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Deep Learning Technology: Sebastian Arnold, Betty van Aken, Paul Grundmann, Felix A. Gers and Alexander Löser. Learning Contextualized Document Representations for Healthcare Answer Retrieval. The Web Conference 2020 (WWW'20)
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According to the World Health Organization, fetishistic fantasies are common and should only be treated as a disorder when they impair normal functioning or cause distress. Goals of treatment can include elimination of criminal activity, reduction in reliance on the fetish for sexual satisfaction, improving relationship skills, or attempting to remove deviant arousal altogether. The evidence for treatment efficacy is limited and largely based on case studies, and no research on treatment for female fetishists exists.
Cognitive behavioral therapy is one popular approach. Cognitive behavioral therapists teach clients to identify and avoid antecedents to fetishistic behavior, and substitute non-fetishistic fantasies for ones involving the fetish. Aversion therapy can reduce fetishistic arousal in the short term, but is unlikely to have any permanent effect.
Antiandrogens and selective serotonin reuptake inhibitors (SSRIs) may be prescribed to lower sex drive. Cyproterone acetate is the most commonly used antiandrogen, except in the United States, where it may not be available. A large body of literature has shown that it reduces general sexual fantasies. Side effects may include osteoporosis, liver dysfunction, and feminization. Case studies have found that the antiandrogen medroxyprogesterone acetate is successful in reducing sexual interest, but can have side effects including osteoporosis, diabetes, deep vein thrombosis, feminization, and weight gain. Some hospitals use leuprolide acetate and goserelin acetate to reduce libido, and while there is presently little evidence for their efficacy, they have fewer side effects than other antiandrogens. A number of studies support the use of SSRIs, which may be preferable over antiandrogens because of their relatively benign side effects. None of these drugs cure sexual fetishism, but they can make it easier to manage.
Relationship counselers may attempt to reduce dependence on the fetish and improve partner communication using techniques like sensate focusing. Partners may agree to incorporate the fetish into their activities in a controlled, time-limited manner, or set aside only certain days to practice the fetishism. If the fetishist cannot sustain an erection without the fetish object, the therapist might recommend orgasmic reconditioning or covert sensitization to increase arousal to normal stimuli (although the evidence base for these techniques is weak).
Psychosexual disorders can vary greatly in severity and treatability. Medical professionals and licensed therapists are necessary in diagnosis and treatment plans. Treatment can vary from therapy to prescription medication. Sex therapy, behavioral therapy, and group therapy may be helpful to those suffering distress from sexual dysfunction. More serious sexual perversions may be treated with androgen blockers or selective serotonin reuptake inhibitors (SSRIs) to help restore hormonal and neurochemical balances.
Biological treatments physically alter primary and secondary sex characteristics to reduce the discrepancy between an individual's physical body and gender identity. Biological treatments for GID without any form of psychotherapy is quite uncommon. Researchers have found that if individuals bypass psychotherapy in their GID treatment, they often feel lost and confused when their biological treatments are complete.
Psychotherapy, hormone replacement therapy, and sex reassignment surgery together can be effective treating GID when the WPATH standards of care are followed. The overall level of patient satisfaction with both psychological and biological treatments is very high.
Until the 1970s, psychotherapy was the primary treatment for gender dysphoria, and generally was directed to helping the person adjust to the gender of the physical characteristics present at birth. Psychotherapy is any therapeutic interaction that aims to treat a psychological problem. Though some clinicians still use only psychotherapy to treat gender dysphoria, it may now be used in addition to biological interventions. Psychotherapeutic treatment of GID involves helping the patient to adapt. Attempts to cure GID by changing the patient's gender identity to reflect birth characteristics have been ineffective.
Therapeutic approaches for GIDC differ from those used on adults and have included behavior therapy, psychodynamic therapy, group therapy, and parent counseling. Proponents of this intervention seek to reduce gender dysphoria, make children more comfortable with their bodies, lessen ostracism, and reduce the child's psychiatric comorbidity. The majority of therapists currently employ these techniques. "Two short term goals have been discussed in the literature: the reduction or elimination of social ostracism and conflict, and the alleviation of underlying or associated psychopathology. Longer term goals have focused on the prevention of transsexualism and/or homosexuality."
