Migraines affect an estimated 1.04 billion people worldwide annually. To address the global prevalence of migraines, new migraine treatments should be of utmost importance. To date, magnesium hydroxide [Mg(OH)2] and magnesium sulfate are two common treatments for delivering magnesium to patients with low intracellular levels, which are believed to be linked to migraines. One major downside to using Mg(OH)2 as an over-the-counter treatment for magnesium delivery is the possibility of side reactions in the acidic environment of the stomach, further affecting the pH stability necessary during uptake in the small intestine. To address these downfalls, Mg(OH)2 was synthesized with capping agents betaine and citrate [Mg(OH)2 B/C] to protect the Mg(OH)2 particles from side reactions in the acidic environment of the stomach. The addition of betaine is expected to improve particle absorption, distribution, and potential to cross the blood-brain barrier via the betaine transporter while citrate is expected to decrease particle size and reduce particle aggregation. Fourier transform infrared and ultraviolet-visible spectroscopy validated the presence of key Mg(OH)2 B/C functional groups present in Mg(OH)2 citrate and Mg(OH)2 betaine controls. Dynamic light scattering confirmed the average hydrodynamic diameter of Mg(OH)2 decreased with capping agents betaine and citrate from 960 nm to 660 nm. Likewise, the average pH of the Mg(OH)2 B/C particle solution in gastric juice over 48 hours was 7.6, slightly above neutral pH (pH ˜ 7.0-7.4) and within the pH range of the small intestine (pH ˜ 6-8). Scanning electron microscopy energy dispersive x-ray spectroscopy analyzed the atomic composition of the Mg(OH)2 B/C particle core, revealing a high density of magnesium and oxygen in the Mg(OH)2 particle core. In gastric juice, the high density of magnesium and oxygen were less affected in Mg(OH)2 B/C particles compared to uncoated Mg(OH)2, confirming the hypothesis capping agents betaine and citrate help protect the Mg(OH)2 core structure from side reactions in acidic environments. Lastly, cell viability studies on J774 human macrophage cells with Mg(OH)2 B/C particles, Mg(OH)2, milk of magnesia, Mg(OH)2 citrate, and Mg(OH)2 betaine confirmed normalized cell viability percentages for all treatments within a magnesium concentration range of 159 to 0.2 mM were above 100%. Thus, this study introduces a pH-stable magnesium delivery system that is safe to use while protecting the Mg(OH)2 core against the acidic environment of the stomach for use in migraine patients.

After the completion and failure of 44 phase III clinical trials, Traumatic Brain Injury (TBI) continues to be a leading cause of disability, morbidity, and mortality amongst military personnel and civilians of all age groups. TBI is characterized by primary and secondary injury processes of which the secondary injury is defined by oxidative stress, increased energy demands, mitochondrial dysfunction, neuroinflammation, and more; characteristics which are also shared with neurodegenerative diseases. Creatine (Cr) is one of the most abundantly used and studied supplements in the fitness industry which, when in the form of Phosphoryl-Creatine (PCr), directly aids in the conversion of ADP to ATP, particularly in metabolically stressed conditions where oxygen is unavailable, and hypothesized to be a JAK2 inhibitor. Similarly, Tannic Acid (TA) is a polyphenol naturally available in teas and nuts that provides neuroprotective effects against TBI through the PGC-1?/Nrf2/HO-1 pathway. However, bioavailability of these compounds in the brain is limited through oral supplementation. Therefore, increasing the local concentration of these compounds in the brain parenchyma may provide therapeutic benefits after cerebral injury. In this study, efficiently loaded, TA-based Creatine nanoparticles (NPs) were synthesized as a potential therapeutic for secondary TBI and related neuroinflammatory conditions. This nanosystem demonstrates surface chemistry augmentation, high loading efficiency, and biodegradation with 24 hours. Purified NPs had an average hydrodynamic diameter of 200 nm, an average surface charge of -44mV, and a polydispersity index (PDI) of 0.171. Purified particles also demonstrate long shelf life and stability over many months, suggesting this inexpensive formulation could be utilized as a cheap therapeutic in underserved, low-income areas.

