By Mark D'Agostino and Greg Martin

The US Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism (The Commission), was established in 2007 by the Congress of the United States in House Resolution 1 (P.L. 110-53) to assess and provide a clear and comprehensive strategy and concrete recommendations for prevention activities, initiatives, and programs. In December 2008, the Commission released a report, World At Risk, addressing these objectives.

The Report's findings received considerable press coverage in the United States and internationally, in part because of the dire prediction that "it is more likely than not that a weapon of mass destruction will be used in a terrorist attack somewhere in the world by the end of 2013", and that "terrorists are more likely to be able to obtain and use a biological weapon than a nuclear weapon" [1]. The bold prediction that an attack with a WMD is likely somewhere in the world by the end of 2013 was arguably not substantiated in the text of the report, potentially fueling the discussion that the biological weapon threat is exaggerated [2]. This issue will not be addressed in this paper. Throughout the Report, many questions were posed that lie squarely at the intersection of globalization and health. In this paper, we aim to address the following questions: Firstly, how will the bioscience revolution change the nature of the biological weapons threat? And which levers and interventions might best mitigate the risk of such an attack?

The Bioscience Revolution

The Commission posed many questions, one of which was how in the future will the bioscience revolution and the globalization of the biotechnology industry change the nature of the biological weapons threat? The biotechnology revolution discussed herein began in 1973, 20 years after Watson & Crick's sentinel paper describing the structure of DNA, when Stanley Cohen of Stanford University and Herbert Boyer of the University of California-San Francisco discovered the basic technique for recombinant DNA [3,4]. In the subsequent years, dramatic advances in information technology and processing power helped to spur the rise of many biotechnology companies, principally centered around large research universities within the San Francisco and Boston areas [3]. Presently, thousands of biotechnology companies exist in the United States and throughout the world. This international expansion was driven by a host of factors, such as the growing use of international subcontracting and technological cooperation agreements, including biodefense-related research and vaccine development [5].
A role for the biotechnology and pharmaceutical industries

The World at Risk Report addresses the role of the biotechnology and pharmaceutical industries in addressing the biological weapons threat, and advocates that the United States Department of Health and Human Services (DHHS) press for an international conference of countries with major biotechnology and pharmaceutical industries to discuss the norms and safeguards necessary to keep dangerous pathogens out of the hands of terrorists, and to ensure that the global revolution in the life sciences unfolds safely and securely. Given the vital role that the industries could play in an attack with regards to vaccine dissemination and education, this is a reasonable recommendation; but to have any value the safeguards will require clearly delineated, verifiable safety guidelines with significant sanctions for non-compliance. However, the question of who will regulate the safeguards needs to be addressed. Governmental regulation, through unannounced site visits and investigations would be preferred over self-regulation, particularly if there is a threat of sanctions for non-compliance.

Biotechnology and pharmaceutical companies, governmental agencies (such as the NIH/NSF in the US), and foundations play a critical role in funding life sciences research, particularly in universities. We propose that obtaining grants and continued funding for life sciences research should be made contingent upon proof of adherence to biosafety protocols. This would serve the dual-purpose of increasing the chance of adherence to protocols, while concurrently sensitizing researchers to biosecurity issues. However, this would have little impact inside of the private sector. Working to ensure that the global revolution in the life sciences unfolds safety is a worthwhile goal, but it would likely prove to be extraordinarily difficult to implement given the issues of regulation, enforcement, and the "dual-use" issues arising in biotechnology.

The Dual-Use Dilemma

The World at Risk report addresses the 'dual-use dilemma' of biotechnology, stating that: "at the same time that [biotechnology] has benefited humanity by enabling advances in medicine and agriculture, it has also increased the availability of pathogens and technologies that can be used for sinister purposes" [1]. Emerging technologies and machine automation of complex molecular biological processes has made it easier to synthesize long strands of DNA coding for genes and even entire microbial genomes. By piecing together large fragments of genetic material synthesized in the laboratory, it is possible to assemble highly virulent infectious viruses. At this juncture this process would be technically challenging, expensive, and unreliable. However, as DNA synthesis and manipulation technologies continue to advance at a rapid pace, it will soon be possible to synthesize nearly any virus whose DNA sequence has been decoded [1].

Chyba and Greninger note that experiments performed and published over the last decade-ranging from the incorporation of immune-suppressing interleukin-4 (IL-4) into the mousepox virus to create a deadlier virus able to infect vaccinated animals, to the ability to synthesize viruses from scratch using chemicals on the open market-already demonstrate that the technological know-how to construct dangerous pathogens is widespread [5]. This highlights the dual-use dilemma. Attempting to ban these technologies or stifle technology transfer is not a viable or reasonable option. It is necessary therefore to design policies that can concurrently suppress biological weapons development whilst accommodating and encouraging the spread of dual use technologies for technical and scientific advancement by the life sciences community [6-9].

