I usually have my Reader propped up so I am reading hands-free, and I use my pinky fingernail on my left hand in a right-to-left gesture most of the time (sometimes I use the buttons).
I read while I'm eating, with my Sony in a bookstand on the left of my lapdesk and my food on the right. I can keep my left pinky fingernail clean no matter what I'm eating!
Never having had an eReader before, I took the raised frame for granted. It will make it easier to apply a screen protector, and I think it looks elegant!!

Since I never got used to anything else, I also have no big problem having no "back" button, although I can see it would be useful.
The only thing I have doubts about is the size of the buttons and their placement. I was hitting the "home" button when I meant to turn a page (

, more careful now!

), and I have to support the Reader with my hand behind it to use the buttons. That's because I have mine in a pink(!) m-edge case flipped backwards and held closed by its strap. You see?? No? Aarrrgh!

If I had a picture I wouldn't need so many words!
Fi