Made by DATEXIS (Data Science and Text-based Information Systems) at Beuth University of Applied Sciences Berlin
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)
Funded by The Federal Ministry for Economic Affairs and Energy; Grant: 01MD19013D, Smart-MD Project, Digital Technologies
In terms of treating the mental aspect of paruresis, such treatment can be achieved by graduated exposure therapy and cognitive behavioral therapy. In graduated exposure therapy, the subject has a trusted person stand outside the restroom at first, and once the fear is overcome the observer is brought closer in, until step by step the phobia is vanquished. The International Paruresis Association provides a detailed discussion of this method on its website.
In addition to gradual exposure therapy, cognitive behavioral therapy is used to change a sufferer's mental approach to the condition, from one of a person who cannot urinate, to a person who can urinate or is not overly fearful when they can't publicly urinate.
Refusal of work is behavior which refuses to adapt to regular employment.
As actual behavior, with or without a political or philosophical program, it has been practiced by various subcultures and individuals. Radical political positions have openly advocated refusal of work. From within Marxism it has been advocated by Paul Lafargue and the Italian workerist/autonomists (e.g. Antonio Negri, Mario Tronti), the French ultra-left (e.g. Échanges et Mouvement); and within anarchism (especially Bob Black and the post-left anarchy tendency).
Education is the most common treatment, although psychotherapy, including cognitive-behavioral therapy, is indicated when the fear becomes so severe as to cause dysfunction for the individual who suffers from the phobia.
Paruresis ( ) is a type of phobia in which the sufferer is unable to urinate in the real or imaginary presence of others, such as in a public restroom. The analogous condition that affects bowel movement is called parcopresis.
The roots of counterdependency can be found in the age-appropriate negativism of two-year-olds and teens, where it serves the temporary purpose of distancing one from the parental figure[s]. As Selma Fraiberg put it, the two-year-old "says 'no' with splendid authority to almost any question addressed to him...as if he establishes his independence, his separateness from his mother, by being opposite". Where the mother has difficulty accepting the child's need for active distancing, the child may remain stuck in the counterdependent phase of development because of developmental trauma.
In similar fashion, the teenager needs to be able to establish the fact of their separate mind to their parents, even if only through a sustained state of cold rejection; and again unresolved adolescent issues can lead to a mechanical counterdependence and unruly assertiveness in later life.
Counterdependency is the state of refusal of attachment, the denial of personal need and dependency, and may extend to the omnipotence and refusal of dialogue found in destructive narcissism, for example.
Digital hoarding (also known as e-hoarding) is excessive acquisition and reluctance to delete electronic material no longer valuable to the user. The behavior includes the mass storage of digital artifacts and the retainment of unnecessary or irrelevant electronic data. The term is increasingly common in pop culture, used to describe the habitual characteristics of compulsive hoarding, but in cyberspace. As with physical space in which excess items are described as "clutter" or "junk," excess digital media is often referred to as "digital clutter."
Modern medical treatment for computer-induced medical problems like carpal tunnel syndrome include splints, surgery, corticosteroids, and physiotherapy therapy.
Alternative medicine for computer-induced medical problems has also been shown to be effective, notably acupuncture.
The fear of producing foods that are not rendered as they normally are expected to be. Food that is more dry or too moist, or is improperly seasoned, or has an imbalance of ingredients causing it to lose the intended flavors.
Digital hoarding can lead to many problems:
- Digital clutter can make it more difficult to locate specific files among the extra irrelevant material.
- Excessive digital content takes up more hard drive space than it merits, and may even require the addition of extra digital storage to one’s computer or mobile phone.
- Server farms use more electricity as they need more disk drives. The extra load is especially notable in corporate domains. This adds to an individual’s or company’s electricity expenses and carbon footprint.
- Digital clutter can be mentally draining, requiring time and attention. For example, hoarded emails can make an inbox seem overwhelming. The user wastes time sifting through excess emails, which can result in lowered employee productivity.