The Life Sciences Community

The life sciences community -defined as universities, medical and veterinary schools, nongovernmental biomedical research institutes, trade associations, and biotechnology and pharmaceutical companies- has an important role to play in mitigating the bioterrorism threat. The World at Risk Report states that the life sciences community must foster a "bottom-up effort to sensitize researchers to biosecurity issues and concerns, and to strive to design and conduct experiments in a way that minimizes safety and security risks" [1]. It is paramount that the life sciences community works toward increased cooperation with intelligence agencies, while concurrently working towards fostering an increased awareness of potential threats at the design phase of experiments. To address the Commission's recommendation of sensitizing researchers to biosecurity issues, we propose the development of a web-based didactic course in bioterrorism and weapons of mass destruction (WMD) identification and treatment for the life sciences community. The site could outline safety protocols, have detailed disaster management tutorials, and could be specifically tailored for different subsets of industry and health professionals including: researchers, medical/veterinary students, graduate students in the biological and life sciences, amongst others. Furthermore, to provide an educational resource for the public, we propose that the biotechnology and/or pharmaceutical industry, as a demonstration of corporate social responsibility, create a pictorial-based patient-centered web interface designed to educate the public and optimize and coordinate use of emergency services in the event of a bioterrorism attack.

The Growing Threat Of Non-State Actors

Intelligence estimates appear to agree that the acquisition and dissemination of deadly pathogens would entail fewer hurdles than the theft or production of weapons-grade uranium or plutonium and its assembly into an improvised nuclear device, thus rendering the biological weapons threat greater than the nuclear threat in this respect [1]. With the growing threat of non-state actors obtaining biological weapons and other weapons of mass destruction, over the past five years the international community has launched initiatives to address it. These include the Proliferation Security Initiative (PSI) and UN Security Council Resolution 1540, which were created in 2004 to ensure that states prohibit non-state actors from manufacturing, acquiring or obtaining materials that could support the use of biological or chemical weapons [9,10]. Initiatives have also been launched from the International Committee of the Red Cross (ICRC), the International Criminal Police Organization (Interpol), and the Organization for Economic Cooperation and Development (OECD) [11].

While there are still significant technical hurdles that terrorist groups would need to surpass to be able to weaponize biological agents, synthetic genomics, machine automation of complex molecular biological processes, and a flurry of emerging technologies will make this barrier easier to cross. Furthermore, the Commission found that terrorist groups could upgrade their capabilities by recruiting scientists adept in these technologies. This highlights the importance of fostering a culture of sensitivity to biosecurity issues within the life sciences community, as well as the importance of increasing communication between the life science and intelligence communities.

Biological Weapons Convention

The 1972 Convention on the Prohibition of the Development, Production and Stockpiling of Bacteriological (Biological) and Toxin Weapons and on their Destruction (BWC), entered into force March 26, 1975, has greater than 160 nation-state signatories and provides a multilateral control of the stockpiling and spread of weapons technology. The World at Risk report recommends that an action plan for achieving universal adherence to and effective national implementation of the BWC be proposed for adoption at the next review conference in 2011. This is a worthwhile goal, particularly if one believes that those who seek to use biological weapons against a civilian population are likely to obtain the pathogens by stealing them or by recruiting scientists from state-funded programs. However, due to the dual-use nature of biotechnology materials, verification of adherence by a regulatory body or other means remains difficult, if not impossible.

The difficulty is verifying the BWC was highlighted in 2001, when the United States withdrew its support for a draft Biological Weapons Convention (BWC) Protocol, in part because they felt it created the false perception that a biological weapons program could be effectively verified by an international organization [1]. Furthermore, developing nations expressed concern that export controls from the protocol discriminated against them. Since 2003, BWC signatories have held annual expert and political meetings to discuss BWC related domestic legislation, pathogen security, and other issues, and are scheduled to hold review conferences every five years, with the next review conference scheduled for 2011. The continued spread of biotechnology information and materials in the period since the last conference makes it very likely that export controls in developing nations, verification of BWC adherence and the dual-use issue will need to be addressed at the upcoming conference.
Export controls

