Introductions and Course Overview

1. Lecture 1 Bangkok Scientific Writing Workshop 30 January - 10 February 2006 Introductions and Course Overview Monday 30 January 2006

2. UCSF Participants UCSF, University of California, San Francisco UCB, University of California, Berkeley

3. Participants

4. Participants

5. Participants (Thailand)

6. Participants (Thailand)

7. Why publish? • Ethical obligation to subjects and society • To have the greatest public health and clinical impact • Really understand your topic • Currency of academic research • Future grant applications

8. Course objectives By the end of the workshop, you will hopefully have: • A complete draft of paper: • <3000 words, 3 tables, 1 figure, 20 references • A template for writing future research papers • The experience of peer review • A timeline for submission and publication

9. Sections of a research paper • Introduction • Methods • Results • Discussion • Acknowledgments • References • Tables • Figures • Title page • Long title • Short (running) title • Authors • Affiliations • Correspondence • Abstract • Key words

10. Structure of the Course • 2 weeks in length • First week for lectures and drafting sections of paper • Last week for completing writing with mentors and for formal peer review • Assigned reading and writing sections to be completed each day • Peer review of each section first thing each morning in week 1 • Individual mentoring, writing time, statistical consultation • Usually in the afternoon, and more time towards the end of the course • Peer review of full articles • Last two days of course

11. Lecture topics- Week 1 • Monday 30 January: • Course overview • Title, introduction, literature review, references • Group excercise – “Elevator test” • Tuesday 31 January: • Choosing a statistical test • Methods • Wednesday 1 February: • Results • Tables and figures

12. Lecture topics- Week 1 • Thursday 2 February: • Discussion • Friday 3 February: • Abstract • Authorship, title page, choosing a journal, instructions to authors, cover letter, submission

13. Lecture topics - Week 2 • Monday 6 February • The peer review process • Tuesday 7 February • Responding to reviewers’ comments • Wednesday 8 February • Draft manuscript is due at 4:00 PM

14. Lecture topics - Week 2 • Thursday 9 February • Peer reviews - Groups 1 and 2 • Friday 10 February • Peer reviews - Group 3 and 4 • Completed manuscript is due at 4:00 PM • Course wrap up and evaluation • Graduation

15. Additional course activities • Every day: • One-on-one work with advisors/instructors • Team writing • Individual writing • Statistical consultation and analysis

16. Additional course activities • Tea x 2 • Lunch

17. Lecture 2 Bangkok Scientific Writing Workshop 30 January - 10 February 2006 The Research Question Monday 30 January 2006

18. Learning to summarize research study or question in 1-2 sentences • Forces author to understand and synthesize all the important elements of the study • Valuable skill for communicating clearly with colleagues • Applicable format to describe a research proposal, a study underway, or one that is completed

19. Examples Describing a study already completed: We present the results of a randomized controlled trial among HIV-uninfected Thai injection users that evaluated if a recombinant gp120 vaccine reduces the incidence of HIV infection. Describing a proposal: Using an observational longitudinal cohort design, we will determine whether HIV+pregnant women who take vitamin supplements have improved pregnancy outcomes, compared to women who are not taking supplements.

20. Three elements of research summary statements 1. Study design • Trial – randomized, controlled, blinded (or not) • Cohort – longitudinal, cross-sectional, double, retrospective • Other sampling designs – cross sectional consecutive, convenience, chart review 2. Subjects Men, women, HIV infected/uninfected, place of recruitment (clinic, hospital, community, geographic area – India, Africa, US) 3. Primary variables • Predictor • Outcome

21. Examples of research questions We present the results of a year long randomized controlled trial(1. study design) among 3000 HIV-uninfected Thai injection drug users(2. subjects) that evaluated if a recombinant gp120 vaccine(3. predictor) reduces the incidence of HIV infection (3.outcome variables) . Class to identify 3 components: Using an observational longitudinal cohort design, we will determine whether HIV-infected pregnant women who take vitamin supplements have improved pregnancy outcomes, compared to women who are not taking supplements.

22. Class introductions and examples Everyone please introduce themselves WILL EACH PARTICIPANT PLEASE TELL THE CLASS: Your name A summary of your paper/study including the 3 main elements Areas needing most work– yourgoals for workshop

23. Lecture 3 Bangkok Scientific Writing Workshop 30 January - 10 February 2006 Getting Started Monday 30 January 2006

24. First: get organised • The best papers are hinged on a primary finding and its significance • Identify and select which findings you want to present in this paper • Avoid including everything-- can write other papers to elaborate on other findings • Think of the “MPU”: minimal publishable unit • Know the literature -- be a scholar

25. Second: be familiar with the specific manuscript-structure of journals • Obtain “Instructions for Authors” from the journal in which you wish to publish • Examples: • Journal of the Medical Association of Thailand • AIDS • Lancet • Read model papers: • From journal of where you’d like to publish your paper • On topic similar to your paper

26. Third: make an outline • Make an outline with major headings: • Introduction • Methods • Results • Discussion • Use subheadings for Methods and Results • Make lists of each major point to be addressed in the introduction and the discussion • Keep manuscript parts together in one electronic and hard copy file

27. Introduction (general to specific) Men who have sex with men (MSM) exist in all countries and cultures MSM are severely affected by HIV/AIDS Prior research in developing world has focused mostly on Brazil and Thailand More recently, studies conducted in India However, almost nothing is know about MSM in Africa We implemented a survey of MSM in Uganda to gauge their level of risk for HIV Example of an outline

