04 Oct 2010

Perioperative nurses celebrated for dedication to patient safety

By Laura Gayton
Perioperative nurses everywhere are being celebrated for their important role and commitment to safe patient care during the annual Perioperative Nurse Week, Nov. 8-14. The Association of periOperative Registered Nurses (AORN), a 40,000 member strong organization with state and local chapters nationwide, supports operating room nurses in hospitals and outpatient surgery centers.

Perioperative nursing is a specialized area of nursing practice, providing nursing care to surgical patients before, during, and after surgery. As a fundamental member of the surgical team, the perioperative registered nurse works in collaboration with other health care professionals which may include the surgeon, anesthesia provider, surgical assistant, and other assistive personnel.

Perioperative nursing requires a unique and highly-specialized skill set gained from specialized training and education. As a perioperative nurse, I am responsible for planning and directing all nursing care for patients who undergo invasive surgical procedures, and I serve as the patient's advocate while they are powerless to make their own decisions.

If you or someone you love had a surgical procedure, the perioperative RN was directly responsible for you or your loved one's well-being throughout the operation.  While all of the other well-qualified medical professionals are focused on their specific duty, the perioperative RN focuses on the patient. By employing their critical thinking, assessment, diagnosing, outcome identification, planning, and evaluation skills, the RN circulator directs the nursing care and coordinates activities of the surgical team for the benefit of the patient.

We want to come from behind the masks and the closed doors to let you know that our nurses are dedicated to working hard to protect you, our patients, when you are most vulnerable. We are your advocate using evidence based interventions to provide superior patient care. Join in celebrating the perioperative nurse in your life during the 2010 Perioperative Nurse Week.
30 Sep 2010

TOPS Helps Figure Out Fiber

By Kimberly Greene

MILWAUKEE, WI - For years, any weight-loss aficionado could easily tell you the best sources of dietary fiber:  whole grains, legumes, fruits, and vegetables.  But in today's environment, things have changed.  Grocery store shelves have become crowded with traditionally low-fiber foods that are now packed with fiber, like candy, ice cream, and artificial sweeteners. 

According to TOPS Club, Inc. (Take Off Pounds Sensibly), the nonprofit weight-loss support organization, these "new fiber" foods may not yield the same health benefits as their traditional high-fiber food counterparts.

Defining Fiber

Dietary fiber - also called roughage - is defined by the Institute of Medicine as the edible, nondigestible component of carbohydrate and lignin found naturally in plant food.  Fiber is not digested or absorbed in the small intestine, and it does not contribute calories; rather, bacteria in the stomach metabolize the fibrous parts of food.  When you eat a food that contains a natural source of dietary fiber, you are said to be eating intact fiber.

Added fiber consists of isolated, nondigestible carbohydrates that have beneficial physiological effects in humans.  These fibers can be synthetically manufactured or derived from other plant or animal sources.  An example of an added fiber is pectin extracted from citrus peel and used as a gel in making jam or jelly.  Generally, added fiber is referred to as isolated or functional fiber.

Total fiber is the sum of dietary (or intact) fiber plus added (or isolated or functional) fiber.  Things can seem confusing on the Nutrition Facts panel of food packaging because "dietary fiber" includes all sources of fiber in that food, whether they are from intact or isolated sources.  This is why you can see upwards of ten grams of dietary fiber listed for a fiber-fortified flour tortilla that traditionally would have only one or two grams of fiber.

Fiber can help lower cholesterol, regulate blood sugar, and promote satiety or the feeling of fullness. 

According to The Institute of Medicine, women ages 50 and younger should consume 25 grams of fiber per day.  Women ages 51 and older should aim for 21 grams per day.  For males, those 50 and under need 38 grams per day, and men ages 51 and older should consume 30 grams of fiber per day.


Isolated vs. Intact Fiber

According to Katie Clark, M.P.H., R.D., C.D.E., Assistant Clinical Professor of Nutrition at the University of California - San Francisco and nutrition expert for TOPS, the health benefits of intact fiber are widely accepted among health professionals. 

Researchers who study the effects of fiber on health have done so largely by analyzing the dietary fiber that occurs naturally in high-fiber foods.  But do the health benefits of dietary fiber extend to synthetically manufactured or extracted fibers added to traditionally low-fiber foods?  The American Dietetic Association (ADA) maintains that, "Whether isolated, functional fibers provide protection against cardiovascular disease remains controversial."  The ADA's position paper on dietary fiber goes on to say, "Longer-term studies of fiber intake which examine the effects of both intrinsic (intact) and functional (isolated) fibers...are required."

