Last year, Dr. Rachel Maseke recruited me to help with data collection in her research. It was my first experience with clinical research, so I was excited. I was even more excited after being promised co-authorship of the particular paper; it could have been my first authorship of a research paper!
I have been struggling with an eating disorder for the past few years. I am afraid to eat and afraid I will gain weight. The fear is unjustified as I was never overweight. I have weighed the same since I was 12 years old, and I am currently nearing my 25th birthday. Yet, when I see my reflection, I see somebody who is much larger than reality.
I told my therapist that I thought I was fat. She said it was 'body dysmorphia'.
She explained this as a mental health condition where a person is apprehensive about their appearance and suggested I visit a nutritionist. She also told me that this condition was associated with other anxiety disorders and eating disorders. I did not understand what she was saying as I was in denial; I had a problem, to begin with. I wanted a solution without having to address my issues.
Upon visiting my nutritionist, he conducted an in-body scan and told me my body weight was dangerously low.
I disagreed with him.
I felt he was speaking about a different person than the person I saw in the mirror. I felt like the elephant in the room- both literally and figuratively. He then made the simple but revolutionary suggestion to keep a food diary to track what I was eating.
This was a clever way for my nutritionist and me to be on the same page. By recording all my meals, drinks, and snacks, I was able to see what I was eating versus what I was supposed to be eating. Keeping a meal diary was a powerful and non-invasive way for my nutritionist to walk in my shoes for a specific time and understand my eating (and thinking) habits.
No other methodology would have allowed my nutritionist to capture so much contextual and behavioural information on my eating patterns other than a daily detailed food diary.
However, by using a paper and pen, I often forgot (or intentionally did not enter my food entries) as I felt guilty reading what I had eaten or that I had eaten at all.
I also did not have the visual flexibility to express myself through using photos, videos, voice recordings, and screen recordings. The usage of multiple media sources would have allowed my nutritionist to observe my behaviour in real-time and gain a holistic view of my physical and emotional needs.
I confessed to my therapist my deliberate dishonesty in completing the physical food diary and why I had been reluctant to participate in the exercise. My therapist then suggested to my nutritionist and me to transition to a mobile diary study.
Whilst I used a physical diary (paper and pen), a mobile diary study app would have helped my nutritionist and me reach a common ground (and to be on the same page) sooner rather than later.
As a millennial, I wanted to feel like journaling was as easy as Tweeting or posting a picture on Instagram. But at the same time, I wanted to know that the information I provided in a digital diary would be as safe and private as it would have been as my handwritten diary locked in my bedroom cabinet.
Further, a digital food diary study platform with push notifications would have served as a constant reminder to log in my food entries as I constantly check my phone. It would have also made the task of writing a food diary less momentous by transforming my journaling into micro-journaling by allowing me to enter one bite at a time rather than the whole day's worth of meals at once.
Mainly, the digital food diary could help collect the evidence that I was not the elephant in the room, but rather that the elephant in the room was my denied eating disorder.
The elephant in the room
In July 2021, our research study finally came to an end. Sadly, She didn't include me in the authorship because my contribution to the paper wasn't enough. I was very heartbroken. However, I was reminded not to give up on what matters. You might also come across a similar situation when your will is put to the test. It is important always to remember that persistence is the name of the game.
A famous quote by a French mathematician and politician, François Jean Arago says, "To get to know, to discover, to publish—this is the destiny of a scientist." Research publication and dissemination form the ultimate feeling of satisfaction and accomplishment for every scientist. You can't forget the time you were the author of a research publication. In addition to the feeling of happiness, you feel more confident and appreciated that your hard work, sacrifice, sweat and tears have finally paid off. I didn't believe that they wouldn't include me in the authorship of Dr. Maseke's paper.
Authorship is one of the most disputable topics in the scientific community, usually raising conflicts, especially among junior researchers.
It would help if you also looked on the bright side of any obstacle on your way. At first, I was disappointed with Dr. Maseke. But later, I realized that she wasn't really at fault. Although my first authorship dream didn't come into reality, I finally understood the guidelines for research authorship. There are standards to be met to qualify for authorship.
