Incorporation of patient and family values and preferences for health-related outcomes in paediatric obesity management: A systematic review.

OBJECTIVE: A systematic review of value and preference studies conducted in children and their caregivers related to the estimated benefits and harms of interventions for managing paediatric obesity. METHODS: We searched Ovid Medline (1946-2022), Ovid Embase (1974-2022), EBSCO CINAHL (inception to 2022), Elsevier Scopus (inception to 2022), and ProQuest Dissertations & Theses (inception to 2022). Reports were eligible if they included: behavioural and psychological, pharmacological, or surgical interventions; participants between (or had a mean age within) 0-18 years old with overweight or obesity; systematic reviews, primary quantitative, qualitative, or mixed/multiple methods studies; and values and preferences as main study outcomes. At least two team members independently screened studies, abstracted data, and appraised study quality. RESULTS: Our search yielded 11 010 reports; eight met the inclusion criteria. One study directly assessed values and preferences based on hypothetical pharmacological treatment for hyperphagia in individuals with Prader-Willi Syndrome. Although not having reported on values and preferences using our a priori definitions, the remaining seven qualitative studies (n = 6 surgical; n = 1 pharmacological) explored general beliefs, attitudes, and perceptions about surgical and pharmacological interventions. No studies pertained to behavioural and psychological interventions. CONCLUSION: Future research is needed to elicit the values and preferences of children and caregivers using the best available estimates of the benefits and harms for pharmacological, surgical, and behavioural and psychological interventions.

Examining Adverse Childhood Experiences (ACEs) within Indigenous Populations: a Systematic Review.

Health concerns in Indigenous people are often greater in comparison to those in non-Indigenous populations, including increased rates of chronic diseases and mental health concerns. Adverse childhood experiences (ACEs) may be an explanatory variable for such heightened rates of mental and physical health difficulties for Indigenous populations as these communities have experienced a lack of adequate health care due to remoteness, historical traumas, cultural insensitivity, racism, and perpetuating systemic discrimination. To date, relatively few studies have examined ACEs within an Indigenous population and their relevance to both physical and mental health outcomes. The present study explored existing ACE literature relevant to Indigenous populations and mental or physical health outcomes by retrieving and organizing available ACE literature. A systematic review was conducted using 14 electronic databases of peer-reviewed literature and 18 grey literature databases. Twenty-one publications investigating general health outcomes and prevalence of ACEs met eligibility criteria. ACEs were reported to be higher in Indigenous populations when compared to non-Indigenous population. Higher ACE scores for Indigenous participants were associated with increased rates of suicidality and psychological distress. Protective factors to reduce the impact of ACEs were cultural identity and connectedness, education, social support, and psychological resilience. Future research may further explore the relationship between ACE scores and protective factors, varying prevalence within specific sub-populations, and consistent reporting of outcomes across studies. Ongoing research has the potential to clarify existing dose-response relationships between early traumatic experiences and current health disparities experienced within some Indigenous communities.

A Systematic Review of Childhood Adversity and Executive Functions Outcomes among Adults.

OBJECTIVE: Exposure to adverse childhood experiences (ACEs) is linked to disruptions in typical neurodevelopment of brain structures and functioning, including changes in executive functions. Although the relationships among ACEs, executive functions, and psychopathology are well documented in pediatric samples, a systematic review is needed to examine these relationships in adulthood. METHOD: A systematic review examining the link between ACEs and executive functions among adult clinical and nonclinical samples was conducted across 33 scientific and grey literature databases. Among reviewed studies, 17 sources met review criteria, with 11 involving clinical samples and six involving nonclinical samples. RESULTS: Among clinical samples, evidence suggested that ACEs increased risk for executive function difficulties among those diagnosed with bipolar disorder, schizophrenia, post-traumatic stress disorder, and those experiencing a first episode of psychosis, however not within those diagnosed with major depressive disorder. Among nonclinical samples, executive function difficulties associated with ACEs were found among those in early and middle adulthood. Not all retrieved sources showed consistent findings, and two studies described better executive function outcomes among those who experienced childhood sexual abuse and emotional abuse. CONCLUSIONS: Executive function difficulties associated with ACEs appear to persist into adulthood, though inconsistently. Future research may further explore distinct differences among specific ACEs and executive function difficulties to further inform ongoing prevention and treatment efforts.

Adverse Childhood Experiences and Executive Function Difficulties in Children: A Systematic Review.

BACKGROUND: The relationship between adverse childhood experiences (ACEs) and detrimental mental health outcomes has been increasingly explored within scientific literature since the original ACE study was published by Felitti et al. (1998). Given that deficits in executive functions (EF) are prominent in most forms of psychopathology across the lifespan, there is utility in considering how ACEs relate to EF outcomes. OBJECTIVE: To consolidate the research to date on the relationship between ACEs and EF outcomes among child samples. METHODS: A systematic review was conducted that included 16 scientific databases and 17 grey literatures. RESULTS: Across 36 studies, many examined EF related to forms of maltreatment (e.g. abuse, neglect, and exposure to intimate partner violence) and found a strong relationship between maltreatment and EF deficits among children. Similarly, family member mental illness (maternal depression in particular) was associated with poor EF outcomes. The relationship between other ACEs and EF outcomes have not been uniquely examined, including intimate partner violence and family member incarceration. CONCLUSIONS: This review acts as a preliminary step towards broader understanding of outcomes related to early childhood experiences through the consideration of EFs. Through documentation of such relationships, it is possible to consider how prevention and treatment approaches may be improved.