In the year 2005, the editors, editorial board, and publisher celebrate the 20th year of publication of the Journal of Head Trauma Rehabilitation. For this special occasion, we have invited a number of select, distinguished leaders in our field to contribute manuscripts that document progress and prospects within a variety of critical areas.
As we look back, the editors would like to review a few highlights of the history of JHTR-notable turning points and future directions for the journal and perhaps the field of head trauma rehabilitation. We also dedicate this issue to the original founding editor, Sheldon Berrol, MD, who died in 1991, just a few years after JHTR was established. The idea of a specialty journal focused on head trauma rehabilitation was the brainchild of a former editor named Margaret Quinlin, who was employed by Aspen Publishers, the former publisher of JHTR. She initially approached Sheldon Berrol, MD, in 1985 with the proposal, who subsequently invited myself (M.R.) to plan, develop, and publish this journal within the next year. The initial guidelines were as follows: (1) publish 4 issues per year; (2) each issue needs to be addressed to a specific topical theme (related to head trauma); and (3) each issue should contain at least 6 to 8 original articles-theoretical, empirical, and patient-oriented-that would be aimed at the practicing clinician. We also expected to target the journal at a multidisciplinary audience. Within the first year of publication, JHTR fulfilled its initial objectives and established a broad, multidisciplinary circulation, which extended across and beyond the borders of the United States. Our thematic topics in the first year of publication focused on several critical issues (ie, persistent vegetative state, minor head injury, attention and memory and pediatric head injury) that are relevant today and are reflected in a number of the special articles commissioned for the commemorative issues of 2005. It is also of note that some of the original authors of those articles have authored several of the articles found in this issue. We also broadened the format of the journal, by including special feature columns-Abstracts of Selected Literature, Technology, Medicolegal Issues, Update on Pharmacology, Controversies, Ethical Issues, Legislative Issues, and Book Reviews-several of which remain fixtures within JHTR.
The first article chosen by one of your current editors (N.H.M.) for JHTR's inaugural column of Abstracts of Selected Literature in 1986 featured an article by Livingston et al1 that described relatives' psychiatric and social functioning in the year following their family member's severe head injury. Family functioning has become an increasingly relevant and complicated issue over the past 2 decades because of the sea change in hospital length of stay. Constriction of the length of stay brought on by managed care and governmental regulatory approaches has been, in our view, the most important external factor affecting family functioning and burden of societal care since JHTR's inception. As expressed in caricature, acute care discharges patients "quicker and sicker" while acute rehabilitation discharges patients as soon as "quicker and sicker" patients become "stable (medically), tabled (in too few team conferences), and (discharged) inevitably more disabled." Shortened lengths of stay also had a significant professional and emotional impact on rehabilitation staff, who, distressingly, had to hurry their preparation of patient and family for an all too soon discharge to home and community. Invariably more disabled and with less time for the rehabilitation staff to help them through early grieving and adjustment, patients and, especially, families experienced more burden and stress. Under the guise of an "efficiency" mantra that sought to discharge the hospitalized patient to the next level of (less costly) care, families also discovered that funding options for next levels of care were not so readily available. In the 2 decades of JHTR's existence, dollar cost of hospital care has been reduced for payors but families and communities continue to pay in other social currencies. In our view, societal support for the ethical principle of beneficence is challenged daily by economic practices of the current healthcare system.