Individual therapy with the child seeks to identify and resolve underlying factors, including familial factors; encourage identification by sex assigned at birth; and encourage same-sex friendships. Parent counseling involves setting limits on the child's cross-gender behavior; encouraging gender-neutral or sex-typical activities; examining familial factors; and examining parental factors such as psychopathology. Longtime researchers of gender identity disorder, Kenneth Zucker and Susan Bradley, state that it has been found that boys with gender identity disorder often have mothers who to an extent reinforced behavior more stereotypical of young girls. They also note that children with gender identity disorder tend to come from families where cross-gender role behavior was not explicitly discouraged. However, they also acknowledge that one could view these findings as merely indicative of the fact that parents who were more accepting of their child's cross-gender role behavior are also more likely to bring their children to a clinical psychiatrist as opposed to parents who are less accepting of cross-gender role behavior in their children (Bradley, Zucker, 1997). " Proponents acknowledge limited data on GIDC: "apart from a series of intrasubject behaviour therapy case reports from the 1970s, one will find not a single randomized controlled treatment trial in the literature" (Zucker 2001). Psychiatrist Domenico Di Ceglie opines that for therapeutic intervention, "efficacy is unclear," and psychologist Bernadette Wren says, "There is little evidence, however, that any psychological treatments have much effect in changing gender identity although some treatment centres continue to promote this as an aim (e.g. Zucker, & Bradley, 1995)." Zucker has stated that "the therapist must rely on the 'clinical wisdom' that has accumulated and to utilize largely untested case formulation conceptual models to inform treatment approaches and decisions."
Sexual fetishism or erotic fetishism is a sexual fixation on a nonliving object or nongenital body part. The object of interest is called the fetish; the person who has "a fetish" for that object is a fetishist. A sexual fetish may be regarded as a non-pathological aid to sexual excitement, or as a mental disorder if it causes significant psychosocial distress for the person or has detrimental effects on important areas of their life. Sexual arousal from a particular body part can be further classified as partialism.
While medical definitions restrict the term "sexual fetishism" to objects or body parts, "fetish" can also refer to sexual interest in specific activities in common discourse.
Transvestism is the practice of dressing and acting in a style or manner traditionally associated with the opposite sex. In some cultures, transvestism is practiced for religious, traditional or ceremonial reasons.
Males with late onset gender dysphoria "frequently" display transvestic fetishism.
Some male transvestic fetishists collect women's clothing, e.g. panties, nightgowns, babydolls, bridal gowns, slips, brassieres, and other types of nightwear, lingerie, stockings, pantyhose, shoes, and boots, items of a distinct feminine look and feel. They may dress in these feminine garments and take photographs of themselves while living out their fantasies.
According to DSM-IV, this fetishism was limited to heterosexual men; however, DSM-5 does not have this restriction, and opens it to women and men with this interest, regardless of their sexual orientation.
There are two key criteria before a psychiatric diagnosis of "transvestic fetishism" is made:
1. Individuals must be sexually aroused by the act of cross-dressing.
2. Individuals must experience significant distress or impairment – socially or occupationally – because of their behavior.
Transvestic fetishism is a psychiatric diagnosis applied to those who are thought to have an excessive sexual or erotic interest in cross-dressing; this interest is often expressed in autoerotic behavior. It differs from cross-dressing for entertainment or other purposes that do not involve sexual arousal, and is categorized as a paraphilia in the Diagnostic and Statistical Manual of the American Psychiatric Association. (Sexual arousal in response to donning sex-typical clothing is homeovestism.)
Some people experience sexual excitement from the look or feel of a women's bra. The attraction may be to the look or feel of the material, such as lace, or how it looks on a person. Some people get excitement from removing a bra.
Psychosexual disorder is a term which may simply refer to a sexual problem that is psychological, rather than physiological in origin. "Psychosexual disorder" was a term used in . The term of psychosexual disorder (Turkish: "Psikoseksüel bozukluk") used by the TAF for homosexuality as a reason to ban the LGBT people from military service.
Some people experience sexual excitement from the look or feel of articles made of silk or satin fabric. Such interest is usually directed towards the person wearing silk or satin, but it can also be directed towards the garment itself, or to the feel of the garment when worn.
The attraction can be to the physical properties of the garment, such as softness, smoothness, drape and shine, and to its association with elegance, glamour, romance and opulence.
The principal materials which are considered erotic are charmeuse silk (silk woven so that it has a sheen) and satins (such as acetate satin and rayon satin), but other materials with similar properties, such as spandex and polyester are also admired.
