Wednesday, December 18, 2013

A Frequently Asked Comma Question

Today's topic: The Oxford (or "serial") comma 

Quick quiz.  Which is correct? 

A. I bought apples, oranges and bananas. 

OR 

B. I bought apples, oranges, and bananas. 

Note that in both examples, we have a list of three items.  The difference is whether the author used the Oxford (a.k.a. "serial," a.k.a. "Harvard") comma, a comma that in a series of three or more items comes between the second-to-last item and the "and."  In the example above, the Oxford comma is highlighted in yellow.  So let's have the results of our quiz... 

If you said A, you're right.  

If you said, B, you're right. 

Everybody wins, huh?  Not so much.  The irritating fact is that there is no true consensus on whether to use the Oxford comma.  Some style manuals say to always use it, some say to never use it, and some say to use it only in certain circumstances.  Ugh, ambiguity. 

Both the Purdue OWL (Online Writing Lab) and the 6th edition APA handbook say to use the Oxford comma.  However, the AP manual (used by journalists) says not to use it.  Also, amusingly, Oxford University no longer recommends using the comma that bears its name.

So how should we determine whether to use the Oxford comma?  Since there isn't a consensus, I think the rule of thumb should be to use it when it is necessary to avoid confusion.  For example, take this sentence: 

I'd like to thank my parents, former Secretary of State Madeline Albright and Colin Powell.  

The way that's punctuated, it looks like the author's parents are Madeline Albright and Colin Powell.  On the other hand, if you use the Oxford comma... 

I'd like to thank my parents, former Secretary of State Madeline Albright, and Colin Powell. 

In that example, it's clear that the author is thanking four people.  She's thanking her parents, and she's also thanking Madeline Albright and Colin Powell.   

So.  In sentences where omitting the Oxford comma might cause confusion, I say put it in.  However,  you should definitely make sure to check the author guidelines of the journals to which you submit, as well as any style manual required by a professor or journal editor.  

For information on which style guides and organizations say to use the Oxford comma and which say to omit it, check out this entertaining chart:  http://www.quickanddirtytips.com/education/grammar/oxford-comma-pictures?page=all 

I hope you found this week's post helpful.  Happy scribbling!

Subject Verb (Dis)Agreement

Today's topic: Subject-verb (dis)agreement

Problems with subject-verb agreement definitely make the "grammar greatest hits" list.  As my granddad used to say, "if I had a nickel" for every subject-verb clash I see, I'd be able to retire pretty soon.  If you don't do anything else to improve your writing this week, take the time to read this post.  It may save you from an editor's wrath some day.

What does "subject-verb agreement" mean?  As you know, a complete sentence must have a subject (which tells us who or what is performing the action) and a verb (which tells us what that action is).  If the subject is plural, the verb must also be plural.  If the subject is singular, the verb must also be singular.  Here are some simple examples to show proper S-V agreement:

The cat loves her new bowl.  "Cat" is singular, and "loves" is singular.
           S     V

The cats love their new bowl.  "Cats" is plural, and "love" is plural.
           S     V

Each patient in the ICU has a private room.
        S                                       V

Everyone in our culture has his or her own beliefs about this difficult issue. 
         S                                          V

Most people wouldn't make mistakes with those simple, straightforward sentences, because it is very clear where the subjects and verbs are.  Some people might raise an eyebrow at the last example, because many people erroneously believe that the words "everybody" and "everyone" are plural (in fact they are singular, referring to every individual body and every individual one).  But most of us would have gotten those four right.  However, it isn't always this easy.  The more words there are between a subject and its verb, the harder it can be to ensure subject-verb agreement. 

Let's get more complicated.  Which of the following is correct?


A. Evaluation of the new innovation, with a special focus on patient safety and quality improvement, is essential.

B. Evaluation of the new innovation, with a special focus on patient safety and quality improvement, are essential. 

If you guessed A, pat yourself on the back (or have a cupcake).  You're correct! 

This is a tough one, because there are so many words between the subject ("evaluation") and the verb phrase that connects to it ("is essential"). 

It could also be confusing because at first glance you might think this sentence has more than one subject--that more than one thing is being identified as essential in this sentence.  You might think the author is saying that both evaluation of the new innovation AND a special focus on patient safety and quality improvement are essential.  But look closer, and you'll see that the focus on patient safety and quality improvement is presented as PART OF evaluation of the new innovation.  The word "with" is what clues us in to that.  You wouldn't say "Pizza with pepperoni and green peppers are my favorite dish," right?  You'd say "Pizza with pepperoni and green peppers is my favorite dish."  Same situation.

Let's do another one.  Which of these is correct?

A.  A need for improvements in patient education and follow-up care were the main topics of discussion at last week's meeting.

B.  A need for improvements in patient education and follow-up care was the main topic of discussion at last week's meeting.


If you guessed B, you are correct!  This example is tricky in a similar way to the previous example.  At first glance, it could look as though the author is simply listing two topics that have come up at recent meetings--improving patient education, and follow-up care.  However, look closer and you will see that the subject of the sentence is actually the NEED for these two things, and it is the NEED for both improved patient education and better follow-up care that was discussed at these meetings. 

Note that based on the order of the two list items we can tell that they are closely connected--they talked about a need to improve both patient education and follow-up care.  If we flipped the order of the two list items, it might be a different story.  This would actually be okay, but the meaning would be different:  The need for follow-up care and improvements in patient education were the main topics of discussion at last week's meeting.  This wording presents two separate topics, so the subject and verb are both plural  However, the original wording breaks down like this:

The need for improvements in patient education and follow-up care has been 

 S-singular                                                                                                                  V-singular
a topic of discussion at several recent meetings.   

Remember that the longer and more complex a sentence, the more likely it is that you will accidentally end up with a mismatched subject and verb pair.  This is yet another excellent reason to read your work aloud when you proofread, and to read slowly and carefully.  Make sure you are clear about which word or phrase is the subject of your sentence, and then make sure it matches the verb.

