Confronting the evolution and expansion of anti-vaccine activism in the USA in the COVID-19 era

Over the past two decades, anti-vaccine activism in the USA has evolved from a fringe subculture into an increasingly well organised, networked movement with important repercussions for public health. The COVID-19 pandemic has exacerbated this evolution and magnified the reach of vaccine misinformation. Anti-vaccine activists, who for many years spoke primarily to niche communities hesitant about childhood vaccinations, have used traditional and social media to amplify vaccine-related mistruths about COVID-19 vaccines while also targeting historically marginalised racial and ethnic communities. These efforts contributed to COVID-19 vaccine hesitancy and expanded the movement, with early indications suggesting that this hesitancy could now also be increasing hesitancy that existed pre-pandemic towards other vaccines. It is important to understand the implications of this recent evolution of anti-vaccine activism on vaccination uptake and the promotion of sound public health strategies. In this Viewpoint, we summarise the latest developments in US-based anti-vaccine activism and propose strategies for confronting them

Vascular Remodeling in Health and Disease

The term vascular remodeling is commonly used to define the structural changes in blood vessel geometry that occur in response to long-term physiologic alterations in blood flow or in response to vessel wall injury brought about by trauma or underlying cardiovascular diseases.1, 2, 3, 4 The process of remodeling, which begins as an adaptive response to long-term hemodynamic alterations such as elevated shear stress or increased intravascular pressure, may eventually become maladaptive, leading to impaired vascular function. The vascular endothelium, owing to its location lining the lumen of blood vessels, plays a pivotal role in regulation of all aspects of vascular function and homeostasis.5 Thus, not surprisingly, endothelial dysfunction has been recognized as the harbinger of all major cardiovascular diseases such as hypertension, atherosclerosis, and diabetes.6, 7, 8 The endothelium elaborates a variety of substances that influence vascular tone and protect the vessel wall against inflammatory cell adhesion, thrombus formation, and vascular cell proliferation.8, 9, 10 Among the primary biologic mediators emanating from the endothelium is nitric oxide (NO) and the arachidonic acid metabolite prostacyclin [prostaglandin I2 (PGI2)], which exert powerful vasodilatory, antiadhesive, and antiproliferative effects in the vessel wall

Fathers and Developmental Psychopathology

When we first began compiling a review of the literature concerning fathers and developmental psychopathology several years ago, a colleague stated that fathers do not have an impact on children\u27s lives because fathers spend so little time with their children. Although it may be true that many children do not have contact with their fathers, the majority of U.S. children under the age of 18 have some contact with their biological fathers and often with stepfathers. In addition, fathers make a genetic contribution to their children\u27s functioning regardless of their presence. Interest in the contribution of fathers to their children\u27s development is evident in the attention that fathers have received in the research literature on normative developmental processes. The same cannot be said, however, for the research literature on developmental psychopathology

How do voters form positive economic beliefs? Evidence from the Survey of Americans and Economists on the Economy

Beliefs about normative economics appear to be primarily determined by sociotropic rather than egocentric variables. (Sears & Funk, 1990; Citrin & Green, 1990) Using the Survey of Americans and Economists on the Economy, the current paper finds that the same holds for positiveeconomic beliefs in most – but not all – cases. This hinges on whether a question is “causal” or “non-causal”: Causal beliefs depend on sociotropic variables, especially education and ideology; non-causal beliefs, in contrast, depend on egocentric variables, with income growth playing the leading role. This is consistent with a cognitive model where actors answer easier questions using personal experience, and harder ones with ``off-the-shelf" theories. Copyright Springer Science+Business Media B.V. 2006Economic beliefs, Sociotropic voting, Voter cognition,

Pseudoanaphylaxis

Profound hypotension and cardiac arrest after commencement of combined spinal and general anaesthesia in a patient for knee replacement surgery raised the suspicion of anaphylaxis. This seemed to be confirmed when a mast cell tryptase test taken about 90 minutes after the onset of the hypotension was elevated. However, subsequent intradermal skin testing twelve weeks later did not identify a causal drug. Repeat mast cell tryptase at the time showed the same elevation, which led to the correct diagnosis of mastocytosis and a secondary diagnosis that the patient’s hypotension and cardiac arrest were the result of her spinal anaesthesia. If the serum tryptase is elevated during the event but no allergic agent can be identified, a further serum tryptase should be taken several weeks later to exclude a persistent elevation due to mastocytosis.http://www.aaic.net.au/Article.asp?D=200636