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Background/Aims: We developed an observer disfigurement severity scale for neurofibroma-related plexiform neurofibromas to assess change in plexiform neurofibroma–related disfigurement and evaluated its feasibility, reliability, and validity. Methods: Twenty-eight raters, divided into four cohorts based on neurofibromatosis type 1 familiarity and clinical experience, were shown photographs of children in a clinical trial (NCT01362803) at baseline and 1 year on selumetinib treatment for plexiform neurofibromas (n = 20) and of untreated participants with plexiform neurofibromas (n = 4). Raters, blinded to treatment and timepoint, completed the 0–10 disfigurement severity score for plexiform neurofibroma on each image (0 = not at all disfigured, 10 = very disfigured). Raters evaluated the ease of completing the scale, and a subset repeated the procedure to assess intra-rater reliability. Results: Mean baseline disfigurement severity score for plexiform neurofibroma ratings were similar for the selumetinib group (6.23) and controls (6.38). Mean paired differences between pre- and on-treatment ratings was −1.01 (less disfigurement) in the selumetinib group and 0.09 in the control (p = 0.005). For the disfigurement severity score for plexiform neurofibroma ratings, there was moderate-to-substantial agreement within rater cohorts (weighted kappa range = 0.46–0.66) and agreement between scores of the same raters at repeat sessions (p > 0.05). In the selumetinib group, change in disfigurement severity score for plexiform neurofibroma ratings was moderately correlated with change in plexiform neurofibroma volume with treatment (r = 0.60). Conclusion: This study demonstrates that our observer-rated disfigurement severity score for plexiform neurofibroma was feasible, reliable, and documented improvement in disfigurement in participants with plexiform neurofibroma shrinkage. Prospective studies in larger samples are needed to validate this scale further. [ABSTRACT FROM AUTHOR]

Background/Aims: Individuals with neurofibromatosis 1 may experience changes in their appearance due to physical manifestations of the disorders and/or treatment sequelae. Appearance concerns related to these physical changes can lead to psychological distress and poorer quality of life. While many neurofibromatosis 1 clinical trials focus on assessing changes in tumor volume, evaluating patients' perspectives on corresponding changes in symptoms such as physical appearance can be key secondary outcomes. We aimed to determine whether any existing patient-reported outcome measures are appropriate for evaluating changes in appearance concerns within neurofibromatosis 1 clinical trials. Methods: After updating our previously published systematic review process, we used it to identify and rate existing patient-reported outcome measures related to disfigurement and appearance. Using a systematic literature search and initial triage process, we focused on identifying patient-reported outcome measures that could be used to evaluate changes in appearance concerns in plexiform or cutaneous neurofibroma clinical trials in neurofibromatosis 1. Our revised Patient-Reported Outcome Rating and Acceptance Tool for Endpoints then was used to evaluate each published patient-reported outcome measures in five domains, including (1) respondent characteristics, (2) content validity, (3) scoring format and interpretability, (4) psychometric data, and (5) feasibility. The highest-rated patient-reported outcome measures were then re-reviewed in a side-by-side comparison to generate a final consensus recommendation. Results: Eleven measures assessing appearance concerns were reviewed and rated; no measures were explicitly designed to assess appearance concerns related to neurofibromatosis 1. The FACE-Q Craniofacial Module—Appearance Distress scale was the top-rated measure for potential use in neurofibromatosis 1 clinical trials. Strengths of the measure included that it was rigorously developed, included individuals with neurofibromatosis 1 in the validation sample, was applicable to children and adults, covered item topics deemed important by neurofibromatosis 1 patient representatives, exhibited good psychometric properties, and was feasible for use in neurofibromatosis 1 trials. Limitations included a lack of validation in older adults, no published information regarding sensitivity to change in clinical trials, and limited availability in languages other than English. Conclusion: The Response Evaluation in Neurofibromatosis and Schwannomatosis patient-reported outcome working group currently recommends the FACE-Q Craniofacial Module Appearance Distress scale to evaluate patient-reported changes in appearance concerns in clinical trials for neurofibromatosis 1-related plexiform or cutaneous neurofibromas. Additional research is needed to validate this measure in people with neurofibromatosis 1, including older adults and those with tumors in various body locations, and explore the effects of nontumor manifestations on appearance concerns in people with neurofibromatosis 1 and schwannomatosis. [ABSTRACT FROM AUTHOR]

Copyright of Aled: Revista Latinoamericana de Estudios del Discurso is the property of Asociacion Latinoamericana de Estudio del Discurso and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cancers of the head and neck and their treatment can cause disfigurement and loss of functioning, with a profound negative impact on the person’s self-image and psychosocial wellbeing. This can lead to experiences of shame and stigma, which are important targets for psychosocial interventions. Accurate measurement and identification of these problems enables clinicians to offer appropriate interventions and monitor patients’ progress. This study aimed to validate the Canadian version of the Shame and Stigma Scale (SSS) among French- and English-speaking head and neck cancer patients. Data from 254 patients from two major Canadian hospitals were analysed. The existing four-factor structure of the SSS was supported, with the following subscales: Shame with Appearance, Sense of Stigma, Regret, and Social/Speech Concerns. The Canadian SSS showed adequate convergent and divergent validity and test–retest reliability. Rasch analysis suggested scale improvement by removing two misfitting items and two items with differential functioning between French- and English-speaking patients. The final 16-item scale version was an adequate fit with the Rasch model. The SSS provides more accurate measures for people with high levels of shame and stigma, and thus has utility in identifying patients with more severe symptoms who may be in need of psychosocial interventions.