- Digital hoarding can create an unhealthy attachment to digital content and foster a sort of “media addiction.” It is often good for one’s mental health to let go of useless clutter, and decluttering digital devices can help with decluttering the mind.
Disability fraud is the receipt of payment(s) intended for the disabled from a government agency or private insurance company by one who should not be receiving them, or the receipt of a higher amount than one who is entitled to them should be receiving. There are various acts that may constitute disability fraud. These include feigning a medical problem in order to be declared disabled, exaggeration of an existing medical problem that potentially can but in reality does not render the person disabled, continuing to receive payments after having recovered from a medical problem, or continuing to receive payments while working (usually unreported) above the allowable level for those receiving the payments.
Disability fraud can be harder to detect than other forms of fraud, as the majority of people receiving disability payments (at least 90%) do not use a wheelchair or walker, while at the same time, many people who need wheelchairs would not qualify for disability payments. Since most disabilities are "silent" (meaning that they cannot be seen by others), it is not easy to visually determine if a person receiving disability is not disabled. Such people are often able to perform physical activities, but have some other underlying cause of their disability. It is therefore common for people to believe they must report a neighbor who they see, for example, climbing on the roof while collecting disability payments, but this is not always the case.
Meanwhile, true disability fraud cases exist, for which it is hard to determine the cause as being fraudulent. Often, the perpetrator claims to have a medical condition to be declared disabled. Some medical conditions are truly debilitating and make it impossible or difficult to work if one has them, but are hard to prove against one's own word that one does not have them. These include chronic fatigue syndrome, chronic pain, or various mental disorders. Even if one with one of them is viewed engaging in some other "work-like" activity not for pay, they may have difficulty holding a job.
It is possible that the illegal recipient of the disability payments is not truly disabled, and may have a case of work aversion, which in many countries is not alone considered a valid reason for being declared disabled, or the person may otherwise lack a work ethic. Others who are receiving payments are actually working, but are not reporting their employment and collecting their income in a manner that cannot easily be detected.
Disability fraud can result in denial of future benefits as well as criminal prosecution.
It is ethically difficult when it comes to dealing with diagnosed patients, for many of them deny their poor conditions and refuse to accept treatment. The main objectives of the doctors are to help improve the patient’s lifestyle and wellbeing, so health care professionals must decide whether or not to force treatment onto their patient.
In some cases, especially those including the inability to move, patients have to consent to help, since they cannot manage to look after themselves. Hospitals or nursing homes are often considered the best treatment under those conditions.
When under care, patients must be treated in a way in which they can learn to trust the health care professionals. In order to do this, the patients should be restricted in the number of visitors they are allowed, and be limited to 1 nurse or social worker. Some patients respond better to psychotherapy, while others to behavioral treatment or terminal care.
Results after hospitalization tend to be poor. Research on the mortality rate during hospitalization has shown that approximately half the patients die while in the hospital. A quarter of the patients are sent back home, while the other quarter are placed in long time care. Patients under care in hospitals and nursing homes often slide back into relapse or face death.
There are other approaches to improve the patient’s condition. Day care facilities have often been successful with maturing the patient’s physical and emotional state, as well as helping them with socialization. Other methods include services inside the patient’s home, such as the delivery of food.
Unfortunately, no evidence-based treatment is known for PRS. However it is widely accepted that the treatment must incorporate a complete multidisciplinary team approach and a controlled yet flexible management plan with a visible basis engaged over months to years. Recovery from pervasive refusal syndrome is slow, usually demands one year after diagnosis and introduction of treatment, but many children have a complete recovery and relapse is almost never seen. It is important to remember that adding pressure on recovery times can set him or her back.
Due to the fact that PRS is such a severe disorder, it is almost always required to hospitalize in a child and adolescent psychiatric unit. Outpatient treatment does display symptom-free periods, but relapses of short-lived episodes of depressive symptoms or anorexia are observed. It is therefore necessary to partake in inpatient treatment. Treatment ought to involve gentle loving care. The person treating the patient must be very sensitive and tolerant because it takes a long period of time for the patient to get better, and putting pressure on them adds severity to their condition. It frequently takes several months of treatment before it is likely to employ a very steady rehabilitation programme.