Though coined as late as the 1910s, the phenomenon is not new. It was referred to in the Hebrew Bible. The word has undergone several changes of meaning since it was first coined and is still used in a variety of senses. Today, the term "transvestite" is commonly considered outdated and derogatory, with the term "cross-dresser" used as a more appropriate replacement. This is because the term "transvestite" was historically used to diagnose medical disorders, including mental health disorders, and transvestism was viewed as a disorder, but the term "cross-dresser" was coined by the transgender community. In some cases, however, the term "transvestite" is seen as more appropriate for use by members of the transgender community instead of by those outside of the transgender community, and some have reclaimed the word.
Uniform fetishism is a sexual fetishism where an individual is sexually aroused by uniforms.
In May 2013, the American Psychiatric Association published the DSM-5 in which the GIDC diagnosis was removed and replaced with gender dysphoria, for the first time in its own distinct chapter. Lev states that gender dysphoria places the focus on distress with one's body rather than conformity with societal gender norms, and that this change was accompanied by changes to sexist language and a reduced reliance on binary gender categories. Gender dysphoria reframes the diagnosis as a time-limited distress of the body which is potentially rectified with access to gender transition procedures, rather than a lifetime disorder of the identity.
Among the most common uniforms in uniform fetish are those of a police officer, prison officer, soldier, schoolgirl, nurse, French maid, waitress, cheerleader, and Playboy Bunny. Some people also regard nuns' habits or even aprons as uniforms. The uniforms may be genuine, realistic, or they may be sexualized through the use of a very short miniskirt, a very long hobble skirt or a corset, through the use of stockings, fishnet tights, or high heels, or by being made of leather or latex, according to preference. Sometimes uniforms are used according to what activity is being done. For example, someone may wear a nurse's uniform to administer an enema or a police uniform to handcuff and cage someone. Two people may dress as inmates for cell mate-on-cell mate activities in a prison setting or as a submissive to a third (prison guard) roleplayer. This may add a sense of authenticity to the game play. A stripper dressed as a police officer is a popular fixture at birthday and bachelor parties. The "officer" begins with a mock "arrest", often using handcuffs, of the guest of honor before going into a dance routine.
Transmisogyny (sometimes trans-misogyny) is the intersection of transphobia and misogyny. Transphobia is defined as "the irrational fear of, aversion to, or discrimination against transgender or transsexual people". Misogyny is defined as "a hatred of women". Therefore, transmisogyny includes negative attitudes, hate, and discrimination of transgender or transsexual individuals who fall on the feminine side of the gender spectrum, particularly transgender women. The term was coined by Julia Serano in her 2007 book "Whipping Girl" and used to describe the unique discrimination faced by trans women because of "the assumption that femaleness and femininity are inferior to, and exist primarily for the benefit of, maleness and masculinity", and the way that transphobia intensifies the misogyny faced by trans women (and vice versa). It is said many trans women experience an additional layer of misogyny in the form of fetishization; Serano talks about how society views trans women in certain ways that sexualize them, such as them transitioning for sexual reasons, or ways where they’re seen as sexually promiscuous.Transmisogyny is a central concept in transfeminism and is commonly referenced in intersectional feminist theory. That trans women's femaleness (rather than only their femininity) is a source of transmisogyny is denied by certain radical feminists, who claim that trans women are not female.
Transmisogyny is generally understood to be caused by the social belief that men are superior to women. In "Whipping Girl", Julia Serano writes that the existence of trans women is seen as a threat to a "male-centered gender hierarchy, where it is assumed that men are better than women and that masculinity is superior to femininity". Gender theorist Judith Butler echoes this assumption, stating that the murder of transgender women is "an act of power, a way of re-asserting domination... killing establishes the killer as sovereign in the moment that he kills".
Trans women are also viewed as threatening the heterosexuality of cisgender men. In media, "deceivers" such as Dil, a transgender woman from the 1992 film "The Crying Game", have been observed to invoke outrage and male homophobia in an audience when their "true" maleness is unveiled.
A disability pretender is subculture term meaning a person who behaves as if he or she were disabled. It may be classified as a type of factitious disorder or as a medical fetishism.
One theory is that pretenders may be the "missing link" between devotees and wannabes, demonstrating an assumed continuum between those merely attracted to people with disabilities and those who actively wish to become disabled. Many wannabes use pretending as a way to appease the intense emotional pain related to having body integrity identity disorder.