Abstract Objectives Noma is a facially disfiguring disease that affects the oral cavity and midface structures. If left untreated, the disease is fatal. Noma causes severe cosmetic and functional defects in survivors, leading to psychiatric and social problems. However, there are limited data on psychosocial and functional sequelae associated with this disease. This cross-sectional study aimed to investigate psychosocial and functional morbidity among facially disfigured untreated Noma cases. Study participants were volunteer patients diagnosed with noma and awaiting surgery at two noma treatment centers in Ethiopia. A questionnaire derived from the APA’s DSM-5, the DAS59, and the Appearance Anxiety Inventory protocol was used to measure the psychosocial and functional morbidity of the cases between September 16 and October 10, 2022. Results A total of 32 noma cases (19 women and 13 men) awaiting the next surgical campaigns were involved in the study. Study participants reported severe social (Likert score = 2.8) and psychological (Likert score = 3.0) morbidity. Functional limitation was moderate (Likert score = 2.9). This study has shown that psychosocial and functional morbidity in untreated noma cases in Ethiopia is substantial. Therefore, policymakers, clinicians, and researchers need to pay sufficient attention to providing adequate health care and preventing the occurrence of the disease in the long term.

Objectives: Noma is a facially disfiguring disease that affects the oral cavity and midface structures. If left untreated, the disease is fatal. Noma causes severe cosmetic and functional defects in survivors, leading to psychiatric and social problems. However, there are limited data on psychosocial and functional sequelae associated with this disease. This cross-sectional study aimed to investigate psychosocial and functional morbidity among facially disfigured untreated Noma cases. Study participants were volunteer patients diagnosed with noma and awaiting surgery at two noma treatment centers in Ethiopia. A questionnaire derived from the APA's DSM-5, the DAS59, and the Appearance Anxiety Inventory protocol was used to measure the psychosocial and functional morbidity of the cases between September 16 and October 10, 2022. Results: A total of 32 noma cases (19 women and 13 men) awaiting the next surgical campaigns were involved in the study. Study participants reported severe social (Likert score = 2.8) and psychological (Likert score = 3.0) morbidity. Functional limitation was moderate (Likert score = 2.9). This study has shown that psychosocial and functional morbidity in untreated noma cases in Ethiopia is substantial. Therefore, policymakers, clinicians, and researchers need to pay sufficient attention to providing adequate health care and preventing the occurrence of the disease in the long term. [ABSTRACT FROM AUTHOR]

In the differential geometric formulation of nonlinear elasticity, the strain tensor can intrinsically be regarded as a measure of change of the metric of the Riemannian manifold that embodies the continuum undergoing a deformation. Here, this classical concept is revisited and complemented with two newly defined higher order deformation measures, namely the disfigurement and flexure tensors, which respectively measure the change of the Levi-Civita connexion and the Riemann curvature of the continuum. The strain, disfigurement and flexure tensors can, thereby, roughly indicate the alteration of the geometry of a deforming body in the zeroth, first and second orders, respectively. In this light, one may predict that the disfigurement and flexure tensors should be related to the first and second covariant derivatives of the strain tensor. While this is true, the exact strain-disfigurement-flexure relations, as derived in this paper, are found to be involved and non-trivial, offering a deeper understanding of the deformation. In our discussions, distance-preserving, geodesic-preserving and curvature-preserving deformations are studied as three special cases to help better interpret the above-mentioned deformation measures. Some related results have also been found as by-products that might be of current interest or prove useful in future investigations. [ABSTRACT FROM AUTHOR]

BACKGROUND: Despite the recent advancements in the design and manufacture of prostheses for individuals with craniofacial irregularity and amputation, these individuals tend to become self-conscious about their appearance. The aim of this study was to investigate the reliability and validity of Persian version of the Derriford Appearance Scale24 (P-DAS24) for a sample of individuals with craniofacial irregularity and limb loss. METHODOLOGY: Reliability of the P-DAS24 was determined by computing internal consistency and test-retest reliability utilizing Cronbach’s alpha coefficient and Pearson’s correlation coefficient. Discriminant validity was investigated with comparing the total score of the P-DAS24 between disfigured participants and those with no appearance problem. Known-groups validity was evaluated regarding the participants’ gender and their level of involvement. FINDINGS: The sample size comprised of 251 individuals with disfigurement and 101 without disfigurement who were deemed normal in appearance. The P-DAS24 showed satisfactory internal consistency (Cronbach’s alpha = 0.89) and excellent test-retest reliability (r = 0.96). The total score of the P-DAS24 showed a statistically significant difference between individuals deemed disfigured or normal (P=0.01). The total scores P-DAS24 in individuals with different levels of involvement were significantly different (P

