JNER at 15 years: analysis of the state of neuroengineering and rehabilitation.

On JNER's 15th anniversary, this editorial analyzes the state of the field of neuroengineering and rehabilitation. I first discuss some ways that the nature of neurorehabilitation research has evolved in the past 15 years based on my perspective as editor-in-chief of JNER and a researcher in the field. I highlight increasing reliance on advanced technologies, improved rigor and openness of research, and three, related, new paradigms - wearable devices, the Cybathlon competition, and human augmentation studies - indicators that neurorehabilitation is squarely in the age of wearability. Then, I briefly speculate on how the field might make progress going forward, highlighting the need for new models of training and learning driven by big data, better personalization and targeting, and an increase in the quantity and quality of usability and uptake studies to improve translation.

Health-Enabling and Ambient Assistive Technologies: Past, Present, Future.

BACKGROUND: During the last decades, health-enabling and ambient assistive technologies became of considerable relevance for new informatics-based forms of diagnosis, prevention, and therapy. OBJECTIVES: To describe the state of the art of health-enabling and ambient assistive technologies in 1992 and today, and its evolution over the last 25 years as well as to project where the field is expected to be in the next 25 years. In the context of this review, we define health-enabling and ambient assistive technologies as ambiently used sensor-based information and communication technologies, aiming at contributing to a person's health and health care as well as to her or his quality of life. METHODS: Systematic review of all original articles with research focus in all volumes of the IMIA Yearbook of Medical Informatics. Surveying authors independently on key projects and visions as well as on their lessons learned in the context of health-enabling and ambient assistive technologies and summarizing their answers. Surveying authors independently on their expectations for the future and summarizing their answers. RESULTS: IMIA Yearbook papers containing statements on health-enabling and ambient assistive technologies appear first in 2002. These papers form a minor part of published research articles in medical informatics. However, during recent years the number of articles published has increased significantly. Key projects were identified. There was a clear progress on the use of technologies. However proof of diagnostic relevance and therapeutic efficacy remains still limited. Reforming health care processes and focussing more on patient needs are required. CONCLUSIONS: Health-enabling and ambient assistive technologies remain an important field for future health care and for interdisciplinary research. More and more publications assume that a person's home and their interaction therein, are becoming important components in health care provision, assessment, and management.

Taking care of one's brain: how manipulating the brain changes people's selves.

The increasing attention to the brain in science and the media, and people's continuing quest for a better life, have resulted in a successful self-help industry for brain enhancement. Apart from brain books, foods and games, there are several devices on the market that people can use to stimulate their brains and become happier, healthier or more successful. People can, for example, switch their brain state into relaxation or concentration with a light-and-sound machine, they can train their brain waves to cure their Attention Deficit Hyperactivity Disorder (ADHD) or solve their sleeping problems with a neurofeedback device, or they can influence the firing of their neurons with electric or magnetic stimulation to overcome their depression and anxieties. Working on your self with a brain device can be seen as a contemporary form of Michel Foucault's "technologies of the self." Foucault described how since antiquity people had used techniques such as reading manuscripts, listening to teachers, or saying prayers to "act on their selves" and control their own thoughts and behaviours. Different techniques, Foucault stated, are based on different precepts and constitute different selves. I follow Foucault by stating that using a brain device for self-improvement indeed constitutes a new self. Drawing on interviews with users of brain devices and observations of the practices in brain clinics, I analyse how a new self takes shape in the use of brain devices; not a monistic (neuroscientific) self, but a "layered" self of all kinds of entities that exchange and control each other continuously.

La apropiación de un espacio asistencial por una élite profesional. Los médicos del Hospital Real de Granada en el siglo XVI / Appopriation of a healthcare space by a professional elite. Physicians of the Hospital Real of Granada in the 16th century

El presente trabajo aborda el estudio de la nómina de médicos del Hospital Real de la ciudad de Granada en el siglo XVI y singularmente los procesos de selección que precedieron a sus respectivos y sucesivos nombramientos. Pretende ilustrar acerca de la determinación mostrada por dicha clase de profesionales para hacerse con ese oficio asistencial e igualmente sobre las exigencias académicas y socioculturales que afrontaron en contrapartida. Éstas remitieron a la posesión de un grado universitario y a la acreditación de una reputada experiencia quirúrgica, y, en menor medida, a la limpieza de sangre y a la posesión del título de médico del Tribunal local del Santo Oficio (AU)

This study investigates the staffing by physicians of the Hospital Real in the city of Granada in the 16th century, focussing on the selection processes that preceded their respective and successive appointments. The aim is to illustrate the determination shown by this class of professionals to claim this healthcare space and the academic and socio-cultural requirements that they had to meet in return. These included the possession of a university degree and the accreditation of reputable surgical experience and, to a lesser degree, «limpieza de sangre» (proof of Spanish Christian ancestry) and the title of physician awarded by the local court of the Inquisition (AU)

Clinical pearls for home health nursing: recollections from an oral history.

Before the current array of prepackaged disposable supplies and durable medical equipment, many "clinical pearls" were devised by home healthcare nurses to facilitate self-care and family caregiving in the home. Analysis of the oral history of a home healthcare nurse practicing between 1965 and 1980 identified the practical clinical pearls she created and targeted ingenuity, resourcefulness, and caring as essential attributes of past, present, and future home healthcare nurses.