Export controls have been employed to mitigate the impact of exports on the development of WMDs with limited success. Examples of such organizations include the Australia Group, an informal forum of countries which, through the harmonization of export controls, seeks to ensure that exports do not contribute to the development of chemical or biological weapons; and the Wassenaar Arrangement on Export Controls for Conventional Arms and Dual-Use Goods and Technologies, signed by 33 nations on July 12, 1996, to suppress the hostile application of dual-use technologies [9]. The Australia Group does not include many of the strategically important developing nations with burgeoning biotechnology industries; and the Wassenaar Arrangement was described by Keller & Nolan as having received scant attention from the policy community and ridicule from the arms lobby because it has "no teeth" [12].
Levers and interventions

Bioterrorism is a central issue at the interface of globalization and health. This is the result of the globalization of the biotechnology industry, the global spread of biotechnology materials and information, the changing nature of global travel, as well as the ability of infectious diseases to spread worldwide and have a crippling economic impact. Below are the recommendations from the World at Risk Report discussed in this paper, in addition to proposed levers and interventions.
International Biotechnology Conference

We concur with the Report's recommendation for an international conference of countries with major biotechnology and pharmaceutical industries to discuss the norms and safeguards necessary to keep dangerous pathogens out of the hands of terrorists and to ensure that the global revolution in the life sciences unfolds safely and securely. To be effective, the following should be met:


To address the Report's recommendation that the life sciences community foster a bottom-up effort to sensitize researchers to biosecurity issues and concerns, and to strive to design and conduct experiments in a way that minimizes safety and security risks", the following should be addressed:


The World at Risk report recommends that an action plan for achieving universal adherence to and effective national implementation of the BWC be proposed for adoption at the next review conference in 2011. With regards to the review conference:


In December 2008, the US Commission on the Prevention of Weapons of Mass Destruction Proliferation and Terrorism released a report, World At Risk, reporting that "it is more likely than not that a weapon of mass destruction will be used in a terrorist attack somewhere in the world by the end of 2013", and that "terrorists are more likely to be able to obtain and use a biological weapon than a nuclear weapon." A myriad of economic, technical and political factors are contributing to the elusive and rapidly evolving nature of the biological weapons threat. The dual-use nature of biotechnology and the globalization of the biotechnology industry has made regulation of materials that can be used for biological weapons proliferation cost-prohibitively expensive and laborious.

Furthermore, biological weapons programs can be easily concealed, making regulation by an International Atomic Energy Agency (IAEA)-type regulatory body dedicated to biological weapons detection and materials management equally difficult to implement. As a result, a multi-pronged approach must be employed to address the biological weapons threat. Strong international guidelines and intelligence cooperation needs to be complemented by national and local enforcement. Preventative measures and preparatory measures need to be implemented, such as the wide-spread use of detection systems including aerosol sampling, particulate counters and biomass indicators as well as diagnostic decision support systems for bioterrorism detection at the local level [13]. Such a multi-pronged approach is necessary to address this critical national security imperative at the intersection of globalization and health.


Mark D'Agostino, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA and Greg Martin, Faculty of Life Science, Genetics Institute, University College London, London, UK. This article was originally published in the Globalization and Health Journal.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Notes:


1. Graham B, Talent J, Allison G, Cleveland , Rademaker R, Roemer T, Sherman W, Sokolski H, Verma R: World At Risk: The Report of the Commission on the Prevention of WMD Proliferation and Terrorism (2008). [http://www.preventwmd.org/report] Vintage Books, New York, NY;


2. Leitenberg M: Bioterrorism, Hyped. Los Angeles Times; 2006.


3. McMillan SG, Narin F, Deeds DL: An analysis of the critical role of public science in innovation: the case of biotechnology. Research Policy 2000, 29:1-8. Publisher Full Text


4. Cohen S, Chang A, Boyer H, Helling R: Construction of Biologically f Functional Bacterial Plasmids in vitro. Proceedings of the National Academy of Science 1973, 70:3240-3244. Publisher Full Text

5. Chyba C, Greninger A: Biotechnology and Bioterrorism: An Unprecedented World. Survival 2004, 46:143-162. Publisher Full Text

6. Molas-Gallart J: Which way to go? Defense technology and the diversity of "dual use' technology transfer. Research Policy 1997, 26:367-385. Publisher Full Text

7. Molas-Gallart J: The political and economic context of European defense R & D. SPRU Electronic Working Paper Series No. 52, University of Sussex 2000.