"Because we don't know to what degree the health benefits of dietary fiber are attributable to intact fibers (the additional nutrients in those high-fiber foods), most dietitians and nutrition professionals are recommending that consumers focus on eating foods that are naturally high in fiber," says Clark. 

Whole foods such as whole grains, legumes, fruits, and vegetables are not only high in fiber, but low in salt, devoid of added sugar, and tend to be lower in calories than processed and packaged foods.  Many of the isolated fiber foods on the market are highly processed and are high in salt, added sugars, and extra calories. 

"Much like the notion that 'organic junk food is still junk food,' keep in mind that a 'high-fiber cookie is still a cookie!'" notes Clark.


Side of Package Sleuthing

To determine whether the fiber in a food product comes from an intact or isolated source, you should search the ingredients list on food packaging.

The most common isolated fibers that manufacturers use to bulk-up traditionally low-fiber foods are:
•    Maltodextrin
•    Inulin (chicory root)
•    Polydextrose
•    Oat fiber
•    Resistant start
•    Pectin
•    Gum

Keep in mind that rapidly increasing the amount of fiber in your diet can lead to gas, bloating, and other gastrointestinal discomfort.  Drinking more water alongside increasing fiber intake and slowly increasing fiber intake by a few grams per day can help alleviate symptoms.

By increasing the amount of whole grains and legumes in your diet and making sure to eat five to seven servings of fruits per day, it's quite possible to meet your dietary fiber needs without eating fiber-fortified or isolated fiber foods.  Eating whole foods that are naturally high in fiber are oftentimes more satiating - and less expensive - than foods that contain functional fiber or are fiber-fortified. 

"Fiber can be an important tool in weight loss, diabetes management, and reducing the risk for other chronic diseases," says Clark.  "When selecting high-fiber foods, look for whole fiber foods over fake fiber foods to maximize your health potential."

TOPS Club Inc. (Take Off Pounds Sensibly), the original, nonprofit weight-loss support and wellness education organization, was established more than 62 years ago to champion weight-loss support and success.  Founded and headquartered in Milwaukee, Wisconsin, TOPS promotes successful, affordable weight management with a philosophy that combines healthy eating, regular exercise, wellness information, and support from others at weekly chapter meetings. TOPS has about 170,000 members in nearly 10,000 chapters throughout the United States and Canada.

Visitors are welcome to attend their first TOPS meeting free of charge. To find a local chapter, view www.tops.org or call (800) 932-8677.

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28 Sep 2010

More Than $3 Million to Iowa State Department of Public Health

By Grassley Press

Tuesday, September 27, 2010

WASHINGTON - Senator Chuck Grassley today said that the U.S. Department of Health and Human Services' Center for Substance Abuse Treatment has awarded a $3,352,000 grant to the Iowa State Department of Public Health.

According to the Department of Health and Human Services, the Iowa State Department of Public Health will use the money to fund the project entitled, "Access to Recovery."

Each year, thousands of local Iowa organizations, colleges and universities, individuals and state agencies apply for competitive grants from the federal government.  The funding is then awarded based on each local organization or individual's ability to meet criteria set by the federal entity administering the funds.

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28 Sep 2010

Health care savings

By Grassley Press

Monday, September 27, 2010

Grassley:  Independent assessment needed to verify savings for hospitals and others under existing system for group purchasing

WASHINGTON - Senator Chuck Grassley said today that more needs to be done to determine if Group Purchasing Organizations are helping to achieve significant savings for hospitals and others buying medical products, much of which is ultimately taxpayer funded.

"Whether Group Purchasing Organizations are able to help save money on medical supply costs, or not, impacts federal health care spending," Grassley said.  "There's no data with which to independently verify the effect, one way or another, and that's a shortcoming in the current system."

Grassley's comments came along with the release of a new review by the Government Accountability Office (GAO) and a report of his own staff about Group Purchasing Organizations.  Grassley requested the GAO report in January 2009, to update its earlier study on the business practices of Group Purchasing Organizations.