Cancers of the head and neck and their treatment can cause disfigurement and loss of functioning, with a profound negative impact on the person's self-image and psychosocial wellbeing. This can lead to experiences of shame and stigma, which are important targets for psychosocial interventions. Accurate measurement and identification of these problems enables clinicians to offer appropriate interventions and monitor patients' progress. This study aimed to validate the Canadian version of the Shame and Stigma Scale (SSS) among French- and English-speaking head and neck cancer patients. Data from 254 patients from two major Canadian hospitals were analysed. The existing four-factor structure of the SSS was supported, with the following subscales: Shame with Appearance, Sense of Stigma, Regret, and Social/Speech Concerns. The Canadian SSS showed adequate convergent and divergent validity and test–retest reliability. Rasch analysis suggested scale improvement by removing two misfitting items and two items with differential functioning between French- and English-speaking patients. The final 16-item scale version was an adequate fit with the Rasch model. The SSS provides more accurate measures for people with high levels of shame and stigma, and thus has utility in identifying patients with more severe symptoms who may be in need of psychosocial interventions. [ABSTRACT FROM AUTHOR]

Takotsubo cardiomyopathy is accompanied by transitory left ventricular dysfunction without substantial coronary artery disease. A history of acute physical or mental stress typically precedes such a presentation. We want to highlight a case of Takotsubo cardiomyopathy in the early postoperative period in a young female patient who underwent extensive surgery for buccal mucosal carcinoma. The onset of this cardiomyopathy can be ascribed to a fear of disfigurement and prolonged surgical stress. [ABSTRACT FROM AUTHOR]

Burn injuries have a long-term negative impact on patients, families, and healthcare systems, and prevention remains the primary goal. Head and neck lesions have a reported prevalence between 6-65.6%, sometimes even 95.1%. There are various risk factors and predictors of facial burns, like younger age, male sex, flame or flash burns, and work-related injuries. Surgical and non-surgical management is chosen depending on the burn type and extension, and the patients’ previous health status. Tangential necrosectomy is the gold standard of third-degree burn care. In the last years, enzymatic debridement showed promising results. Long-term complications, from altered sensibility, and face motor dysfunction, to hypertrophic scarring and mutilating aspects, frequently lead to depression, post-traumatic stress disorders, and social exclusion. To improve patients’ quality of life, various programs targeting reconstructive surgeries with cosmetic purposes, social skill training, and cognitive behavioural therapies should be implemented.

Patients with head and neck cancer face important life-altering effects in appearance and function, affecting distress and quality of life and requiring the involvement of a multidisciplinary team. Psycho-oncology makes an important contribution to the field, as head and neck cancers carry a huge adaptational toll. To illustrate the value of this discipline, we report two cases of patients with advanced head and neck cancer for which the treatment-related body changes were of major significance. A commentary by the treating surgeons and psycho-oncologists precedes a general discussion about the clinical management of such patients. The article outlines strategies to address health literacy, doctor–patient communication, treatment decision-making, and emotional distress; placing the person at the center of oncological care. It calls for the broad application of principles of psychological first aid by healthcare professionals in oncology.

The author evokes some hypotheses on the question of the negative way as a structural data in relation to the process of Beckettian writing (the critical position with respect to language; the practice of dispossession; disfigurement) by taking up elements of his books published by Classiques Garnier in 2019: La parole trouée. Beckett, Tardieu, Novarina, and Les Voies négatives de l'écriture dans le théâtre moderne et contemporain. [ABSTRACT FROM AUTHOR]

Dutch director Sacha Polak’s Dirty God (2019) is the first narrative film with a female lead whose scars are real, and arguably the first to tackle the assumption that scars (especially on a woman’s body) are shameful or tragic. Vicky Knight, who plays Jade, a young woman rebuilding her life after an acid attack, has talked about the revelation of seeing her body on screen after enduring years of abuse because of her appearance. Polak ‘saved my life’ she says, by enabling her to see her scarred body as beautiful, ‘a piece of art.’ Like any art form, film has the potential to be transformative, and in interviews both Knight and Polak have repeatedly spoken of their work in those terms. This article uses Dirty God to think about what is at stake in the dismantling of stereotypes and the reclamation of beauty — a goal shared by many disability rights campaigners. Made at a time when escalating cases of acid violence in London were making headlines around the world, Polak’s film prompts comparisons with Katie Piper’s Beautiful (2011) and other survivor memoirs. Privileging imperfection over repair and fragility over strength, it challenges existing portrayals of disfigurement and, in the process, offers a more radical understanding of beauty and authenticity.

