Medicine and Health Sciences Commons^™

Structural Atrophy Of The Right Superior Frontal Gyrus In Adolescents With Severe Irritability, Ji-Woo Seok, Sahil Bajaj, Brigette S. Vaughan, Arica Lerdahl, William Garvey, Alexandra Bohn, Ryan Edwards, Christopher J. Kratochvil, James Blair, Soonjo Hwang

Journal Articles: Psychiatry

Severe irritability is common in youths with psychiatric disorders and results in significant dysfunction across domains (academic, social, and familial). Prior structural MRI studies in the pediatric population demonstrated that aberrations of cortical thickness (CT) and gray matter volume (GMV) in the fronto-striatal-temporal regions which have been associated with irritability. However, the directions of the correlations between structural alteration and irritability in the individual indices were not consistent. Thus, we aim to address this by implementing comprehensive assessments of CT, GMV, and local gyrification index (LGI) simultaneously in youths with severe levels of irritability by voxel-based morphometry and surface-based morphometry. …

Elevated S-Adenosylhomocysteine Induces Adipocyte Dysfunction To Promote Alcohol-Associated Liver Steatosis, Madan Kumar Arumugam, Srinivas Chava, Karuna Rasineni, Matthew C. Paal, Terrence Donohue, Natalia A. Osna, Kusum K. Kharbanda

Journal Articles: Internal Medicine

It has been previously shown that chronic ethanol administration-induced increase in adipose tissue lipolysis and reduction in the secretion of protective adipokines collectively contribute to alcohol-associated liver disease (ALD) pathogenesis. Further studies have revealed that increased adipose S-adenosylhomocysteine (SAH) levels generate methylation defects that promote lipolysis. Here, we hypothesized that increased intracellular SAH alone causes additional related pathological changes in adipose tissue as seen with alcohol administration. To test this, we used 3-deazaadenosine (DZA), which selectively elevates intracellular SAH levels by blocking its hydrolysis. Fully differentiated 3T3-L1 adipocytes were treated in vitro for 48 h with DZA and analysed for …

Neutralization Of Il-33 Modifies The Type 2 And Type 3 Inflammatory Signature Of Viral Induced Asthma Exacerbation, Kristi J. Warren, Jill A. Poole, Jenea M. Sweeter, Jane M. Devasure, John D. Dickinson, R. Stokes Peebles, Todd A. Wyatt

Journal Articles: Environmental, Agricultural & Occupational Health

BACKGROUND: Respiratory viral infections are one of the leading causes of need for emergency care and hospitalizations in asthmatic individuals, and airway-secreted cytokines are released within hours of viral infection to initiate these exacerbations. IL-33, specifically, contributes to these allergic exacerbations by amplifying type 2 inflammation. We hypothesized that blocking IL-33 in RSV-induced exacerbation would significantly reduce allergic inflammation.

METHODS: Sensitized BALB/c mice were challenged with aerosolized ovalbumin (OVA) to establish allergic inflammation, followed by RSV-A2 infection to yield four treatment groups: saline only (Saline), RSV-infected alone (RSV), OVA alone (OVA), and OVA-treated with RSV infection (OVA-RSV). Lung outcomes included …

Capacity Building For A New Multicenter Network Within The Echo Idea States Pediatric Clinical Trials Network, Robert D. Annett, Scott Bickel, John C. Carlson, Kelly Cowan, Sara Cox, Mark J. Fisher, J. Dean Jarvis, Alberta S. Kong, Jessica S. Kosut, Kurtis R. Kulbeth, Abbot Laptook, Pearl A. Mcelfish, Mary M. Mcnally, Lee M. Pachter, Barbara A. Pahud, Lee A. Pyles, Jennifer Shaw, Kari Simonsen, Jessica Snowden, Christine B. Turley, Andrew M. Atz

Journal Articles: Pediatrics

Introduction: Research capacity building is a critical component of professional development for pediatrician scientists, yet this process has been elusive in the literature. The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) seeks to implement pediatric trials across medically underserved and rural populations. A key component of achieving this objective is building pediatric research capacity, including enhancement of infrastructure and faculty development. This article presents findings from a site assessment inventory completed during the initial year of the ISPCTN. Methods: An assessment inventory was developed for surveying ISPCTN sites. The inventory captured site-level activities designed to increase clinical trial research …