Grassley said the report of his staff of the Senate Committee on Finance summarizes the information he received directly from Group Purchasing Organizations, about their activities and operations, in response to the requests he made in 2009.  He said there is not empirical data available to support claims of savings by Group Purchasing Organizations.

Group Purchasing Organizations act as purchasing intermediaries that negotiate contracts between health care providers and vendors of medical products.  The GAO said that a 2009 study found that Group Purchasing Organization contracts account for an average of 73 percent of non-labor purchases that hospitals make.  Others estimate that about 98 percent of hospitals use Group Purchasing Organizations to purchase products.

-30-

 

28 Sep 2010

Release Report on Medicaid's Status

By Grassley Press

Friday, September 24, 2010

Grassley Continues to Press for Release of Congressionally Mandated Report on Medicaid's Status

WASHINGTON - Sen. Chuck Grassley is again pressing the federal Department of Health and Human Services to finish and release a long overdue, congressionally mandated report on Medicaid's financial and enrollment status.  The report was due Jan. 1, 2010.

"I said before that the report might contain bad news, but we all need to see it," Grassley said.  "The new health care reform law expands Medicaid by the greatest amount in the program's history, yet states are already struggling to afford their existing Medicaid responsibilities.  A true picture of Medicaid's financial state is necessary to ensure that services are funded adequately for the millions of people who rely on the program.  It would really bother me if HHS were withholding the report because they don't want people to know what the true picture of Medicaid is."

Grassley is ranking member of the Committee on Finance, with jurisdiction over health care programs including Medicaid.  The text of his letter to HHS Secretary Kathleen Sebelius is available here.
27 Sep 2010

Iowa seeking delay in health requirement

By Grassley Press

Thursday, September 23, 2010

Sen. Chuck Grassley, ranking member of the Finance Committee, today made the following comment on news that state insurance commissioners told the White House that insurers in several states may not be able to meet the Medical Loss Ratio requirement set for next year in the health care overhaul law, and reports that Susan Voss, president-elect of the National Association of Insurance Commissioners and Iowa's insurance commissioner, asked the federal government for a gradual phasing-in of the requirement in Iowa to avoid having consumers lose their insurance if companies are forced to exit the market.

"News that Iowa is already seeking to delay some of the new insurance requirements in the partisan health care overhaul is just more proof of how poorly this law was put together.  Concerns have already been raised about how the new federal Medical Loss Ratio (MLR) standard will hinder disease management programs and efforts to reduce fraud and abuse, but now it is clear that the timeline for this new standard may also cause Iowans to lose their coverage.  Since the health care bill was written behind closed doors without public input or bipartisan support, it's not surprising that we're seeing states trying to avoid all the flawed policies that are scheduled to go into effect over the next few years."

27 Sep 2010

Award for Home Health Care Efforts

By Grassley Press

WASHINGTON, DC - Sept. 21, 2010 - This week, more than 100 nonprofit home health and hospice leaders will convene on Capitol Hill for the Visiting Nurse Associations of America (VNAA) Public Policy Leadership Conference (PPLC), September 22-23, to educate lawmakers about the nonprofit home health and hospice delivery systems and the vulnerable patients they serve.

A primary focus of this year's conference is to reduce the additional case-mix creep cuts and increase flexibility in new regulatory burdens such as the face-to-face visit requirements. PPLC attendees will also welcome VNAA's 2010 Congressional Champions and Congressional staff award recipients during the Capitol Hill Reception on Wednesday evening. Congressional Champions Senator Jeanne Shaheen (D-NH), Senator Chuck Grassley (R-IA), Representative John Lewis (D-GA) and Representative Bruce Braley (D-IA) are planning to attend. Appearances by other VNAA Champions and additional members of Congress and their staff are also expected. A full listing of this year's Congressional Champions and Congressional staff award recipients is available on the VNAA's Website.

The PPLC exposes attendees to expert speakers on healthcare reform implementation and the CMS proposed rule for home health and hospice. Conference speakers include :

  • Jennifer Beeson, Director of Government Affairs at Families USA.
  • Dr. Mary Naylor, FAAN, RN, Medicare Payment Advisory Commissioner (MedPAC) and Professor in Gerontology at the University of Pennsylvania.
  • Congressional Panel consisting of congressional staff from key committees to healthcare, such as Chuck Clapton (HELP Committee), Tony Clapsis (Senate Finance Committee), Jennifer Friedman (Subcommittee on Health, Ways and Means) and others.
  • Panel of Centers for Medicare and Medicaid Services (CMS) officials from the Center for Medicare Management, Center for Medicaid, CHIP and Survey and Certification and the Office of Clinical Standards and Quality.