Camouflage is defined as a combination of materials, colouration or illumination for concealing something. Skin camouflage therapy is the use of specially formulated products to conceal skin diseases and disfigurements, with the goal of giving a temporarily normal appearance. It gives immediate relief in various dermatological disorders, especially those affecting the visible areas, which are known to be associated with profound psychosocial impact. Despite considerable evidence for its emotional benefits, its utilisation among dermatologists in clinical practice remains low. This article is intended to familiarise dermatologists with the use of skin camouflage therapy including its availability, indications, contraindications, techniques, limitations and future trends. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop an instrument to measure the experience of viewing one's reflection in the mirror for use in rehabilitation, nursing, psychology, and in research studies designed to improve the mirror-viewing experience for those who have suffered psychological or bodily trauma. A secondary purpose was to explore demographic differences in each subscale of the instrument. The developed items went through content expert validation, exploratory and confirmatory factor analyses, and internal consistency reliability testing. Using an exploratory factor analysis (n = 137) and a confirmatory factor analysis (n = 142), we validated a 17-item instrument for two distinct populations: veterans (n = 108) and individuals with upper and lower limb loss (n = 210). The mirror viewing comfort subscale (9 items; α = 0.90) and the mirror avoidance subscale (8 items, α = 0.94) were deemed reliable. Strong, significant correlations between pre-and post-comfort scores (r = 0.81, p < 0.001), as well as pre-and post-avoidance scores (r = 0.94, p < 0.001) provide evidence of test-retest reliability. Demographic differences were noted in the subscales. This instrument contributes to a greater understanding of the experience of mirror-viewing in clinical practice. In interventional research studies to improve the mirror-viewing experience, this instrument can act as a manipulation check or outcome measure. Individuals who suffer actual or perceived body disfigurement due to surgery or trauma may suffer mirror discomfort or mirror trauma when viewing their bodies in a mirror. This reaction is due to a pre-frontal cortex neurological disruption and autonomic nervous system fright/flight or faint. Psychological disorders (e.g., devastation, shame, self-revulsion, decreased body image) may ensue. Falls have occurred due to mirror trauma due to an autonomic nervous system disturbance (faint) and may result in ongoing mirror avoidance. When mirrors are needed for incision visualization, mirror avoidance has led to severe surgical site infections. Although there were many scales available in the literature to measure several aspects of the effects of actual or perceived body disfigurement, there were no scales that measured the mirror-viewing experience. Clinicians and researchers can use the Mirror Comfort and Avoidance Scale (MICAS) to assess mirror comfort and avoidance. [ABSTRACT FROM AUTHOR]

Patients with head and neck cancer face important life-altering effects in appearance and function, affecting distress and quality of life and requiring the involvement of a multidisciplinary team. Psycho-oncology makes an important contribution to the field, as head and neck cancers carry a huge adaptational toll. To illustrate the value of this discipline, we report two cases of patients with advanced head and neck cancer for which the treatment-related body changes were of major significance. A commentary by the treating surgeons and psycho-oncologists precedes a general discussion about the clinical management of such patients. The article outlines strategies to address health literacy, doctor–patient communication, treatment decision-making, and emotional distress; placing the person at the center of oncological care. It calls for the broad application of principles of psychological first aid by healthcare professionals in oncology. [ABSTRACT FROM AUTHOR]

Introduction: Physical changes to appearance caused by burn injuries can have significant psychological consequences. Medical tattooing is an intervention aimed at restoring appearance but little is known about the experiences of patients or the psychological impact of medical tattooing following burns. This study aimed to explore burn patients' psychological experiences of medical tattooing.Method: In-depth interviews were conducted with eight adult women who had experienced a burn injury and subsequently undergone medical tattooing.Results: Using interpretative phenomenological analysis (IPA) to analyse the verbatim transcripts of interviews, two subordinate themes ('Management of Hope' and 'The Medical Tattooing Process') and one superordinate theme ('Impact of Medical Tattooing: 'Normal-ish is Fantastic'') emerged, which were set within a broader context of another superordinate theme: 'Inner Conflict about Acceptability of Perceived Need'. The findings suggested that medical tattooing is experienced positively, may have positive psychological consequences, and may allow women to regain a sense of normality and an improved sense of being acceptable in society following burn injuries. Findings additionally highlighted a conflicting narrative of a pressure to conform to certain expectations of appearance, alongside a sense that a desire to meet these expectations may also not be viewed as important, acceptable or legitimate.Conclusions: Medical tattooing may be a potentially valuable intervention psychologically, although support and information seem important and further research is required. [ABSTRACT FROM AUTHOR]

This essay contends that Ellen Wood's East Lynne reveals a surprising spatial relationship that a woman can have with a property outside the legal restrictions outlined by mid-nineteenth-century married women's property law. Isabel Vane, the main character, cultivates a sense of perversity in orienting herself in the object world as a response to the fundamental deprivation of the property in question, East Lynne. Isabel's misunderstanding of the ownership of her paraphernalia, sentimental overvaluation of East Lynne, and intentional propagation of disfigurement all constitute her perverse relation with the object world. [ABSTRACT FROM AUTHOR]

Abstract Background There is limited discussion on the influence of psychosocial factors on the oral health of patients with a facial burn injury. This report investigated the relationship between oral health and psychosocial distress in patients with facial burns and the role of oral health behaviour in mediating the relationship. Methods The data were part of a cross-sectional study that had systematically and randomly selected patients with > 10% total burn surface area from a burn centre in Pakistan. The oral health status (DMFT, CPI, OHI-S) and severity of facial disfigurement were assessed. Validated instruments in the Urdu language were self-administered and information relating to oral health behaviour (brushing and dental visits), oral health-related quality of life (OHIP-14), satisfaction with appearance, self-esteem, anxiety and depression, resilience, and social support were collected. The statistical analyses included simple linear regression, Pearson correlation, t-test, and ANOVA. Mediation analysis was carried out to examine the indirect effect by oral health behaviour. Results From a total of 271 participants, the majority had moderate to severe facial disfigurement (89%), low self-esteem (74.5%), and moderate to high levels of social support (95%). The level of satisfaction with appearance was low, whereas anxiety and depression were high. Disfigurement and satisfaction with appearance were associated with lower self-esteem and social support (p