The treatment of tube dependency is tube weaning. The best time to make the transition from exclusive tube feeding to oral feeding is between the ages of 6–12 months.
The earlier the tube is removed and the younger the child, the easier the transition. At the same time, the intended nutritional goals of ENS (enteral nutrition support) must be defined and assessed critically and individually.
Small studies of children undergoing cardiac surgery have shown that they have the easiest transition and highest success rate (n=20) and it has been postulated that this is due to them being able to maintain oral intake throughout the feeding period.
There are a few techniques that are used to aid tube weaning when initial attempts have failed.
- A single paper report of an approach uses analgesic medication based on the theory that children experience pain with oral intake. A study in 2009 showed a 82% (n=9) success rate.
- Behavioral treatment has been used in small samples. A randomised control trial in 2000 showed a 47% (n=32) success rate.
- The Graz approach uses a combination of multiple theories and therapeutic inputs and Play Picnics and has a 92% (n=221) success rate.
Although medication is the first-line treatment for most psychiatric disorders, it does not always improve every aspect of a patient's life, and for the negative symptoms in schizophrenia, the responses to anti-psychotics are less favourable than for positive symptoms. As a result, psychotherapy might be an alternative for the treatment of these symptoms, even if medication has a good effect on other manifestations of the disorder.
Cognitive behavioural therapy (CBT), is the kind of psychotherapy that shows most promise in treating avolition (and other negative symptoms of schizophrenia), but more research is needed in the area. CBT focuses on understanding how thoughts and feelings influence behaviour, in order to help individuals develop methods and strategies to better handle the implications of their disorder. Some research suggests that CBT focusing on social skills and practice of interpersonal situations, like job interviews, seeing a doctor (to discuss medication, for example), or interacting with friends and co-workers, as well as seemingly simple things like riding a bus, might reduce negative symptoms of schizophrenia and be beneficial to patients with avolition.
Other forms of psychotherapy might also complement the role of medication and help patients, their families, and friends to work through emotional and other challenges of living with a chronic psychological disorder, including avolition.
A gutter punk is a homeless or transient individual, often through means of freighthopping or hitchhiking. Gutter punks are often juveniles who are in some way associated with the anarcho-punk subculture. In certain regions, gutter punks are notorious for panhandling and often display cardboard signs that make statements about their lifestyles. Gutter punks are generally characterized as being voluntarily unemployed.
No medications are indicated for directly treating schizoid personality disorder, but certain medications may reduce the symptoms of SPD as well as treat co-occurring mental disorders. The symptoms of SPD mirror the negative symptoms of schizophrenia, such as anhedonia, blunted affect and low energy, and SPD is thought to be part of the "schizophrenic spectrum" of disorders, which also includes the schizotypal and paranoid personality disorders, and may benefit from the medications indicated for schizophrenia. Originally, low doses of atypical antipsychotics like risperidone or olanzapine were used to alleviate social deficits and blunted affect. However, a recent review concluded that atypical antipsychotics were ineffective for treating personality disorders. In contrast, the substituted amphetamine Bupropion may be used to treat anhedonia. Likewise, Modafinil may be effective in treating some of the negative symptoms of schizophrenia, which are reflected in the symptomatology of SPD and therefore may help as well. Lamotrigine, SSRIs, TCAs, MAOIs and Hydroxyzine may help counter social anxiety in people with SPD if present, though social anxiety may not be a main concern for the people who have SPD. However, it is not general practice to treat SPD with medications, other than for the short term treatment of acute co-occurring Axis I conditions (e.g. depression).
School refusal is the refusal to attend school due to emotional distress. School refusal differs from truancy in that children with school refusal feel anxiety or fear towards school, whereas truant children generally have no feelings of fear towards school, often feeling angry or bored with it instead. Children's Hospital Boston provides a chart showing the difference between the school refusal and truancy.