 

View a full PPLC agenda, speaker listing and the VNAA's comments on the latest home health and hospice regulations, visit www.AdvocacyConference.org.

 

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27 Sep 2010

More Benefits in New Health Reform Law Roll Out Sept. 23!

By Jim Duffett
NEW BENEFITS OF HEALTH REFORM LAW IN EFFECT SEPT 23
New Benefits Will Protect Health Care Consumers, Increase Access, Improve Quality and Lower Costs for Young Adults, Kids, and People with Pre-Existing Conditions
CHICAGO - U.S. Senator Dick Durbin (D-IL), HHS Regional Director Cristal Thomas, and Executive Director Bob Robinson from the Hemophilia Foundation of Illinois joined Executive Director Jim Duffett of the Campaign for Better Health Care today for a telebriefing to discuss the new set of benefits rolling out on Thursday from the recently enacted Patient Protection and Affordable Care health reform law.  Also on the call was CBHC member Tim Fraas of Elgin, who currently faces a lifetime benefit cap following a heart transplant.
The new health reform law will save lives.  Without it, an estimated 9,400 Illinoisans would have died prematurely due to a lack of health coverage over the next decade.  Not any more.  With the provisions of the new law, 1,163,000 uninsured Illinoisans will gain insurance coverage by 2019.
On September 23, another set of benefits of the new health reform law takes effect.  "The reforms we passed in the groundbreaking health care bill have begun to take effect - curbing insurance company abuses that prevent people from getting the healthcare they need.  On Thursday, we are going to start seeing even more tangible benefits from this bill," said Senator Durbin.  "The provisions taking effect will give parents peace of mind by preventing insurance companies from denying children coverage because of pre-existing conditions.  The provisions will also ensure that patients aren't dropped from their insurance plan when they get sick and will lower health care costs by emphasizing prevention and healthy lifestyles."
"Thanks to the Affordable Care Act, we have begun to create a more competitive, consumer-friendly healthcare marketplace, to crack down on the worst insurance company practices, and to provide real benefits to the people of Illinois," said Director Thomas. Bob Robinson of HFI added, "Starting Thursday, insurance companies can no longer search through your file when you get sick to find some reason to drop you or exclude you for a pre-existing condition. And there will be no more annual or lifetime limits on the amount an insurance company will pay for your care.  These benefits are a huge step forward for our members and for all Americans."
Tim Fraas, a CBHC member, shared his personal health care story.  "In August 2008, at age 51, my cardiologist informed me that I would need a heart transplant. God blessed me with a donor heart October 27, 2008. I was released to return to my job June 1st 2009, but in July I was let go from work.  The official line was lack of work, but I was told that it was mostly due to my health issues.  Luckily, I have great insurance through my wife's employer.  But even with good insurance we are over $10,000 in debt to the hospital, and we spend over $200 a month on my medications. Without insurance it would be over $1900.  It is a real struggle.  Also, with ongoing checkups and expensive medications, I am nearing my lifetime benefit cap.  Once I reach the cap, I am out of insurance.  I consider myself richly blessed, but it is time to reign in the insurance companies and lower costs, and this law does that."
Eliminating insurance company denials based on pre-existing conditions is just one of the new benefits of the health care law rolling out on September 23.  On that day, new consumer protections go into effect prohibiting insurance companies from taking your coverage away when you get sick and need it most, and eliminating lifetime caps.   The new provisions will also improve quality and lower costs by requiring all new plans to cover certain preventive services such as mammograms and colonoscopies without charging a deductible, co-pay or coinsurance.
Jim Duffett, Executive Director of the Campaign for Better Health Care, said,"Health care is the key to economic security and opportunity.  The passage of the recent reform legislation means hundreds of thousands of Illinois' hard working families and small businesses can now enjoy the peace of mind and security that comes from knowing that no matter what happens, they and their families will be able to access the health care they need."
NOTE:  An audio recording of the telebriefing will be available starting Thursday, Sept. 23, in the Audio Archive of the Campaign for Better Health Care's website.
# # #
About the Campaign for Better Health Care
We believe that accessible, affordable, quality health care is a basic human right for all people.  The Campaign for Better Health Care is the state's largest coalition representing over 300 diverse organizations, organizing to help create and advocate for an accessible, quality health care system for all.  For more information, visit www.cbhconline.org.
20 Sep 2010

