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Biomedical subjects

Daniel Rayson

Publications and source records attributed to Daniel Rayson.

10 recordsLinked to original sources
PubMed2006

The decision-making experience among women diagnosed with stage I and II breast cancer.

A cancer diagnosis signals entry for many patients into the complex and often bewildering world of cancer care. Understanding the role women prefer and their level of satisfaction with the decision-making process at time of diagnosis will help to inform healthcare professionals how to better support breast cancer patients as they navigate the cancer journey. Logistic regression was used to identify significant factors influencing outcomes in role preferences and satisfaction. A complementary method, principal components analysis was used to explore patterns of co-association between outcomes and their influencing factors. Results showed women tended to adopt cancer decision-making roles similar to those used for general health decision-making. Overall, women preferred a collaborative/active role (40/38%) over a passive role (16%). Satisfaction rates were high with 88.1% of women being satisfied/very satisfied with their cancer treatment choice; 89.7% of women satisfied with their decision-making role and; 83.6% satisfied with the information provided to support their decision. Further research involving cohorts of women diagnosed with more advanced disease and for whom decisional regret may be greater, is needed to further explore the link between preferred decision-making role and satisfaction.

Adult↗
PubMed2005

Witness.

Explore the source record for details and available documents.

Adult↗
PubMed2005

Gendered and cultured relations: exploring African Nova Scotians' perceptions and experiences of breast and prostate cancer.

Although breast and prostate cancer are those most frequently diagnosed in Canada, information about the ways in which gender, class, race, culture, and other social determinants impact the experience of African Canadians living with cancer is lacking. This study began to address this gap by exploring cultured and gendered dimensions of African Nova Scotians' experiences of these two cancers. Using a participatory action research approach, data were collected in two phases of focus group discussions in five African Nova Scotian communities from a total of 57 people, including those with breast or prostate cancer and their families and associates. Findings provide insight into how gender and meanings of masculinity and femininity in the African Nova Scotian community unavoidably interact with other social structures such as race and class to affect women and men's perceptions and experiences of these two cancers. These insights point to the need for culturally appropriate and meaningful health interventions. As a prerequisite, health care professionals need to have an understanding of the overlapping and contextualized nature of gender, class, and race and be willing and able to work in partnership with African Nova Scotian communities to identify and develop strategies that reflect the realities of peoples' lives.

Adaptation, Psychological↗
PubMed2004

Elapsed time from breast cancer detection to first adjuvant therapy in a Canadian province, 1999-2000.

BACKGROUND: A number of studies have examined time intervals between care steps in breast cancer diagnosis and treatment. The objective of this study was to document the elapsed time from first clinical or mammographic detection of breast abnormality to initiation of first adjuvant therapy in women with invasive breast cancer in Nova Scotia and to examine the effect of age, disease stage and place of residence on these intervals. METHODS: All dates were abstracted from patient charts and the Oncology Patient Information System. Eligible women were those with invasive breast cancer detected by Sept. 1, 1999, who were referred to 1 of 2 provincial cancer treatment centres by Sept. 1, 2000. All time intervals were calculated in days, and only patients experiencing both care events defining an interval were included in the analysis of time to event for that interval. We used proportional hazards regression analysis to evaluate the influence of patient age, disease stage and place of residence on times between care events. RESULTS: A total of 776 new diagnoses of breast cancer were reported to the Nova Scotia Cancer Registry over the study period. Of the 776, 467 met the inclusion criteria, and 364 patients were eligible for analysis. The overall median time from clinical or mammographic detection of breast cancer to initiation of first adjuvant therapy was 91 days (interquartile range 72-123 days). Disease stage was the strongest predictor of elapsed time: the median interval from disease detection to initiation of first adjuvant therapy for patients with stage I disease was 118 days, as compared with 85 days for those with stage II disease and 75 days for those with stage III disease (adjusted hazard ratio [HR] 2.1, 95% confidence interval [CI] 1.6-2.8). Patients aged 70 years or more at diagnosis experienced longer elapsed times (median interval 98 days) than did younger patients (93 days for those aged 50-69 years and 82 days for those aged 49 years or less) (adjusted HR 1.6, 95% CI 1.1-2.4). INTERPRETATION: Women aged 70 or more and those with stage I breast cancer experienced longer elapsed times from disease detection to initiation of first adjuvant therapy than did younger women and those with more advanced disease. These findings may have implications for the design of interventions to minimize intervals between steps in breast cancer care and should be validated within the Canadian context. Future investigation exploring the full spectrum of breast cancer care may lead to a more complete understanding of processes and gaps in the current system.

Aged↗
PubMed2002

A Phase I study of bizelesin (NSC 615291) in patients with advanced solid tumors.

PURPOSE: To evaluate the toxicities, characterize the pharmacokinetics, and determine the maximum-tolerated dose of bizelesin administered once every 4 weeks. PATIENTS AND METHODS: Patients with advanced solid tumors received escalating doses of bizelesin as an i.v. push every 4 weeks. Pharmacokinetic studies were performed with the first treatment cycle. RESULTS: Nineteen eligible patients received a total of 54 courses of bizelesin at doses ranging from 0.1 to 1 microg/m(2). Dose-limiting toxicity of neutropenia was seen in 2 of 4 patients treated at the 1 microg/m(2) dose level. Nonhematological toxicity was generally mild with maximum toxicity being <or= grade 2 per National Cancer Institute Common Toxicity Criteria. No objective responses were seen in the 19 eligible patients. An L1210 bioassay was used to determine bizelesin plasma levels. The terminal elimination half-life was 140 min at the recommended Phase II dose. The area under the concentration time curve increased in proportion to administered dose, and the clearance remained constant over the dose range studied. Correlation analysis demonstrated relationships between dose and area under the concentration with cycle 1 hematological parameters, including absolute neutrophil and leukocyte nadirs. CONCLUSION: Bizelesin administered every 4 weeks as an i.v. push is well tolerated with dose-limiting toxicity of neutropenia. The maximum-tolerated dose (and recommended Phase II dose) is 0.8 microg/m(2) administered once every 4 weeks.

Adult↗