According to Harvard Medical School, authorship gives credit and assign responsibility for a published intellectual work. An author is a person who has made a significant contribution to a scientific report. (1) They must agree to have their name printed in the byline of the published report.
As we know, science fosters collaborations, so some scientific articles have more than one author. I was recently a co-author of a published article under Dr. Olivier Uwishema. Our paper had eight authors from different countries such as Rwanda, Kenya, Nigeria and Turkey. Generally, we can categorize Authors into the following:
The lead author is sometimes called the first or main author of the published article. These are authors who have made the most contributions and performed the central experiments in the project. They have the role of preparing the first draft of the manuscript. In most cases, if you want to be the lead author, you must be willing to sacrifice the majority of your time and energy to research. In addition, they should ensure that other authors meet the requirements for authorship. In our paper, Dr. Olivier Uwishema was the lead author. He made sure each author had submitted their expected contribution in time. In addition, he instructed us to submit our affiliations; he sent them to the journal of medical virology.
The lead author, in most cases, serves as the corresponding author. He is responsible for responding to editorial queries on time. After publication, the corresponding author should respond to critiques of the work. Some journals, for example, Gigascience, allow two corresponding authors. An author's availability throughout the submission and peer review process is essential to avoid publication delays. However, if the author is too busy for the role, he should propose another person (co-author). You are encouraged to resign from the role whenever you are overwhelmed by other duties.
These are other people who have qualified for authorship. They should contribute substantially and review and approve the manuscript. In our paper, Dr Olivier Uwishema distributed tasks to us and always insisted on punctuality in submitting our expected contributions.
Some projects with many authors, such as multi-centre trials, prefer using a group name. The corresponding author has the task of specifying the group name during the submission of the manuscript. Typically, the byline will include a group name, whereas Medline will consist of a list of authors. For example, multi-institutional project consortiums often use group authorship.
We all want to publish articles. But when you want to publish in high-impact journals, you have to be prepared to take on the standard scientific responsibilities. According to the Council of Science Editors Organization, research authors should adhere to the following responsibilities.
The author-editor should maintain confidentiality in their relationship. Moreover, Authors should ensure confidentiality in all communication between themselves and the journal. For example, even after I received emails of acceptance of our manuscript. I tried to maintain confidentiality until the paper I co-authored was published in August 2021.
Editors often give low priority to studies that don't advance scientific knowledge. Moreover, Authors are usually required to provide a statement showing evidence of the originality of the study.
Authors should be open when complying with journal submission requirements—for example, an author's financial and conflict of interest disclosures. You must report all sources of funding and any products or services provided by third parties in the research. In our paper, we reported no conflict of interest.
These agreements allow authors to retain certain rights to the material. Authors should assign copyright to the journals publishing their work, especially in medical publishing. In addition, journals encourage authors to double-check and ensure the article doesn't contain any plagiarized content. You can use Grammarly to double-check for plagiarism in your paper.
Some authors wish to reuse previously published content, such as previously published images. Journals usually have guidelines for reusing any copyrighted material, so authors should seek "permission" from them. For example, we managed to get permission to reuse a chart in our article.
In the biomedical sciences, authors are usually not allowed to submit their manuscripts to multiple journals simultaneously. Moreover, the violation of this policy can lead to the rejection of the paper.
In addition, authors should wait until the original journal formally rejects the submitted manuscript undergoing peer review. For example, I remember how Dr Olivier Uwishema insisted on a single submission of our paper. He emphasized submission to the journal of medical virology only.
There are no universally accepted standards for awarding authorship across cultures and scientific disciplines. However, basic authorship principles are almost similar in different institutions, including medical schools and journals. Sadly, various research motives can sometimes encourage practices that violate these standards. According to the Elsevier fact-sheet, the following types of authorship are considered unacceptable:
It involves professional writers usually paid by commercial sponsors, thus contributing substantially to a paper but not getting acknowledged. For example, it occurs when a clinician (author) conducts research; they collect data but don't write the article themselves. You are required to acknowledge everyone who assisted in the research output. (2)
These authors haven't made any significant contribution to the paper. They are usually listed to increase the chances of publication. For example, if you include a very senior person in authorship just because you believe they will improve the odds of publication.