I hope this post has helped clarify the tricky topic of subject-verb agreement.  Happy scribbling!

Who vs. Whom

Believe it or not, this week's post was inspired by an owl.   Or rather, a wonderfully quirky owl-shaped throw pillow my husband gave me.  We were talking about what to call him (he's got a lot of personality--he needed a name), and my husband suggested "Whom."  And lo, the topic for this week's tip was born.

So.  Who vs. whom.  Most of us struggle with this one from time to time.  Fortunately, it's not terribly difficult once you learn the rules, and there is an easy trick to help you remember those.

What are "who" and "whom?"  They are pronouns, just like him/her/his/hers/they/their/theirs/it/etc.  To decide whether to use "who" or "whom," you have to determine whether your pronoun will be the subject or the object of the sentence.  Bear with me for a second and all will become clear.

The subject of a sentence is the ACTOR--in other words, who or what is doing something.  The object of a sentence is the RECIPIENT OF THAT ACTION--who or what is having something done to them.  Let's look at some examples:

I fired Janet.  In this sentence, "I" is the subject and "Janet" is the object (poor Janet). 
I married Paul eleven years ago today.  In this sentence, "I" is the subject and "Paul" is the object (lucky Paul).
I treated that patient last week. In this sentence, "I" is the subject and "that patient" is the object.

Internet "Grammar Girl" Mignon Fogerty has a neat trick for remembering which is the subject and which is the object in a sentence.  She suggests thinking about the sentence "I love you," and remembering that "you" are the OBJECT of my affection (and the OBJECT of that sentence).

So...when do I use "who" and when do I use "whom?"  Use "who" when you are referring to the subject of a sentence, and use "whom" when you are referring to the object.  That's:

WHO = SUBJECT:  The one who's doing something
WHOM = OBJECT: The one who's having something done to him/her

Examples:

Whom: Referring to the object of the sentence:

Whom did you fire?  I fired Janet.
Whom did you marry?  I married Paul.
Whom did you treat last week?  I treated that patient.
With whom are you going snorkeling? I'm going snorkeling with Sarah.

In these examples, we're asking about the OBJECT, the recipient of action, the person having something done to him or her (Janet, Paul, that guy).

Who: Referring to the subject of the sentence:
 

Who fired Janet?  I did.
Who married Paul?  I did.
Who treated that guy last week?  I did.
Who's going snorkeling with Sarah?  I am.

In these examples, we're asking about the SUBJECT, the person who did something (fired Janet, married Paul, treated that guy, went snorkeling with Sarah).

A trick to help you remember:  Since high school, I've used this to help me remember when to use "whom."  As you probably noticed, "whom" ends in "m."  So does the pronoun "him."  If you can't decide whether to use "who" or "whom," just think--if I asked myself the question, would the answer be "he," or "him?"  Example:

If you ask, "who/m did I marry?" you'd answer "I married him."  You wouldn't say "I married he."  So the correct pronoun here is "whom:"  Whom did I marry?  Him=whom.

If you ask, "with who/m am I going to the party?" you'd answer "I'm going to the party with him." You wouldn't say, "I'm going to the party with he."  In this case, the correct pronoun is "whom."  Him=whom.

If you ask "who/m fired Janet?" you'd answer "He fired Janet." You wouldn't say "Him fired Janet" (unless you suddenly started talking like Tarzan).  So the correct pronoun here is "who:" Who fired Janet?  He=who.

If you ask "who/m invited Joe to the party?" you'd answer "He invited Joe to the party."  You wouldn't say "Him invited Joe to the party."  In this case, the correct pronoun is "who."  He=who.

Just remember the WHOM/HIM connection, and you should be fine. 

Also:  If you want a good laugh, check out this handy comic on how to use "whom," by hilarious genius "The Oatmeal" (warning--it's a little silly and irreverent): http://theoatmeal.com/comics/who_vs_whom

I hope you found this week's post helpful.

Monday, October 28, 2013

"His or her" or "Their?" Which is correct?

"Generic" or "Gender-Neutral" Pronouns: A Huge Mess

Have you ever wondered which of these is correct?  

A. Each student must bring his or her own laptop to the seminar.   

B. Each student must bring their own laptop to the seminar.    

Technically, A is correct and B is incorrect.  This is because "each student" is singular--it refers to each individual student--while "their" is a plural pronoun.  A noun must match its pronoun. 

However, although "their" is technically grammatically incorrect in that sentence, not every editor would flag it.  Here's why:  In the days before politically correct speech became the norm, everyone just used "he/his/him" as "gender neutral" pronouns.  When we started paying more attention to using unbiased language, we realized that "he" isn't actually neutral at all--it's masculine.  This poses a problem, though.  Do we use "he or she" instead?  Some people say yes, but others argue that plugging in "he or she" every time is cumbersome.   

So--many people use "they/their" to deal with this issue.  The reason this is technically ungrammatical is that "they" is a plural pronoun.  In a sentence like the example above, where you've established a singular subject ("an individual"), you technically need a singular pronoun.   

Let's look at another example: 

*According to the Health Belief Model (Rosenstock, Strecher, & Becker, 1988; Rosenstock, 2004), an individual's behavior is the result of their health beliefs or the subjective value that he or she places on a given outcome (e.g., the desire to avoid illness or to get well) and their belief or expectation that a particular action will lead to that outcome. 
As you can see, this sentence employs a mix of singular and plural pronouns--the author uses both "he or she" and "their."  You could fix this sentence in a number of ways (I have highlighted my changes): 

His/her and he/she: 

*According to the Health Belief Model (Rosenstock, Strecher, & Becker, 1988; Rosenstock, 2004), an individual’s behavior is the result of his or her health beliefs or the subjective value that he or she places on a given outcome (e.g., the desire to avoid illness or to get well) and the belief or expectation that a particular action will lead to that outcome. 
Notice that I changed "their" to "the" in the latter part of the sentence to avoid using "his or her" again. You could also do this (to further avoid the "his or her...he or she" repetition):   

S/he: 

*According to the Health Belief Model (Rosenstock, Strecher, & Becker, 1988; Rosenstock, 2004), an individual’s behavior is the result of his or her health beliefs or the subjective value that s/he places on a given outcome (e.g., the desire to avoid illness or to get well) and the belief or expectation that a particular action will lead to that outcome. 
In this example, I changed "he or she" to "s/he."  Some writers like this solution, while others claim that it looks too informal.    

