http://currents.plos.org/outbreaks/article/zika-virus-and-microcephaly-applying-the-bradford-hill-criteria-for-causation/
Answer the following questions:
1. Compare deterministic model and stochastic models of disease causality and provide examples of each type.
2. Describe three types of associations (chance, non-causal, and causal) that are possible among exposures and health outcomes. Give an example of each one.
3. Describe each of Sir Austin Bradford Hill’s NINE Criteria of Causality.
4. Read the article “Does the Zika Virus cause Microcephaly”. Explain whether or not each of the nine Hill’s criteria has been met to establish causality between Zika and Microcephaly. Make sure to explain each criteria.
Sample solution
Dante Alighieri played a critical role in the literature world through his poem Divine Comedy that was written in the 14th century. The poem contains Inferno, Purgatorio, and Paradiso. The Inferno is a description of the nine circles of torment that are found on the earth. It depicts the realms of the people that have gone against the spiritual values and who, instead, have chosen bestial appetite, violence, or fraud and malice. The nine circles of hell are limbo, lust, gluttony, greed and wrath. Others are heresy, violence, fraud, and treachery. The purpose of this paper is to examine the Dante’s Inferno in the perspective of its portrayal of God’s image and the justification of hell.
In this epic poem, God is portrayed as a super being guilty of multiple weaknesses including being egotistic, unjust, and hypocritical. Dante, in this poem, depicts God as being more human than divine by challenging God’s omnipotence. Additionally, the manner in which Dante describes Hell is in full contradiction to the morals of God as written in the Bible. When god arranges Hell to flatter Himself, He commits egotism, a sin that is common among human beings (Cheney, 2016). The weakness is depicted in Limbo and on the Gate of Hell where, for instance, God sends those who do not worship Him to Hell. This implies that failure to worship Him is a sin.
God is also depicted as lacking justice in His actions thus removing the godly image. The injustice is portrayed by the manner in which the sodomites and opportunists are treated. The opportunists are subjected to banner chasing in their lives after death followed by being stung by insects and maggots. They are known to having done neither good nor bad during their lifetimes and, therefore, justice could have demanded that they be granted a neutral punishment having lived a neutral life. The sodomites are also punished unfairly by God when Brunetto Lattini is condemned to hell despite being a good leader (Babor, T. F., McGovern, T., & Robaina, K. (2017). While he commited sodomy, God chooses to ignore all the other good deeds that Brunetto did.
Finally, God is also portrayed as being hypocritical in His actions, a sin that further diminishes His godliness and makes Him more human. A case in point is when God condemns the sin of egotism and goes ahead to commit it repeatedly. Proverbs 29:23 states that “arrogance will bring your downfall, but if you are humble, you will be respected.” When Slattery condemns Dante’s human state as being weak, doubtful, and limited, he is proving God’s hypocrisy because He is also human (Verdicchio, 2015). The actions of God in Hell as portrayed by Dante are inconsistent with the Biblical literature. Both Dante and God are prone to making mistakes, something common among human beings thus making God more human.
To wrap it up, Dante portrays God is more human since He commits the same sins that humans commit: egotism, hypocrisy, and injustice. Hell is justified as being a destination for victims of the mistakes committed by God. The Hell is presented as being a totally different place as compared to what is written about it in the Bible. As a result, reading through the text gives an image of God who is prone to the very mistakes common to humans thus ripping Him off His lofty status of divine and, instead, making Him a mere human. Whether or not Dante did it intentionally is subject to debate but one thing is clear in the poem: the misconstrued notion of God is revealed to future generations.
References
Babor, T. F., McGovern, T., & Robaina, K. (2017). Dante’s inferno: Seven deadly sins in scientific publishing and how to avoid them. Addiction Science: A Guide for the Perplexed, 267.
Cheney, L. D. G. (2016). Illustrations for Dante’s Inferno: A Comparative Study of Sandro Botticelli, Giovanni Stradano, and Federico Zuccaro. Cultural and Religious Studies, 4(8), 487.
Verdicchio, M. (2015). Irony and Desire in Dante’s” Inferno” 27. Italica, 285-297.
Sample Answer
Sample Answer
Does the Zika Virus Cause Microcephaly?
The link between the Zika virus and microcephaly has been a topic of extensive research and debate in recent years. Various studies have attempted to establish a causal relationship between the two, applying Sir Austin Bradford Hill’s criteria for causation. Let’s delve into each of the nine criteria to evaluate whether the evidence supports the assertion that the Zika virus causes microcephaly:
Strength of Association: The strength of association between Zika virus infection and microcephaly is supported by ecological evidence from multiple reports by organizations like WHO and CDC. Studies have shown a significant increase in the number of microcephaly cases in countries affected by Zika outbreaks, such as Brazil, Colombia, and Panama. The evidence indicates a strong link between Zika virus infection and microcephaly.
Consistency: Multiple epidemiological studies have consistently found a positive association between Zika virus infection during pregnancy and the occurrence of microcephaly. Studies conducted in French Polynesia and Brazil have shown a strong correlation between Zika virus infection in pregnant women and the development of microcephaly in infants.
Specificity: While traditionally specificity refers to one exposure causing one disease, in the case of Zika virus and microcephaly, the specific association between Zika virus infection in pregnant women and the occurrence of microcephaly strengthens the argument for causation. This targeted impact on a specific population group adds weight to the causal relationship.
Temporality: Temporality refers to the sequence of events where the cause precedes the effect in a consistent manner. Studies have demonstrated that Zika virus infection during pregnancy precedes the development of microcephaly in infants, fulfilling this criterion for causality.
Biological Gradient: Also known as dose-response relationship, this criterion examines whether a higher exposure to the potential cause leads to a greater effect. While this aspect requires further investigation in the context of Zika virus and microcephaly, studies have shown a clear link between Zika virus infection intensity in pregnant women and the likelihood of microcephaly in newborns.
Plausibility: Plausibility assesses whether there is a biological or theoretical basis for the proposed causal relationship. The mechanism through which Zika virus crosses the placental barrier and affects fetal brain development provides a plausible explanation for how the virus could lead to microcephaly.
Coherence: Coherence evaluates whether the proposed causal relationship aligns with existing knowledge and scientific understanding. Studies linking Zika virus infection during pregnancy to microcephaly are coherent with our understanding of viral teratogenic effects and their impact on fetal development.
Experiment: While conducting experiments to establish causation in this context may be ethically challenging, animal models and laboratory studies have provided supporting evidence of the neurotropic effects of Zika virus and its potential to cause developmental abnormalities like microcephaly.
Analogy: Analogies with other known teratogenic viruses, such as rubella, strengthen the argument for causation between Zika virus and microcephaly. The similarities in the impact on fetal development provide analogical support for this causal relationship.
In conclusion, applying Sir Austin Bradford Hill’s criteria for causality to the link between Zika virus and microcephaly reveals that several key criteria have been met, supporting the assertion that Zika virus causes microcephaly. The strength of association, consistency across studies, specificity to pregnant women, temporality, plausibility, coherence with existing knowledge, and analogy with other teratogenic viruses all contribute to establishing a causal relationship between Zika virus infection during pregnancy and the development of microcephaly in infants. Further research and ongoing surveillance will continue to strengthen our understanding of this complex relationship.