It involves authorship based solely on insubstantial affiliation with the study. For example, lead authors usually face conflicting pressure to include their supervisor in publication even though they haven't made any direct, meaningful contribution.
Moreover, you shouldn't extend authorship to someone just because he is a senior or mentor. I believe that the standard for authorship should be adhered to by all researchers. Another example is when you get authorship because you are the head of the department where the study takes place.
There are cases when a non-author attempts to buy authorship in an article. It occurs especially after the paper has been invited for review or provisionally accepted. There have been numerous reports in China (3), where people sometimes buy authorship for as little as $1600. I believe this is a violation of our values as scientists.
Authorship should be transparent, and the authors should take public accountability for the published work. In very rare cases when attaching one's name can threaten their safety or loss of employment, a journal editor can publish anonymously.
In September 2021, I had a brief dialogue with my mentor, Dr Kristin Schroeder. She said, "Each author is expected to have made a significant contribution in the conception, design, conduct, analysis, or interpretation of data in the research project." According to the International Committee of Medical Journal Editors (ICMJE), you should fulfil the following four criteria to qualify for authorship:
Contributors who adhere to fewer than all 4 of the above criteria for authorship should not qualify to be authors. (3) They should be part of the 'Acknowledgements'. For example, In Dr Rachel's study, I was part of the acknowledgements for my valuable contribution to data collection.
Some journals, such as the BMJ, encourage a contributor-ship policy. It ensures that individuals qualify for authorship. They usually request and publish information about the contributions of each person who participated in the original research. These policies help to remove much of the ambiguity surrounding contributions. But it leaves unresolved the question of the quantity and quality of contributions that qualify an individual for authorship. As a corresponding author, you should regularly communicate with your co-authors, which helps to minimize the risks of conflicts in the future.
Without a doubt, the failure to determine whether a researcher has qualified for authorship is a potential cause for conflicts among researchers. Another cause of conflicts in the scientific community, especially among junior researchers, is the order of authorship. In most disciplines, the order of authorship indicates the degree of contributorship in a paper. Examples of authorship policies include descending order of contribution, placing the highest-valued author first and the most senior author last. The ICMJE recommends that researchers should decide the best order of authorship during the initiation of the study. In Dr. Olivier Uwishema's paper, he communicated with us about the order of authorship.
Authorship disputes are rife. Results from an online survey organized by the National Institute of Environmental Health Sciences among 6700 international researchers showed that 46.6% had experienced disagreements about author naming and that 37.9% had had disputes about name order on author lists.
Reports from the Committee of Publication Ethics (COPE) showed, there are two types of classifications on conflicts about authorship :
These mainly include disagreements that do not breach ICMJE guidelines. Examples of questions of interpretation, such as whether someone's contribution was "substantial" or not.
As the victim author, you should clarify and show that you have contributed enough to the project. You have to negotiate with your fellow co-authors to reach a consensus. For example, if a supervisor instructs you to add or omit an author's name, you should first politely show them documentary proof such as guidelines to authors. If the supervisor is still not convinced, you can follow a senior such as the department head or dean.
These are disagreements that breach ICMJE guidelines, such as the use of authorship lists that are unethical. An honest author usually faces conflicting pressures about whether to say nothing (and therefore be complicit in unethical behaviour) or blow the whistle, even though this might damage their career prospects or future funding.
You should explain that the suggested author list contravenes editors' recommendations and could be considered scientific misconduct. We shouldn't keep silent and encourage the violation of authorship principles. Moreover, we should warn the unethical authors since it can also harm their careers or create possible funding problems in the future.
Disagreements over authorship have a damaging effect on the effectiveness and reputation of individuals and their academic institutions. Many of these disagreements usually arise from misunderstandings and failed communication between researchers.
