i have attach the powerpoint which also includes the references. the instructions are attach as well
PH 3120 Introduction to Epidemiology
Group Project #5
The purpose of this assignment is for each group to write a summary describing their systematic review of the specific research question identified in GP#1. There is no page limitation, however the paper should have the following 5 sections: Introduction, Methods, Results, Discussion and References.
This assignment is worth 50 points.
The five parts that will be evaluated for this assignment are as follows:
· Introduction.This section should include the research question, hypothesis of the group and any definitions of the disease or exposure.Background information on the disease would be appropriate here as well (5 points).
· Methods.This section should describe the process of how original peer reviewed research articles were selected.The flow chart, key words and details of exclusions should be included. Each student in the group will identify three original research articles that address the research question that the student group is evaluating for causality.The quality criteria checklist should also be utilized and discussed (15 points)
· Results.This section should include a Table of Evidence that summarizes each of the original research articles.The headings for each column should include those described in class. The table must for formatted and in a readable font (no smaller than 9-point font and all columns on the same page).The students may use a Word or Excel table, however a written summary referencing the table should be included (15 points).For up to an additional 10 points, a forest plot and explanation of results from the forest plot can be included.
· Discussion.A discussion section should be provided that states the conclusions the group has drawn regarding the research questions and why.Students should also include a strengths and limitation section summarizing the overall strengths and limitation of original research included in the systematic review (10 points).
· References.Each paper should include a reference section of all the original research articles as well as any other articles cited in the paper. When an original article is referenced in the summary, the students should use the American Public Health Association style.The references should be numbered sequentially in the text and should appear as follows in the reference section: 1. Morland KB, Evenson KR. Obesity prevalence and the local food environment. Health and Place 2009;15:491-495 (PMID 19022700) (5 points).
Association Between Smoking During Pregnancy and ADHD
Group #1: Hazel Ortiz, Coral Oros, Dillon Razo, Coral Trujillo
Research Question & Hypothesis
Research Question: Is smoking cigarettes during pregnancy a potential cause of offspring ADHD?
Hypothesis: Smoking cigarettes during pregnancy causes ADHD in offspring.
Searched term: Smoking
Smoking during pregnancy
effect of smoking during pregnancy
smoking during pregnancy ADHD
maternal smoking during pregnancy ADHD
Attention-deficit/hyperactivity disorder, prenatal exposures, cigarette smoke
Smoking, Pregnancy, Child ADHD
Attention deficit disorder with hyperactivity, maternal exposure, paternal exposure, causality, confounding factors, smoking, pregnancy
Author (Year) Research Question and Hypotheses Study Design Subjects Response Rate Length of follow-up Exposure Outcome Confounding Statistical Analysis Results Rigor Score
(2012) Does smoking cigarettes during pregnancy cause ADHDin offspring?
Smoking during pregnancy does cause ADHD in offspring Longitudinal study Women with due dates (1991-1992)
Avon Study of parents and children (n=13,988) N=8324 of studyfrom initial n=13,988 7 years (18-36 weeks of gestation) Maternal smoking habits from week 18-36 Upon reaching age 7, children were put under DAWBA for ADHD diagnosis Childs sex, ethnicity, multiple birth, low birthweight, maternal alcohol use, social class Maternal smoking habits were associated with ADHD in offspring (β=0.25, 95% confidenceinterval CI:0.18,0.32) Exposed vs unexposed (5.99 v 4.52), ADHD symptoms (4.79 SD=6.71),correlation (0.39), no exposure mean=4.31SD=6.29) 70%
Gustavson (2017) Is smoking cigarettes during pregnancy a potential cause of offspring ADHD?
