Interests and Values in Obama's foreign Policy: Leading from Behind?

Abstract This study will exam the relative importance of values and interests in Obama's foreign policy, focusing on crucial cases: the military actions related to Afghanistan, Iraq, Libya, Non-Syria, Al-Qaeda and ISIL. We will argue that his "leading from behind" strategy is not very distant from the foreign and defense strategies of his post-Cold War predecessors, by which democracy is seen as an assurance to security. According to Obama's strategy, Americans will only provide support for the building of democracy in the target countries, while this task should be performed by the locals themselves. Americans will provide military training to the new governments as well so they can be responsible for their own security, including preventing regrouping of terrorists in their soil. If Obama opposes the imposing of democracy by the use of force, empirical data shows that his administration is "not prepared to accept" any option that threats US security or American liberal-democratic values, bringing in this way values and interests very close to each other.

Diversity and distribution of sandflies (Diptera: Psychodidae: Phlebotominae) in a military area in the state of Amazonas, Brazil

This study reports the distribution, ecotopes and fauna diversity of sandflies captured in five training bases on a military reserve in Manaus, state of Amazonas (AM). A total of 10,762 specimens were collected, which were distributed among 58 species, with the highest number recorded at Base Instruction 1 (BI1). A higher rate of species richness was found at the Base Instruction Boina Rajada and low levels of diversity associated with a high abundance index with the clear dominance of Lutzomyia umbratilis, Lutzomyia ruii and Lutzomyia anduzei were found at BI1. The abundance of Lu. umbratilis raises the possibility of outbreaks of American cutaneous leishmaniasis by the main vector of the disease in AM.

Brazil: an emerging military power? The problem of the use of force in Brazilian international relations in the 21st century

The central goal of this paper is thinking about the Brazilian military power and its linking to the international ambitions of the country in the 21st century. After a comparative analysis to other BRICs and with a historical one about Brazil's strategic irrelevance, we aim to establish what the minimum military capacity Brazil would need in order to meet the country's latest international interests. Similarly, it will be discussed if the National Strategy of Defense, approved in 2008, and the recent strategic agreements signed with France represent one more step toward this minimum military capacity.

An outline of military technological dynamics as restraints for acquisition, international cooperation and domestic technological development

The expectation that technological returns from defense expenditure through acquisition, international cooperation and domestic research would further national development underappreciates the different technological dynamic of the armed services. This paper outlines the technological dynamic the stems from fighting in the air, at sea and on land, exemplifying consequences for the case of acquisition.

Vocal warm-up and breathing training for teachers: randomized clinical trial

OBJECTIVE To compare the effectiveness of two speech therapy interventions, vocal warm-up and breathing training, focusing on teachers’ voice quality.METHODS A single-blind, randomized, parallel clinical trial was conducted. The research included 31 20 to 60-year old teachers from a public school in Salvador, BA, Northeasatern Brazil, with minimum workloads of 20 hours a week, who have or have not reported having vocal alterations. The exclusion criteria were the following: being a smoker, excessive alcohol consumption, receiving additional speech therapy assistance while taking part in the study, being affected by upper respiratory tract infections, professional use of the voice in another activity, neurological disorders, and history of cardiopulmonary pathologies. The subjects were distributed through simple randomization in groups vocal warm-up (n = 14) and breathing training (n = 17). The teachers’ voice quality was subjectively evaluated through the Voice Handicap Index (Índice de Desvantagem Vocal, in the Brazilian version) and computerized voice analysis (average fundamental frequency, jitter, shimmer, noise, and glottal-to-noise excitation ratio) by speech therapists.RESULTS Before the interventions, the groups were similar regarding sociodemographic characteristics, teaching activities, and vocal quality. The variations before and after the intervention in self-assessment and acoustic voice indicators have not significantly differed between the groups. In the comparison between groups before and after the six-week interventions, significant reductions in the Voice Handicap Index of subjects in both groups were observed, as wells as reduced average fundamental frequencies in the vocal warm-up group and increased shimmer in the breathing training group. Subjects from the vocal warm-up group reported speaking more easily and having their voices more improved in a general way as compared to the breathing training group.CONCLUSIONS Both interventions were similar regarding their effects on the teachers’ voice quality. However, each contribution has individually contributed to improve the teachers’ voice quality, especially the vocal warm-up.TRIAL RECORD NCT02102399, “Vocal Warm-up and Respiratory Muscle Training in Teachers”.

Adenoviruses isolated from civilian and military personnel in the city of Rio de Janeiro, Brazil

Adenovirus are important pathogen primarily associated to respiratory infections of children and military personnel, even though it is also associated to cases of conjunctivitis and keratoconjunctivitis. We analyzed respiratory secretion collected from subjects with and without respiratory infection symptoms, being 181 civilians and 221 military subjects. The samples were inoculated in HEp-2 and/or A549 tissue cultures for viral isolation. Samples presenting cytopathogenic effect (CPE) in any tissue culture were tested by a polymerase chain reaction (PCR) assay to confirm adenovirus isolation. The isolates confirmed as adenovirus were further analyzed by restriction endonuclease assay for determination of viral species. Three isolates were identified as specie A (two from civilian and one from military), one isolate from military was identified as specie C, and one isolate from civilian was identified as specie D. For two isolates the specie could not be identified.