Some experts (myself included) recommend wording sentences to avoid the whole problem, like this:   

*According to the Health Belief Model (Rosenstock, Strecher, & Becker, 1988; Rosenstock, 2004), an individual’s behavior is the result of the health beliefs or the subjective value that individual places on a given outcome (e.g., the desire to avoid illness or to get well), and the belief or expectation that a particular action will lead to that outcome. 

Or like this (change the singular noun to a plural noun): 

*According to the Health Belief Model (Rosenstock, Strecher, & Becker, 1988; Rosenstock, 2004), individuals behave according to their health beliefs or the subjective value they place on a given outcome (e.g., the desire to avoid illness or to get well), and the belief or expectation that a particular action will lead to that outcome. 

that example, I changed "an individual" (singular) to "individuals" (plural).  This made it appropriate to use the plural pronouns "they" and "their," thus eliminating the problem. This won't always be a good option; it depends on the sentence. 

Earlier I said that not every editor would have flagged this.  This is because it's been a lot of years since the advent of politically correct speech, and people are getting tired of having to wrestle with their pronouns.  Using "they/their" instead of "he or she" is an easy solution that doesn't usually cause reader confusion (most of the time, readers will realize that you are simply trying to avoid cumbersome wording).  Many experts believe that eventually using "they/their" as gender neutral pronouns will become the new rule, but at the moment it's still technically grammatically incorrect.  For some people, in fact, it's a pet peeve.  Until the rule changes, then, the best thing to do is word the sentence to avoid the whole sticky mess.  

For more on this, check out this great post by "Grammar Girl" Mignon Fogerty:  http://www.quickanddirtytips.com/education/grammar/generic-singular-pronouns?page=all 

I hope you've found this week's post helpful.  Happy scribbling! 

Friday, October 4, 2013

I.e. vs. E.g

Today's topic: I.e. or e.g.?

Deciding  whether to use i.e. or e.g. tends to give people fits.  Some writers just decide which abbreviation they think sounds better, and use that one for everything.  There are rules for when to use each one, however, and the two are not interchangeable.  So let's get this sorted out once and for all.

What i.e. and e.g. stand for:
I.e. stands for the Latin phrase "id est," which essentially means "that is."  E.g. stands for the Latin phrase "exempli gratia," which means "for instance" or "for example."  This alone should go some way toward helping you distinguish between them, but let's go a little further.

When to use which:
There are a few tricks that experts advise using to help you remember when to use which abbreviation.  For example, internet "Grammar Girl" Mignon Fogerty says to remember that i.e., which starts with i, means "in other words," and that e.g., which starts with e, means "for example."  E: for example.  I: in other words.  I find this trick to be the most helpful.

If you don't like that tip, try remembering it this way: "e.g." looks a bit like the word "egg," which rhymes with "example."  E.g. = for example.  "I.e." could stand for "in essence," which is quite similar to its actual meaning, "in other words."

Examples:

E.g.: "for example."  Use e.g. to tell readers that you are about to give them an example of something.

"I love desserts, e.g. cheesecake and gelato." 

Note that I love plenty of other desserts other than cheesecake and gelato; my use of "e.g." doesn't indicate that I'm going to give you a comprehensive list of ALL the desserts I like.  It just indicates that I'm giving you a couple of examples to illustrate my point.

"He likes watching sports, e.g. baseball and basketball."

Similarly, the use of "e.g." in this sentence implies that the guy likes watching lots of different sports, not just baseball and basketball.  Those are just given as two examples from a list that probably includes quite a few others as well.

I.e.: "in other words."  Use i.e. to introduce a detailed, specific clarification.  If I only loved two desserts--cheesecake and gelato--then I'd want to use i.e., as in:

"I love desserts, i.e. cheesecake and gelato."

In this example, because I used "i.e.," you can deduce that cheesecake and gelato are the only two desserts I love.

"He likes watching sports, i.e. baseball and basketball."

In this example, the use of "i.e." tells us that this guy only likes watching two sports, baseball and basketball.

Still confused?
There's no reason why you absolutely HAVE to use the abbreviations, so if you're still a little fuzzy on which is which, just spell out what you mean, either "for example" or "in other words."

To read Mignon Fogerty's excellent post on the particulars of e.g. and i.e. (including how to punctuate them), click here: http://www.quickanddirtytips.com/education/grammar/ie-versus-eg

I hope this has helped clarify when to use these two often-troublesome abbreviations.  Happy scribbling!

That vs. Which

Today's topic: That vs. Which

"Should I use 'that' or 'which' in this sentence?"  It's a frequently asked question, and a frequent blunder.  Fortunately, the rules governing "that" and "which" are fairly simple.  Let's clear up this troublesome topic, shall we?

THAT:

"That" should precede a restrictive clause.
  What's a restrictive clause?  It's a phrase that is essential to the meaning of a sentence.  If you eliminate a restrictive clause, the meaning changes.  Let's look at some examples.

Cupcakes that have caramel in them are addictive to me.

If we remove the underlined clause, we totally change the meaning.  I'm not addicted to regular cupcakes, just the ones with caramel in them. 

Flowers that have a strong scent fascinate my dog. 

Not all flowers have a strong scent, so if we remove the underlined clause we totally change the meaning of the sentence.  My dog isn't fascinated by odorless flowers.

