ruled out. Several additional human H9N2 infections were reported from China in 1998-99.

(Source: CDC: Avian Influenza. Instances of Avian Influenza Infections in Humans. http://www.cdc.gov/flu/avian/gen-info/avian-flu-humans.htm)

            The mentioned reports mainly highlight the

Primary Healthcare

            Primary Healthcare programs are most likely concentrated on the procedures whereas the prospected victims could be helped in avoiding the illness caused by the H5N1 (Avian Flu) virus. The following guidelines of prevention are taken from the Committee on Health Promotion and Protection Site in the Internet. This has been made available to the public to be able to host to the needs of the possible population which are the main target of the illness being tackled herein.

· Droppings of infected birds and poultry may carry the avian flu virus, so avoiding touching live birds or poultry or their droppings is a must especially when traveling in and Asian country like Hong Kong

· If there has been any contact with live birds or poultry, immediately washing the hands thoroughly with liquid soap and water would help in preventing any Avian virus tin contaminating a person’s body.

· Cook poultry and eggs thoroughly before eating.

· If there are flu symptoms, an individual must consult a doctor and wear a mask to prevent spreading the disease.

· The best protection against influenza is having good body resistance. This can be achieved through a balanced diet, regular exercise, and adequate rest, reducing stress, and not smoking.

· Avoid crowded places with poor ventilation.

· If there happens to be a development of fever and respiratory symptoms after returning from a country that reports an avian flu outbreak, a traveler must immediately doctor and tell him/her about the travel history.

SOURCE: Committee on Health Promotion and Protection. (1997). PREVENTION GUIDELINES AVIAN FLU PREVENTION. http://www.cuhk.edu.hk/health_promote_protect/prevention11.htm.

            December 23, 2006)

            Taking these precautionary measures into consideration whether a person is in travel or in a place which is reported to have a high risk of being infected by the said virus could help in at least lessening the infectious effect of the said illness to the human population.

            The correlation of the health issues with the primary healthcare measures that are taken by experts [mainly in Hong Kong] is indeed designed to support each other. As the issue continues to rise, it could be noticed that through reports, the ways by which the preventive measures are applied are further heightened and strictly implied.

            The review of the literatures that would be helpful in the completion of this paper indeed introduces the main theme that this paper is focused upon. Hence, further examination of the effectiveness of the preventive measures mentioned in this chapter would be done in the actual survey and interview that would be performed by the researcher.

Assessment

Types of Needs (of Correspondents)

            The correspondents of this research would mainly be addressed through the internet. A conference interview would also be hosted by the researcher through the Internet just the same. As a result, the researcher expects that the correspondents would have better and more relaxed pattern of answering the questions that would be asked to them since they are simply going to sit in a comfortable chair infront of the computer for approximately five to ten minutes for each interview. The survey questionnaires would be given out to at least five medical experts situated in Hong Kong who have been able to encounter the cases of the Avian Flu patients. Their availability would be decided by them as the surveys are to be given online and would take lesser time in answering them since the questions are rather easy and straight to the point.

Assessment of Methods

            The interview and the survey method have been chosen by the researcher as the best possible source of actual examination and observation on the target area of study. This is mainly because of the fact that these tools could be sent online and could be one online as well. Hence, this would naturally allow the researcher longer time of evaluation and lesser expenses when it comes to financial matters.

            Aside from this, the researcher believes that on the part of the correspondents, this would also be a great help as to their confidence in answering the questions. They would feel less shy in meeting up face to face with a foreigner and would likely give better answers on the inquiries of the researcher regarding the illness.

Planning

Decision Making Process

            On the part of decision making, the researcher has used several other researches that could help in coming up with a better result for the topic to be discussed in this paper. The methods that were chosen were based from different ways by which the study could be completed. Aside from that, the said choices were also based upon the capabilities and the limitations of the researcher to perform the duties required by the methods that were chosen to be utilized.

Strategies

            As mentioned earlier, aside form the researches which would come from both online, journal and book sources, this study would be based on the actual interviews and opinions of the elderly, their families and the medical experts attending to them in Hong Kong. As a major way to complete the said task, the researcher carefully sees to it that it meets the need for the research paper while it also fits the capabilities of the author as well. In this regard, the Internet comes in as a handy tool for the researcher to utilize in the best possible way there is.

Priorities

            The topic of this paper is directly linked to Hong Kong issues on the Avian Flu outbreak in the year 1997 onwards. Along with this, the paper too focuses on the possible preventive measures that could be taken for the elderly population of the said country to be protected from the harms brought about by the disease. Hence, set as guidelines, these two main focuses of this paper would help the researcher stay on track as the completion of the research is formulated.

Summary of the time table

            The researcher expects at least a two-week completion on the literature research, the survey questionnaires and the conference interviews as well. As the data are collected, the researcher plans to evaluate the results as they come and merge them together to arrive at a single and yet practical conclusion on how the Avian Flu virus attack on the elderly could be prevented. Another week after the two is to be devoted to the final furnishing and revising of the paper for proof reading and clarification. This way, the paper could be expected to be free of plagiarism and fallacious reports.

Implementation

            The implementation of the program that has been prepared by the author would mostly depend on the capability of the author himself to cope up with the time and the limited fund that is prepared for this research. Hence, it should be noticed constantly that although there are certain limits to the budget as well as with the time, the professionalism of the author himself would be the reason for the excellent results of this research.

Evaluation

Justification

            The research topic of this paper is timely. This could be proven by the fact that the outbreak has happened in Asia just recently. In this regard, it could be noted that another outbreak of the same virus not only in Asia but on other parts of the world could occur again. Hence, studying the ways by which the medical experts could help specifically the elderly population in avoiding the said disease is indeed an important matter of concern.