Accumulation Of Succinyl Coenzyme A Perturbs The Methicillin-Resistant Staphylococcus Aureus (Mrsa) Succinylome And Is Associated With Increased Susceptibility To Beta-Lactam Antibiotics, Christopher Campbell, Claire Fingleton, Merve S. Zeden, Emilio Bueno, Laura A Gallagher, Dhananjay Shinde, Jong-Sam Ahn, Heather M. Olson, Thomas L. Fillmore, Joshua N. Adkins, Fareha Razvi, Kenneth W. Bayles, Paul D. Fey, Vinai Chittezham Thomas, Felipe Cava, Geremy C. Clair, James P. O'Gara

Journal Articles: Pathology and Microbiology

Penicillin binding protein 2a (PBP2a)-dependent resistance to β-lactam antibiotics in methicillin-resistant Staphylococcus aureus (MRSA) is regulated by the activity of the tricarboxylic acid (TCA) cycle via a poorly understood mechanism. We report that mutations in sucC and sucD, but not other TCA cycle enzymes, negatively impact β-lactam resistance without changing PBP2a expression. Increased intracellular levels of succinyl coenzyme A (succinyl-CoA) in the sucC mutant significantly perturbed lysine succinylation in the MRSA proteome. Suppressor mutations in sucA or sucB, responsible for succinyl-CoA biosynthesis, reversed sucC mutant phenotypes. The major autolysin (Atl) was the most succinylated protein in the proteome, …

The Prospect Of Nanoparticle Systems For Modulating Immune Cell Polarization During Central Nervous System Infection, Lee E. Korshoj, Wen Shi, Bin Duan, Tammy Kielian

Journal Articles: Pathology and Microbiology

The blood-brain barrier (BBB) selectively restricts the entry of molecules from peripheral circulation into the central nervous system (CNS) parenchyma. Despite this protective barrier, bacteria and other pathogens can still invade the CNS, often as a consequence of immune deficiencies or complications following neurosurgical procedures. These infections are difficult to treat since many bacteria, such as Staphylococcus aureus, encode a repertoire of virulence factors, can acquire antibiotic resistance, and form biofilm. Additionally, pathogens can leverage virulence factor production to polarize host immune cells towards an anti-inflammatory phenotype, leading to chronic infection. The difficulty of pathogen clearance is magnified by …

Patient-Reported Outcomes Through 1 Year Of An Hiv-1 Clinical Trial Evaluating Long-Acting Cabotegravir And Rilpivirine Administered Every 4 Or 8 Weeks (Atlas-2m), Vasiliki Chounta, Edgar T. Overton, Anthony Mills, Susan Swindells, Paul D. Benn, Simon Vanveggel, Rodica Van Solingen-Ristea, Yuanyuan Wang, Krischan J. Hudson, Mark S. Shaefer, David A. Margolis, Kimberly Y. Smith, William R. Spreen

Journal Articles: Infectious Diseases

BACKGROUND: Advances in HIV-1 therapeutics have led to the development of a range of daily oral treatment regimens, which share similar high efficacy rates. Consequently, more emphasis is being placed upon the individual's experience of treatment and impact on quality of life. The first long-acting injectable antiretroviral therapy for HIV-1 (long-acting cabotegravir + rilpivirine [CAB + RPV LA]) may address challenges associated with oral treatment for HIV-1, such as stigma, pill burden/fatigue, drug-food interactions, and adherence. Patient-reported outcomes (PROs) collected in an HIV-1 clinical trial (ATLAS-2M; NCT03299049) comparing participants' experience with two dosing regimens (every 4 weeks [Q4W] vs. every …

Clinical Nurses Research Priorities In Hospital Settings: A Delphi Survey., Mariann Fossum, Marlene Z. Cohen, Vivi Haavik Tønnessen, Mette Dobler Hamre, Agno Lisbeth Vabo Ødegaard, Ingjerd Lind, Kari Olsen Håheim, Anne Opsal

Journal Articles: College of Nursing

This study aimed to identify the research priorities of clinical nurses to develop a research program at a health care services system that includes three hospitals. A Delphi survey was emailed to all clinical nurses in two rounds. The Delphi method was used to collect data from the nurses in regards to their priority research themes, and the data were analyzed using descriptive and comparative statistics. A total of 933 clinical nurses returned the first round of the Delphi survey and 543 nurses answered the second round. Clinical nurses identified 89 potential research themes. Patient safety and ethical challenges were …