The increasing incidence of chronic diseases worldwide has encouraged the discovery of treatment alternatives for chronically ill patients. To increase patient compliance and diminish secondary effects, delayed drug release systems have been developed. However, current pharmaceutical coatings still face limitations in targeting, loading efficiency, and pH tunability when administered orally. In this thesis, we demonstrate the potential of using atomic layer deposition (ALD) as a technique to coat 5-Aminosalicylic acid (5-ASA)—a drug to treat inflammatory bowel disease—to control 5-ASA's release throughout the gastrointestinal tract. 5-ASA was coated with 300 cycles of Al2O3 and 200 cycles ZnO ALD and was characterized by Fourier transform infrared spectroscopy (FTIR), scanning transmission electron microscopy (SEM), high resolution transmission electron microscopy (TEM), energy dispersive x-ray spectroscopy (EDX), and UV-visible spectroscopy, to confirm 5-ASA as a viable ALD substrate and its ability to be studied at a wavelength of 298 nm for release rate characterization. Three different form factors of 5-ASA—pellets, films, and powders— which were coated with 300 cycles of Al2O3 ALD were studied via UV-Vis in acidic HCl pH 4 media. To further understand the etching rate of Al2O3 films, quartz crystal microbalance (QCM) crystals were coated following the same ALD protocols used in our UV-Vis studies. Based on the results gathered from 5-ASA coated with Al2O3 ALD, equivalent studies were made with ZnO inorganic film coatings via ALD. This thesis demonstrates and encourages ALD's potential in coating 5-ASA as a proof-of concept to achieve delayed and controlled drug release that is tunable based on the ALD coating thickness and chemistry.

In the past 40 years, the health of citizens in the United States has changed significantly. The population of the United States managed to get sicker and die slower across the prior four decades. Adding to this complexity is the fact that illnesses and health behaviors in the United States are also not equally distributed by race, class, gender, or other social factors. These facts do not only reflect level of the disease and illness in the United States, but also the disparities that exist within them and the sociomedical factors that impact health. Despite costing American taxpayers between $120 billion to $1.32 trillion a year, one sociomedical factor not addressed in the literature is the impact of healthcare fraud on health. Data for US counties and county-equivalents were used to create a custom dataset of secondary data that was used in heat maps, bivariate correlations, and logistic regressions to examine the relationships between social disorganization, urbanization, healthcare fraud, and community health. This study sought to test whether: (1) social disorganization increases healthcare fraud, (2) healthcare fraud decreases community health outcomes, and lastly, (3) Medicare and Medicaid expenditures mediate the effect of healthcare fraud on community health. Results from this analysis showed that counties with high social disorganization are 1.63 times more likely (log odds: 1.6300, p < .05) to have high healthcare fraud rates than counties with low social disorganization when controlling for health insurance and education. The data also showed that healthcare fraud is not a significant predictor (p >.05) of community health when controlling for health insurance and education. Additionally, the results showed that Medicare and Medicaid expenditures did not significantly (p > .05) mediate the effect of social disorganization on healthcare fraud, or of healthcare fraud on community health outcomes. However, the biggest finding of this study was that the size, complexity, invisibility, and trusted nature of the public health insurance system in the United States make it "easy money" for perpetrators.

The current research examines trust as a component of the Healthcare Relationship Scale (HCR) using data from the Medical Monitoring Project (MMP), a program designed by the Centers for Disease Control and Prevention (CDC). This dataset focuses on the experiences and needs of people living with HIV (PLWH). We examined how relationships between people living with HIV and their HIV providers may be associated with two distinct variable groups: (1) socio-demographic characteristics, such as age, gender, race, education and poverty status; and (2) patient health as it relates to the continuum of care, such as patient-rated general health, adherence to a care plan, and trust of information from healthcare providers. To analyze these groups, we used confidence intervals to examine statistical significance between mean trust scores. We present the use of emotional tuning as a possible mediator which could be used to strengthen patient trust and improve the patient-provider relationship. The research finds differences in trust by the aforementioned variable groups. These findings add to the growing body of literature on patient-provider trust, focusing specifically on people living with HIV by examining the role of trust in patient health, and broaden the application of emotional tuning.