The UK Equality Act 2010 prohibits direct and indirect discrimination with respect to nine characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation. We argue that the best way of understanding the Act is to see it as protecting those who are vulnerable to systematic disadvantage, partly in virtue of being at risk of experiencing discrimination that violates what we call the meritocratic principle. If this is a key principle underpinning the Act, then there is a compelling case for extending the legislation to include the protection of at least one further characteristic, namely, appearance. We consider but reject various difficulties that might be raised with extending the Act in this way, including the objection that those vulnerable to forms of appearance discrimination that violate the meritocratic principle could be adequately protected by treating them as disabled. [ABSTRACT FROM AUTHOR]

Copyright of Dirassat in Humanities & Social Sciences is the property of Research & Development of Human Recourses Center (REMAH) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Maxillofacial injuries are a serious public health problem and are often associated with severe morbidity, disfigurement, and psychological problems. The life of the patient often takes a turn for the worst and he/she has to face many difficulties moving forward. Analysing and determining the quality of life of such cases will give us a better understanding and insight and will further improve the care and treatment of the patients. Aims: Analyse and evaluate the psychosocial impact of maxillofacial fractures on individuals who were healthy pre-trauma. Material and Methods: The participants are the 30 patients with facial trauma reported to the Department of Oral and maxillofacial surgery of the School of Dental Sciences and Krishna hospital, Karad, who will be required to undergo surgical treatment (i.e., Open reduction and internal fixation for facial fractures) and are willing to participate in this study. All 30 patients were given a questionnaire form modified from the pre-existing Acute Stress Disorder Scale, Oral Health Impact Profile questionnaire and Posttraumatic Diagnostic Scale, which includes questions regarding speech, sense of taste, pain, uncomfortable eating, orientation, tension, unsatisfactory diet, interrupted meals, difficulty to relax, embarrassment, irritability, occupational dysfunction, etc. during their 15 days follow up appointment post-surgery. This obtained data was then analysed and was subjected to appropriate statistical analysis. Result: In a study sample of 30 patients, 8% were found with intense psychosocial issues due to trauma, 14% had a moderate, and 18% had mild issues that affected the quality of their life post-trauma. Conclusion: The study shows a great need for psychological screening and evaluation of patients with maxillofacial injury/fractures due to trauma to improve the patient's physical and psychological recovery.

Proteus syndrome is a rare disease manifested by progressive segmental overgrowth involving the skeletal, Cutaneous, subcutaneous, and nervous systems. We report the case of a 24-year-old female who was born with no obvious abnormality at birth. From the age of 1 year, she developed asymmetric enlargement of her left upper limb and bilateral lower limbs leading to enlargement of the right-hand phalanges with radial deviation, enlargement of the right big toe, lateral deviation of left foot, and discrepancy in the length of lower extremities and kyphoscoliosis. She had become bed-bound for the last few years due to increasing disability. She was diagnosed with Proteus syndrome based on clinical features of progressive course, mosaic distribution, and sporadic occurrence of the lesions. [ABSTRACT FROM AUTHOR]

This article analyzes Candice Lin's 2020 solo exhibition, Natural History: A Half-Eaten Portrait, an Unrecognizable Landscape, a Still Still Life , a show that reflects the artist's ongoing enquiry into non-Western botanical knowledge and attempts to develop nontoxic death rituals by building more-than-human intimacies. Merging the biological processes associated with decomposition and the discursive formations of race and gender, the work also interrogates the knowledge systems constructed by museums. I examine Lin's works through the lens of queer inhumanisms to illustrate how this exhibition challenges modern curatorial practices and historical representations of the Asiatic in natural histories. I refer to this aesthetics of disfigurement as "decompositional forms." Ultimately, I forward that this method of representation renders Asian American racial form into multisensorial registers (which literally penetrate art consumers) to recognize racial histories beyond identity and alongside the omni-presence of the more-than-human. [ABSTRACT FROM AUTHOR]

Objective: The Inventory to Measure and Assess imaGe disturbance – Head and Neck (IMAGE-HN) is a validated patient-reported outcome measure of head and neck cancer-related body image-related distress (BID). However, the IMAGE-HN score corresponding to clinically relevant BID is unknown. The study objective is to determine the IMAGE-HN cutoff score that identifies head and neck cancer patients with clinically relevant BID. Methods: We conducted a cross-sectional study at six academic medical centers. Individuals ≥18 years old with a history of head and neck cancer treated with definitive intent were included. The primary outcome measure was the IMAGE-HN. A Receiver Operating Characteristic curve analysis was performed to identify the IMAGE-HN score that maximized sensitivity and specificity relative to a Body Image Scale score of ≥10 (which indicates clinically relevant BID in a general oncology population). To confirm the validity of the IMAGE-HN cutoff score, we compared the severity of depressive [Patient Health Questionnaire-9 (PHQ-9)] and anxiety symptoms [Generalized Anxiety Disorder-7 (GAD-7)], and quality of life [University of Washington-QOL (UW-QOL)] in patients with IMAGE-HN scores above and below the cutoff. Results: Of the 250 patients, 70.4% were male and the mean age was 62.3 years. An IMAGE-HN score of ≥22 was the optimal cutoff score relative to a Body Image Scale score of ≥10 and represents a clinically relevant level of head and neck cancer-related BID. Relative to those with an IMAGE-HN score of <22, patients with IMAGE-HN scores of ≥22 had a clinically meaningful increase in symptoms of depression (mean PHQ-9 score difference = 5.8) and anxiety (mean GAD-7 score difference = 4.1) as well as worse physical (mean UW-QOL score difference = 18.9) and social-emotional QOL (mean UW-QOL score difference = 21.5). Using an IMAGE-HN cutoff score ≥22, 28% of patients had clinically relevant BID. Conclusion: An IMAGE-HN score of ≥22 identifies patients with clinically relevant head and neck cancer-related BID. This score may be used to detect patients who could benefit from strategies to manage their distress, select patients for studies evaluating interventions to manage head and neck cancer-related BID, and improve our understanding of the underlying epidemiology of the disorder. [ABSTRACT FROM AUTHOR]