8. Molas-Gallart J: Coping with dual-use: a challenge for European research policy. Journal of Common Market Studies 2002, 40:155-165. Publisher Full Text

9. McLeish C, Nightingale P: Biosecurity, bioterrorism and the governance of science: The increasing convergence of science and security policy. Research Policy 2007, 36:1635-1654. Publisher Full Text

10. United Nations Security Council Resolution 1540: Non-proliferation of weapons of mass destruction. S/RES/1540. 2004.

11. Salerno R, Hickok L: Strenthening Bioterrorism Prevention: Global Biological Materials Management. Biosecurity & Bioterroism: Biodefense Strategy, Practice & Science 2007, 5(2):107-116. Publisher Full Text

12. Keller W, Nolan JE: The Arms Trade: Business As Usual? Foreign Policy 1997, 109:113-125. Publisher Full Text

13. Bravata DM, Sundaram V, McDonald KM, Smith WM, Szeto H, Schleinitz MD, et al.: Detection and diagnostic decision support systems for bioterrorism response. [http://www.cdc.gov/ncidod/EID/vol10no1/03-0243.htm] Emerging Infectious Disease 2004.

A shortage of flu vaccines may soon become a problem of the past, according to European researchers.

In a note from the Wageningen University, Netherlands, researcher Manon Cox is said to have developed an alternative process for producing large quantities of safe and effective vaccines at twice to four times the usual speed.

The process is based on using cells in bioreactors instead of fertilised chicken’s eggs, which have a limited availability.

The prompt availability of sufficient suitable vaccine is always a problem when facing the outbreak of a flu epidemic. At the moment, it takes three to six months to produce a vaccine to counter a new strain of flu virus using chicken’s eggs.

Moreover, there is no possibility of expanding production capacity in the event of a pandemic as the limited availability of fertilised chicken’s eggs needed for production inevitably becomes an insurmountable problem.

Cox’s new process demonstrates that it is possible to make a vaccine available in commercial quantities within 45 days. The new production method makes use of a baculovirus that multiplies only inside insect cells, and which cannot spread in vertebrates. The insect cells produce huge quantities of so-called HA proteins, which mobilise the immune system into fighting the flu virus.

The aspect that most slows down the production of vaccine according to the conventional method is the need for fertilised chicken eggs. Furthermore, this creates extra problems if the flu virus is also capable of infecting birds (as was the case in the Netherlands in 2003), as the egg production often grinds to a halt. In addition, the vaccines produced are not suitable for people with an egg allergy. The new production process using insect cells can be used on a large scale, at all times and simultaneously at various locations throughout the world.

The process can easily be adapted to new influenza strains and enhance pandemic preparedness.

Meanwhile, the new production process has already been put through clinical trials involving three different strains of flu virus in 460 healthy people.

None of the test subjects injected with the vaccine developed symptoms of flu, while 4.6% of those taking part in the control group contracted the disease naturally. Three follow-on studies involving approximately 3,000 people showed no striking or frequent side-effects. The vaccine also appears to protect people from influenza viruses that have undergone genetic changes and in more than 50% of cases, it results in better antibody production than the flu vaccines currently available.

Vaccines for the flu virus contain the HA protein (haemagglutinin) which, once in the bloodstream, puts the body in a state of high alert. The protein also stimulates the production of flu-specific antibodies. The same protein is found on the surface of a flu virus. When a vaccinated person encounters a flu virus , the antibodies produced attach to the proteins on the surface of the virus and inactivate the virus.

A special issue of Deutsches Ärzteblatt International contains the first scientific presentation of clinical experience with the new influenza A virus (H1N1/09) in the German-speaking countries since the start of the pandemic.

Ralf Winzer and his coauthors from the Düsseldorf University Hospital retrospectively evaluated data from a large clinical cohort of infected persons in Germany (Dtsch Arztebl Int 2009; 106[47]: 770-6). Their medical-scientific article is accompanied by an editorial by the clinical microbiologist Georg Peters of the University of Münster (Dtsch Arztebl Int 2009; 106[769]).

The results of the study by Winzer corroborate the initial research findings on the A/H1N1 epidemic.

In the initial phase of the pandemic, the disease tended to take a mild course and most infections in the German population were acquired outside the country. Later on, as Peters explains, more severe cases were reported in Germany as well, and most infections with the novel influenza A (H1N1) virus are now being acquired within the country.

In a further, thematically related article, Rafael Mikolajczyk and coauthors explain the principles underlying model calculations of the course of an epidemic. Their article does not contain a direct extrapolation of current data about the novel influenza A virus (H1N1/09), yet it describes the theoretical foundation of calculations that apply to all epidemics, including influenza epidemics.

The World Health Organization says it is investigating possible mutations in the H1N1 swine flu virus following reports of mutations from at least six countries.

WHO pandemic influenza adviser Keiji Fukuda says the question is whether the reported mutations suggest a "fundamental change" in the virus. He says right now, health officials are not sure.