Pretending takes a variety of forms. Some chatroom users on internet sites catering to devotees have complained that chat counterparts they assumed were female were revealed as male devotees. This form of pretending (where a devotee derives pleasure by pretending to be a disabled woman) may indicate a very broad predisposition to pretending among devotees.
Pretending includes dressing and acting in ways typical of disabled people, including making use of aids (Walking sticks, crutches, wheelchairs, mobility scooters, white canes, etc. Pretending may also take the form of a devotee persuading his or her sexual partner to play the role of a disabled person. Pretending may be practiced in private, in intimacy, or in public, and may occupy surprisingly long periods. In the latter case, some pretenders hope that the disability may become permanent, such as through tissue necrosis caused by constricted blood supply.
The cat should be taken to a veterinarian. The most suspected cause of skin problems in cats will be fleas. Other causes of over-grooming are not as easily ascertained. As household antiseptics are known to be toxic to cats, veterinary antiseptics for cats can be used to treat open sores, if they do occur. Sores can also be treated with cream, oral or injected anti-inflammatories, however if the problem continues to recur it may be more cost effective to subject the cat to laboratory testing early on. It may be difficult to keep a clean dressing on a cat's belly, and an anti-lick collar is adequate to let the wound heal. If an anti lick collar is used, a soft anti-lick collar is less cumbersome, although they are less durable. If the cat wears a plastic anti-lick collar, it may use the edge of the collar to grind against existing wounds, making them worse. A soft anti lick collar will become less effective as it is kicked out of the shape by the cat's hind leg, and will need prompt replacement. The cat can sanitize the wound if the collar is removed for daily short periods of time, also giving the cat an opportunity for an overall grooming. Scratches and wounds can heal completely using this method. When the cat stops wearing the collar, thinned hair, redness of skin or cracked nipples on the cat are early indicators that the cat has started to over-groom again.
Antidepressants for cats may be suggested by a vet.
A specific fear of clowns has sometimes been discussed in terms of a specific phobia. The term "" is a neologism coined in the context of informal ""-phobia" lists".
The term is not listed in the World Health Organisation's ICD-10 nor in the American Psychiatric Association's DSM-5 categorization of disorders.
Dapsone is an effective treatment in most people. Itching is typically reduced within 2–3 days. However, dapsone treatment has no effect on any intestinal damage that might be present.
Therefore, a strict gluten-free diet must also be followed, and this will usually be a lifelong requirement. This will reduce any associated intestinal damage and the risk of other complications. After some time on a gluten-free diet, the dosage of dapsone can usually be reduced or even stopped, although this can take many years.
Dapsone is an antibacterial, and its role in the treatment of DH, which is not caused by bacteria, is poorly understood. It can cause adverse effects on the blood, so regular blood monitoring is required.
Dapsone is the drug of choice. For individuals with DH unable to tolerate dapsone for any reason, alternative treatment options may include the following:
- colchicine
- lymecycline
- nicotinamide
- tetracycline
- sulfamethoxypyridazine
- sulfapyridine
First-line therapy for disseminated or localized instances of pyoderma gangrenosum is systemic treatment by corticosteroids and ciclosporin. Topical application of clobetasol, mupirocin, and gentamicin alternated with tacrolimus can be effective.
Pyoderma gangrenosum ulcers demonstrate pathergy, that is, a worsening in response to minor trauma or surgical debridement. Significant care should be taken with dressing changes to prevent potentially rapid wound growth. Many patients respond differently to different types of treatment, for example some benefit from a moist environment, so treatment should be carefully evaluated at each stage.
Papules that begin as small "spouts" can be treated with Dakins Solution to prevent infection and wound clusters also benefit from this disinfectant. Wet to dry applications of Dakins can defeat spread of interior infection. Heavy drainage can be offset with Coban dressings. Grafting is not recommended due to tissue necrosis.
If ineffective, alternative therapeutic procedures include systemic treatment with corticosteroids and mycophenolate mofetil; mycophenolate mofetil and ciclosporin; tacrolimus; thalidomide; infliximab; or plasmapheresis.
There is currently a phase III trial for the use of the IL-1B modulating agent gevokizumab in treating the ulcers of pyoderma gangrenosum.
Azathioprine is a steroid-sparing agent used in combination with Prednisone. It functions by inhibiting RNA and DNA synthesis.
Psychogenic alopecia, also called "over-grooming" or "psychological baldness," is a compulsive behavior that affects domestic cats. Generally, psychogenic alopecia does not lead to serious health consequences or a decreased lifespan.