The enchiladas that were made with hot peppers made him sick.   

By now, you get the idea.  The regular enchiladas didn't make him sick, only the ones with hot peppers.

WHICH:

Use "which" before a nonrestrictive clause. 
What is a nonrestrictive clause?  It's a phrase that can be omitted from a sentence without substantially changing its meaning.  Nonrestrictive clauses are non-essential; they  just provide extra details.  Let's look at some examples.

The Ferrari Enzo, which costs a fortune, is my brother's dream car.

If we eliminated the underlined phrase, it wouldn't substantially change the meaning of the sentence (everyone knows Ferraris are expensive). 

The couch, which has a wine stain on the left armrest, needs to be cleaned.

Again, the message is the same with or without the underlined portion.  The couch needs cleaning.  The underlined clause simply gives us more information about why.

Notice that the nonrestricted clauses in the two examples above are bookended by commas.  In fact, nonrestricted clauses are almost always either surrounded by commas or preceded by them (as in "We saw a double rainbow, which was gorgeous").

If you have trouble remembering phrases like "restricted clause" and "nonrestricted clause," just remember this: If you could take out the phrase without substantially changing the meaning of the sentence, use "which."  If you need the phrase to make your meaning clear, use "that."

One more tip:  Never use "which" or "that" when referring to people; use "who" or "whom."  Example:  The participants, who were chosen through random sampling, ranged in age from 18 to 35.

Pretty simple, no?  I hope you've found this week's post helpful.  As always, happy scribbling!

Tuesday, September 10, 2013

Introductions

Today's topic: Introductions
 
Your introduction is the first impression you make on your readers, and as the saying goes, "you never get a second chance to make a first impression."  Unfortunately, many writers neglect to give the introduction the careful attention it deserves.  The result can be a reader who trudges reluctantly into the body of the paper, disinterested in or confused about the author's message--or worse, a reader who decides not to read the paper at all.
 
An introduction has two jobs.  It should engage the reader's attention and interest, and it should clearly and specifically preview the content of the paper.
 
#1.  Engage the reader's interest:
 
You can accomplish this in a number of different ways.  How you choose to do so will depend on the type of paper you're writing--its purpose and audience--and what your paper is about.  You may remember from your undergraduate English 101 class that the instructor sometimes encouraged you to open with an anecdote or an appeal to the reader's emotions.  This is okay for certain types of papers--personal narratives, for example, or persuasive essays on controversial topics.  In scientific writing, however, it's best to stay away from those techniques. 
 
In scientific writing, you can engage your readers' attention by convincing them of the importance and relevance of your topic--essentially, by showing them why they should care.  If you are writing about diabetes, you can provide statistics about how widespread the disease is, how many Americans it affects, its consequences and complications, how many people die from it each year, and how much money it costs the healthcare system.  You might show how much more prevalent the disease has become in recent years. 
 
Let's look at an example.  This is an excerpt from the introduction to a paper titled “Psychometrics of the PHQ-9 as a measure of depressive symptoms in patients with heart failure” by Hammash, Lennie, Seongkum, Chung, Lee, & Moser, 2012. 
 
        The purpose of this study was to assess the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) as a measure of depressive symptoms in patients with heart failure (HF). HF affects more than 5.7 million Americans.¹ About 14% to 63% of patients with HF have depressive symptoms.2-4
             Depression in patients with HF is associated with poor functional status, poor adherence to medication and exercise, poor perceived control, increased morbidity and mortality, and increased readmission rates. 5-15 Therefore, identifying depressive symptoms in patients with HF is important to improve patients’ physical and mental well-being. However, depressive symptoms commonly go undiagnosed and untreated.16-19 Several factors may contribute to under-treatment, but a major issue is lack of clinician familiarity and comfort with assessing depression.20 The potential overlap of depressive symptoms and symptoms of HF or associated co-morbidities also creates a challenge for clinicians in the diagnosis of depressive symptoms in patients with HF.21,22
The Beck Depression Inventory-II (BDI-II) is a valid, self-report measure of depressive symptoms; however, it is relatively long and complex. It consists of 21 items with up to six response options for each. On average, it takes about five minutes to complete. The BDI-II also has a pre-administration fee, which makes it expensive to use in the primary care settings. Thus, non-psychiatric health care providers need a brief instrument to diagnose depressive symptoms, particularly in the population of patients with HF.
Notice how the authors immediately establish the prevalence of heart failure, and how many heart failure patients suffer from depression.  Not only that, but they also describe some serious consequences of depression in this population--poor functional status, increased morbidity and mortality, etc.  This establishes the importance of the problem.  They go on to point out a further problem; despite the importance of identifying and treating depression in heart failure patients, depressive symptoms often go unnoticed and unmanaged.  They explain that the current gold standard measurement tool for depressive symptoms (the Beck Depression Inventory) is long, complicated, and expensive to use in the primary care setting.  They assert, then, that providers need a better, easier tool for diagnosing depressive symptoms in patients with heart failure.
The authors have done a beautiful job of concisely explaining the problem at hand, and convincing us of its importance.  Each piece builds on the pieces before in a smooth, logical flow of ideas.  In a moment I'll show you how they go on to describe their paper's purpose...
 
#2.  Clearly and specifically preview the paper's content:
 
Think of an introduction as a road map for your paper.  A reader should be able to read your introduction and know precisely, specifically, what your paper will be about. An important part of this equation is the inclusion of a clear and complete purpose statement.  You may have also heard this referred to as a thesis statement or statement of specific aims.  Whatever you call it, it's a crucial part of your paper's introduction (and contrary to the name, a purpose statement does not have to fit into a single sentence--they are often several sentences long).
 
One common problem with purpose statements is that they are too vague.  For example:
 
The purpose of this paper is to explore the effects of instant messaging on youth literacy.
 