The ethical dimension of the field of rehabilitation was a major concern of founding editor Sheldon Berrol, MD. In this 20th anniversary issue, we honor his memory and remember him as a founder of JHTR, as mentor, teacher, and healer, and as an advocate for the severely disabled. In particular, we remember Shelly as being "one of the strongest advocates and ahead of his time in promoting the ethical dimensions of our practice" (From the Editor, JHTR 7(2), 1992). Shelly's last From the Editor piece highlighted his humanistic and ethical strivings to promote the rights of people with disabilities as illustrated by his connection to an issue regarding the educational rights of children with disabilities. In the California of his day, certain children with behavioral problems in the school system were subjected to inhumane and unvalidated "aversion therapy." Shelly got involved in the California battle against such mistreatment and was able, with pride, to tell JHTR's readership that the California Department of Education had examined the issue and declared that mistreatment of disabled children constituted a violation of the right to a free, appropriate public education. California's new regulations emphasized positive-support strategies (an approach thoroughly discussed by Ylvisaker et al in this issue) and state-of-the-art functional behavior assessments by qualified individuals. Moreover, the California Department of Education had agreed to ensure that special education students were appropriately integrated and not assigned to segregated schools on the basis that "no integrated options exist." Dr Berrol contributed to the successful resolution of these issues and he provided JHTR and its readers with a bona fide legacy of ethical advocacy.
PERSONAL NOTES
On a personal note, it has been a great pleasure for me (N.H.M.) to pick up JHTR's editorial duties in Shelly's footsteps. I could not have done it without the support of JHTR's other founder, Dr Mitchell Rosenthal. Mitch remains the guide and soul of the journal and I have been very fortunate to be able to work together with him on the many details that go into recruiting topical issues and developing them for publication. Bruce Caplan, PhD, the other pillar of editorial strength, ably edits the research issues of JHTR and is a pleasure to work with. Thank you, Bruce!! My thanks also go to previous clinical editors Drs Kathleen Bell, Elizabeth Sandel, and Ross Zafonte, who helped us with generating issues for practicing clinicians. Finally, our Editorial Board has been marvelously responsive, dedicated, and fair in managing their peer reviews. I have learned a great deal from their incisive and helpful reviews. Thank you all with a thousand blessings. Of course, the "binding" for this publishing venture resides in our dedicated office staff, who really make and track all the things that happen. So, thank you Ann Serianni and Katherine Clawson (and your predecessors) for the wonderful job you have been doing for so many years.
As the other founding coeditor of JHTR (M.R.), I was overwhelmed with sadness and grief when I learned about Shelly's death on December 31, 1991. The task of finding a new "partner" for JHTR was challenging, but one that resulted in a marvelous outcome. As I quoted Shelly when I introduced Dr Nathaniel Mayer to the JHTR readership as coeditor in September 1992-Shelly had remarked about Nat-"He's effected dramatic changes in how the rest of the field thinks, and developed new concepts that have set the tone in the field." In the 13 years that have passed, I have found those words to be right on the mark-his wisdom, judgment, depth of knowledge, and commitment to TBI rehabilitation have been remarkable, inspirational, and profound in shaping the direction and quality of our endeavor. Another key appointment, noted by Dr Mayer above, has been that of Dr Bruce Caplan, who assumed the reins as editor of the "Focus on Clinical Research" section in 1995, when JHTR expanded to bimonthly publication. Dr Caplan has been its guiding force in its 10 years of publication, with 2 of the 6 issues per year now being largely dedicated to new, empirical research from throughout the world. His work and commitment has been exceptional and deserving of the highest of accolades.
We would be remiss if I did not recognize a few other notable landmarks in the history of JHTR within the past 2 decades. In 1993, JHTR dedicated a special issue to research findings from the TBI Model Systems program, the first major dissemination of findings from this major, multicenter research program. In 1998, the National Library of Medicine welcomed JHTR into its list of indexed journals-an honor received by only 25% of the world's published biomedical journals. In 2000, JHTR was cited as one of the top 10 journals subscribed to or read regularly by board-certified as well as non-board-certified clinical neuropsychologists, another mark of distinction.2
So, it is with a sense of humility and appreciation to our readers, authors, editors, reviewers, publishers (Aspen and Lippincott, Williams & Wilkins), staff, and families that we acknowledge the past 20 years and look forward to the next 2 decades of further advances in the care of persons with traumatic brain injury and the opportunity to "chronicle" those advances in the pages of the Journal of Head Trauma Rehabilitation.
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