Definition of Methods

            The methods chosen by the author to be used could be attested as legitimate and effective all at the same time. The fact that there is a certain barrier between the researcher and the correspondents to have an actual or personal conversation, the use of the internet in completing the said task would appear to be the best way of reaching the respondents.

Discussion

Significance of the Study

            As earlier claimed, the topic that is to be discussed in this paper holds so much importance in the health industry. With the aim of the medical experts of each society making up the whole neighborhood of mankind, the issue on the possible outbreak of the Avian Flu towards the elderly in the future is indeed an important matter of concern.

Limitation

            The distance of the correspondents would be the main problem in this study. However, the availability of the cyber space and cyber conversation would be effectively utilized by the researcher in completing the tasks required for the final furnishing of this paper.

Suggestion for Future Program Development

            The program that would be posted in this paper would be more likely based upon the researches that are done by the author as well as the surveys and online interviews that would be performed as well. Hence, an actual or personal conversation is suggested by the author to be completed by other researchers in the future who would have the enthusiasm in completing a paper under this topic. This then would enhance the order of the program featured herein which is mainly based on opinions. Environmental observations which could only be done through actual traveling could further bring better results for this type of research topic.

Conclusion

            Health is one of the most important wealth that anybody in this world could posses. Hence, increasing the lifespan of the elderly population is also the main concern of the medical experts nowadays. Hence, studying the viruses that attack the weak resisting system of the bodies of the elderly would indeed help in this aim of the medical world.

            In this regard, this study would be of much help in educating the public and helping them see the necessary measure that are needed to be implied to be able to prevent the possible future outbreak of the Avian Flu, not only in Hong Kong but also on other parts of the world.

References

Magazines:

Oner AF et al. Avian influenza A (H5N1) infection in eastern Turkey in 2006. N Engl J Med 2006 Nov 23; 355:2179-85.

Kandun IN et al. Three Indonesian clusters of H5N1 virus infection in 2005. N Engl J Med 2006 Nov 23; 355:2186-94.

Webster RG and Govorkova EA. H5N1 influenza — Continuing evolution and spread. N Engl J Med 2006 Nov 23; 355:2174-7.

Internet Sources:

Mayo Clinic. (2006). Bird flu (avian influenza). http://www.mayoclinic.com/health/bird-flu/DS00566. (December 23, 2006).

Global research. (2005). The Threat of the Avian Flu Pandemic. http://www.globalresearch.ca/index.php?context=viewArticle&code=20051004&articleId=1040. (December 23, 2006).

:WHO OMS. (2006).  Avian influenza (” bird flu”) – Fact sheet

http://www.who.int/csr/disease/avian_influenza/country/cases_table_2006_11_29/en/index.html. (December 23, 2006)

Committee on Health Promotion and Protection. (1997). PREVENTION GUIDELINES AVIAN FLU PREVENTION. http://www.cuhk.edu.hk/health_promote_protect/prevention11.htm.

(December 23, 2006).

CDC: Avian Influenza. Instances of Avian Influenza Infections in Humans. http://www.cdc.gov/flu/avian/gen-info/avian-flu-humans.htm (December 23, 2006).

Books:

Mike Davis. (2006). The Monster at Our Door: The Global Threat of Avian Flu. Owl Books; Reprint edition.

E.Williams. (2003). Avian flu outbreaks, production curbs boost Thai chicken exports and prices. (Focus on Thailand).: An article from: Quick Frozen Foods International. E.W. Williams Publications, Inc.

Patricia Vowinkel. (2006). Facing killer terms: life insurers face massive payouts in the event of an outbreak of the avian flu. There is a silver lining as well: there would be … storm.: An article from: Risk & Insurance. Thomson Gale.

Joseph Mercola. (2006). The Great Bird Flu Hoax: The Truth They Don’t Want You to Know About the “Next Big Pandemic”. Nelson Books.

Marc MD Siegel. (2006). Bird Flu: Everything You Need to Know About the Next Pandemic. Wiley Publishing.

Budget Table

Type of Expenses
Allotted Budget
Actual Expense Price
Internet Connection Expenses
$60

Printing Expenses (For Final paper)
$25

Miscellaneous expenses for the paper
$23

Timetable

WEEK DIVISION/Day Division
Activity
WEEK ONE

Day 1-Day 3
Preparation of the questionnaires, interview patterns and process of surveying that would be utilized
Day 4-Day 6
Preparation of the Letters for the correspondents
WEEK TWO
Completing the Interviews and the Surveys as well as the literature research
WEEK THREE
Final completion of the paper [revising, clarifying and modifying of details]

Questionnaires and Interview Plots

A. Survey Questionnaires

To the Medical Experts online

As Hong Kong medical experts, how do you gauge the Avian Flu outbreak that happened in 1997?
·         Small scope of outbreak

·         Medium scope of outbreak

·         Large scope of outbreak

As the outbreak began, how would you gauge the preventive measures that your health agencies take as primary healthcare processes towards the Avian Flu?
·         Satisfactory

·         Average

·         Above average

·         excellent

Have you prepared yourselves in a possible Avian Flu outbreak in the future?
·         Yes

·         No

Please do compare the ratio of the young ones with the elderly generation who were infected by the Avian Flu

As medical experts what further suggestions could you give with regards the necessary preventive measures that should be taken to avoid Avian Flu especially with regards the elderly population?
B. Interview Plot

1. As an elderly, how do you gauge your health resistance from viruses that affects your community?

2. Are you aware of the Avian Flu?

3. What do you know about the Avian Flu?

4. Are you aware of the necessary preventive measures that are needed to avoid the illness brought about by the Avian Virus?

5. Are you prepared incase any future Avian Flu outbreak would occur in your community?

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