Androgen Receptor, Although Not A Specific Marker For, Is A Novel Target To Suppress Glioma Stem Cells As A Therapeutic Strategy For Glioblastoma, Nan Zhao, Fei Wang, Shaheen Ahmed, Kan Liu, Chi Zhang, Sahara J. Cathcart, Dominick J. Dimaio, Michael Punsoni, Bingjie Guan, Ping Zhou, Shuo Wang, Surinder K. Batra, Tatiana K. Bronich, Tom K. Hei, Chi Lin, Chi Zhang

Journal Articles: Biochemistry & Molecular Biology

Targeting androgen receptor (AR) has been shown to be promising in treating glioblastoma (GBM) in cell culture and flank implant models but the mechanisms remain unclear. AR antagonists including enzalutamide are available for treating prostate cancer patients in clinic and can pass the blood-brain barrier, thus are potentially good candidates for GBM treatment but have not been tested in GBM orthotopically. Our current studies confirmed that in patients, a majority of GBM tumors overexpress AR in both genders. Enzalutamide inhibited the proliferation of GBM cells both in vitro and in vivo. Although confocal microscopy demonstrated that AR is expressed …

Tumor- And Osteoclast-Derived Nrp2 In Prostate Cancer Bone Metastases, Navatha S. Polavaram, Samikshan Dutta, Ridwan Islam, Arup K. Bag, Sohini Roy, David Poitz, Jeffrey Karnes, Lorenz C. Hofbauer, Manish Kohli, Brian A. Costello, Raffael Jimenez, Surinder K. Batra, Benjamin A. Teply, Michael H. Muders, K Datta

Journal Articles: Biochemistry & Molecular Biology

Understanding the role of neuropilin 2 (NRP2) in prostate cancer cells as well as in the bone microenvironment is pivotal in the development of an effective targeted therapy for the treatment of prostate cancer bone metastasis. We observed a significant upregulation of NRP2 in prostate cancer cells metastasized to bone. Here, we report that targeting NRP2 in cancer cells can enhance taxane-based chemotherapy with a better therapeutic outcome in bone metastasis, implicating NRP2 as a promising therapeutic target. Since, osteoclasts present in the tumor microenvironment express NRP2, we have investigated the potential effect of targeting NRP2 in osteoclasts. Our results …

Implementation Of A Nurse-Led Family Centered Engagement Intervention For Caregivers Of Extremely Premature Infants In The Neonatal Intensive Care Unit, Emily Keenan, Michaela L. Ranallo, Kathleen A. Walsh, Haley Chapko, Tiffany A. Moore

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this feasibility study was to examine the implementation and usefulness of an intervention for extremely premature infant (EPI) caregivers.

Results: One caregiver and five nurses provided feedback with a mean score of 4.4 out of 5 pertaining to helpfulness.

Conclusions: Implementation of the Caregiver’s Guide was feasible and was positively received by NICU nurses and caregivers. We recommend implementing a revised version of this tool based on nurse and caregiver feedback. The delivery of education should be divided between dayshift and nightshift nurses so that one nurse is not responsible for providing all the information. The …

Evaluation Of A Renewal Room For Nurses, Danica Lee, Courtney Batra, Megan Knutson

Doctor of Nursing Practice Projects: College of Nursing

Wellness is an emerging and prominent issue in recent years, and specifically has a heavy influence on healthcare institutions and their employees. Having an outlet for self-care is important in developing resilience to life’s challenges. A Renewal Room is one approach to encouraging resilience and mental health restoration. The purpose of this study is to evaluate the usability of a wellness room for nurses. Data were collected in the form of an electronic survey that examined the utility (does it do what users need) and usability of the Renewal Room by determining who uses the room, when it is used, …

Multimodal Neuroimaging Of Hiv And Aging, Brandon Lew

Theses & Dissertations

HIV infection remains a significant contributor to disease burden, and with the success of antiretroviral therapies, the population of people with HIV is aging. A growing literature suggests a relationship between HIV-infection and a profile of age advancement, most notably in molecular studies of epigenetics. However, despite the widely-known high prevalence of HIV-related brain atrophy, functional deficits, and HIV-associated neurocognitive disorder (HAND), epigenetic age advancement has not been linked to HIV-related changes in neuroimaging metrics.