Fukuda commented Thursday in a briefing from Geneva. He says officials are trying to determine if the mutations are leading to changes in the virus' "clinical picture" -- which could result in more severe or less severe forms of swine flu.

The WHO adviser named Norway, Brazil, China, Japan, Ukraine and the United States as countries that have reported mutations. He also said world health officials are investigating some cases of drug-resistant swine flu.

Last week, WHO said more than 6,700 people have died from swine flu since the virus was first discovered in Mexico earlier this year.

Source: VOA

By Bruce Pannier

The hajj is just getting under way in Mecca, but for Turkmen pilgrims, their country's homegrown version of one of the Five Pillars of Islam has been going on for weeks.

Fears of swine flu led the Turkmen government to ban its citizens from participating in this year's hajj, the annual Islamic pilgrimage to the holy cities of Mecca and Medina in Saudi Arabia that every able-bodied Muslim is required to make during his or her lifetime if able to afford it.

In its stead, according to the Turkmen state news agency, the Turkmen government answered calls by "elders and faithful" by launching the country's first official internal pilgrimage on the eve of the hajj.

A resolution authorized by Turkmen President Gurbanguly Berdymukhammedov paved the way for the inaugural pilgrimage, in which an official delegation of elders and pilgrims originally chosen to make the hajj will travel by plane, train, and automobile to 38 "holy" sites within Turkmenistan.

Many of the 38 sites chosen for the inaugural Turkmen pilgrimage, which began on November 11 and is set to finish on November 29, are indeed impressive and religiously significant, but a number of sites simply have little, if anything, to do with religion.

Local Landmarks

The Paraw Bibi mosque, which is among the sites and is located in the western Balkan Province, has long been visited by religious pilgrims.

The mosque stands on the site where Paraw Bibi is said to have disappeared forever into the mountains. According to legend, Paraw Bibi was a pious Muslim and for centuries she has been a patron saint of pregnant women and children.

"According to one of the legends, the local governor's daughter was named Paraw. When the enemy was about to conquer the fortress, she wanted to escape with her servants and one of these servants was a traitor and revealed where they were hiding," Turkmen writer Ashyrguly Bayri says.

"To prevent being captured she went to the mountains, and they say the mountains opened up and hid her inside."

Another site, the Kutlug-Temir minaret, is the tallest minaret in Central Asia and is located in the northern city of Urgench (formerly Gurganj), the ancient capital of the Khwarezmian Empire (1077-1231).

Thirty kilometers to the west of the Silk Route city of Merv (now called Mary) lies the Talkhatan Baba, a mosque built in the 11th century to commemorate Sufi saints.

Members of the delegation this week planted pine trees in a park near the grave of Talkhatan Baba (1020-1095), a saint who, the Turkmen news agency noted, "devoted his life to serve the God."

The Mausoleum of Sultan Sanjar, also located near Mary, is all that remains of a larger religious complex dating back to the 12th century. The mausoleum itself, however, is dedicated to Seljuk ruler Ahmad Sanjar, a political rather than a religious figure.

The ancient ruins of Nisa was the capital of the Parthian Empire (third century B.C. to third century A.D.). But the site, located a short drive from the Turkmen capital Ashgabat, was long past its glory by the time Islam made its way into Central Asia in the early 8th century.

'Why Spend All That Money?'

Considering the sites' sometimes questionable relation to religion, do the people of Turkmenistan accept local pilgrimage sites as an acceptable substitution for Mecca?

The answer is "yes" a woman who says she has made the hajj abroad tells RFE/RL's Turkmen Service.

"Inside this country we have famous places you can visit where great people are buried -- more than you can count," she says. "If in Saudi Arabia people go to Mecca, then here in our country we have the '360 site,'" where 360 defenders of northern Turkmenistan were killed by Mongol invaders.

The woman adds that even pilgrims making the hajj express surprise that Turkmen would "spend all that money" and make the trip to Mecca when there is an abundance of pilgrimage sites in Turkmenistan.

"The [Turkmen] people who went to Mecca spent a lot of money and they didn't need to spend that so much, the [Turkmen] state doesn't need to spend so much money," she says. "It's better to make the pilgrimage inside the country. We could develop those sites and people from outside the country would come here to make pilgrimage."

The woman says that she and some family members traveled to Iran once to visit pilgrimage sites and found the Iranian sites to be crowded to the point where "one could not even take a step."

She concedes, however, that Iranian sites were more popular for pilgrims and added that the sites in Turkmenistan were certainly not "on the same level" as Mecca.

Saving The State Money

At times, the Turkmen pilgrimage appears intended to serve the government's interests in ways that go beyond its stated intention.