Pregnant Women Urged to Get Flu Shots

By Tricare Communicatons

FALLS CHURCH, Va. - The Centers for Disease Control and Prevention (CDC) recently teamed up with leaders from several health care groups to stress the importance of pregnant women getting vaccinated against the flu this year. In a letter sent to health care professionals nationwide, the group warns of the increased risk for serious complications from influenza among pregnant women and how getting vaccinated is the single best way to protect themselves and their unborn babies.

To read this release, please visit: http://www.tricare.mil/mediacenter/news.aspx?fid=661

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20 Sep 2010

Breakthrough Prosthetic System Improves Performance for Persons with Limb Loss

By Mark McLaughlin
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High-Fidelity Interface touted as the closest thing to osseointergration without the surgery.

THOUSAND OAKS, Calif. - biodesigns inc., a company specializing in the most biomechanically advanced upper and lower limb prosthetic systems, is introducing a revolutionary socket - the High-Fidelity Interface - to improve the comfort and functionality for persons with limb loss. The patent-pending design was developed by biodesigns' CEO and chief prosthetist, Randall Alley.

Alley explains that the High-Fidelity Interface was developed in response to patients' complaints that their socket is not fitting snugly or comfortably, resulting in poor positional, operational, and functional control. "A person can have the most technologically advanced prosthetic foot, knee, hand, or arm, but if it doesn't connect to or 'interface with' the body properly, it won't deliver the performance it should and the individual is less likely to wear it and enjoy all the benefits it is intended to deliver," he said.

The High-Fidelity Interface for both upper and lower limb applications offers a radical departure from the traditional model in that it imparts a high level of intrinsic bone control. "The term High-Fidelity refers to the precision with which the interface captures and reproduces skeletal motion," Alley said.

"The High-Fidelity Interface addresses wearers' desire to have a more efficient, better performing and more comfortable socket. In fact, we don't even consider it a socket. The technique mimics many of the benefits of osseointegration (where the connector to the prosthesis is embedded in the bone) - without the surgery," he said. "In our patients' own words, the design not only makes it seem that it feels more like a part of their body, but the perceived weight of the prosthesis is also significantly less."

Feedback

"I've been an amputee for 35 years, and I am very, very particular about the fit and finish of the socket. In fact, when I was asked to try Randy's new interface socket, I thought, okay, I'll agree to have him mold his new and improved, whiz-bang socket?and then I will show him why it won't work on a VERY active amputee. Now when I see Randy, I can hardly talk to him because my mouth is so full of black feathers from eating crow," said Ron Currier, a retired chief of prosthetics at the Manchester, N.H., Department of Veterans Affairs (VA) Medical Center.

"In this new technology, there's no more slushy skin. I have more freedom of movement and more stability and better control of the arm," said Chuck Hildreth, Gifford, N. H. who has a left short humeral and right interscapulothoracic amputation.

Both Currier and Hildreth are participating in a clinical study involving the "Luke Arm" developed by famed inventor Dean Kamen's DEKA Research and Development, Manchester, N. H., and the High-Fidelity Interface with DEKA enhancements, as part of the Defense Advanced Research Projects Agency (DARPA) Revolutionizing Prosthetics program.

High-Fidelity Interface vs. traditional socket design

Alley explains that in traditional socket designs, a patient's soft tissue is simply encapsulated or surrounded by the socket, restricting the amount of control the socket can impart upon the bone buried beneath the soft tissue. He compared it to trying to control the motion of a metal cylinder (the intrinsic bone) within a fluid-filled balloon (soft tissue and associated fluids) by merely wrapping your arms around it.

"This soft tissue 'barrier' allows significant skeletal motion within the interface prior to the interface responding, and hence the prosthesis partially absorbs rather than captures and efficiently transferring this motion. This inner skeletal motion decreases prosthesis stability, the wearer's positional precision, functional range of motion and overall efficiency of movement, thus increasing energy expenditure while concurrently increasing the perceived weight of the prosthesis," he said.

