The loss of one hand can significantly affect the level of autonomy and the capability of performing daily living, working and social activities. The current prosthetic solutions contribute in a poor way to overcome these problems due to the limitations of the interfaces adopted for controlling the prosthesis and to the absence of force or tactile feedback which limit the hand grasp capabilities. In order to provide indications for further developments in the prosthetic field to increase user satisfaction rates and therefore to reduce device abandonment, this paper reports a literature review on needs analysis of upper limb prosthesis users, by pointing out the critical aspects of the prosthetic solutions in terms of users satisfaction and activities of daily living they would like to perform with the prosthetic device. A list of requirements for upper limb prostheses is proposed, grounded on the performed analysis on user needs. The defined list of requirements for the prosthetic system aims to provide (i) some guidelines for improving the level of acceptability and usefulness of the prosthesis, by accounting for hand functional and technical aspects; (ii) a possible functional scheme of a PNS-based prosthetic system able to satisfy the emerged user wishes; (iii) some hints for improving the quality of the methods (such as questionnaires) adopted for understanding the user satisfaction with their prosthesis.

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Literature Review on Needs of Upper Limb Prosthesis Users.

The authors reviewed the literature on psychological and psychosocial outcomes for individuals undergoing cosmetic surgery, to address whether elective cosmetic procedures improve psychological well-being and psychosocial functioning and whether there are identifiable predictors of an unsatisfactory psychological outcome. They conducted a search of appropriate computerized databases for studies that evaluated psychological and psychosocial status both before and after elective cosmetic surgery. They identified 37 relevant studies of varying cosmetic procedures that utilized disparate methodologies. Overall, patients appeared generally satisfied with the outcome of their procedures, although some exhibited transient and some exhibited longer-lasting psychological disturbance. Factors associated with poor psychosocial outcome included being young, being male, having unrealistic expectations of the procedure, previous unsatisfactory cosmetic surgery, minimal deformity, motivation based on relationship issues, and a history of depression, anxiety, or personality disorder. Body dysmorphic disorder was also recognized by some studies as a predictor of poor outcome, a finding reinforced by reference to the psychiatric literature. The authors conclude that although most people appear satisfied with the outcome of cosmetic surgical procedures, some are not, and attempts should be made to screen for such individuals in cosmetic surgery settings.

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A Review of Psychosocial Outcomes for Patients Seeking Cosmetic Surgery

Alexithymia is characterized by difficulties in identifying, differentiating and describing feelings. A high prevalence of alexithymia has often been observed in clinical disorders characterized by low social functioning. This review aims to assess the association between alexithymia and the ability to decode emotional facial expressions (EFEs) within clinical and healthy populations. More precisely, this review has four main objectives: (1) to assess if alexithymia is a better predictor of the ability to decode EFEs than the diagnosis of clinical disorder; (2) to assess the influence of comorbid factors (depression and anxiety disorder) on the ability to decode EFE; (3) to investigate if deficits in decoding EFEs are specific to some levels of processing or task types; (4) to investigate if the deficits are specific to particular EFEs. Twenty four studies (behavioural and neuroimaging) were identified through a computerized literature search of Psycinfo, PubMed, and Web of Science databases from 1990 to 2010. Data on methodology, clinical characteristics, and possible confounds were analyzed. The review revealed that: (1) alexithymia is associated with deficits in labelling EFEs among clinical disorders, (2) the level of depression and anxiety partially account for the decoding deficits, (3) alexithymia is associated with reduced perceptual abilities, and is likely to be associated with impaired semantic representations of emotional concepts, and (4) alexithymia is associated with neither specific EFEs nor a specific valence. These studies are discussed with respect to processes involved in the recognition of EFEs. Future directions for research on emotion perception are also discussed.

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Alexithymia and the Processing of Emotional Facial Expressions (EFEs): Systematic Review, Unanswered Questions and Further Perspectives

Body image and cosmetic medical treatments

Learning Objectives:After studying this article, the participant should be able to: 1 Identify the diagnostic criteria and clinical features of body dysmorphic disorder 2 Describe the prevalence of body dysmorphic disorder in cosmetic populations 3 Identify appropriate treatment strategies for

Body dysmorphic disorder and cosmetic surgery.

Five-year follow-up of cosmetic rhinoplasty

This work explores the functional and psychosocial impact of the multigrip Michelangelo (M) prosthetic hand. Transradial myoelectric prosthesis users (6 men, median age: 47 y) participated in a crossover longitudinal study. A multifactorial assessment protocol was applied before the application of M and after 3 mo (functional assessment) and 6 mo (psychosocial assessment) of home use. Functional assessment included both practical tests (i.e., Southampton Hand Assessment Procedure [SHAP], Box and Blocks Test [BBT], and Minnesota Manual Dexterity Test [MMDT]) and self-report functional scales. Psychosocial assessment consisted of a clinical interview and a battery of self-report questionnaires concerning current anxious-depressive symptoms and health-related quality of life, body image concerns, adjustment and satisfaction with prosthesis, social support, coping style, and personality. Increased manual dexterity was observed after 3 mo based on improvements in the SHAP, BBT, and MMDT. Two important themes emerged from the clinical interviews at the 6 mo follow-up: (1) the enhanced functionality and (2) the "like a real hand" aspect of the M, which further increased prosthesis integration to the Self. A few patients expressed concerns about M dimension, noise, and weight. The M appeared to restore hand function and natural appearance. The present findings provide preliminary evidence, and additional studies are needed.

Impact of Michelangelo prosthetic hand: Findings from a crossover longitudinal study.

OBJECTIVE: Referring to the alexithymia construct and Bruch's clinical observations, this study investigated the ability to decode nonverbal signs of emotion in obese boys and girls, and their mothers. METHOD: A group of 10 boys and 11 girls with obesity and their mothers, and a control group were tested. Both mothers and children were asked to recognize a set of 32 brief film sequences interpreted by four actors expressing four emotions (anger, sadness, fear, happiness) with two intensity levels. Each sequence was presented first without sound, second without video, and finally with video and sound. RESULTS: As expected, boys and girls suffering from obesity and their mothers showed a reduced ability to decode visual and verbal signs of emotion compared to the control group. DISCUSSION: This result may be interpreted in accordance with the alexithymia construct, and suggests the importance of developing therapeutic strategies to face alexithymic characteristics in obese children and their mothers.

Deficit in the discrimination of nonverbal emotions in children with obesity and their mothers

Short-term outcome of rhinoplasty for medical or cosmetic indication.

This study of the presence of alexithymic characteristics in obese adolescents and preadolescents tested the hypothesis of whether they showed impaired recognition and expression of emotion. The sample included 30 obese young participants and a control group of 30 participants of normal weight for their ages. Stimuli, 42 faces representing seven emotional expressions, were shown to participants who identified the emotion expressed in the face. The Level of Emotional Awareness Scale was adapted for children to evaluate their ability to describe their emotions. Young obese participants had significantly lower scores than control participants, but no differences were found in recognition of emotion. The lack of words to describe emotions might suggest a greater prevalence of alexithymic characteristics in the obese participants, but the hypothesis of a general deficit in the processing of emotional experiences was not supported.

Nicolino Cesare Franco Rossi

Papers

Five-year follow-up of cosmetic rhinoplasty

Impact of Michelangelo prosthetic hand: Findings from a crossover longitudinal study.

Deficit in the discrimination of nonverbal emotions in children with obesity and their mothers

Short-term outcome of rhinoplasty for medical or cosmetic indication.

Emotion recognition and expression in young obese participants: preliminary study.