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Brugada syndrome (BrS) is a common occult cause of sudden cardiac arrest in otherwise healthy-appearing adults. The pathognomonic electrocardiographic pattern may be unmasked only by certain medications, many of which are unknown. We report a case of a depressed but otherwise healthy man with an asymptomatic right bundle branch block on electrocardiography who experienced antidepressant-induced BrS and ultimately recovered with transcranial magnetic stimulation (TMS). After an initial trial of nortriptyline, the patient’s depressive symptoms improved; however, he experienced a syncopal event and was subsequently diagnosed as having BrS. Cross titration to bupropion, which had not previously been known to exacerbate BrS, was followed by another cardiac event. As a result, the patient was referred for TMS as a substitute for pharmacotherapy. After 31 TMS sessions over 8 weeks, the patient demonstrated significant improvement by subjective report and objective reduction in his Patient Health Questionnaire-9 scores from 10 (moderate) to 1 (minimal). Transcranial magnetic stimulation is a Food and Drug Administration–approved nonpharmacologic treatment for depression. Given the potential lethality of BrS with known and unknown psychopharmacologic agents, providers should consider TMS as first-line therapy in this patient population. Bupropion should be added to the list of agents known to exacerbate this disease.

Frustrated efforts in both Iraq and Afghanistan give urgency to the question of how to craft effective, humane, and legitimate security institutions in conflict-ridden states—and whether legitimate policing can in fact be developed in the midst of insurgency and terrorism. David H. Bayley and Robert M. Perito confront these questions head on. Against the backdrop of failed US attempts to train police forces in Iraq and Afghanistan, Bayley and Perito explore the role of the local police as an element of successful peace operations and counterinsurgency campaigns. Their analysis ranges from the specifics of training to the larger arena of broad institutional reform. Equally practical and grounded in theory, their work offers crucial guidance on the role and training of local police forces that must grapple daily with the challenges of ongoing conflicts.

Democratic governments are under siege around the world from forces that threaten the basic principles of representative government—freely elected leaders, democratic institutions, and the rule of law. In countries as diverse as Azerbaijan, Cambodia, and Egypt, authoritarian leaders have \"snuffed out civil society, suborned or faked elections, asphyxiated free expression, and repressed human rights.\" Populist regimes are consolidating power in Europe and Latin America where citizens have lost faith in political institutions and rejected conventional leaders. Centralized authoritarian governments in Russia and China have put forward an alternative autocratic governance model and are striving for world leadership. Meanwhile, democracy in the United States has taken a dangerous turn.

While there is no certain way to negate America's vulnerability to hostile sentiment and actions, providing essential services to the international community and setting an example for other states to follow is the country's best bet. No longer can the nation afford to be grudging in its attention to troubled regions and situations heretofore defined as distinct from the traditional geopolitical definition of vital interests.

Discusses creation of a US intervention force for stability operations, consisting of military, police-constabulary, civilian police, and lawyers, in context of war on terrorism. Potential European response.

The study is based on interviews with staff members of the Senate and House Armed Services and Foreign Affairs Committees and representatives from the Office of Secretary of Defense, the Joint Chiefs of Staff, the Department of State, and the U.S. Agency for International Development [USAID]. The Congressional Mandate and History of the Legislation The Senate version of the NDAA for FY 2006 contained a provision (Section 1207) to provide the Secretary of Defense with the authority to transfer funds, services, and articles to the Secretary of State to provide immediate assistance to crisis states to maintain or restore peace and security.