An alternating combination of precise compression coupled with release of tissue is design key

In contrast, the High-Fidelity Interface provides a high level of bone control by optimizing soft tissue flow and applying local and focused compression on the soft tissue overlying the intrinsic bone.

This skeletal stabilization is accomplished by using a series of alternating soft tissue compression and release areas oriented carefully along the long axis of the intrinsic or target bone. A specialized sensor can be used to ensure adequate blood flow at the interfacial boundary where compression occurs.

"In between these longitudinal areas of compression that travel nearly the entire length of the bone are areas or windows - depending on whether the interface is a solid body or an open cage-style interface - where soft tissue can flow out of the way or out of the interface entirely. This allows increased compression on the intrinsic bone, far greater than can be achieved in a traditional hydrostatic (uniform pressure distribution) socket," he said.

He emphasized the compression must be very precise. "That is why I have applied for a patent and why I often employ a blood perfusion sensor to ensure a safe compression level," he said. "Above a certain level, you lose adequate blood flow; below a certain level, you minimize the benefits."

The chief benefits to the patients are increased prosthesis stability and more energy efficiency as the interface preserves motion rather than absorbing it so that more of the wearer's input is converted to prosthetic output. In its most radical version, the exposed skin also eliminates the problem of heat and moisture dissipation, a problem with encapsulated sockets when over the course of a day trapped moisture and heat causes the socket to get hot, sweaty, and slippery.

The High-Fidelity Interface can be used for prostheses in upper and lower limb applications alike, with any control system including myoelectric, body-powered, or hybrid, and with any type of suspension system, from self-suspending to auxiliary suspension to negative pressure and elevated vacuum.

High-Fidelity Interface utilized in advanced research projects

Alley is working closely with Matt Albuquerque, Vice President of Next Step O&P, Manchester, N.H., on the DEKA/DARPA project. "Matt instantly recognized the benefits of the High-Fidelity Interface and it has been a real joy to work beside him refining this design for our DEKA test pilots and mutual patients we have consulted together on" Alley said. Albuquerque noticed the immense change this design had on Hildreth: "It was heartwarming to see a patient go from rarely wearing a prosthesis because it was uncomfortable and didn't give him the functionality he desired to now not wanting to leave home without it and wearing it all day. The High-Fidelity Interface is going to have an incredible impact on the way we fit prosthetics from now on," he said.

Currently biodesigns is licensing this technology to a select number of prosthetic offices. "I will be holding certification courses for the High-Fidelity Interface in the near future and we are currently collecting names of those prosthetists and therapists who are interested in learning this design," Alley said.

Alley is also working with T. Walley Williams of Liberating Technologies, Inc. and Matt Garibaldi of UCSF (University of California San Francisco) on a jig for lower limb applications that will assist in ensuring a more standardized approach and hence quality control for creating an interface in the weight-bearing environment, which has its own requirements and challenges. "We are very pleased with the initial prototype casting jig and will soon be instrumenting it for interfacing with a computer. In this way we will be able to discern more information during the initial impression taking about the limb under weight-bearing and compression that will help us refine the design even further," states Alley. "It is our hope that we gain IRB (Institutional Review Board) approval to initiate a formal clinical study at UCSF that will undertake analysis of energy efficiency, gait quality, including stride length, speed and positional control, perceived prosthesis weight and other factors that will provide some additional answers regarding the benefits of the High-Fidelity Interface."

About Randall Alley

Randall Alley, CP, LP is the creator of the High-Fidelity Interface, the XFrame and ACCI (Anatomically Contoured and Controlled Interface), three  prosthetic interface designs that brought superior biomechanical principles to the O&P field. Alley has contributed to five prosthetic textbooks, is a clinical columnist, international speaker, and received a Certificate of Appreciation from the Department of the Army for his upper limb training of military personnel. Alley received both his bachelor of science in kinesiology and his prosthetic certificate from UCLA, and is a licensed and board certified prosthetist.

About biodesigns inc.

Southern California-based biodesigns inc. is a technology-driven prosthetics company specializing in the most advanced upper and lower limb prosthetic solutions.. The company's proprietary approach utilizes high tech laser scanners, innovative clinical techniques, and the most biomechanically advanced prosthetic interfaces (sockets) available..  biodesigns works with all levels of upper and lower limb patients, but especially caters to highly active individuals who demand more from their prostheses. For more information, visit www.biodesigns.com.

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