Bryan A. Sisk

Bio: Bryan A. Sisk is an academic researcher from Washington University in St. Louis. The author has contributed to research in topics: Medicine & Pediatric cancer. The author has an hindex of 14, co-authored 60 publications receiving 713 citations. Previous affiliations of Bryan A. Sisk include Case Western Reserve University & University of Washington.

Interventions to Improve HPV Vaccine Uptake: A Systematic Review.

Abstract: CONTEXT: The human papillomavirus (HPV) vaccine is a safe, effective cancer prevention method that is underutilized in the United States. Despite increased understanding of barriers to vaccination, rates remain low. Globally, developed and developing nations have achieved high rates of vaccination. OBJECTIVE: Identification of effective strategies is necessary to optimize uptake of the HPV vaccine. We systematically reviewed the literature for national and international interventions that have successfully increased HPV vaccine uptake. DATA SOURCES: We used a standardized protocol to search for articles published between January 1, 2006, and April 30, 2015, in 3 electronic databases: PubMed, Scopus, and Embase. STUDY SELECTION: We identified interventions designed to increase HPV vaccine uptake among adolescents and young adults aged 11 to 26 years. All study designs were acceptable. Only articles that included postintervention vaccination rates were included. DATA EXTRACTION: Two authors independently reviewed each article for data extraction and quality assessment. Interventions were classified according to the Community Preventive Service Task Force guide. RESULTS: Results were reported according to the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Fifty-one articles met eligibility criteria: 2 informational interventions, 18 behavioral interventions, and 31 environmental interventions. Factors associated with HPV vaccine uptake were increased vaccine availability, decreased financial barriers, and interventions targeting both providers and patients. LIMITATIONS: Lack of consistent RE-AIM metric reporting, limiting our ability to assess intervention validity and quality. CONCLUSIONS: Population-based vaccination strategies that increased vaccine availability reached the greatest number of adolescents and were most successful in achieving high rates of vaccination.

Prognostic Disclosures to Children: A Historical Perspective.

Abstract: Prognostic disclosure to children has perpetually challenged clinicians and parents. In this article, we review the historical literature on prognostic disclosure to children in the United States using cancer as an illness model. Before 1948, there was virtually no literature focused on prognostic disclosure to children. As articles began to be published in the 1950s and 1960s, many clinicians and researchers initially recommended a “protective” approach to disclosure, where children were shielded from the harms of bad news. We identified 4 main arguments in the literature at this time supporting this “protective” approach. By the late 1960s, however, a growing number of clinicians and researchers were recommending a more “open” approach, where children were included in discussions of diagnosis, which at the time was often synonymous with a terminal prognosis. Four different arguments in the literature were used at this time supporting this “open” approach. Then, by the late 1980s, the recommended approach to prognostic disclosure in pediatrics shifted largely from “never tell” to “always tell.” In recent years, however, there has been a growing appreciation for the complexity of prognostic disclosure in pediatrics. Current understanding of pediatric disclosure does not lead to simple “black-and-white” recommendations for disclosure practices. As with most difficult questions, we are left to balance competing factors on a case-by-case basis. We highlight 4 categories of current considerations related to prognostic disclosure in pediatrics, and we offer several approaches to prognostic disclosure for clinicians who care for these young patients and their families.

Communication in pediatric oncology: State of the field and research agenda.

Abstract: From the time of diagnosis through either survivorship or end of life, communication between healthcare providers and patients or parents can serve several core functions, including fostering healing relationships, exchanging information, responding to emotions, managing uncertainty, making decisions, and enabling patient/family self-management. We systematically reviewed all studies that focused on communication between clinicians and patients or parents in pediatric oncology, categorizing studies based on which core functions of communication they addressed. After identifying gaps in the literature, we propose a research agenda to further the field.

Student perspectives on assessment: experience in a competency-based portfolio system.

Abstract: Despite considerable evidence recognizing the importance of learners’ perceptions of the assessment process, there is little literature depicting the participants’ experience. We aim to capture these perceptions in order to gain insights into the strengths and weaknesses of a competency-based assessment system. Cleveland Clinic Lerner College of Medicine has implemented a learner-centered portfolio assessment system built around competency standards and continuous formative feedback. Promotion of students is based upon their feedback-supported portfolio essays, but feedback itself is individualized and formative in nature under the umbrella of the competencies. Importantly, there are no grades or ranking awarded for the competencies or at promotion. Four students share personal reflections of their experience to illuminate themes from the subjective experience of the learner and to understand how to align the learners’ interests with the requirements of an assessment program.

Prognostic disclosures over time: Parental preferences and physician practices

Abstract: BACKGROUND Although the majority of parents of children with cancer say they want prognostic information, to the authors' knowledge little is known regarding how their desire for and experiences with prognosis communication change over time. METHODS A longitudinal, prospective questionnaire-based cohort study of 156 parents of children with cancer treated at 2 academic pediatric hospitals was performed. Previously published scales were administered at the time of diagnosis and at 4 months and 12 months later. RESULTS The majority of parents preferred to hear about prognosis in as much detail as possible throughout the first year after a diagnosis of cancer (87%, 85%, and 84%, respectively, at the time of diagnosis, 4 months, and 12 months). Although nearly no parents reported wanting less information (<5% at any time point), a significant percentage reported wanting more information at each time point (25%, 28%, and 24%, respectively, at the time of diagnosis, 4 months, and 12 months). The majority of parents reported having had new prognostic discussions with the physician at each time point (93%, 74%, and 81%, respectively, at the time of diagnosis, 4 months, and 12 months). Irrespective of prognosis, parents were more likely to be satisfied with prognostic communication when physicians provided more extensive disclosure at the time of diagnosis (odds ratio, 1.85 per element of disclosure; 95% confidence interval, 1.25-2.74 [P = .002]) and when physicians discussed prognosis again before 4 months (odds ratio, 8.71; 95% confidence interval, 2.64-28.72 [P = .0004]). CONCLUSIONS The majority of parents wanted detailed, longitudinal prognostic conversations; nearly none of the parents preferred less prognostic information. A return to these conversations over time can help rather than hurt parents. Future studies should assess the ideal contents of these longitudinal discussions, and the communication preferences of pediatric patients. Cancer 2017;123:4031-8. © 2017 American Cancer Society.