The Turkmen state news agency, for example, reported in announcing the government-led project that while "taking a pilgrimage to the holy places the faithful will see the grandiose changes that have taken place in the ancient Turkmen land in the epoch of New Revival.

"They will see and tell about them to their fellow villagers, neighbors, relatives and friends. New factories, roads and bridges, schools and hospitals, cultural centers, and stadiums -- all of these vivid symbols of the epoch of New Revival, a result of President Gurbanguly Berdymukhammedov's policy aimed at increasing the welfare of the Turkmen people."

Considering that the Turkmen state usually pays to send a group of pilgrims to Saudi Arabia, the internal pilgrimage could presumably improve the welfare of the state budget as well.

Every year at the end of Ramadan the Turkmen government pays for some 200 pilgrims to make the hajj, exactly the number of seats on one airplane. This year, those selected to go to Mecca will instead be participating in the Turkmen pilgrimage, keeping any money they spend inside the country.

Saudi Arabia gives every a country a quota for pilgrims wanting to make the hajj (1,000 people for every million of a country's Muslim population), and 200 to 300 of Turkmenistan's Muslims usually make the trip to Mecca using their own money.

This year, however, the fear of exposure to swine flu has led the government to advise citizens against paying their own way to circumvent the ban and traveling to Mecca.

According to an official at the Saudi Embassy in Turkmenistan who spoke to RFE/RL's Turkmen Service on condition of anonymity, it appears Turkmen Muslims are abiding by the government's wishes.

"This year we are very, very sad because our embassy has given visas only for foreigners living in Ashgabat -- Turkish, Iranian, and so on -- but no one from Turkmenistan," the official said.

Turkmen writer Amanmyrat Bugaev also laments the loss of an opportunity for Turkmen to make the hajj.

As wonderful as the pilgrimage sites in Turkmenistan may be, Bugaev says, they cannot replace the hajj, one of the Five Pillars of Islam that is incumbent on every Muslim.

"I believe in God, and greatly respect traditions of Islam and I cannot understand why the hajj is replaced with the pilgrimage to the holy and historical sites in the country," he says.


RFE/RL Turkmen Service Director Oguljamal Yazliyeva contributed to this report.

Copyright (c) 2009. RFE/RL, Inc. Reprinted with the permission of Radio Free Europe/Radio Liberty, 1201 Connecticut Ave., N.W. Washington DC 20036.

In a study published in an upcoming issue of The Journal of Child Psychology and Psychiatry researchers show that over reactive parenting, such as heavy criticism or yelling as a response to a child’s negative behavior, can produce higher levels of aggression or rule-breaking in a child who is normally introverted, non-benevolent, non-conscientious, or imaginative.

Children who are extraverted, benevolent, conscientious, or not that imaginative by nature are least adversely affected by this parental response.

The research (taken from 586 families) shows that rule-breaking and aggressive behavior is influenced by the inherent personality traits of a child.

The study also shows that aggression-related behavior generally decreases as the children grow but on average the rule-breaking behavior does not change, and both genders exhibit these behaviors between the ages six to fifteen.

When examining both personality and gender boys and girls are not different affected by parenting methods.

RIA Novosti interviews TAMARA LOBOVA, Ph.D. (Medicine), Academic Secretary of the North-West Department of the Russian Academy of Medical Sciences

Question: Is the A/H1N1 flu dangerous?

Answer: This flu is primarily dangerous because the majority of people are not immune to the new virus. Older people may have some immunity, because a similar strain had previously affected the human population. Clinically, this disease is more serious that other types of flu. More people die from it and there are more complications. But this flu has not affected Russia that much.

Q: Are you saying that there are no bad cases in Russia yet?

A: In most cases, the disease caused by this new pandemic virus is relatively mild, although there are complications, such as pneumonia and bronchitis.

Q: Early this week Dmitry Lvov reported the first death. Is this true?

A: I cannot comment on this situation because he first spoke about this case, but then the Ministry of Health denied it. As of today, we have not received any information about this case having been officially registered in Russia.

Q: When will this flu reach its peak? Or has the peak already come and gone?

A: No, the peak has not passed and is yet to come. Generally, there is a seasonal increase in disease rates and virus infections. This pandemic flu is not the only one.

Q: Do you think early diagnosis of this flu is done well in Russia? Many people say that they arrive in Russia, fill out some form, and that’s it.

A: I’m afraid I cannot answer this question. Applied health workers, including us, are working on this.

Q: So, you cannot yet say if there is a clear-cut plan?