28. Fourth: start writing • Fill in outline as sentences and paragraphs are written • Be concise • Short sentences, short paragraphs • Use sub-headings to keep organized • Shorter papers have better chance of publication

29. Tips for writing well • Start each paragraph with a topic sentence • Flow: move smoothly between paragraphs • Thought of last sentence flows into thought of first sentence of next paragraph • Avoid clichés • “Important”, “Significant” • “More research is needed” (unless you specifically say what is needed)

30. Tips for writing well • Peer review at least once; twice is better • Re-write & re-write & re-write • At some point soon: “Out the door” • If rejected, re-submit: • Every paper has a home • Reviewers can be biased and capricious • So can editors

31. Comments on general style: Use scientific English (or Thai!) • Papers dont have to be bland or boring • Use concise language and sentences • Imitate writing and language conventions of the field (psychology vs. Clinical or public health writing) • Use active voice (active verbs) as much as possible • Stick to facts that can be documented, and avoid speculation • Avoid the use of “I”. Limited use of “we” is OK. • American vs. British conventions • Spelling—depends on the journal, be consistent • Laboratory values

32. Two orders for writing manuscripts

33. In what order should an article be written? • Results -- Put tables and data together first-- • Use “working tables” to organize and understand data and relationships – too lengthy for publication, but useful for author • Helps to Identify primary 1-2 findings of the paper • Rule of thumb: 3 tables and 1 figure for publication 2. Writing up results: follow order of the tables and figure • Describe subjects, distribution of demographics, main variables and main outcome (“univariate analyses”) • Bivariate analyses: association of predictors with main outcome • Multivariate and longitudinal analyses • Elaborate upon single most important finding • Sub-analysis of important groups and potential biases

34. In what order should an article be written? 3. Methods • Matches how you got Results (no more, no less) 4. Discussion • Primary important finding clearly stated first – punch line • Relevant other findings, confirmation of other studies, enhancing causal inference • Surprising, contradictory, unexpected findings • Limitations • Public health implications (HIV prevention or care)

35. In what order should an article be written? 5. Introduction If written last – allows you to lead reader appropriately • First identify the general issue (HIV epidemiology, prevention, care in Asia, Thailand) • Specific issue • What is missing in current knowledge • How this study will address holes in current understanding 6. References • 20 is usually sufficient

36. In what order should an article be written? 7. Title • Title should reflect single main finding, or main point of study, and should be interesting 8. Abstract • Usually written last; falls more easily into place once results and discussion are written

37. Alternative order of writing • Introduction first • Use background section of your research protocol • Use this system if you need to research the literature to understand importance or context of primary findings. Can help focus. • Methods early on • Easy to write if already known • Helps you to recall exactly what was done in the study – particularly important if you didn’t implement or design the study. Clear understanding of methodology and its limitations is important for interpretation of results • Write this section if still waiting for analyses to be completed

38. Alternative order of writing • Results, table and figures • Always construct tables first, before writing • Discussion • This is the method we’ll use

39. Tips for writer’s block • Only work on a topic that you are interested in • Just start. • Start filling in easy pieces • Don’t worry how it looks at first. It’s always easier to edit • Stay here, no e-mail, no cell phones • Write incrementally, by sentence, by paragraph, by section

40. Lecture 4 Bangkok Scientific Writing Workshop 30 January - 10 February 2006 Title, Title page, Introduction and References Monday 30 January 2006

41. Title page • Title (today) • Authors (more later) • Author’s affiliations • Corresponding author’s address • Word count text, word count abstract • Disclosures, conflicts of interest, funding, previous presentations

43. Types of titles • Explanatory • Interrogatory • Declarative • Cute and Catchy

44. The explanatory title • Says exactly how the study was done • Study design • Main outcome • Main predictor • Study population, site • Advantages • Most common, recognized, standard • Sometimes required by journal • Targets relevant audience with key title words • Disadvantages • Can be boring, long

45. Examples of explanatory titles Descriptive HIV voluntary counseling and testing and HIV incidence in male injecting drug users in northern Thailand: evidence of an urgent need for HIV prevention Analytic Lack of association between human immunodeficiency virus type 1 antibody in cervicovaginal lavage fluid and plasma and perinatal transmission, in Thailand. Intervention The efficacy of fluconazole 600 mg/day versus itraconazole 600 mg/day as consolidation therapy of cryptococcal meningitis in AIDS patients.

46. The interrogatory title • Poses the most important question • Advantages • Catches interest • Focussed • Disadvantages • You better answer the question in the paper! • Says little about the design • May not be allowed by journal

47. Examples of interrogatory titles HIV seroconversion among factory workers in Phnom Penh: Who is getting newly infected? Is there a heterosexual HIV epidemic in the United States? (Note: this paper did not answer the question) Are recent increases in sexual risk behaviour among older or younger men who have sex with men? Answer: Both. (Note: question and answer in title)

48. The declaratory title • Says the main finding as a simple sentence • Advantages • No one misses the point • Interesting, provocative, focussed • Good for conference abstracts • Disadvantages • May not be allowed by journal • Invites disagreement

49. Examples of declarative titles HIV infection may adversely affect clinical response to chloroquine therapy for uncomplicated malaria in children Deferral of blood donors with HIV risk factors saves lives and money in Zimbabwe Low socioeconomic status is associated with a higher rate of death in the era of highly active antiretroviral therapy, San Francisco

50. The cute and catchy title • Uses a pun, humor, or trendy term • Advantages • Catches attention, interesting, provocative • Good for conference abstracts • Disadvantages • Glib, flippant, sometimes in bad taste • May not be allowed by journal