Communication – 2: Scientific publishing. Risk communication. Working with the mass media. Preben Aavitsland

Scientific publishing

Different traditions The British/American/Scandinavian tradition –Sceptical –Critical –Open

Why publish in English? The world is interested in Baltic and Russian science Spread your experiences Contribute to global scientific progress Personal merits But: You need a message!

Before you start writing What do I want to say? Is it worth saying it? What is the best format? What is the target audience? Which journal is best suited? –General or specialty journal –Have a look in the library –Ask a colleague

Decide on authorship Authors are those who contributed to a, b and c: a) conception and design, or analysis and interpretation b) drafting or revising the article c) final approval

When you have decided the journal Read Instructions to authors Have a look in a recent issue Each journal has its own rules

The structure of a biomedical paper Title Abstract (=summary) Introduction Material and methods Results Discussion Acknowledgements References Tables (with legends) Legends for figures Figures A good protocol makes the writing much easier. A lot is just cut and paste

Title Say what the paper is about Keep it simple (but not sensationalistic) Consider the readers Be brief Provoke interest

Abstract (summary) Contains the essence Should stand alone Four parts –Why the study was done(background) –What was done(method) –What was found(result) –What was concluded(interpretation) Clear and concise Some journals have structured abstracts

Introduction Write short!!! (10-15% of the total length) Tease the reader State your objective and research question Why did you do the study? Why is it important? What has been done before? What are the gaps in knowledge? What is the design?

Material and methods Design and conduct –Design –Definitions –Sample –Methods of measurements –Data collection and handling Analysis –Statistical methods Ethics

Results Answer the problem! Objectively (no interpretations or opinions) Tell what you found Lead your reader to the main findings Use text, self-explanatory tables (and figures), but do not repeat Have a look in the journal

Discussion 30-40% of the total length Statement of principal findings Strengths and weaknesses of the study; validity (bias and confounding) Strengths and weaknesses in relation to other studies, discussing important differences in results Meaning of the study: possible explanations and implications for clinicians and policymakers Unanswered questions and future research Conclusion

References Restrict the number Check the Instructions to authors for format –In-text-citation: (5), [5], (Johnson 1995), 5 –Reference list: Consecutive or Alphabetic Style

Usual format of reference list 1Tsolia MN, Theororidou MN, Mostoru GJ, et al. Epidemiology of invasice Haemophilus influenzae type b infections among children in Greece before the introduction of immunization. Scand J Infect Dis 1998; 30: [Authors surname and initials]. [Title]. [Journal name, Medline abbreviated]. [Year]; [Volume]: [Page numbers].

Style Keep it short Short sentences, short words Active voice: We did not It was done Avoid medical jargon and technical words; use normal English Careful with abbr.

Data graphics (tables, charts, graphs and maps) Have a look in the journal! Use charts and graphs carefully Use simple tables instead Self-explanatory titles –variables, person, time, place Do not repeat data in text

Sending the manuscript To one journal only Several copies Cover letter –Signed by all authors –Statement on prior publication –Statement on financial relationships –Statement of approval by authors –Contact details for corresponding author

People involved Author(s) Editor Associate editors Reviewers (referees, assessors) Technical editors (copy editors) Printer

Initial decision by the editor 1 Is the information…. –New? –True? –Important? –Interesting (for my readers)? 2Has the author followed the instructions? 3 Does it look nice? Based on title and abstract

The editorial process

The reviewer An expert in your field Anonymous Recommendation to the editor –Reject, Revise, Accept Advices the author on improvements –Report

Revising the manuscript Read editors letter carefully Follow recommendations for improvements –if possible –if not bad Write careful letter

Summing up Decide on your message Choose a suitable journal Follow the instructions to authors Write short and clear Tables usually better than figures

More reading Hall GM, ed. How to write a paper. London: BMJ Publishing Group. ISBN Huth EJ. Writing and publishing in medicine. 3rd ed. Baltimore: Williams & Wilkins. ISBN The Vancouver Group. Uniform requirements for manuscripts submitted to biomedial journals. N Engl J Med 1997; 336:

Free access journals on the Internet British Medical Journal – Journal of the American Medical Association – Eurosurveillance – EpiNorth – BioMed Central – –Many journals, note BMC Public Health and BMC Infectious Diseases

Contents Bulletin of the network of infectious disease control institutes in Denmark, Norway, Iceland, Sweden, Finland, Russia, Estonia, Latvia, and Lithuania English and Russian language Features –News of recent epidemics in the area –Annual surveillance data –Reports of public health policies –Communicable disease control and prevention –Communicable disease epidemiology

Editors –Kuulo Kutsar, Estonia –Kåre Mølbak, Denmark –Karl Ekdahl, Sweden –Preben Aavitsland, Norway –Markku Kuusi, Finland Editorial Board –One person from each country/region Editorial secretariat –Norwegian Institute of Public Health, Oslo

Manuscripts English or Russian Vancouver style Outbreak news, short communications – words –May be unstructured without headings Original papers – words –Introduction, Methods, Results, and Discussion. 50 compensation for costs to Russian and Baltic authors.