Childhood and Society.

Abstract: Erik Eriksen is a remarkable individual. He has no college degrees yet is Professor of Human Development at Harvard University. He came to psychology via art, which explains why the reader will find him painting contexts and backgrounds rather than stating dull facts and concepts. He has been a training psychoanalyst for many years as well as a perceptive observer of cultural and social settings and their effect on growing up. This is not just a book on childhood. It is a panorama of our society. Anxiety in young children, apathy in American Indians, confusion in veterans of war, and arrogance in young Nazis are scrutinized under the psychoanalytic magnifying glass. The material is well written and devoid of technical jargon. The theme of the volume is that it is human to have a long childhood which will leave a lifelong residue of emotional immaturity in man. Primitive groups and

Death and dying

Abstract: Death is the new sex, last great taboo in Western society and Western medicine, as Richard Smith discusses in his editorial (p 129). In the trinity of births, marriages, and deaths, only death does not have glossy magazines devoted to stylish consumption at the attendant ceremonies. On the web, of course, …

The Righteous Mind: Why Good People Are Divided by Politics and Religion

Abstract: The Righteous Mind: Why Good People Are Divided by Politics and Religion Jonathan Haidt Pantheon Books, 2012One has likely heard that, for the sake of decorum, religion and politics should never be topics of conversation with strangers. Even amongst friends or even when it is known that others hold opposing political or religious views, why is it that discussion of religion and politics leads to visceral-level acrimony and that one's views are right and the other's views are wrong? Professor Jonathan Haidt of the University of Virginia examines the psychological basis of our "righteous minds" without resorting to any of the pejorative labeling that is usually found in a book on politics and religion and eschews a purely comparative approach. Haidt proposes the intriguing hypothesis that our visceral reaction to competing ideologies is a subconscious, rather than leaned, reaction that evolved over human evolution to innate senses of suffering, fairness, cheating and disease, and that moral foundations facilitated intra-group cooperation which in turn conferred survival advantages over other groups. These psychological mechanisms are genetic in origin and not necessarily amenable to rational and voluntary control - this is in part the reason debating one's ideological opposite more often leads to frustration rather than understanding. Haidt also suggests that morality is based on six "psychological systems" or foundations (Moral Foundations Theory), similar to the hypothesized adaptive mental modules which evolved to solve specific problems of survival in the human ancestral environment.While decorum pleads for more civility, it would be better, as Haidt suggests, dragging the issue of partisan politics out into the open in order to understand it and work around our righteous minds. Haidt suggests a few methods by which the level of rhetoric in American politics can be reduced, such that the political parties can at least be cordial as they have been in the past and work together to solve truly pressing social problems.There are a number of fascinating points raised in the current book, but most intriguing is the one that morality, ideology and religion are products of group selection, as adaptations that increased individual cooperation and suppressed selfishness, thereby increasing individual loyalty to the group. That morality, political ideology and religion buttress group survival is probably highly intuitive. However, given the contemporary focus on the individual as the source of adaptations, to the exclusion of all else, to suggest that adaptations such as religion and political ideology arose to enhance survival of groups is heresy or, as Haidt recounts, "foolishness". While previous rejection of group selection itself was due in part to conceptual issues, one could also point out the prevailing individualist social sentiment, "selfish gene" mentality and unrelenting hostility against those who supported the view that group selection did indeed apply to humans and not just to insects. Haidt gives a lengthy and convincing defense of group selection, his main point being that humans can pursue self- interest at the same time they promote self-interest within a group setting - humans are "90 percent chimp, 10 percent bees". One can readily observe in the news and entertainment mediate that religion is a frequent target of derision, even within the scientific community - Haidt points to the strident contempt that the "New Atheists" hold for religion. They claim that religion is purely a by-product of an adaptive psychological trait and as a mere by-product religion serves no useful purpose. However, the religious "sense" has somehow managed to persist in the human psyche. One explanation by the New Atheists of how religion propagated itself is that it is a "parasite" or "virus" which latches onto a susceptible host and induces the host to "infect" others. As a "virus" or "parasite" that is merely interested in its own survival, religion causes people to perform behaviors that do not increase their own reproductive fitness and may even be detrimental to survival, but religion spreads nonetheless. …

Biological Activities of Polyphenols from Grapes

Abstract: The dietary consumption of grape and its products is associated with a lower incidence of degenerative diseases such as cardiovascular disease and certain types of cancers. Most recent interest has focused on the bioactive phenolic compounds in grape. Anthocyanins, flavanols, flavonols and resveratrol are the most important grape polyphenols because they possess many biological activities, such as antioxidant, cardioprotective, anticancer, anti-inflammation, antiaging and antimicrobial properties. This review summarizes current knowledge on the bioactivities of grape phenolics. The extraction, isolation and identification methods of polyphenols from grape as well as their bioavailability and potential toxicity also are included.