ABSTRACT
BACKGROUND: Psychoeducation plays an important role in how people understand their own psychiatric classification. Since children and parents see psychoeducation as a representation of how their story is understood by the therapist, it affects the therapeutic alliance. Moreover, psychoeducation indirectly shapes the way society understands psychological differences. AIM: To understand how the classification ADHD is given meaning through psychoeducation. METHOD: We analyzed the discourse of 41 written psychoeducational materials from four different countries (USA, UK,
the Netherlands and Hungary). RESULTS: We identified five patterns, of which four contained an element of internal conflict. Notably, conflicts were found within a single thematic stance on ADHD as opposed to a conflict between parties with a different vision on ADHD. CONCLUSION: These conflicts cause confusion, misrepresentation and decontextualization of problems. Ultimately, for those diagnosed with ADHD and their parents, this may hamper their ability to understand themselves in the context of their difficulties.
Subject(s)
Attention Deficit Disorder with Hyperactivity , Humans , Child , Attention Deficit Disorder with Hyperactivity/drug therapy , Parents/psychology , NetherlandsABSTRACT
PURPOSE: The prognosis of patients with pancreatic cancer remains poor, even after potentially curative R0 resection. This discrepancy may be due to the histopathological misclassification of R1 cases as curative resections (R0) in the past. MATERIALS AND METHODS: To test this hypothesis, color coding of all resection margins and organ surfaces as part of a standardized histopathological workup was implemented and prospectively tested on 100 pancreatic head specimens. RESULTS: Thirty-five patients were excluded from the analysis owing to the pathohistological diagnosis; only pancreatic ductal adenocarcinoma, distal bile duct adenocarcinoma, and periampullary adenocarcinoma were included. Applying the International Union Against Cancer criteria, 32 cancer resections were classified R0 (49.2%), while 33 cases turned out to be R1 resections (50.8%). The mesopancreas was infiltrated in 22 of the 33 R1 resection specimens (66.6%). It proved to be the only site of tumor infiltration in 17 specimens (51.5%). Applying the Royal College of Pathologists' criteria, 46 resections were classified R1 (70.8%). As expected, the mesopancreas again was the most frequent site of noncurative resection (n = 27; 58.7%). CONCLUSION: Using the intensified histopathological workup for pancreatic head cancer specimens resulted in an increased rate of R1 resections and the mesopancreas represents the primary site for positive resection margins. Such results are of relevance for patients' stratification in clinical trials.
