Respond to at least two of your fellow students discussion posts. These responses must include a journal, news, or website article that critically reflects and pertains to the points of the initial post. You can either agree, disagree, or elaborate using these sources.
Jasleen Palencia (student’s name)
The disease I chose is type 2 diabetes which is a non-communicable chronic disease. The model that I chose was Rothman’s Pie Model. As the CDC states Rothman’s pie model is an epidemiological model used to understand the causal mechanisms of a disease, where “an individual factor that contributes to cause disease is shown as a piece of pie. After all the pieces of a pie fall into place, the pie is complete – and disease occurs.” Each individual factor is known as a component cause. After the pie is complete, each component cause is known as a sufficient cause. Depending on the disease, there may be more than one sufficient cause, with each sufficient cause made up of several component causes.
The article Universal risk factors for multifactorial diseases – European Journal of Epidemiology discusses a few component causes of type 2 diabetes categorized into genetic, environmental, or complex factors. For example, being overweight and/or obese is a complex factor that increases the risk of developing type 2 diabetes. The aspect of being overweight is complex as being overweight is often an interaction between multiple other factors, such as genetic predisposition and environmental factors. In addition, the article discusses the concept of effect modifiers, which are categorized into risk-factor modifiers, outcome modifiers, or generic modifiers. These modifiers help one understand how they can alter the relationship between the determinant and the disease. For example, age is a generic modifier that can influence the risk of developing type 2 diabetes. Rothman’s pie model helps one understand the multifactoral nature of type 2 diabetes and the correlation between the various component causes. We are able to see that not one single factor is responsible for the disease but it is a combination of the various factors that lead to the development of the disease.
Reference:
Stolk, R. P., Rosmalen, J. G. M., Postma, D. S., Boer, R. A. de, Navis, G., Slaets, J. P. J., Ormel, J., & Wolffenbuttel, B. H. R. (2007, December 13). Universal risk factors for multifactorial diseases – european journal of epidemiology. SpringerLink.
Breanna Zulz (student’s name)
Hill's Criteria of Causality, named after the British epidemiologist Sir Austin Bradford Hill, provide a series of considerations that can help guide the establishment of cause-and-effect relationships in epidemiology. This discussion with present the application of Hill's Criteria to the relationship between human immunodeficiency virus (HIV) infection and Acquired Immunodeficiency Syndrome (AIDS).
Strength: The correlation between HIV infection and the subsequent development of AIDS is remarkably strong, as shown by multiple studies (UNAIDS, 2022). Individuals infected with HIV are significantly more likely to develop AIDS than those without the virus.
Consistency: The association between HIV infection and AIDS has been observed consistently across different populations and regions globally (Centers for Disease Control and Prevention, 2022). This consistent association strengthens the claim of causation.
Specificity: While the specificity criterion is somewhat challenging, given that HIV can result in a variety of health outcomes (not exclusively AIDS), the progression from HIV to AIDS is nonetheless a highly specific pathway observed in untreated patients (World Health Organization, 2022).
Temporality: In the causal relationship between HIV infection and AIDS, temporality is clearly observed. The HIV infection always precedes the development of AIDS, thereby satisfying this criterion (National Institute of Allergy and Infectious Diseases, 2022).
Biological Gradient (Dose-response relationship): A dose-response relationship exists, where individuals with higher viral loads of HIV are generally more likely to progress to AIDS more rapidly (National Institutes of Health, 2022).
Plausibility, Coherence, and Analogy: The biological mechanism explaining how HIV leads to AIDS, the destruction of CD4+ T cells, is well-understood and fits with the existing body of biomedical knowledge (National Institute of Allergy and Infectious Diseases, 2022). Therefore, the relationship between HIV and AIDS is plausible, coherent, and can draw analogies with other viral infections.
Experiment: Experimental evidence, such as the reversal of AIDS progression with antiretroviral therapy, strengthens the argument that HIV causes AIDS (World Health Organization, 2022).
In conclusion, the relationship between HIV infection and the development of AIDS satisfies all of Hill's Criteria for causality, making a compelling case for HIV as the causal agent of AIDS. Future public health strategies should focus on HIV prevention to reduce the incidence of AIDS worldwide.
ReferencesCenters for Disease Control and Prevention. (2022). About HIV/AIDS. National Institute of Allergy and Infectious Diseases. (2022). Understanding HIV/AIDS. National Institutes of Health. (2022). HIV/AIDS: The Basics. UNAIDS. (2022). Global HIV & AIDS statistics. World Health Organization. (2022). HIV/AIDS.
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