Literature Review: Support for caregivers of children on the ketogenic diet for epilepsy and other neurologic disorders.

Epilepsy affects millions of people and when medications are insufficient to maintain seizure control, individuals are diagnosed with refractory epilepsy (RE). Medical ketogenic diet therapy (KDT), a diet high in fat and low in carbohydrates and sufficient in protein, is a well-established treatment for RE. However, compliance is one of the main reasons for discontinuation of KDT and, with pediatric RE patients, the ability of informal caregivers, typically family members, to maintain diet adherence is vital for successful KDT treatment. The central role that informal caregivers play for effective KDT implementation is recognized, however, there is a need to elucidate the rationale and theoretical underpinnings of effective KDT caregiver support programs to inform best practices. Therefore, this systematic literature review aims to identify the existing fundamental understandings of KDT caregiver support to help build a foundation of theory-based knowledge to promote evidenced practice. After screening 137 publications, three studies that discussed potential underlying components of effective caregiver support were included in this review. These articles followed a similar approach as they 1) employed qualitative methods delving into caregiver needs, 2) findings highlighted the importance of support from family, friends, fellow caregivers and their child's medical team, and 3) the inclusion of caregiver support findings were a supplement to the main purpose of the manuscript. Research focused on KDT caregivers is in its infancy. There is a clear need for the systematic examination of support for KDT caregivers to build a foundation for effective support programs and to increase the access to quality support programming to foster KDT implementation, desirable patient outcomes, and caregiver well being. In this article we discuss opportunities to apply self-determination theory to the KDT caregiver support research and practice.

League of VetaHumanz SuperPower Pack Program: Introducing Young People from Diverse Backgrounds to STEM Learning Activities and Veterinary Science Careers.

League of VetaHumanz uses a nationwide network of university-community partnerships to provide veterinary STEM learning experiences for children who are more likely to lack access to enriching, supplemental educational opportunities due to systemic barriers based on their race, ethnicity, or socioeconomic status. To include participation beyond in-person programming, SuperPower Packs, self-guided, learning experiences, were developed. Leveraging social cognitive career theory and the "Batman Effect," SuperPower Packs are designed to build self-efficacy, and seed STEM and veterinary science career aspirations by engaging children in STEM learning through connections with a veterinary role model. Four SuperPower Packs were developed. Beginning in the fall of 2021, for 17 months, 16,655 SuperPower Packs were distributed to children in 23 states. A small portion of children who received the game (3.8%, N = 614, 6-12 years old) returned evaluation surveys that measured activity engagement, likelihood of role model identification and demographics. Participants indicated variation in their experiences, but mean scale scores show desirable perceptions of engagement (MRange = 2.38 - 2.90/3) and role model identification (MRange = 2.15 - 2.94/3). These positive learning and role model experiences help set the stage to encourage youth to pursue similar learning and career opportunities in the future.

Using Strategies from Physical Training of Athletes to Develop Self-Study Programs for Veterinary Medical Students.

Veterinary medical students, similar to elite collegiate athletes, are developing strategies for learning new skills and for self-care to take their performance to the next level. As veterinary students learn to successfully navigate an information-dense, high-volume curriculum, many sacrifice wellness, leadership opportunities, extracurricular activities, and social interactions. Strategies from athletes' physical training were used to design a self-study program for first-year veterinary medical students. Major considerations in program design were the characteristics of the human being, learning goals, and contextual constraints. The study program included a warm-up, study sessions, and a cooldown. The program was offered to first-year veterinary medical students at Purdue University's College of Veterinary Medicine. Thirty-two students requested study programs and 21 completed surveys at the semester end. Results were analyzed quantitatively and by using an adapted conventional content analysis approach. Responses were organized into three main domains: reason for participation, program utility, and program satisfaction. Students shared that the most helpful aspects of the program were assisting with organization and time management, providing accountability, and reducing overwhelm by enhancing well-being and performance; they reported that these learned skills would support their well-being as future professionals. This article describes the experiences of one group of veterinary students at one college using these programs. The long-term goal is to develop a model program for all veterinary students to manage curricular demands while maintaining well-being.

Associations between participation in a Physical Activity-Based Positive Youth Development Program and Academic Outcomes.

