Editors Note

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By Andrea Spridgen

Specialized areas of O&P care can be nearly as individualized as the patients they serve, and some of these niche practice specialties don't fit neatly into a general category box. They are, nevertheless, vitally important to the patients who need them, and learning more about them is important to our readers. So in this issue, we dedicate our editorial content to the clinical issues and niche practices that fall outside of the higher profile lower- and upper-limb prosthetic and orthotic services.

"Options in Post-mastectomy Prosthetic Care" shares several recent advances in post-mastectomy prosthetic care. It also explores the factors that impact patient access and awareness, including insurance issues, which can affect the financial viability for O&P facilities that want to offer post-mastectomy prostheses, and future developments that may increase comfort and customization.

Unlike advances in lower-limb prosthetic devices, or high-tech orthotic devices such as the IDEO, orthotic management of congenital chest wall conditions typically receives little press. This issue's second feature, "Pectus Carinatum: The Other Deformational Molding Orthosis," covers insights about orthotic treatment that has advanced as a first-line therapy, as opposed to surgical treatment, particularly when initiated early enough. Because pectus carinatum is much less common than pectus excavatum, clinicians may not be as familiar with orthotic rehabilitation of it, but the growing acceptance of the modality demonstrates that it is undoubtedly worthy of exploration.

Finally, in a time when we are regularly called upon to confront subconscious prejudice in our interactions with others, one area of bias in O&P and other medical care may be easy to overlook but can have a significant impact—ageism. "Ageism in Clinical Encounters" looks at this complex issue beyond age influencing the choice of orthotic or prosthetic device, the language used in the clinical encounter, and attitudes of valuation of the elderly when they don't fit the perception of their chronological age.

I hope this issue in which we've gathered an eclectic mix of O&P concerns provides insight into areas you may not often think about.

Happy reading.