Objective: The Inventory to Measure and Assess imaGe disturbance – Head and Neck (IMAGE-HN) is a validated patient-reported outcome measure of head and neck cancer-related body image-related distress (BID). However, the IMAGE-HN score corresponding to clinically relevant BID is unknown. The study objective is to determine the IMAGE-HN cutoff score that identifies head and neck cancer patients with clinically relevant BID.Methods: We conducted a cross-sectional study at six academic medical centers. Individuals ≥18 years old with a history of head and neck cancer treated with definitive intent were included. The primary outcome measure was the IMAGE-HN. A Receiver Operating Characteristic curve analysis was performed to identify the IMAGE-HN score that maximized sensitivity and specificity relative to a Body Image Scale score of ≥10 (which indicates clinically relevant BID in a general oncology population). To confirm the validity of the IMAGE-HN cutoff score, we compared the severity of depressive [Patient Health Questionnaire-9 (PHQ-9)] and anxiety symptoms [Generalized Anxiety Disorder-7 (GAD-7)], and quality of life [University of Washington-QOL (UW-QOL)] in patients with IMAGE-HN scores above and below the cutoff.Results: Of the 250 patients, 70.4% were male and the mean age was 62.3 years. An IMAGE-HN score of ≥22 was the optimal cutoff score relative to a Body Image Scale score of ≥10 and represents a clinically relevant level of head and neck cancer-related BID. Relative to those with an IMAGE-HN score of

Scalp arteriovenous malformation (AVM) accounts for only 8.1% of all AVM cases. These lesions are made up of an abnormal fistulous tangle of tortuous dysmorphic network of vessels “vascular nidus” directly connecting between the feeding arteries and draining veins, without capillary connection, located within the incision subcutaneous layer. With time, these congenital lesions may evolve and enlarge and clinically manifest with variable features. The only effective method of preventing evolution of these malformations is to exclude the lesion completely from the circulation. Involvement of the orbit and face may cause severe facial disfigurement, proptosis, visual obstruction and even facial palsy. These lesions may be complicated by ulceration, infection and profuse bleeding. We present a rare case of 40-year-old female with a recurrent congenital scalp-orbital AVM causing proptosis, visual obstruction on the right eye with severe facial disfigurement. The lesion was successfully excised with acceptable cosmesis and removal of the visual obstruction. A brief literature review, imaging findings and the surgical techniques have been presented.

Background Disfigurement and dysfunction of the face are attributes of body image disturbance in individuals with head and neck cancer. Research in body image has highlighted that people with head and neck cancer experience significant disfigurement and dysfunction with altered body image disturbance. Although research has advanced our understanding and knowledge of the characteristics of body image and body image disturbance, there is a lack of focus on the theoretical frameworks that interrogate the body image construct in individuals with head and neck cancer and the role of the face in formulating this construct. Aim This paper aims to appraise body image conceptual frameworks with an emphasis on the face as an integral organ in formulating body image. Methods Schilder's seminal body image conceptual framework was appraised and contrasted with that of Kolb's and Price's model as well as with the current evidence on body image disturbance in relation to the face. Findings Body image conceptual frameworks are valuable tools for understanding body image and body image disturbances in individuals with head and neck cancer. However, Schilder's framework integrates the physiological, psychological and sociocultural aspects the body image. Conclusion Schilder's framework embodies body image and enables an integrated and inclusive approach to body image in individuals with head and neck cancer. [ABSTRACT FROM AUTHOR]

Disability studies as an academic field has long sought to highlight the lived experiences of people with disabilities, thereby giving voice to a population that has been the object of much discourse but rarely its subject. Despite the field’s engagement with various conditions, there is limited scholarly work on the personal meanings of amputation and prosthetics usage. Experiences associated with the loss of part(s) of the face, in particular, have remained uncharted. In this article, I address this lacuna by drawing on interviews with twenty affected individuals. Situating their accounts in contemporary scholarship on bodily difference within the humanities and social sciences, I demonstrate that losing part(s) of the face calls for various ways of ‘doing’ difference in everyday life. This empirical-philosophical analysis serves three purposes. On an empirical level, the article unpacks the everyday doing of facial difference, showing it simultaneously involves social, embodied, and material dimensions. On a practical level, this integrative understanding of facial difference complements prevalent approaches to ‘disfi gurement’ that construe it as an individual—biomedical or psychosocial—problem. On a theoretical level the article clarifi es and advances the concept of doing, which plays a key role in gender studies, phenomenology, and science and technology studies.