Risk communication

The old days People Government Mass media Reality is defined by the government

The negotiation society People Government Mass media Reality is negotiable and no longer defined by governments

Features of the information society Information is power Information is easily available The information flow is enormous Information does not have a quality stamp Information cannot be controlled

The goals of public information Strengthen democratic rights Strengthen the legitimacy of regulatory authorities Govern society Contribute to quality of life

Principles of public information Coordinated Bidirectional –Listen to the public Integrated –Information is one of your tools Active –Do not wait till you are asked

People react negatively towards late information withholding of information (conspiration) hiding of unpopular truths political or other underlying interests lies categorism, not taking things seriously alarmism

Public perception of epidemiology

The risk information vacuum

Quarantellis theses on crisis communication People are not interested in a problem until it occurs The information problems during a crisis are often others than those expected Communication is inefficient. The aim is coordination, not control. The mass media define the problems Panic is unusual. People usually acts rationally also during crises and catastrophies

Better risk communication Avoid risk information vacuums Authorities and industry are responsible for risk information Act early and often There is always more than science Educating the public is no substitute Banish no risk messages Address the contestants

Build trust in your institution Actions speak louder than words Openness: Tell what evidence is available Acknowledge emotions Competent Objective Fair Consistent

Communication from surveillance institute State: We are here to protect the health of the people! State: We are independent from industry and regulatory authorities. Open and honest about what is known. Meet concerned groups and people. Involve community groups in study planning.

Fright factors Risk is involuntary Risk is inequitable Risk is inescapable Source of risk is unfamiliar or new Risk is man-made Hidden damage Danger to children Much dread Identifiable victims Poorly understood by science Contradictory statements Department of Health, UK

Media triggers Questions of blame Alleged secrets or cover-ups Human interest Links to high- profile issues or persons Conflict Signal value Many people at risk Visual impact Sex or crime Snowballing Department of Health, UK

Working with the mass media

Your reasons for contact with the mass media Acute health promotion –warn of danger –relieve fear and uncertainty Permanent health promotion –improve health related behaviours –public education

Health promotion information Definition:Information to the public in order to impove knowledge about a health problem and its prevention Aim:Contribute to attitudes and behaviours that conserves and strengthens health Contents:Problem information Causal information Action information

The demands of mass media Early information Correct information Available information Sellable information, a story Six answers: What - who - where - when - how - why

Contacts with mass media Interview –Newspaper news or feature –Radio, TV news or feature recording or live Source –Off the record = no citation by name –Background material –Other assistance Debate programme Know your role at any time!

Before you say yes Ask the journalist about background and aims: Who is the journalist? What is the subject? Why this subject? Why do you ask me? Where and when will the interview take place? When will the interview be published? How will the interview be conducted?

Hints for interviews - 1 Define your main message (write it down) –Learn one easy and simple sentence –Say it early –Repeat it at least three times Tell the truth –Do not exaggerate –Dont answer if you dont know –Correct mistakes Say it simple –No medical jargon –No difficult words –Use concrete examples

Hints for interviews - 2 Send background information by telefax before the interview Do not criticise others Answer shortly to the negative or irrelevant questions and go back to your main message Ask to have difficult questions repeated; it gives you a break Ask to have citations read out to you before print

Hints for radio and TV interviews Prepare Make a 20 seconds message Find out the kind of programme and the subject Find out the time frame Go back to your message no matter the question Take initiatives, dont only answer Drop the details Be calm and open Show your feelings TV: Well-dressed (conservative) TV: Smile! Look at the interviewer Dont bring notes

Hints for press conferences Only for the big news that must be released to everyone simultaneously Timing –Invitation the evening before or the same morning –Start between 10 and 13, precisely One chairman, max two persons Give also written background information Allow time for questions Allow time for individual interviews

Press releases: logistics Is a press release the wisest method? Send when? Send where? Send how? Sell the news in stead? Clear, simple, short, no jargon Extra material (fact sheet, statistics)

Press release: contents and format Heading (date and sender) Title –with main message Leading text –repeat main message –what, who, where, when, how, why Text –repeat main message –most important things first (pyramid) Contact person (name, phone)

Make a press release True story: The main infectious disease hospital in your region reports to you (as a doctor at the surveillance centre) that a drug injector has just been diagnosed post mortem with anthrax. He has probably been infected by injecting heroin contaminated with anthrax spores. What is your main message to the public? Write the press release.