Why isn't this a strong purpose statement?  Because it's too general.  It doesn't express a point of view, or provide any details about what aspects of the topic the paper will cover.  Does the author think that instant messaging is having positive effects on youth literacy?  If so, what are those positive effects?  Does he think instant messaging is having negative effects on youth literacy?  What negative effects? 
 
I could imagine a dozen different papers on the topic of instant messaging and youth literacy.  From reading the sentence above, I can't tell much about what the author's paper will be about.  So let's look at another version of this same sentence:
...Instant messaging seems to be a beneficial force in the development of youth literacy because it promotes regular contact with language, the use of a written medium for communication, and the development of an alternative form of literacy.*
 *From a sample student essay by David Craig, in The St. Martin's Handbook, 6th ed., by Andrea Lunsford.
 
This is a much stronger purpose statement.  It tells us the author's point of view--that instant messaging has positive effects on the development of youth literacy.  It also previews the three main reasons why the author believes this is true.  I assume the rest of the essay will follow the road map set out in this purpose statement, and that the author will fully develop each of those three arguments in order to convince us of his overall point.
 
Let's get back to the Hammash, et al. introduction we looked at in the previous section.  Note how these authors preview the content of their paper.  I'll reproduce the entire introduction here, so that you can see it in one piece. I will highlight what I view as the purpose statement in blue.
        The purpose of this study was to assess the reliability and validity of the Patient Health Questionnaire-9 (PHQ-9) as a measure of depressive symptoms in patients with heart failure (HF). HF affects more than 5.7 million Americans.¹ About 14% to 63% of patients with HF have depressive symptoms.2-4
             Depression in patients with HF is associated with poor functional status, poor adherence to medication and exercise, poor perceived control, increased morbidity and mortality, and increased readmission rates. 5-15 Therefore, identifying depressive symptoms in patients with HF is important to improve patients’ physical and mental well-being. However, depressive symptoms commonly go undiagnosed and untreated.16-19 Several factors may contribute to under-treatment, but a major issue is lack of clinician familiarity and comfort with assessing depression.20 The potential overlap of depressive symptoms and symptoms of HF or associated co-morbidities also creates a challenge for clinicians in the diagnosis of depressive symptoms in patients with HF.21,22
The Beck Depression Inventory-II (BDI-II) is a valid, self-report measure of depressive symptoms; however, it is relatively long and complex. It consists of 21 items with up to six response options for each. On average, it takes about five minutes to complete. The BDI-II also has a pre-administration fee, which makes it expensive to use in the primary care settings. Thus, non-psychiatric health care providers need a brief instrument to diagnose depressive symptoms, particularly in the population of patients with HF.
            The PHQ-9 is a simple instrument derived from the Primary Care Evaluation of Mental Disorders (PRIME-MD) version to help clinicians easily screen for depression disorder in primary care settings.23 It is a self-report questionnaire based on the nine diagnostic criteria for major depressive disorder in the Diagnostic and statistical manual of mental disorders, fourth edition (DSM-IV).24 The PHQ-9 has evidence of reliability and validity in a variety of populations, mainly in primary care and general hospital settings as well as in general population;23, 25-32 however, it has not been validated in patients with HF.  The purpose of this study was to assess the reliability and validity of the PHQ-9 as a measure of depressive symptoms in patients with HF. The specific aims were to: 1.) assess the internal consistency, reliability, and homogeneity of the PHQ-9; 2.) evaluate the concurrent validity of the PHQ-9 using the BDI-II as the gold standard; and 3.) evaluate the construct validity of the PHQ-9 by testing the following hypotheses:
       Hypothesis 1: The PHQ-9 will have acceptable sensitivity and specificity using the BDI-II as the criterion for comparison.
       Hypothesis 2: Patients with higher levels of perceived control will have lower PHQ-9 scores
 
In the next paragraph (beginning "The PHQ-9..."), the authors get into the specific details of their paper.  Having convinced us in the first half of their introduction that depression in heart failure patients is a serious problem, and that it is going underdiagnosed and undertreated, AND that the current gold standard tool is inadequate, they now proceed to describe the tool they believe will work better, the PHQ-9.  They briefly describe the PHQ-9, and explain that it has delivered good results in the hospital, general population, and primary care settings. However, they tell us, it has not been validated in heart failure patients.  This leads us to the central purpose of the paper, which is a report of a research study which aimed to assess the PHQ-9's usefulness as a measure of depressive symptoms in heart failure patients.  The authors go on to list the specific aims of their study, and the hypotheses they sought to test. 
 
You may notice that the first sentence of this introduction might be viewed as a purpose statement.  I would argue that this introduction actually has two purpose statements--the first sentence of the introduction, which briefly tells us the general purpose of the paper, and a much more detailed one (highlighted in blue) at the end of the introduction.  Not all writers include a general purpose statement at the beginning, but I think in this case it was a good approach. 
 
 
So that's it.  An introduction should engage our interest by establishing the topic and convincing us of its importance and relevance, and provide us with a clear and specific road map of the paper's content and purpose.  Remember how important a first impression is, and spend some extra time and effort on your next introduction.  Also, pay attention to the introductions of the articles you read for class.  Reading well-written introductions will help you train yourself to write them.
 
I hope you've found this week's post helpful.  Happy scribbling!

Tuesday, September 3, 2013

Advice to Start the Semester


Today's topic: Advice to start off the semester

This week's writing tip was inspired by one of the new students in our program, who wrote to me asking what general advice I would give to someone new to graduate school.  However, my advice applies not only to new students, but to all students.  Hopefully these suggestions will help you manage your writing more effectively.

1. Ask questions. 

Many students are reluctant to ask questions of their instructors.  Sometimes it's because of shyness.  Sometimes it's because they don't want to "bother" the instructor.  Sometimes it's because they haven't taken the time to read through their syllabus, rubric, or assignment prompt carefully enough to formulate any questions.  By the time they realize they're not clear on what is expected of them, it might be too late to ask substantive questions.