INTRODUCTION: Physical activity-based positive youth development (PYD) programs offer asset building experiences to foster the overall well-being of youth. These programs have the potential to enhance success in other important contexts for children, such as school. However, rigorous examination of this potential impact is needed. METHODS: Propensity score matching was used to compare school outcomes among children who participated in a short, summer physical activity-based PYD program in the USA and children who were from similar backgrounds and from the same school district but did not attend the program. The sample included 149 pairs of students aged 7-12 years (M = 10.11, SD = 1.26) and, in each group, 62% were from ethnically diverse backgrounds, 38% were from primarily Caucasian backgrounds, and 80 were female and 69 were male, and birth years were equally distributed. Ordinal and logistic regression models were used to test for differences between standardized math and language arts test scores, excused and unexcused absences, and total suspensions and expulsions between the two groups. RESULTS: PYD program youth had 55% and 46% greater odds being in the highest math (χ2(1, N = 298) = 4.06, p = .04) and total days attended categories (χ2(1, N = 298) = 5.58, p = .02) respectively. No other significant differences were found. When using a more rigorous quasi-experimental and longitudinal design, participation in a PYD program predicted some but not all academic performance and behaviors. PYD programs may need to be designed to specifically nurture academic skills to consistently impact academic outcomes.

Developing a Scalable STEM Career Development Program for Elementary School-Aged Students.

This article describes an approach to designing a scalable career development curriculum for elementary school students using minimal-cost and readily available resources. Content experts, veterinary medical students, university staff, teachers, community partners, evaluation experts, and a children's book illustrator developed a library of low-cost, culturally responsive, fun, and educationally engaging lessons to expose elementary school-aged students to scientific knowledge and careers in veterinary medicine. The home team piloted and evaluated the approach at a local community center. Teams in eight other states were provided materials to pilot and assess the program. Seven of those teams successfully piloted the program and provided evidence of child engagement. Although models, props, and other costly supplies enhance delivery of Science Technology Engineering and Math lessons, our experience with the delivery of this curriculum was proof of concept that a low-cost curricular model is one strategy to facilitate scaling and sustainability of an engaging veterinary science curriculum.

A Test of Basic Psychological Needs Theory in a Physical-Activity-Based Program for Underserved Youth.

This study used a randomized controlled design to test the pathways in basic psychological needs theory, where social relationships characterized by autonomy support, involvement, and structure foster psychological need satisfaction and well-being. Participants were recruited from a physical-activity-based youth program. A new staff training was implemented to manipulate the use of each interpersonal characteristic by program staff (N = 24 observed) and perceptions of each interpersonal characteristic, psychological needs, hope, and self-worth in youth (N = 379 surveyed pre- and postprogram). Staff in the intervention condition used greater overall observed autonomy support, involvement, and structure. Condition assignment did not lead to differences in youth perceptions, but observed staff behaviors positively predicted youth perceptions of staff and perceptions of staff positively predicted change in well-being. Findings indicate that the training manipulated how staff engaged youth, and autonomy support, involvement, and structure are useful strategies to foster well-being in youth.

An empirical evaluation of two theoretically-based hypotheses on the directional association between self-worth and hope.

Fostering self-worth and hope are important goals of positive youth development (PYD) efforts, yet intervention design is complicated by contrasting theoretical hypotheses regarding the directional association between these constructs. Therefore, within a longitudinal design we tested: (1) that self-worth predicts changes in hope (self theory; Harter, 1999), and (2) that hope predicts changes in self-worth (hope theory; Snyder, 2002) over time. Youth (N = 321; Mage = 10.33 years) in a physical activity-based PYD program completed surveys 37-45 days prior to and on the second day and third-to-last day of the program. A latent variable panel model that included autoregressive and cross-lagged paths indicated that self-worth was a significant predictor of change in hope, but hope did not predict change in self-worth. Therefore, the directional association between self-worth and hope is better explained by self-theory and PYD programs should aim to enhance perceptions of self-worth to build perceptions of hope.

Peers and teachers as sources of relatedness perceptions, motivation, and affective responses in physical education.

Research has demonstrated the importance of relatedness perceptions to self-determined motivation in physical education. Therefore, studies have begun to examine the social factors contributing to feelings of relatedness. The purpose of this study was to examine teacher (perceived emotional support) and peer (acceptance, friendship quality) relationship variables to feelings of relatedness, motivation, and affective responses in junior high physical education students (N = 411). Results revealed that perceived relatedness mediated the relationship between variables and self-determined motivation and related directly to the amount of enjoyment and worry students experienced. These findings demonstrate that relationships with both teachers and peers are important for students' relatedness perceptions, motivation, enjoyment, and worry in physical education.