This study demonstrates how adversity during the covid pandemic has impacted the lives of diverse college students. Specifically, this study analyzes students' perspectives on how they respond through resilience to daily academic, financial, and social stressors impacting their health during the pandemic. For this study, the research questions are: 1) what themes and forms of coping emerge among marginalized racially, ethnically diverse U.S. college students about their mental health and daily life experiences exacerbated by the covid pandemic? 2) And to what do experiences with stressors in combination with the covid pandemic reveal about the mental health of marginalized groups of students? The method used was semi-structured phone call interviews with 14 college students. Results reveal how students deal with covid and non-covid stressors, manage both physical and mental health concerns, and how they utilize resources from formal and informal social support, gaining thriving or surviving style coping strategies. Overall, the findings provide novel insight to the large body of literature on life experiences in response to social inequities, stressors, and adverse life events in times of crisis, highlighting the significance of listening to diverse college students' needs and their physical and mental health concerns.

Candida albicans is a fungal microbe that is often present inside of humans in the mouth and gastrointestinal tract. It shares a mostly commensal relationship with its hosts but can develop into an opportunistic pathogenic infection under conditions of immune suppression. Oral thrush or candidiasis is an uncomfortable condition resulting from excessive growth of Candida albicans in the oral cavity. Candidiasis is prone to progressing into more threatening symptoms without proper treatment. There are few effective antifungal medicines used for treatment and the problem of antimicrobial resistance is growing. Alcaligenes faecalis is a bacterial microbe that does not pose a significant threat to human health in many cases. It is also present in the human gastrointestinal tract and shares an inhibitory relationship with Candida albicans. Streptococcus mutans is also a bacterial microorganism present in the oral cavity and GI tract of humans. It is one of the primary factors related to dental decay, one of the most common modern health issues humans face. In cases of dental caries, Candida albicans and Streptococcus mutans have been found to have positive correlation in the biofilm coating teeth. This study examines the effects on microbial growth under the presence of all three organisms in a tri-culture. The results of this experiment could help better understand how to inhibit growth of Candida albicans and Streptococcus mutans and promote oral health.

Physical inactivity has become a public health crisis which can be the trigger to many other chronic diseases. Participation in physical activity is correlated with a variety of factors at multiple levels, including individual physical and psychological health, interpersonal social support, and community physical and social environments. Previous studies found that individuals' social networks influenced health behaviors, including physical activity. However, it remains unclear how social networks at different life stages affect adult engagement in physical activity among different socio-demographic groups. Built upon a theoretical framework which integrates the social-ecological model, social cognitive theory and social network theory, this study addresses three research questions: 1) Do the effects of social networks on adult engagement in physical activity vary among different socio-demographic groups? 2) How has adult participation in physical activity been influenced by their social networks during adolescence and adulthood, as mediated by their psychological health? 3) Does the association between physical activity and social and physical environments vary across space due to unequal distribution of resources? Individuals' sociodemographic status, psychological and physical health, and social network indicators were obtained from the National Longitudinal Study of Adolescent to Adult Health Wave I and Wave IV. County-level physical and social environment variables were collected from multiple sources (e.g. Census Bureau). Statistical and spatial methods such as latent class analysis, path analysis, and geographically weighted regression were applied in this research. The findings indicate that individuals' social networks in both adolescence and adulthood had significant influence on adult participation in physical activity. High-quality relationships with parents, spouses, and friends in both adolescence and adulthood were found to promote physical activity engagements for all population groups. But the effects of other social relationships varied across socio-demographic groups. For example, males tended to be physically active if they had frequent connections with their neighbors, while female participation in physical activity was strongly related to their high contact frequency with children. The findings also suggest that psychological and physical health not only have significant direct influences but also mediate the indirect effects of social networks on physical activity engagement. In addition, unequal community social and physical environments also play a crucial role in adult engagement in physical activity.