It is crucial to make sure that you fully understand what is expected of you in class.  If you don't fully understand a writing assignment, or something on a grading rubric or syllabus, ask for clarification.  If the answer you get doesn't fully clarify the situation, then keep on asking questions until you are 100% clear on what you're supposed to do.  Remember, if your instructor doesn't know you're confused, s/he can't help you.  Most instructors have had the frustrating experience of having to give a student a low grade on a paper because s/he just didn't understand the assignment.  When this happens, nine times out of ten the student never asked a single question about the paper before turning it in.

The same goes when you're working with me on a paper or presentation.  If I give you a comment or suggestion that you don't fully understand, make sure to ask me to explain more thoroughly.  That way, we can both be confident that we're communicating clearly.

And remember: Questions aren't bothersome.  They are a crucial part of the learning process, and you're here to learn.  We are here to help you do that.

2. Read your assignment prompts, rubrics, and syllabi carefully.  Turn your assignment prompts into checklists.

Let me give you an example to illustrate why it's so important to read assignment prompts carefully.  Many instructors write assignment prompts in paragraph form.  Most writing assignments will ask for a number of different things--some description or definition, some explanation, some analysis or interpretation, etc.  Often, we ask students to analyze by using the word "Why?"  That one word can ask you to delve more deeply into a topic.  But it's a three-letter word, and can be easily missed in a block of text.  If you miss that "Why?" you might end up leaving that important analysis out of your paper, which could have serious repercussions for your grade.

I can tell you that one of the main problems I see in student writing is a failure to fulfill each of the requirements of the assignment.  Students frequently, FREQUENTLY miss something--often, it's something crucial. 

So.  Read course materials carefully.  Ideally, read assignment prompts aloud.  Reading aloud forces you to slow down, so you will be less likely to miss something.  Also, it's a good idea to turn assignment prompts into checklists.  If your prompt is written as a paragraph, copy and paste it into a new document and put each requirement on a separate line.  Once you've written a first draft of your paper, you can use your checklist to make sure you haven't missed anything. 

3. Seek out help when you need it.

Again, we (the faculty) are here to help you learn.  Don't flounder around alone.  If you need help, ask for it.  If the help you need is in writing or presentation prep, send me an email; that's what I'm here for. 

And please, if you need help, don't put it off.  I've lost count of the number of times I've heard a student say, "I WISH I'd come to see you earlier in the program!"  Often, a student puts off coming to see me until late in the game.  I can still help them then, but students who go this route often wish they'd asked for my help sooner.  Learn from their experience.

4. Read your writing out loud.

As I mentioned earlier, reading aloud forces you to slow down.  This alone makes you far more likely to catch mistakes--both big mistakes, like problems with sentence structure or organization, and small mistakes like typos.  Also, oddly enough, research shows that when we read silently we don't read every word on the page.  We skim our eyes over the text and pick up the meaning, but we don't "hear" how the sentences sound.  This means that we can easily miss confusing or awkward sentence structure in our own writing.  Reading aloud solves this problem.

There is a wealth of evidence in the field of composition and rhetoric (a.k.a. writing) that supports how helpful this technique is for writers.  You don't have to read your paper aloud every time, but you should do an oral read-through at least a couple of times before you turn in your final draft.

5. Use the resources available to you. 

For my part, this includes the "Writing Resources" website on Blackboard, my "Writing Tips" blog and "Writing Tip of the Week" emails, and the occasional brown-bag workshops I offer, not to mention my one-on-one consultation services. 

We also offer you many other terrific resources.  Beverly Hilton, the Medical Center Library's liason to the College of Nursing, is one example.  Beverly is a wonderful resource for any questions you may have about conducting a literature search, using the library websites or databases, etc.  Robert Shapiro, the Medical Center Library's resident EndNote guru, is another wonderful resource.  Robert is always happy to answer questions about the EndNote software, and he teaches classes in EndNote throughout the year. 

In addition to that, your advisor and professors are all wonderful sources of information and inspiration.  These are just a few examples of the many resources available to you here.

I could go on for another four pages, but I promised myself I'd stick to the top five.  I hope you found this week's post helpful.  As always, happy scribbling!


Friday, May 3, 2013

Apostrophes

Today's topic: The apostrophe

This little guy tends to be a bit overworked these days, as in the following sentence: 

All student's must register for the workshop by October 16.

Can you spot the mistake?  The word "students" should not contain an apostrophe. 
Why not?  Let's examine the purpose and proper use of this little tadpole-like punctuation mark.

Apostrophes have two uses:

1.) To indicate ownership/possession, as in:

That is Sarah's car.

That guy ate all the kids' desserts!  (Note: In this sentence, the noun is plural--kids--so the  apostrophe goes after the s.  In the first sentence, "Sarah" is singular, so the apostrophe goes before the s.)

2.) To replace the missing letter or letters in a contraction, as in:

That's my notebook.  (The apostrophe helps us turn the phrase "that is" into the contraction that's.)

Oh no, it's raining.  (The phrase "it is" becomes "it's.")

I should take this opportunity to point out that the ONLY TIME an apostrophe is okay in the word "it's" is when you mean to say "it is."  Never use it like this: "The panda cuddled it's cub."  This is correct: "The panda cuddled its cub."

Apostrophes should not be used to form a plural noun.  

INCORRECT: I love cat's. (Your reader might wonder, "You love Cat's what?  Cat's blue sweater?  Cat's new house?")
CORRECT:  I love cats.

INCORRECT:  All participant's signed a waiver form. 
CORRECT:  All participants signed a waiver form.

INCORRECT:  Could you get us some soda's?
CORRECT:  Could you get us some sodas?

INCORRECT:  I saw twelve patient's today. 
CORRECT:  I saw twelve patients today.