Background: Maxillofacial injuries are a serious public health problem and are often associated with severe morbidity, disfigurement, and psychological problems. The life of the patient often takes a turn for the worst and he/she has to face many difficulties moving forward. Analysing and determining the quality of life of such cases will give us a better understanding and insight and will further improve the care and treatment of the patients. Aims: Analyse and evaluate the psychosocial impact of maxillofacial fractures on individuals who were healthy pre-trauma. Material and Methods: The participants are the 30 patients with facial trauma reported to the Department of Oral and maxillofacial surgery of the School of Dental Sciences and Krishna hospital, Karad, who will be required to undergo surgical treatment (i.e., Open reduction and internal fixation for facial fractures) and are willing to participate in this study. All 30 patients were given a questionnaire form modified from the pre-existing Acute Stress Disorder Scale, Oral Health Impact Profile questionnaire and Posttraumatic Diagnostic Scale, which includes questions regarding speech, sense of taste, pain, uncomfortable eating, orientation, tension, unsatisfactory diet, interrupted meals, difficulty to relax, embarrassment, irritability, occupational dysfunction, etc. during their 15 days follow up appointment post-surgery. This obtained data was then analysed and was subjected to appropriate statistical analysis. Result: In a study sample of 30 patients, 8% were found with intense psychosocial issues due to trauma, 14% had a moderate, and 18% had mild issues that affected the quality of their life post-trauma. Conclusion: The study shows a great need for psychological screening and evaluation of patients with maxillofacial injury/fractures due to trauma to improve the patient's physical and psychological recovery. [ABSTRACT FROM AUTHOR]

Background: There is limited discussion on the influence of psychosocial factors on the oral health of patients with a facial burn injury. This report investigated the relationship between oral health and psychosocial distress in patients with facial burns and the role of oral health behaviour in mediating the relationship. Methods: The data were part of a cross-sectional study that had systematically and randomly selected patients with > 10% total burn surface area from a burn centre in Pakistan. The oral health status (DMFT, CPI, OHI-S) and severity of facial disfigurement were assessed. Validated instruments in the Urdu language were self-administered and information relating to oral health behaviour (brushing and dental visits), oral health-related quality of life (OHIP-14), satisfaction with appearance, self-esteem, anxiety and depression, resilience, and social support were collected. The statistical analyses included simple linear regression, Pearson correlation, t-test, and ANOVA. Mediation analysis was carried out to examine the indirect effect by oral health behaviour. Results: From a total of 271 participants, the majority had moderate to severe facial disfigurement (89%), low self-esteem (74.5%), and moderate to high levels of social support (95%). The level of satisfaction with appearance was low, whereas anxiety and depression were high. Disfigurement and satisfaction with appearance were associated with lower self-esteem and social support (p < 0.05). Greater severity of disfigurement, higher levels of anxiety and dissatisfaction with appearance, and lower levels of self-esteem and social support were associated with greater DMFT and OHIP-14 scores, worse periodontal and oral hygiene conditions, and less frequent tooth brushing and dental visits (p < 0.05). The main barriers to oral healthcare utilization were psychological and social issues (p < 0.05). The indirect effect by oral health behaviour was not significant for anxiety but was significant for disfigurement, satisfaction with appearance, self-esteem, and social support. Conclusion: There is an association between the psychosocial factors and oral health of patients with facial burns through a direct effect and mediation by oral health behaviour. [ABSTRACT FROM AUTHOR]

Objective: This issue celebrates the 30th anniversary of Psycho-Oncology as a journal, a home for scholarship integrating the psychological, social and behavioural dimensions of cancer. Psycho-oncology developed as an evidence-based discipline to offer an alternative to unproven therapies and to optimise coping and support for patients with cancer and their families.Methods: A review of key articles was undertaken for this editorial.Results: Empirical studies have defined the prevalence of morbidity arising from cancer and the acute, longer-term and late effects of its varied treatments. Interventions have been adapted to respond to existential challenges, death anxiety, fear of recurrence, disease progression, palliative care and have been continued into bereavement. Mixed modality treatments have combined psychotropic and psychotherapeutic interventions. Survivorship studies have examined rehabilitation, fertility, sexuality, body image and relational impacts of illness.Conclusion: This journal has helped the discipline to flourish by publishing the innovative outputs of its community of researchers. [ABSTRACT FROM AUTHOR]

Previous research supports the categorical perception of faces on dimensions including emotion, identity, and gender. Two experiments using standard paradigms investigated whether facial disfigurement forms another perceptual category. In the Identification task, faces were presented in varying degrees of disfigurement for a simple disfigured / non-disfigured decision. As degree of disfigurement increased, the percentage of participants defining each image as disfigured increased non-linearly such that a cubic curve provided the best fit to the data, consistent with categorical perception (Experiment 1 and 2). In the ABX task, participants displayed superior discrimination between two faces when they crossed the category boundary between non-disfigured and disfigured (Experiment 1 and participants low in Disgust Sensitivity in Experiment 2). Participants high in Disgust Sensitivity (Experiment 2) showed a pattern that suggested the category boundary was shifted towards earlier perception of disfigurement. Overall, the results suggest categorical perception of facial disfigurement. [ABSTRACT FROM AUTHOR]