We applied three neuroimaging methods, structural MRI, resting state functional MRI, and resting state MEG, to study the brain structure and function of 121 virally-suppressed …

Design, Synthesis And Antineoplastic Evaluation Of A Variety Of Small Molecule Scaffolds, Bader Huwaimel

Theses & Dissertations

Several appealing strategies emerged for selective anticancer therapy. Mitochondrial respiratory complex II (CII) is a potential target for many human diseases, including cancer. We have designed, synthesized, and characterized a library of potent CII inhibitors atpenin A5 and diazoxide analogs with enhanced ‘drug-likeness’ and evaluated their antineoplastic activity. Several of these derivatives showed greater activity and selectivity to inhibit the CII. Design aspects of lead derivatives (16c) include optimum ligand lipophilicity efficiency of >5, and half-life of >3 hours. This derivative displayed potent and selective inhibition of cell proliferation in both multiple human prostate cancer cell lines and …

Design, Synthesis And Evaluation Of Novel Inhibitors Of Type 5 And 10 17Β-Hydroxysteroid Dehydrogenases, Ahmed Morsy

Theses & Dissertations

17β-Hydroxysteroid dehydrogenases (17β-HSDs) are essential enzymes in steroid metabolism. More and more evidence points to the pivotal contributions of these enzymes in various other metabolic pathways. Therefore, the latest research results give new insights into the complex metabolic interconnectivity of the 17β-HSDs with human diseases. This dissertation focuses on the metabolic activities of type 5 and 10 17β-HSDs. More specifically, regarding 17β-HSD5 contributions to the progression of prostate cancer (PCa) and 17β-HSD10 aggravation of amyloid-beta (Aβ)-induced toxicity in Alzheimer's disease (AD).

The second leading cause of cancer-related death in males is PCa, with the highest incidence rate of all cancers …

The Effect Of Polyunsaturated And Saturated Fatty Acids On Seizure Presence And Severity In A Cohort Of Subjects In An Epilepsy Monitoring Unit, Jana K. Wells

Theses & Dissertations

Ketogenic diet therapies (KDTs) have been used to treat epilepsy for nearly 100 years. Although effective, restrictive diet patterns and unknown impacts on long-term health outcomes often prevent their use as first-line therapy. To date, a distinct mechanism of action for KDTs has not been determined and evidence suggests fatty acids (FAs) may play a role in eliciting anti-seizure effects. This dissertation aimed to provide insights into the effect of polyunsaturated fatty acids (PUFAs) and saturated fatty acids (SFAs) on seizure presence and severity through the analysis of dietary intake in a cohort of patients admitted to an epilepsy monitoring …

Neural Oscillatory Activity Serving Sensorimotor Control Is Regulated By The Mitochondrial Redox Environment In Health And Disease, Rachel Spooner

Theses & Dissertations

Despite effective regimens of combination antiretroviral therapy, individuals with HIV are still at higher risk for developing forms of cognitive impairment, with one of the most common behavioral abnormalities to manifest being motor dysfunction. This is an important consideration, as deficits in motor control likely contribute to higher-order cognitive impairments, which together, lead to functional dependencies in the ever-growing aging population of HIV-infected adults. While the neuroanatomical bases of motor dysfunction have recently been illuminated in people living with HIV (PLWH), there remains an open question regarding the molecular processes supporting the circuit-level neuronal dynamics that potentially serve these behavioral …

Biomedical Porcine Models For The Study Of Surgical Hemostasis, Hindlimb Ischemia, And Pancreatic Cancer, Shruthishree Aravind

Theses & Dissertations

Murine models have dominated the world of biomedical research and comparative medicine since their development in the early 1900s. [1] While they may be suitable models to study proteomics and genomics, they may not serve as effective translational models. [2-4] Murine models do not accurately model the pathophysiology of human disease and are limited by their size, application of medical imaging and intervention, which reduces their overall preclinical predictive value. [2-4]

Porcine models on the other hand, are slowly and steadily bridging the gap between murine models and human patients. [5] Pigs …