There are (of course) a few little tricky situations in which these rules might not be so clear-cut--for example, how do you indicate possession with a noun that ends in s?  Is it Mr. Jones's car, or Mr. Jones'?  For the answer to that and several more tricky apostrophe questions, click here for "Grammar Girl" Mignon Fogerty's apostrophe tutorial:  http://grammar.quickanddirtytips.com/apostrophe-plural-grammar-rules.aspx

I hope you found this post useful.  Have a great day!

Whitney Kurtz-Ogilvie, MFAW

The Dreaded Semicolon, Pink Plastic Flamingo of the Punctuation World

Today's Topic: The Dreaded Semicolon
Semicolons are a little like pink plastic flamingos.  Nobody really knows what they're for, and they tend to be overused. 

The good news is, there are only a few rules for semicolon usage, and once you learn them, you're fine (unfortunately there are no hard and fast rules governing the use of pink plastic flamingos--you're on your own there).

1.) Use semicolons to separate two phrases that could each stand alone as a complete sentence.

Use semicolons to separate two independent clauses (ICs).  This is a fancy term for a phrase that contains a subject and a verb and could stand alone as a complete sentence. 

Use a semicolon only when the two ICs are closely related, either because the 2nd clause expands upon or restates the first, OR because the 2nd clause is in contrast to the first. 


Examples:
Heart disease is an increasingly common problem for American women; in 2008, heart disease was the leading cause of death for women in the U.S.

Many writing teachers reject the traditional five paragraph essay model, arguing that it is too rigid and discourages analytical thinking; some teachers like the model for its clarity and simplicity.

Use semicolons to separate ICs when the second IC begins with a conjunctive adverb (however, thus, moreover, furthermore, therefore, indeed, nonetheless, meanwhile, etc.) OR a transition (for example, for instance, in fact, in addition, also, in other words, etc.). 


Example:

It is always jarring when summer's balmy temperatures give way to fall's crisp chill; however, I love the gorgeous colors of the turning leaves.
You can also separate ICs with a period, of course, OR with a comma and a coordinating conjunction (and, but, or, so, nor, for). 

Examples:
It is always jarring when summer's balmy temperatures give way to fall's crisp chill, but I love the gorgeous colors of the turning leaves.

Many writing teachers reject the traditional five paragraph essay model, arguing that it is too rigid and discourages analytical thinking.  Some teachers like the five-paragraph model for its clarity and simplicity.

When should you use a semicolon to separate ICs, and when should you use a period, or a comma + a conjunction? 
Well, it's a style choice.  Pay attention to the rhythm of your paragraph.  Semicolons and commas + conjunctions are good for adding variety to a paragraph that's full of short, choppy sentences.  Periods are good when you want to give your reader a moment to pause and let an idea sink in.  Also, periods are most appropriate for two ICs that are not closely related. 

Example: 

It was freezing cold last night.  We ordered pizza. 

2.) Semicolons may be used to separate items in a list, IF one or more of the list items has its own comma. 


Examples:

We bought pansies, which remind Sophie of Mickey Mouse ears; gorgeous deep red mums; and some pumpkins, which we'll carve into jack o' lanterns before Halloween.

Janelle is from Akron, Ohio; Melania is from Jaipur, India; and Rachel is from Honolulu, Hawaii.

For more on the pink plastic flamingos of the punctuation world (such as differences between the semicolon and the colon, and a more comprehensive list of conjunctive adverbs), check out Grammar Girl Mignon  Fogerty's terrific semicolon tutorial here:  http://grammar.quickanddirtytips.com/semicolons.aspx

I hope you've enjoyed this week's writing tip! 

Whitney Kurtz-Ogilvie, MFAW

Using Source Material

Today's topic: Using Sources Effectively

This is a massive topic, and I couldn't possibly cover it all in one post (or even two or three).  This will probably not be my last post on this topic, so why don't we think of it as part I in a series?

First of all, a lot of writers struggle to find the best and most effective ways to incorporate source material.  It's something that takes practice and careful thought, and it goes far deeper than simply picking out a few choice quotations, or a few interesting passages to paraphrase.  Here are a few things to keep in mind when using outside sources:

I.  Let YOUR ideas drive the bus, not those of your source authors.


This is probably the Golden Rule.  It is crucial to ensure that your own assertions and ideas are the primary focus of your paper, and that you are using the source material to support those points, not to make them for you.  Many writers make the mistake of "putting the cart before the horse" in that they let their source material be the driving force of the paper. This is backwards.

So what role should source material play in a well-written paper?  Here are just a few examples of what source material can do:

    *Support your ideas with evidence (e.g., See?  I'm not the only one who believes this.  In   their article "Blah blah blah," Jones and Doe (2012) argued that...)

    *Provide an example to illustrate your idea (particularly effective when you need to express a difficult or complex idea)

    *Help you to develop your idea more thoroughly/add a new dimension to your idea

What you can't and shouldn't do is simply string together a series of quotations or paraphrased/summarized ideas from other sources, intersperse them with a few sentences of your own, and let that stand as your paper.  Why not?  Because that isn't writing; it's like making a quilt in which the squares are your quotes and paraphrases and the stitches are your handful of original sentences (usually tossed in to introduce or link together the source material).  Using sources in this way robs you of the opportunity to really engage with what you've read, and use it to meaningfully enhance your reader's understanding of your topic.  It also almost always results in a boring piece of writing.


What do I mean by "engage with what you've read?"  It means making sure that your source material contributes more than information.  It means making sure to comment on/react to/develop your source material; don't just plunk it down and move on to the next thing.  It means asking questions about what you have read, thinking about its implications--for practice, for further research, etc.  It means addressing the "so what?" question: Why is this important?  Why are you telling us this?  What can we learn from this?  Why do we need to learn it?  What more do we need to know?  What, if anything, might be missing from this information?  It means comparing and contrasting your source material with other source material, and with your own experience and ideas:  How does this author's view compare with the views of other authors I have read?  How does this information jibe with the other things we know about this topic?