Besides calling it School Refusal, it can also be called schooliophobia, school phobia was coined by a former editor. Schooliophobia is coined as all phobias are derived from Greek. In such cases, School in Greek is σχοείο. The term "school refusal" was coined to reflect that children have problems attending school for a variety of different reasons and these reasons might not be the expression of a true phobia, such as separation or social anxiety.
The mental health community does not recognize work aversion as an illness or disease and therefore no medically recognized treatments exist. Those attempting to treat work aversion as an illness may use psychotherapy, counseling, medication, or some more unusual forms of treatment.
In the case where the person has not worked for a while due to a workplace injury, work-hardening can be used to build strength. The person works for a brief period of time in the first week, such as two hours per day and increases the amount of work each week until full-time hours are reached.
People with schizoid personality disorder rarely seek treatment for their condition. This is an issue found in many personality disorders, which prevents many people who are afflicted with these conditions from coming forward for treatment: They tend to view their condition as not conflicting with their self-image and their abnormal perceptions and behaviors as rational and appropriate. There is little data on the effectiveness of various treatments on this personality disorder because it is seldom seen in clinical settings. However, those in treatment have the option of medication and therapy.
A growing method of treatment is peer support. With the advancement of online gambling, many gamblers experiencing issues use various online peer-support groups to aid their recovery. This protects their anonymity while allowing them to attempt recovery on their own, often without having to disclose their issues to loved ones.
Most treatment for problem gambling involves counseling, step-based programs, self-help, peer-support, medication, or a combination of these. However, no one treatment is considered to be most efficacious and no medications have been approved for the treatment of pathological gambling by the U.S. Food and Drug Administration (FDA). Only one treatment facility has been given a license to officially treat gambling as an addiction, and that was by the State of Virginia.
Gamblers Anonymous (GA) is a commonly used treatment for gambling problems. Modeled after Alcoholics Anonymous, GA uses a 12-step model that emphasizes a mutual-support approach. There are three in-patient treatment centers in North America. One form of counseling, cognitive behavioral therapy (CBT) has been shown to reduce symptoms and gambling-related urges. This type of therapy focuses on the identification of gambling-related thought processes, mood and cognitive distortions that increase one's vulnerability to out-of-control gambling. Additionally, CBT approaches frequently utilize skill-building techniques geared toward relapse prevention, assertiveness and gambling refusal, problem solving and reinforcement of gambling-inconsistent activities and interests.
As to behavioral treatment, some recent research supports the use of both activity scheduling and desensitization in the treatment of gambling problems. In general, behavior analytic research in this area is growing There is evidence that the SSRI paroxetine is efficacious in the treatment of pathological gambling. Additionally, for patients suffering from both pathological gambling and a comorbid bipolar spectrum condition, sustained release lithium has shown efficacy in a preliminary trial. The opioid antagonist drug nalmefene has also been trialled quite successfully for the treatment of compulsive gambling.
The decision to begin enteral feeding is made in most cases by a specialized medical team with a clear plan of treatment goals, the existence of some existing tube maintenance strategies and nutritional counselling and some idea of exit strategies.
During the phase of ENS (enteral nutrition support), patients are recommended to receive regular input from speech and language therapists, occupational therapy, physiotherapy and physicians with the aim of preserving oral functions, exposure to taste and texture preferences and supporting the patient and family to maintain some oral intake unless contraindicated.
As with any supplements and drugs, it is best to confer with a veterinarian as to the recommended dosages. Some drugs are not allowed in competition and may need to be withheld a few days before.
Adding potassium and salt to the diet may be beneficial to horses that suffer from recurrent bouts of ER. Horses in hard training may need a vitamin E supplement, as their requirements are higher than horses in more moderate work. The horse may also be deficient in selenium, and need a feed in supplement. Selenium can be dangerous if overfed, so it is best to have a blood test to confirm that the horse is in need of supplemental selenium.
Thyroid hormone supplementation is often beneficial for horses with low thyroid activity (only do so if the horse has been diagnosed with hypothyroidism).
Other drugs that have been used with success include phenytoin, dantrolene, and dimetyl glycine.
Bicarbonate and NSAIDs are of no use in preventing ER.