Training-related accidents during teacher-student-assistance activities of medical students

A survey was done to determine the most common hospital accidents with biologically contaminated material among students at the Medical College of the Federal University of Minas Gerais. Six hundred and ninety-four students (between fifth and twelfth semesters of the college course) answered the questionnaire individually. Three-hundred and forty-nine accidents were reported. The accident rate was found to be 33.9% in the third semester of the course, and increased over time, reaching 52.3% in the last semester. Sixty-three percent of the accidents were needlestick or sharp object injuries; 18.3% mucous membrane exposure; 16.6% were on the skin, and 1.7% were simultaneously on the skin and mucous membrane exposure. The contaminating substances were: blood (88.3%), vaginal secretion (1.7%), and others (9.1%). The parts of the body most frequently affected were: hands (67%), eyes (18.9%), mouth (1.7%), and others (6.3%). The procedures being performed when the accidents occurred were: suture (34.1%), applying anesthesia (16.6%), assisting surgery (8.9%), disposing of needles (8.6%), assisting delivery (6.3%), and others (25.9%). Forty-nine percent of those involved reported the accident to the accident control department. Of these 29.2% did not receive adequate medical assistance. Eight percent of those involved used antiretroviral drugs and of these 86% discontinued the treatment on receiving the Elisa method applied to the patient (HIV-negative); 6.4% discontinued the treatment due to its side-effects; and 16% completed the treatment.

Nurses' training on dealing with alcohol and drug abuse: a question of necessity

The purpose of this article is to present a brief review on the need for changes in nurses' undergraduate education concerning alcohol and drugs. Specialized literature makes it clear that nurses have difficulties giving care to psychoactive substance users as part of their functions in the various health care sites. This may be associated with a deficiency in formal education. In the face of the social importance concerning these related questions in the scope of research, care, and education, we made an attempt at deepening the study on this theme, which could contribute to changes in practice, care, and undergraduate nursing education.

Unsupervised Rehabilitation: effects of Exercise Training over the Long Run

OBJECTIVE: To assess the safety and efficacy of unsupervised rehabilitation (USR) in the long run in low-risk patients with coronary artery disease. METHODS: We carried out a retrospective study with 30 patients divided into: group I (GI) - 15 patients from private clinics undergoing unsupervised rehabilitation; group II (GII) - control group, 15 patients from ambulatory clinic basis, paired by age, sex, and clinical findings. GI was stimulated to exercise under indirect supervision (jogging, treadmill, and sports). GII received the usual clinical treatment. RESULTS: The pre- and postobservation values in GI were, respectively: VO2peak (mL/kg/min), 24±5 and 31± 9; VO2 peak/peak HR: 0.18±0.05 and 0.28±0.13; peak double product (DP peak):26,800±7,000 and 29,000 ± 6,500; % peak HR/predicted HRmax: 89.5±9 and 89.3±9. The pre- and post- values in GII were: VO2 peak (mL/kg/min), 27± 7 and 28±5; VO2 peak/peak HR: 0.2±0.06 and 0.2± 0.05; DP peak: 24,900±8,000 and 25,600± 8,000, and % peak HR/predicted HRmax: 91.3±9 and 91.1± 11. The following values were significant: preobservation VO2peak versus postobservation VO2peak in GI (p=0.0 063); postobservation VO2peak in GI versus postobservation VO2peak in GII (p=0.0045); postobservation VO2 peak/peak HR GI versus postobservation peak VO2/peak HR in GII (p=0.0000). The follow-up periods in GI and GII were, respectively, 41.33± 20.19 months and 20.60±8.16 months (p<0.05). No difference between the groups was observed in coronary risk factors, therapeutic management, or evolution of ischemia. No cardiovascular events secondary to USR were observed in 620 patient-months. CONCLUSION: USR was safe and efficient, in low-risk patients with coronary artery disease and provided benefits at the peripheral level.

Benefits of exercise training in the treatment of heart failure: study with a control group

OBJECTIVE: Exercise training programs have been proposed as adjuncts to treatment of heart failure. The effects of a 3-month-exercise-training-program with 3 exercise sessions per week were assessed in patients with stable systolic chronic heart failure. METHODS: We studied 24 patients with final left ventricle diastolic diameter of 70±10mm and left ventricular ejection fraction of 37±4%. Mean age was 52±16 years. Twelve patients were assigned to an exercise training group (G1), and 12 patients were assigned to a control group (G2). Patients underwent treadmill testing, before and after exercise training, to assess distance walked, heart rate, systolic blood pressure, and double product. RESULTS: In G2 group, before and after 3 months, we observed, respectively distance walked, 623±553 and 561± 460m (ns); peak heart rate, 142±23 and 146± 33b/min (ns); systolic blood pressure, 154±36 and 164±26 mmHg (ns); and double product, 22211± 6454 and 24293±7373 (ns). In G1 group, before and after exercise, we observed: distance walked, 615±394 and 970± 537m (p<0.003) peak heart rate, 143±24 and 143±29b/min (ns); systolic blood pressure, 136±33 and 133±24 mmHg (ns); and double product, 19907± 7323 and 19115±5776, respectively. Comparing the groups, a significant difference existed regarding the variation in the double product, and in distance walked. CONCLUSION: Exercise training programs in patients with heart failure can bring about an improvement in physical capacity.