It also means getting a "bird's eye view."  For example, this is pretty much the main purpose of a literature review; you gather the most relevant and interesting articles on a particular topic, you read and evaluate them individually, and then you synthesize what you've learned by considering what we can learn from taking ALL these articles into consideration, rather than just reading one or two.  You consider how the conclusions drawn by all these authors relate to one another.  Have you ever seen those amazing pointilist paintings, made up of thousands of tiny dots?  If you look at those paintings up close, you just see dots.  However, if you stand back you see the picture emerge.  That is a good analogy for synthesis.  The individual articles you read for a lit review are like those dots.  The picture you get when you stand back far enough from the canvas is your synthesis, the conclusions you draw from a bird's eye view.

To an extent, this kind of critical thinking is necessary any time you use outside source material.  Remember that each quotation or paraphrased idea you incorporate is only one small piece of the whole puzzle.  It is your job to show readers how all this source material relates to the purpose of your paper, how everything you chose to include helps you to make your point.

This is one good reason to make an outline before you sit down to write.  In an outline, you can make a list
of your main points, the main ideas you want to express.  Then you can decide which quotations or paraphrased ideas from your sources will work best to support, illustrate, or develop those ideas.  You can also build your analysis of your source material, and your transitions from idea to idea, into your outline.  Most importantly, make sure that every section of your outline contains a topic sentence that expresses one of your own original ideas, and that ultimately those topic sentences (and the source material you use to support them) will form the "big picture" of your paper--your purpose statement or thesis, the main point you wish to make.

A good general outline for a paper might look something like this:
  • Introduction: Establishes your topic, establishes that the topic is important, and includes a clear, specific purpose or thesis statement that tells readers what your main points are.
  • Body of paper.  Uses topic sentences and transition sentences to guide readers logically from idea to idea.  Here is an example to show the structure of a well put-together paragraph:
    •  Main idea (topic sentence)
      • Supporting detail #1 (could be a quote from one of your sources that backs up your main idea, could be a paraphrased example from one of the articles you read that illustrates how another nurse implemented an idea like yours, etc.)
        • Your response to/commentary on supporting detail #1--as I said above, it's not enough to simply drop in a quote or example from one of your sources.  You have to then engage with that example, use it to help you develop your idea.  You can do this in a number of ways depending on the specifics of the situation. You might also have a supporting detail #2, and then you'd respond to it as you did with supporting detail #1.  You might even have three supporting details--it just depends on the subject.  There is no hard and fast rule for how much support you need for each point, but one good thing to keep in mind is that controversial or complex ideas often need the most support.
    • Lastly, you'd include a transition sentence to lead us from the idea in this paragraph to the idea you'll express in the next paragraph.  This ensures a smooth and logical flow to your paper.  In an outline you should go paragraph by paragraph (I'm just showing you one paragraph as an example--you would of course have many more).  Once you have completed the body of your paragraph, you need a...
  • Conclusion: Provides a concise review of the paper's main points, and leaves us with something more to ponder.  This is often a good place to pose a few more questions, to look to the future.  Now that we know all this, what should we do about it?  What is the next step?  The conclusion is also a good place to discuss the implications of your subject, to wrap up the "so what?" question I mentioned earlier.
II.  Definitely make sure to back up your claims/assertions/main points with plenty of support, but go easy on the direct quotations.

You absolutely do have to use source material to do this (you'll almost always have to offer an evidence-based discussion).  That doesn't mean you have to use direct quotes, though.  Most writing manuals say to rely more on paraphrase and summary than quotations.  This is true for a couple of reasons, the main reason being that quotations tend to interrupt the flow of a paper.  It's okay to use quotes if you use them sparingly.  Use a quotation if you feel that the original author's wording is particularly elegant or persuasive, or if you just can't manage to paraphrase it successfully. 

III.  Paraphrase appropriately. 

In case you aren't familiar with the term, paraphrasing involves putting another author's idea into your own words.  There is an art to paraphrasing; in fact, I could make an entire post on this topic alone.  For now, since I have limited space, suffice it to say that paraphrasing is NOT simply changing around a few words from your original source.  If you use this method, you will almost certainly be guilty of plagiarism.  Instead, try this method:

1.) MAKE SURE YOU FULLY UNDERSTAND THE PASSAGE YOU PLAN TO PARAPHRASE.  I put that in all caps because, in my experience, this is the #1 reason why writers commit unintentional plagiarism; they try to paraphrase something they don't fully understand.  If you don't have a firm grasp of the idea you're trying to paraphrase, there is simply no way that you will be able to express that idea in your own words.  So. Read the passage carefully.  Read it a few times.  Then put the original source away.  Close the book, close the window on the computer, put the article underneath a notebook where you can't see it.  Now you're ready to move on to step 2.

2.) Talk to yourself.  Now that you've put the original source away where you can't see it, tell yourself what the author was trying to say.  I like to do this out loud, but if you really don't want to talk to yourself, just write it down.  The wording doesn't have to be perfect here; you are just telling yourself what the original author was saying, working it out for yourself to make sure that you understand what you've read. 

3.) Try paraphrasing.  Now that you are absolutely sure you understand the author's idea, try paraphrasing the passage.  Again, DON'T LOOK AT THE ORIGINAL AUTHOR'S WORDING.  If you look, you'll be a hundred times more likely to stick too closely to the wording of the original source.  Express the author's idea in your own words. 

4.) Check yourself.  Now you can look at the original source.  Compare what you've written to the original passage.  First make sure that you have expressed the original author's idea accurately, without missing any nuances of meaning.  Then make sure that your wording isn't too close to the original author's.  If it is, you'll need to repeat steps 2-4.  If you go through this process twice and you still end up sticking too closely to the original text, then you might just want to quote the author directly. 

I hope this has been helpful.  Please feel free to get in touch with any questions.  Happy scribbling! 

Whitney Kurtz-Ogilvie, MFAW