Thereis no association between maternal smoking and offspring ADHD Cohort study
Pregnant women recruited from Norway (1999-2008) N=95,00 (maternal)
N=110,000 initial to N=104,846 (children) 2008-2014
(5 years) individual assessments Maternal smoking habits, paternal smoking habits, second hand maternal smoke exposure 6 question assessment for ADHD in children regarding common symptoms on a scale of (not true:1 –very oftentrue: 3) Childs sex, ethnicity, living situation, paternal education, birth weight of children Maternal andpaternal age,education,maternal andpaternal BMIpre-pregnancy,duringpregnancy, post-pregnancy, birthyear,geographicalresidentialregion. BMI and children’s sex was excluded from covariates and data analysis 2035 (2%) of 104,846 children diagnosed with ADHD, 51% boys, 43.7% women, smoking prevalence 8.5% maternal, 24.6% paternal, 3334 maternal reports of secondhand smoke exposure 63%
Materials and Methods
DAWBA assessment for ADHD (age 7)
Maternal smoking habits categorized
Covariates: sex, ethnicity, multiple births, alcohol use, social class
Ultrasound examinations (17 weeks)
Questionnaire containing common ADHD symptoms (1-3 scale)
Maternal + paternal smoking habits
Covariates: child’s sex, ethnicity, living situation, maternal + paternal education, weight
Summaries of the Quality Criteria
Summary #1: Maternal and Paternal Smoking during Pregnancy and Risk of ADHD Symptoms in Offspring.
Research questions wereclearly defined,and the study subjects were wellcomprehended. Response ratewas fullywell coveredhowever the author didnot indicate theportionof characterswho failed toparticipate in theresearch. The author clearly definesthe exposures and outcomes; the author only showedresidual confounders of the diseases. Determining the rigor score,this articlegot a score of 83%which meansit is rigorous.
Summary #2: Smoking in Pregnancy and Child ADHD
Though the author did well in other sections the research was not rigorous due to the article not effectively showing the research questions as it left out the author’s alternative hypothesis. In addition,during the selection of the study, the author failed to indicate the criteria specified with sufficient details. The response rate was effectively looked on by the author however in handling withdrawals only follow-up methods were clearly defined. The use of blinding in preventing bias introduction was not looked into by the author. In confounders,the author only identifies factors related to the disease and exposure. Overall, this article scored 63% which means it is not rigorous.
Findings and Statistical Information
– ADHD was diagnosed in 7.3% of the children.
-The smoking prevalence was 8.5% for mothers
-Paternal (0.18) smoking in pregnancy cause ADHD
Our research question, “Is smoking cigarettes during pregnancy a potential cause of offspring ADHD?“
Studies show an association between maternal smoking and child ADHD
Studies included confounding factors and not causal factors
Overall, Yes smoking during pregnancy is a potential cause of offspring in ADHD.
Some studies check the association between prenatal or maternal smoking during pregnancy and the risk of developing ADHD in offspring. Some other studies reveal that there are confounding factors such as genetics that are also associated with developing attention-deficit/hyperactivity disorder. Only one or two studies said that there is a lesser role of maternal smoking in causing ADHD, and the major role is played by confounding factors. In our opinion, the occurrence of ADHD symptoms in the offspring is due to maternal smoking during pregnancy, but sometimes some confounding factors also contribute to increasing the risk.
https://pubmed.ncbi.nlm.nih.gov/35213510/(only use for the table & flowchart)
https://pubmed.ncbi.nlm.nih.gov/28138005/<--- (focus on for presentation) https://pubmed.ncbi.nlm.nih.gov/22791738/<---(focus on for presentation) Hazel Ortiz: https://acamh-onlinelibrary-wiley-com.mimas.calstatela.edu/doi/full/10.1111/jcpp.12124 https://onlinelibrary-wiley-com.mimas.calstatela.edu/doi/full/10.1002/ajmg.b.32421 https://web-p-ebscohost-com.mimas.calstatela.edu/ehost/pdfviewer/pdfviewer?vid=0&sid=84391554-aa0a-4b17-8c91-cc2f31c7b999%40redis Coral Oros https://pubmed.ncbi.nlm.nih.gov/25049343/ https://pubmed.ncbi.nlm.nih.gov/25416463/ https://pubmed.ncbi.nlm.nih.gov/26379720/ Dillon Razo https://www.nature.com/articles/tp201212 https://academic.oup.com/ntr/article-abstract/15/1/149/1104903?redirectedFrom=fulltext&login=false https://web-p-ebscohost-com.mimas.calstatela.edu/ehost/pdfviewer/pdfviewer?vid=4&sid=6c980c3a-e2a4-40a0-993b-e5fd03ef3e0e%40redis z
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