PHN peers responses

Population Health Nursing week 3 peers response
respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites. For specific details and criteria, refer to the discussion rubric in the Menu (⋮) or in the Course Overview Weekly Discussion Guidelines. 
Respond to your peer in one paragraph. These posts should be thoughtful, respectful, and add value to the discussion. This response could include relating your experience to whatever they initially posted. Use a different scholarly source, reference it using APA format, and include in-text citations when using the referenced material in your post.
You must use DIFFERENT resources, in-text citations, and APA references in your response than your peers used. Use current resources. Please do not routinely cite outdated (no greater than five years old) sources of information. Do NOT use the exact in-text citations or references for your peers in THE INITIAL POST.
1st peer post
Stephanie Saldivar
Mar 19, 2024 at 9:24 PM
A strategy used in this investigation was the implementation of the epidemiological triangle. John Snow identified the 3 sides of the triangle. The Hosts were the people in Soho infected with Cholera, the Agent was Cholera, and the Environment was the water pump contaminated with fecal matter from the infected hosts. Breaking this triangle solved the mystery of how this disease was spread and helped prevent further infections. Causation defines the necessary relationship between one event, (the cause) and another event (the effect) which is the direct consequence (result) of the first component. To answer these causal questions, two categories of evidence are required: (1) evidence for disease causation, and (2) evidence for the causal action(s) of an intervention (Evans, 2022). I believe that John Snow did prove that the contaminated water caused the Cholera outbreak. It was known that the particular pump was preferred by citizens because “it tasted sweet”, and this attracted larger crowds of people using this pump. The fecal matter in the streets of the infected people was discovered to leak into the water supply of this pump and those who used it fell ill. John Snow proved that it was not just poor people, as they had their own water pump to use. They did not fall ill. And those working producing beer drank mostly that and did not fall ill. He was able to prove that those who used this particular pump fell ill when compared to other water pumps in the area. 
The Zika Virus outbreak in 2014-2015 was a worldwide pandemic that effected 87 countries. Using the epidemologic triangle. It was discovered that Zika virus was transmitted during the World Cup games by mosquitos in 2014. The hosts were those infected with Zika, the agent was Zika, and the environment was warm climates with known infected mosquitos. It was also discovered that mothers who were infected with Zika were more likely to give birth to children with microcephaly according to a study done in Brazil (Pergolizzi et al., 2021).

Reference
Evans, D. (2022). How to gain evidence for causation in disease and therapeutic intervention: From Koch’s postulates to counter-counterfactuals.  Medicine, Health Care, and Philosophy,  25(3), 509-521.  https://doi.org/10.1007/s11019-022-10096-x  
Pergolizzi, J., LeQuang, J., Umeda-Raffa, S., Fleischer, C. A., Pergolizzi, C., & Raffa, R. (2021). The Zika virus: Lurking behind the COVID‐19 pandemic?  Ournal of Clinical Pharmacy and Therapeutics,  46(2), 267-276.  https://doi.org/10.1111/jcpt.13310  
2nd peer post
Autumn Collier
Mar 19, 2024 at 9:20 PM
            In the Cholera outbreak investigation by John Snow, he employed various strategies to determine that cholera was caused by contaminated drinking water. After surveying the affected area in the Golden Square of London, he created a spot map that depicted the residences and workplaces of individuals who had contracted cholera. Additionally, he marked the locations of the water pumps in the affected area on this map. Snow’s investigation revealed that one water pump was the primary water source for most affected individuals. He also investigated why other people in the same area were unaffected and found they had access to a private water well (CDC, n.d).
            Causal relationships are established through various types of studies. For instance, a cohort study is an observational study that examines individual data for each participant to observe their exposure and disease status. On the other hand, a case-control study is an observational study that compares groups of participants, with one group having the disease and the other serving as the control group. Cross-sectional studies examine individual participants’ exposures and health outcomes within a population, while ecological studies compare group data instead of individual data. The most effective way to establish causation is by conducting a randomized experimental study to track the effects of the exposure. According to Galen College of Nursing (n.d), data must meet specific criteria for causation, known as Hill’s criteria, to support causal relationships. These criteria include the strength of association, consistency of data, identifying specificity, temporality, biological gradient, biological plausibility, coherence, experimental evidence, and analogy.
            Through descriptive epidemiology, John Snow successfully proved a causal relationship between contaminated drinking water and cholera. He conducted an observational study by surveying the affected area and interviewing the residents. From the gathered information, such as disease incidence by time, place, and person, he not only identified the affected well but also explained why others in the same area were not affected, such as the Brewery workers who had access to a private well that did not use the affected water pump.
            The Bubonic Plague, which caused approximately 50 million deaths between 1347 and 1351 in Europe, is one of the deadliest pandemics in history. According to Galen College of Nursing (n.d), epidemiology studies the distribution and determinants of health and disease frequency in humans. The distribution aspect of epidemiology refers to the “who,” “when,” and “where,” while determinants are the causes that influence the occurrence of a disease. Frequency in humans explains the frequency of a disease occurring (morbidity rates) or the frequency of deaths from the disease (mortality rates). The cause of the Bubonic Plague was not discovered until 1894 when it was found to be caused by flea bites from rodents that carried the bacteria. The response to the Bubonic plague was to isolate or quarantine those affected to slow the spread of the disease. John Snow’s response to the cholera outbreak was to remove the water pump handle to stop the spread of the disease caused by contaminated water. Although the methods for dealing with the Bubonic Plague and the cholera outbreak differed, they both aimed to slow or stop the spread of the diseases. References Centers for Disease Control and Prevention. (n.d).  Principles of epidemiology in public health practice. (3rd ed).  U.S. Department of Health and Human Services.  https://stacks.cdc.gov/view/cdc/6914/cdc_6914_DS1.pdf   Galen College of Nursing. (n.d).  Epidemiological studies & data.  https://files.galencollege.edu/media/BSN/NSG4210/Epidemiological_Studies/index.html#/lessons/ez7CLxtrZmeuIymcQOMaqo-MCu-wtTHI   Galen College of Nursing. (n.d).  Epidemiology: introduction and basic principles. https://files.galencollege.edu/media/BSN/NSG4210/Epidemiology_Introduction_and_Basic_Principles/index.html#/lessons/8IdcJull1MzZTDgFzLewbQnDcpmhWgKE   

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