A: There is a clear-cut plan for examining patients who are already sick. They remain home, call for a doctor, and receive a diagnosis. Many of those who feel sick simply come to our institute and ask for an examination. What can we do? We cannot accommodate all of them, both the sick and the healthy. There are also hypochondriacs with no symptoms but who simply want to make sure they don’t have it. We cannot take them all in, because this examination is quite expensive and labor-intensive.

Q: But when will it reach its peak?

A: Probably in December and January, just as with the usual seasonal flu. The peak usually comes after New Year’s. I’m afraid to predict when the increase will come, but we think this is most likely to happen in that timeframe.

Q: What other preventive measures can Russia take to contain this disease?

A: We are now testing a vaccine. This is our main hope to prevent the disease. If the test shows that the vaccine is harmless and immunogenic, mass vaccination will start in November.

Q: So, coming back to the situation in Russia, should we sound the alarm, or is everything still under control, even if we should be vigilant?

A: On the one hand, we cannot be complacent or tell people to relax, but, on the other hand, inciting panic is also counterproductive. The situation is under control. Medical institutions will organize mass-scale vaccination, and provide medical services. They will make sure there are enough beds in hospitals. We are now working on the vaccine. Our goal is to develop a vaccine in line with protocols and standards, and begin producing it on a large scale.

Q: You said it will be ready some time in November?

A: Yes, we hope to achieve results by November. To draw any conclusions, we have to assess the results of vaccination, and compare the condition of the volunteers before and after it. There are a host of parameters that must undergo serious scientific analysis and comply with certain vaccine standards. When we have done all this, we will announce that the vaccine is ready, that it is harmless and effective, and that it will protect us against the new virus.

By Stephen Soldz

Public health is bedeviled by the public's lack of understanding of uncertainty. Public health policy deals with potential future events. Decisions about policy have to be made with often inadequate data. If, as often happens, bad scenarios don't unfold, policy-makers may well have made make decisions that turn out to be wrong in the sense that the preventive efforts were taken that turned out not to be needed.

We see this in the case of the current H1N1 swine flu pandemic. Skeptics are using the initial concerns about worst case scenarios, which turned out to be wrong when more data was available, to encourage skepticism about current plans to cope with a looming pandemic.

We see this reasoning in a recent Alternet article by Joshua Holland -- H1N1 Just Isn't That Scary: Why There's No Reason to Go Overboard with Swine Flu Hysteria -- which claims that swine flu fears are more dangerous than the swine flu itself. [Holland's article received a furious rebuttal -- More crappy flu journalism, this time Alternet -- from Revere at Effect Measure with which I strongly concur. My comments complement Revere's.]

Holland refers to comments last spring abut the potential danger:

In April, Homeland Security Chief Janet Napolitano called a press conference and declared a public-health emergency. In August, officials for the Centers for Disease Control warned that H1N1 could infect half of the U.S. population and kill 90,000 Americans by year’s end. CDC officials estimated that 1 in 10 New Yorkers had contracted the virus this spring.

Holland refers to these estimates as "grist for their [the media's] sensationalist mills." He, however, makes no argument that the data available in spring 2009 were not consistent with these warnings. We had a highly contagious, fast-spreading pandemic flu strain to which no one under 52 had any apparent immunity. Those most affected by the pandemic were the young. We had reports of many deaths in Mexico, and we had the awareness that influenza has the ability to rapidly mutate. There were a number of deaths of young patients, which is atypical for the seasonal flu.

To not take action, issue warnings, consider school closings, and start a vaccine development program would have been highly negligent. Had the pandemic developed differently, as could well have occurred, likely, many of the same people now criticizing the "hysteria" would soon be screaming at the incompetence or corruption of a public health policy establishment that failed to respond to a looming crisis.

In any case, Holland and similar writers fail to understand that, even with the relatively low severity of the swine flu at this point, the overall risk is greater because of the lack of immunity in the population. Thus, a much larger percentage of the population is likely be become infected. If even a small proportion of the infected become very ill and require hospitalization, our emergency medical system, already operating under great continuous strain, will face much greater strain. Large numbers of severely ill people may be turned away from ERs, to take their chances at home. Revere explains the problem:

Our big city emergency rooms periodically and routinely go "on diversion," meaning that they divert the ambulance that's on its way their hospital to another hospital. The main reason is not the already ludicrous long waits in the ER but the shortage of critical care beds, the ones with the ventilators and skilled nursing that Holland thinks will now save people seriously ill with flu. It's a common mistake. But it's a mistake.

In a healthcare system from which most excess capacity has been wrung by budget cuts, even a mild pandemic can cause severe disruption. If the vaccination program only avoided this eventuality, it would be worth it, contra Holland. But, like the seasonal flu vaccine it is likely to reduce many forms of illness-caused social disruption and save lives. Likely thousands. Possibly many more.

