L. Allen Furr

Psychosocial implications of disfigurement and the future of human face transplantation.

Summary: Although the first face transplants have been attempted, the social and psychological debates concerning the ethics and desirability of the procedure continue. Critics contend that these issues have not yet been sufficiently addressed. With this in mind, the present article seeks to elaborate on key psychological and social factors that will be central for addressing the ethical and psychosocial challenges necessary to move face transplantation into mainstream medicine. The goals of this article are to (1) discuss the psychosocial sequelae of facial disfiguration and how face transplantation may relieve those problems, and (2) delineate inclusion and exclusion criteria for the selection of research subjects for face transplantation. The article uses concepts from symbolic interaction theory in sociology to articulate a theoretically coherent scheme for comprehending the psychosocial difficulties of facial disfiguration and the advantages offered by facial transplantation. The authors conclude that the psychosocial implications of disfigurement warrant surgical intervention and that research in the area of face transplantation should continue.

Psychosocial considerations in facial transplantation

The human face and facial transplantation have long captured the interest and imagination of scientists, the media and the lay public. The face is central to our identity, and our communication with the outside world. It is this great importance we attach to our face that makes facial disfigurement such a devastating condition. Facial transplantation could provide an excellent alternative to current treatments for facial disfigurement caused by burns, trauma, cancer extirpation or congenital birth defects. Herein we discuss some of the principal psychosocial considerations which have preceded the clinical introduction of facial transplantation, and which continue today after cases have been performed world-wide.

The Relative Influence of Social Work Journals: Impact Factors vs. Core Influence.

This article compares the results of two methods of ranking the influence of journals based on citation counts. For 22 core social work journals, ranking by Social Sciences Citation Index’s “impact factors” is compared with ranking by “core influence” scores, which count citations only within the same core journals. The substantial differences between the rankings suggest that impact factors do not accurately indicate the most influential journals within the discipline of social work. The implications of these findings for faculty and libraries are discussed.

Patient expectations in facial transplantation.

Meeting patients’ expectations is essential for successful outcomes in reconstructive surgery. In the case of new procedures like facial transplantation that carry with them many unknowns and real, or potential, risk of toxic side effects this becomes especially important. In this study we assessed patient expectations in facial transplantation by surveying individuals with facial disfigurement (n = 34), reconstructive surgeons (n = 45), and controls from the general population (n = 148). Questions focused on quality of life improvement, esthetic and functional outcomes. Student t test was used to compare means of the 3 study groups. All groups projected low quality of life for nontreated disfigured persons, controls responding the most negatively (M = 1.91), followed by disfigured persons (M = 2.91; t = 2.14, P ≤ 0.03) and plastic surgeons (M = 2.71; t = 2.10, P ≤ 0.04). Regarding face transplantations’ ability to improve a disfigured persons’ quality of life, the disfigured group reported the highest score (M = 8.12) followed by controls (M = 6.99; t = 2.744, P < 0.007) and plastic surgeons (M = 6.57; t = 3,72, P ≤ 0.0001). Regarding the importance of esthetic outcomes, controls (M = 6.63) and disfigured persons (M = 6.15) responded similarly whereas plastic surgeons expected the least (M = 4.84; t = 4.13, P < 0.0001, and 2.74, P ≤ 0.008). Regarding functional outcomes, disfigured individuals (M = 7.55) and controls (M = 7.36; NS) placed significantly more importance on expressive functionality than plastic surgeons (M = 6.11; t = 2.66, P ≤ 0.009, t = 2.79, P < 0.007). We observed a significant difference between disfigured persons and reconstructive surgeons regarding their expectations for face transplantation. When consulting potential face transplantation patients, surgeons should maintain open communication to assure that their expectations are closely aligned with the realities of the procedure.

Who wants a gun license

This article examines factors related to the plan to purchase a license to carry a concealed weapon in Kentucky. Routine activity and lifestyle theory provide a framework for analysis. Data for the project were collected by telephone interviews conducted in Jefferson County shortly after the Kentucky General Assembly passed legislation allowing citizens to purchase concealed weapon licenses. Results suggest that heavy-patterned drinking is significantly related to the plan to purchase a concealed weapon license. Social and policy implications are discussed.

Authoritarianism and Attitudes Toward Mental Health Services

Right-wing authoritarians have been shown to resist change and to demonstrate hostility toward out-groups and social movements that may advocate change from traditional and conventional beliefs. Using data from the Louisville Metropolitan Survey, an omnibus survey of 771 adults interviewed by telephone, the authors investigated the relationship between right-wing authoritarianism (RWA) and attitudes toward mental health services. The findings of the bivariate and regression analyses indicated that high scorers on a version of B. Altemeyers (1988) RWA index were more likely to hold negative attitudes on mental health services. In particular, the Submissive Authoritarianism scale predicted negative attitudes toward mental health services; however, scores on the Conventionality subscale were not related to attitudes toward mental health services.

On the Relationship between Cultural Values and Preferences and Affective Health in Nepal

Background: The westernization of developing countries has improved physical health and life expectancy. Modernization, however, is believed to have injurious effects on mental health. Some research suggests that the effects of modernization vary, hurting some but benefiting others. Economic disparity is usually presumed to cause the mental health problems. The purpose of this study was to determine if aspects of westernization other than economic status predicted depression scores in a sample of adults occupying similar economic stations in Nepal. Methods: Survey data were collected from 276 teachers in Nepal. The questionnaire was administered in Nepali. Statistical tests sought to determine the relationship between scores on a measure of depression and having a western cultural orientation. Results: Bivariate and multi-variate analyses indicate that a higher western orientation was associated with lower depression scores. Non-traditional attitudes towards the Nepalese caste system and gender political equality predicted lower depression scores. Attitudes regarding gender economic equality and a preference for western music and film and English language were not associated with depression scores. Conclusion: Findings suggest that the relationship between modernization and psychological well-being are contextual.

THE EFFECTS OF NEIGHBORHOOD SATISFACTION ON PERCEPTION OF SAFETY AMONG REFUGEES FROM THE FORMER SOVIET UNION

ABSTRACT Neighborhood and urban conditions have long been shown to have a strong impact on residents’ feelings of safety and fear or crime. Researchers, however, have not tested the relationship between neighborhood conditions and perception of safety among refugees groups. Comparisons between a general sample of Louisville residents and refugees from the former Soviet Union indicated that refugees were less satisfied with their neighborhoods than the general sample, yet had significantly higher levels of perception of safety. These findings are contrary of previous research that has shown that less satisfaction is associated with lower perception of safety and are explained in terms of the contextual shifts in the management of risk. The relative and subjective meanings of social change may be of greater importance in understanding refugees’ perception of safety than relationships to immediate neighborhood settings.

Medicalization in Nepal: A Study of the Influence of Westernization on Defining Deviant and Illness Behavior in a Developing Country

One point of debate in discussions of the modernization of developing societies concerns the effects of Westernization on how people in these societies see the world and develop a sense of meaning in light of rapid and often broad-sweeping social and cultural changes. Where Western culture has little influence, traditional and religious based ideologies that define “why people misbehave” dominate modes of thinking, and medicalized definitions of deviant behavior are absent (Conrad 1992).This study of 276 Nepali teachers investigates if definitions of deviant behavior may be influenced by encroaching Westernization. Subjects were presented with a scenario of a 12-year-old girl engaging in deviant behavior. Results indicate that those who were in agreement with certain Western values and cultural tastes were more likely to label the girl’s behavior as a mental illness and to refer her to a Western-style social agent for treatment rather than to a traditional Nepali helper. These findings lend tentative support to the notion that medicalization is a function of Western culture.