As a corresponding author, you have the task of ensuring smooth communication between co-authors. In addition, he also should address any authorship conflicts that might arise during research. We can reduce the incidence of authorship problems in the following ways:
Ignorance of the ethics of authorship is a problem for many researchers who still rely on local customs and practices. We need to be aware of the changes around the ethics of authorship and the guidelines of journals. Departmental libraries should have at least one book on publication ethics. A great starting point is the book "Sharing publication-related Data and Materials: Responsibilities of Authorship in the Life Sciences".
From the beginning of a research project, the whole research team should have authorship discussions, especially face-to-face meetings. As a corresponding author, you should ensure all investigators have an idea of their expected individual contributions to the research output. Proper documentation of the authorship agreements during the evolution of the project is essential. The authorship agreement should include:
All authors should participate and approve any changes in authorship after the initial submission—for example, the deletion, addition, or reordering of authors. Moreover, editors should also be aware of any alterations. They can sometimes contact any authors to ascertain whether all authors agreed to the changes in authorship.
A famous quote from a renowned radio and television writer, Andy Rooney, says, "The best classroom in the world is at the feet of an elderly or senior person." Our mentors have often come across the same challenges we are experiencing, so it's wise to learn from them. We should be cautious and aware that there may be ill-intentioned seniors who are unethical in their profession. It is better to only choose people who you trust. They should be honest and ethical.
The Committee of Publication Ethics (COPE) encourages authors to work on their differences on their own. They remind us that you should not rely on journal editors to solve your article's authorship disputes. However, problems such as power differentials tend to hinder the resolving of most conflicts internally. I have heard of cases when senior faculty/authors act as bullies, thus dictating authorship discussions.
It is without a doubt that discussing authorship is very crucial before beginning any research project. In theory, research authorship sounds straightforward, but in practice, it often causes misunderstandings. This is hardly surprising given the massive pressure on individuals and institutions to "publish or perish."
We all dream to be authors in many publications. Consequently, we are tempted to violate the standards for authorship. Nevertheless, we should maintain our ethical values and diminish authorship conflicts.
I'm glad I learned about research authorship after only being acknowledged in Dr. Rachel Maseke's study. Even if it didn't change the author list as I would have liked, it led to changes in my research perspective. It would be best if you didn't give up even when setbacks arise in your paths to success.
1. Harvard Medical School. Authorship Guidelines. 1996.
2. (ICMJE) INTERNATIONAL COMMITTEE of JOURNAL EDITORS. Defining the Role of Authors and Contributors.2021
3. Academy Enago. Scientific Misconduct: Authorships for Sale. 2020.
If appropriately used in the 21st century, data could save us from lots of failed interventions and enable us to provide evidence-based solutions towards tackling malaria globally. This is also part of what makes the ALMA scorecard generated by the African Leaders Malaria Alliance an essential tool for tracking malaria intervention globally.
If we are able to know the financial resources deployed to fight malaria in an endemic country and equate it to the coverage and impact, it would be easier to strengthen accountability for malaria control and also track progress in malaria elimination across the continent of Africa and beyond.
West African Lead, ALMA Youth Advisory Council/Zero Malaria Champion
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Dear Digital Diary,
I realized that there is an unquestionable comfort in being misunderstood. For to be understood, one must peel off all the emotional layers and be exposed.
This requires both vulnerability and strength. I guess by using a physical diary (a paper and a pen), I never felt like what I was saying was analyzed or judged. But I also never thought I was understood.
Paper does not talk back.Using a daily digital diary has required emotional strength. It has required the need to trust and the need to provide information to be helped and understood.
Using a daily diary has needed less time and effort than a physical diary as I am prompted to interact through mobile notifications. I also no longer relay information from memory, but rather the medical or personal insights I enter are real-time behaviours and experiences.
The interaction is more organic. I also must confess this technology has allowed me to see patterns in my behaviour that I would have otherwise never noticed. I trust that the data I enter is safe as it is password protected. I also trust that I am safe because my doctor and nutritionist can view my records in real-time.
Also, with the data entered being more objective and diverse through pictures and voice recordings, my treatment plan has been better suited to my needs.
No more elephants in this room