Evidence Based Practices for Sensory Stimulation Seeking Impulsive Diagnosis

The purpose of this project is to identify evidence based practices that can be used in the treatment of Sensory Stimulation Seeking Impulsive Disorder (430.0). Identification of these practices will more effectively meet the therapeutic needs of the children diagnosed with this disorder

Specific Performance of Unfulfillable Plea Bargains

This article discusses how courts have handled the remedy dilemma presented by unfulfillable plea bargains. Part I analyzes the seminal Supreme Court opinion on the broken plea bargain question, Santobello v. New York. This section concludes that choice-of-remedy is not entirely a matter of lower court discretion. Rather, Santobello delegates to lower courts the authority to develop a law of remedies which conforms to the underlying principles of that decision. Part I also focuses on what courts have done with this mandate, discussing the elements of decision courts have developed to remedy unfulfillable plea bargains. Finally, Part II suggests a model analysis, requiring a presumption of specific performance when the defendant can show detrimental reliance on the unfulfillable bargain

{Ace}ing Early Childhood in Minnesota

Too many young children are facing ACEs that are detrimentally impacting their development and contributing to negative outcomes that persist into adulthood. There are no current policies using the ACE questions to drive mental health interventions. The Governor’s Task Force on Mental Health made nine recommendations that, if implemented, will greatly improve the mental health and well-being of children and their parents. Improving early childhood prevention and intervention programs helps ALL Minnesota’s families build healthy and rich experiences for their children. Expand the Early Childhood Mental Health Grant program statewide to increase early childhood mental health specialists. Create a Governor’s Task Force focusing prevention and early intervention of ACES. Implement the recommendations of the Governor’s Mental Health Task Force with the needs of children at the forefront. Use the ACEs questionnaire as a standardized tool. Develop trauma-informed learning communities. Require pre- and post-natal depression screenings

MntP and YiiP contribute to manganese efflux in salmonella enterica Serovar Typhimurium under conditions of manganese overload and nitrosative stress

The divalent transition metal cation manganese is important for protein function, particularly under conditions of iron limitation, nitrosative stress, and oxidative stress, but can mediate substantial toxicity in excess. Salmonella enterica serovar Typhimurium possesses multiple manganese importers, but the pathways for manganese efflux remain poorly defined. The S. Typhimurium ATCC 14028s genome was analyzed for putative manganese export pathways, which identified a previously uncharacterized homologue of the Escherichia coli manganese exporter mntP, stm1834, and two cation diffusion facilitator family transporters, zitB (stm0758) and yiiP (stm4061). Manganese acquisition by S. Typhimurium has been shown to occur in response to nitric oxide, an important chemical mediator of the mammalian innate immune response. However, cellular manganese can rapidly return to prechallenge levels, strongly suggesting that one or more S. Typhimurium exporters may contribute to this process. Here, we report that mntP and yiiP contribute to manganese resistance and export in S. Typhimurium. YiiP, also known as FieF, has previously been associated with zinc and iron transport, although its physiological role remains ambiguous due to a lack of zinc-sensitive phenotypes in yiiP mutant strains of S. Typhimurium and E. coli. We report that S. Typhimurium ΔmntP ΔyiiP mutants are exquisitely sensitive to manganese and show that both YiiP and MntP contribute to manganese efflux following nitric oxide exposure. IMPORTANCE Transition metal cations are required for the function of many proteins but can mediate toxicity when present in excess. Identifying transporters that facilitate metal ion export, the conditions under which they are expressed, and the role they play in bacterial physiology is an evolving area of interest for environmental and pathogenic organisms. Determining the native targets of metal transporters has proved challenging since bioinformatic predictions, in vitro transport data, and mutant phenotypes do not always agree. This work identifies two transporters that mediate manganese efflux from the Gram-negative pathogen Salmonella enterica serovar Typhimurium in response to manganese overload and nitric oxide stress. While homologues of MntP have been characterized previously, this is the first observation of YiiP contributing to manganese export.Annie Ouyang, Kendall M. Gasner, Stephanie L. Neville, Christopher A. McDevitt, Elaine R. Frawle

Critical reflections on evidence, ethics and effectiveness in the management of tuberculosis: public health and global perspectives

BACKGROUND: Tuberculosis is a major cause of morbidity and mortality globally. Recent scholarly attention to public health ethics provides an opportunity to analyze several ethical issues raised by the global tuberculosis pandemic. DISCUSSION: Recently articulated frameworks for public health ethics emphasize the importance of effectiveness in the justification of public health action. This paper critically reviews the relationship between these frameworks and the published evidence of effectiveness of tuberculosis interventions, with a specific focus on the controversies engendered by the endorsement of programs of service delivery that emphasize direct observation of therapy. The role of global economic inequities in perpetuating the tuberculosis pandemic is also discussed. SUMMARY: Tuberculosis is a complex but well understood disease that raises important ethical challenges for emerging frameworks in public health ethics. The exact role of effectiveness as a criterion for judging the ethics of interventions needs greater discussion and analysis. Emerging frameworks are silent about the economic conditions contributing to the global burden of illness associated with tuberculosis and this requires remediation