Holland, however, recommends that the non-health professionals among us just ignore swine flu:

The take-away from all this is that the best cure for swine flu hysteria may be a healthy dose of salt....

Public-health officials, epidemiologists and clinicians have to worry about H1N1. As things stand, you really don’t.

In these statements Holland uses the common commentator's trick to pose the options as "hysteria" or forgetting about it, as if those are the only options. Of course, hysteria is never useful. But cautious alertness often is.

Additionally, public health policy to deal with a situation like the swine flu pandemic requires the allocation of public resources and the development of plans and the carrying out of preparatory measures by many in a multitude of systems throughout society. Both resource allocation and preparedness planning cannot be carried out without public involvement and an informed citizenry.

Holland, however, fails the primary task of both journalists and the public heath community of helping people understand the uncertainties and complexities of the situation, developing preparations for potential bad scenarios, and helping people cope, no matter how events unfold. Accurate knowledge and understanding, including knowledge of uncertainties and limits to our information, are among the most effective public heath tools. Unfortunately, Holland's article is no help in developing these tools.

Stephen Soldz is a psychoanalyst, psychologist, public health researcher, and faculty member at the Boston Graduate School of Psychoanalysis. He edits the Psyche, Science, and Society blog. He is a founder of the Coalition for an Ethical Psychology, one of the organizations working to change American Psychological Association policy on participation in abusive interrogations. He is President-Elect of Psychologists for Social Responsibility [PsySR].

(KUNA) -- A Kuwaiti health official dismissed here on Saturday negative local press reports on recently imported A(H1N1) vaccines as baseless.

Recent claims had it that the swine flu vaccine causes foetal abnormalities or complications, and even impotence.

"There is no scientific proof that the vaccine causes foetal abnormalities or complications. So, ongoing fears are due to failure to get back to reliable scientific sources," Dr. Abeer Al-Bahho, Health Promotion Administration Chief, told reporters.

But, she said: "Concerns are justified and expected as such a vaccine is something new worldwide, but this does not mean that it is unsafe." "There is no scientific source saying that the vaccine could cause impotence," she said, asking anybody who may have counter-information in this respect to come up with it immediately.

She quoted the World Health Organization (WHO) and US Centers for Disease Control and Prevention as urging pregnant women to take the swine flu vaccine as infection could lead to abortion or premature birth-giving.

She reiterated that under-five children, chronic disease sufferers, pregnant women and obese people are given a top priority in terms of vaccination.

(RSD) -- As the H1N1 swine flu vaccine becomes increasingly available, 46% of U.S. adults who are considered by the CDC to be members of high priority groups plan to ignore the CDC's recommendation for vaccination, according to a new Zogby pol. The Zogby International interactive survey also finds that the top reasons high risk adults plan to skip the vaccine include concern over the safety of the vaccine (38%) and a general sense that they simply do not need the vaccine (32%).

Similar percentages of all adults surveyed nationwide fear the safety of the vaccine (32%) and also feel they do not need the vaccine (30%).

Political affiliation also seems to have some measure in the poll, with sixty-two percent of adults surveyed plan to skip the H1N1 vaccine; lead by Republicans (74%) and independents (68%), who are much more likely than Democrats (45%) to skip the vaccine. Southerners (69%) are also more inclined than adults who live in other areas to skip the vaccine, about 10 points higher than adults in other regions.

Interestingly, adults who identify themselves as Born Again Christians are also more likely (69%) to skip the vaccine than non-Born Again Christians (55%).

Forty-seven percent of adults overall are very (16%) or somewhat (31%) concerned over nationwide vaccine delays and shortages.

Of those who do not plan to get the vaccine, just 9% say they would be more likely to get the vaccine if they had a clearer understanding of when, where, and how the vaccine would be distributed.

Only 28% of Americans who are not planning to get the H1N1 vaccine would reconsider their decision if a medical professional recommended they receive the vaccine. This is almost the same for those in the high priority groups, with 27% saying they would be more likely to be vaccinated if their medical professional recommended the vaccine. Twenty-one percent of adults in the high priority group would be more likely to seek the vaccination if family, friends, or coworkers became ill with H1N1.

This online survey of 2,330 adults was conducted by Zogby International between November 4th and 6th 2009. A sampling of Zogby International's online panel, which is representative of the adult population of the US, was invited to participate. Slight weights were added region, party, age, race, religion, gender, and education to more accurately reflect the population. The margin of error is +/- 2.1 percentage points. Margins of error are higher in sub-groups.