Development Of Long-Acting Antiviral Drug Nanoformulations, Denise Cobb

Theses & Dissertations

Antiretroviral therapy (ART) has improved the quality and duration of life for people living with human immunodeficiency virus (HIV) infection. However, opportunities to improve its profile abound. ART is limited by putative viral reservoir penetrance, emergence of viral mutations, inherent toxicities, and regimen non-adherence. These highlight the need improved drug delivery schemes. Previously, our lab has demonstrated that targeting mononuclear phagocytes for antiretroviral drug delivery extends drug half-life and improves penetrance into viral reservoirs, addressing these limitations of ART. Herein, we developed synthetic and biologic antiretroviral (ARV) drug nanocarriers improve the pharmacokinetic (PK) and pharmacodynamic (PD) profiles of ARVs through …

The Driving Simulator Visual Field In Glaucoma – A Novel Task To Test Available Field Of View, Deepta Ghate

Theses & Dissertations

Glaucoma causes peripheral vision loss and impaired driving performance. We developed a novel driving simulator visual field task (DSVF) in a panoramic driving simulator to map the available field of view under different perceptual task loads in naturalistic settings. Our hypothesis is that “available field of view” will decrease with increasing task load in both glaucoma subjects and controls. This is a cross-sectional study with 28 glaucoma subjects and 19 controls. DSVF (60̊ x 20̊ visual field at 2.5 m) was tested in a high-fidelity interactive driving simulator in 4 different scenarios: a) no distractions b) no driving condition with …

The Effect Of Obstacle Intervals On Foot Integrated Pressure And Obstacle Negotiation Strategy, Zhuo Wang

Theses & Dissertations

When stepping over a single obstacle, despite of some spatiotemporal parameter changes, the impulse of the leading and trailing leg stays the same. This is considered an efficient obstacle avoidance strategy. However, research has shown that the strategy of multiple obstacles negotiation is different from a single obstacle crossing. Would this efficient strategy still exist during multiple obstacles negotiation? This study attempted to answer this question. Nineteen healthy young adults were recruited in this study. Each participant was required to complete 15 trials under 3 conditions: one-step, two-step, and three-step intervals. Data were collected for foot integrated pressure (FIP), walking …

Reach, Effectiveness, Adoption, And Maintenance Of Mobile Electronic Clinical Decision Support Tools Deployed As Part Of National Quality Improvement Projects, Ellen K. Kerns

Theses & Dissertations

Electronic clinical decision support (ECDS) tools are often developed within quality improvement (QI) projects to increase adherence with the latest clinical practice guidelines. However, the potential reach and maintenance of ECDS use beyond the time and location of their associated project are very limited. Deploying ECDS using a mobile app (mECDS) has shown the potential to be a viable method of overcoming these limitations. However, it is unclear what pattern the reach and adoption of such a tool might follow and what effect this use has on clinical practice. Our team developed an app which contained two different mECDS tools …

Adaptation Of Human Locomotion And Unilateral Limb Loading During Different Inclination Treadmill Walking, Yuhang Zhang

Theses & Dissertations

Human locomotion is adaptive in any external environment or different terrains, which has been widely investigated. For example, people can walk at different walking speeds in each leg on a split-belt treadmill. However, human locomotor behaviors are passively adapted during the split-belt treadmill walking. Therefore, the knowledge of how humans actively adjust the flexibility of locomotion is limited by using the split-belt treadmill. To address this gap, this study investigated the flexibility of locomotion by using a 4-lb ankle weight on the dominant leg to induce the asymmetric walking pattern when walking on the inclined, declined, and level treadmill. Twenty …

Is The Walking Pattern Similar Between Slope Walking And Obstacle Negotiation?, Jiani Lu

Theses & Dissertations

Studying biomechanical characteristics of human motion sheds light on the motor control strategies in the central nervous system. Slope walking and obstacle negotiation appear to have some similarities in control strategies based on subjective observation, but these two motions have never been compared objectively in biomechanics literature. This study aimed to investigate the similarities between obstacle negotiation and slope walking in kinematics and muscle activity. The similarities were determined by the correlation of the maximum heel elevation and muscle co-activation index between obstacle negotiation and inclined treadmill walking. The strength of correlation was compared in four different pairs of conditions: …

Modification And Antichlamydial Activity Evaluation On Dysregulators Of Cylindrical Proteases, Jiachen Feng