Tumor Necrosis Factor alpha antagonists (anti-TNFα) have been extensively used for Crohn's disease (CD) treatment. Even though they may control CD symptoms initially, treatment response varies among patients, which seems to depend on single nucleotide polymorphisms (SNPs) in TNFα receptors superfamily 1A and 1B (TNFRSF1A/B). Most importantly, M. tuberculosis infection has been strongly associated with these medications, but no studies have elucidated the effects of anti-TNFα on CD associated with MAP (Mycobacterium avium subspecies paratuberculosis; a possible causative agent of CD, and closely related to M. tuberculosis). Here, we investigated the effects of recombinant inflammatory cytokines and anti-TNFα therapeutics on macrophages infected with MAP isolated from CD patient. We also tested the prevalence of MAP and the significance of nine SNPs in TNFα, TNFRSF1A and TNFRSF1B from the blood of 54 CD and 50 healthy subjects by IS900 nPCR. Both PEGylated and non-PEGylated forms of anti-TNFα increased MAP viability by nearly 1.5 Log CFU/mL, while rIL-6 and rIL-12 induced MAP viability at 5.42 ± 0.25 and 4.79 ± 0.14 Log CFU/mL, respectively. In contrast, rTNFα reduced MAP survival in infected macrophages by 2.63 Log CFU/mL. Expression of TNFα, IL-6, and IL-12 was upregulated by three folds following MAP or M. tuberculosis infection compared to other bacterial strains (P < 0.05). Four SNPs (TNFα:rs1800629, TNFRSF1A:rs767455, TNFRSF1B:rs1061624 and TNFRSF1B:rs3397) were overrepresented significantly (P < 0.05) among CD patients compared to healthy controls. The TNFRSF1A:rs767455 GG genotype was found in 15/54 CD patients (28%), while it was only found in 2/50 healthy controls (4%) [OR = 9.2, 95% CI: 1.98-42.83]. The TNFRSF1B:rs3397 TT genotype was found in 15/54 CD patients (28%) compared to (4/50) healthy controls (8%) [OR = 4.4, 95% CI: 1.36-14.14]. Furthermore, the SNPs TNFRSF1A:rs767455 and TNFRSF1B:rs3397 were associated with downregulating their corresponding genes significantly (P < 0.05). MAP infection was predominantly found among CD patients in comparison to healthy controls (57% vs 8%, respectively), which was also dependent on the SNPs TNFRSF1A:rs767455 and TNFRSF1B:rs3397. Our SNP haplotype analysis of TNFRSF1A:rs767455 and TNFRSF1B:rs3397 indicates that the G – T haplotype is significantly distributed among CD patients (46%) and MAP infection susceptibility is also associated with this specific haplotype (31%). The data indicate MAP positive CD patients receiving anti-TNFα could result in favorable conditions for MAP infection, which explains the poor response of many CD patients to this treatment, leading to adverse outcomes ultimately.

Currently, the U.S. reports some of the worst health outcomes while spending the most money on health care when compared to other developed countries in the Organization for Economic Co-operation and Development (OECD). In 2018, Americans took out $88 billion in debt to cover the cost of medical care and approximately 28.5 million individuals remained uninsured. Despite poor health outcomes across the country, health care reform is a highly controversial issue and has been for the last century. Historically, elites in the Republican party have aligned themselves with New Right political philosophies, which stand for a privatized health care system with minimal government involvement. Elites in the Democratic party have aligned with Pluralist political philosophies, which is an orientation that encourages government oversight to protect the health of its citizens. Recently there has been a rise in political polarization that has stemmed from the asymmetric movement of the Republican Party further to the right escalating the controversy around health care reform. In addition to growing polarization, recent studies have found that politicians are more responsive to the affluent classes while concurrently accumulating an influx of wealth. When neglecting to vote with the majority of their constituents, politicians have tried to change public opinion rather than address it. These short-term manipulation strategies have been found to confuse constituents more than mobilize them, contributing to the controversy around health care reform today. This project aims to understand how macro level structures affect public opinion on government funding of health care utilizing the thermostatic model and the works of Nicos Poulantzas and Michel Foucault as theoretical frameworks to understand how political structures influence public opinion and how political structures are shaped within Capitalistic societies. Specifically, the current study examines how the political leaning of Congress and the Presidency, total lobbying dollars contributed by the top five medical industries, and the number of health care bills passed per year affects public opinion on government funding of health care between 1986 and 2018. The data were accumulated from multiple sources including the General Social Survey, OpenSecrets.org, GovTrack.us, and the Senate, House, and White House websites. After completing bi-variate and multi-variate autoregressive integrated moving average (ARIMA) models the only variable that was found to impact public opinion was the political party of the Presidency.