Objectives: Distress with self-perceived changes in appearance and function can result in body image disturbance (BID), which is common in head and neck cancer (HNC) survivors and a major source of psychosocial morbidity. To address the lack of psychometrically sound patient-reported outcome measures (PROMs) of HNC-related BID, we aim to create and validate the Inventory to Measure and Assess imaGe disturbancE–Head & Neck (IMAGE-HN). Study Design: Survey study. Setting: Multiple academic centers. Subjects and Methods: Following item development, HNC survivors from 4 academic centers completed the IMAGE-HN. Item responses were psychometrically analyzed using confirmatory factor analysis (CFA) and Rasch analysis. Results: Item development resulted in a 31-item PROM consisting of 5 individual domains and a global domain. In total, 305 HNC survivors of diverse ages, HNC subsites, and reconstructive paradigms completed the initial items. After removal of 3 items for local dependence, CFA confirmed the unidimensionality and local independence (item residual correlations <|0.20|) for each domain. Rasch analysis indicated acceptable fit (infit and outfit mean squares <2.0), monotonicity of all rating scale categories, and low person misfit (<4%). Person separation indices and person reliability were adequate for each domain except appearance concealment, which was removed (4 items). This resulted in the IMAGE-HN, a psychometrically acceptable 24-item PROM of HNC-related BID consisting of a global scale and 4 subscales measuring unique constructs and comprised independent items. Conclusions: IMAGE-HN is a novel, psychometrically sound, multidomain PROM of HNC-related BID for use in clinical and research settings. [ABSTRACT FROM AUTHOR]

Research has consistently demonstrated that viewing one's body in a mirror after an amputation or other perceived or visible body disfigurements can be a traumatic experience. Mirror viewing or mirroring is a taboo subject, which may be the reason this trauma has not been previously detected or acknowledged. Traumatic mirror viewing may lead to mirror discomfort, mirror avoidance, and a host of psychosocial concerns, including post‐traumatic stress. As mirroring is complex, four qualitative mirror viewing studies, embodiment concepts, polyvagal theory, and memory theories were used to develop a model. In this article, foundational knowledge that led to the development of the model is shared. A neurocognitive model of mirror viewing is offered together with implications for nursing research, practice, and education. [ABSTRACT FROM AUTHOR]

Purpose: Psychological distress is reasonably well documented in people with facial disfigurement; however, in patients following eye removal surgery this has not been studied adequately. We hypothesised that lower distress levels would be associated with age and more adaptive coping strategies and that women would be more likely to report higher levels of distress and, therefore, use maladaptive coping strategies. Methods: This exploratory, cross-sectional study measured distress and coping in a sample of 56 post enucleation or evisceration patients. The Hospital Anxiety and Depression Scale and the Brief COPE measured distress and coping strategies. Results: In all, 25.5% and 10.9% of the sample had high levels of anxiety and depression, respectively. Significant associations were found between levels of distress, coping strategies and demographic variables (p <.05). There were significant differences in coping strategies between those with higher and lower levels of distress (p <.05). Females reported higher levels of anxiety (U = 202.5, p <.01) and depression (U = 229, p <.05) than males. Those who experienced enucleation or evisceration aged between 20 and 39 years reported significantly higher levels of depression compared with other age groups (U = 68.5, p <.01). Conclusions: There was a relatively low level of distress across the whole sample, but we found high levels of distress in a considerable proportion (18.18%) of participants. Participants' coping strategies and levels of distress were correlated. Females and participants aged between 20 and 39 years at time of eye removal were particularly vulnerable to distress. [ABSTRACT FROM AUTHOR]

Purpose: Body image is a critical psychosocial issue for patients with head and neck cancer. However, the current status and associated factors of body image in patients with head and neck cancer in Mainland China remain unknown. This study aimed to explore body image concerns for head and neck cancer patients undergoing surgical treatment in Mainland China and to identify the associated factors.Methods: A cross-sectional study was conducted including 154 patients who underwent surgery for head and neck cancer at Tianjin Medical University Cancer Institute & Hospital in Mainland China. Participants were surveyed using the Body Image Scale (BIS), the Perceived Social Support Scale (PSSS), the Simplified Coping Style Questionnaire (SCSQ), the Hospital Anxiety and Depression Scale (HADS), and a questionnaire designed for this study. The Mann-Whitney U test, Kruskal-Wallis H test, Spearman's rank correlation, and stepwise multiple regression analysis were used to analyze the data.Results: The score of BIS was 6.00 (4.00, 8.00). Multiple regression analysis revealed that anxiety, cancer stage, sex, active coping style, and educational level were factors related to body image. These five variables accounted for 40.7% of the total variance in body image.Conclusions: These findings indicate body image dissatisfaction in surgically treated patients with head and neck cancer. Patients with greater anxiety, a more advanced cancer stage, female sex, fewer active coping strategies, and higher education are more likely to have an inferior body image. Assessment and effective psychosocial interventions are needed initially for patients with head and neck cancer to manage body image concerns. [ABSTRACT FROM AUTHOR]