Theses & Dissertations

Chlamydia trachomatis infection is the most commonly reported sexually transmitted disease in the United States and the world. This pathogen can cause long-term health problems including blindness, pelvic inflammatory disease (PID) and ectopic pregnancy, which can be life-threatening if left untreated. To this day, there is no chlamydia-specific drug on the market. The standard treatment uses broad-spectrum antibiotics, which may affect regular functions of the commensal microbiota and leads to the development of bacterial resistance. Recently, a series of compounds based on Activators of Self-Compartmentalizing Proteases (ACP) was reported to show antichlamydial activity. Based on that scaffold, we prepared 21 …

Spinal Muscular Atrophy Carrier Screening: Current Practice And Perceived Barriers In A Midwestern Women’S Health Care Clinic, Elyssa Gray Lewis, Heather Said, Kaeli Samson, Sara Fisher

Capstones: Genetic Counseling

Purpose: Spinal muscular atrophy (SMA) carrier screening has been universally recommended to be offered to all women of reproductive age by the American College of Obstetricians and Gynecologists since 2017. This quality improvement study surveyed women's healthcare providers at a single clinic within an academic institution to evaluate practices and assess barriers to offering SMA carrier screening to patients. Methods: Certified nurse midwife, internal medicine, obstetrician/gynecologists, nurse practitioners, residents, and maternal fetal medicine providers were invited to participate in a survey comprised of multiple choice, Likert scale, and open-ended questions. Full participation included 26 out of 54 providers in …

Quantifying Fear Of Falling By Utilizing Objective Body Sway And Muscle Contraction Measures, Chenfan Gui

Theses & Dissertations

Fear of falling (FOF) is a psychological condition that can lead to increased morbidity and mortality in the elder population. However, the subjective and multidimensional nature of FOF resulted in the limitations of existing FOF measurements, which could influence the quality of those studies. The present study aimed to quantify FOF by using objective center of pressure (COP) trajectories and muscle contraction of the lower extremity to compensate for those limitations. Nineteen young healthy adults (24 years ± 2.47) were recruited in the present study. Subjects were required to watch three 360-degree videos, one control video and two roller coaster …

Secreted Mucin 5ac-Mediated Epithelial And Stromal Modulations Augment Pancreatic Cancer Aggressiveness, Koelina Ganguly

Theses & Dissertations

The mucosal layer that shields the epithelium of the body cavities is made up of high molecular weight, heavily glycosylated proteins called mucins that are broadly categorized into transmembrane and secreted members. Aberrant expression of secreted mucin MUC5AC has been implicated in lung, stomach, and colon cancer pathologies. MUC5AC is expressed de novo in the pancreas upon oncogenic insult, and its abundance in pancreatic tumor and circulation correlates to disease progression. However, few studies have explored beyond the diagnostic and prognostic significance of MUC5AC in pancreatic cancer (PC).

In this dissertation, we sought to investigate the mechanistic contribution of MUC5AC …

The Role Of Vgll4 And Mark2-Hdac Axis In Mitosis And Cancer, Yongji Zeng

Theses & Dissertations

The Hippo pathway is an evolutionarily conserved signaling pathway that plays important roles in stem cell biology, tissue homeostasis, and cancer development. The Hippo core signaling pathway features a kinase cascade consisting of mammalian sterile-20 like protein 1/2 (Mst1/2) and large tumor suppressor 1/2 (Lats1/2). Inactivation of the Hippo pathway is correlated with the promotion of proliferation and anti-apoptosis through activation of the transcriptional co-activator Yes-associated protein (YAP). YAP functions through binding with TEA-domain transcription factors (TEAD1–4) to activate target genes.

Vestigial-like 4 (Vgll4) functions as a transcriptional co-repressor in the Hippo-Yes associated protein (YAP) pathway. Vgll4 inhibits cell proliferation …

An Explanatory Sequential Mixed Methods Nutrition And Physical Activity Intervention Study On Changes In Knowledge, Self-Efficacy, And Outcome Expectations Of Fathers, Sarah Hortman

Theses & Dissertations

Overweight and obesity rates are a continuing concern resulting in poor health outcomes and annual healthcare costs in the billions of dollars. An upstream approach of health promotion is critical to change the focus from treatment and management to prevention of chronic disease. Preventing chronic disease through evidence-based health promotion practices incorporating educational interventions aimed at dietary and physical activity behaviors will preclude negative health outcomes including cardiovascular disease, type 2 diabetes, and hypertension.

The family environment is an important consideration in the prevention of chronic disease including obesity. Parents are role models for their children, including fathers who are …