The long and winding road to publication

It is clear that academic dissemination has a system of checks and balances which authors may experience as barriers. We all want to be sure that scientific information disseminated in academic journals is based on solid data, ethically collected and correctly interpreted. The process of peer reviewing helps to prevent bad science and/or poor scientific papers being published. Many published scientific papers differ from the original submitted manuscript since papers go through a process of peer-review, editing and rewriting. However, there are other potential obstacles in the field of academic publishing. This paper is a case-study of one methods paper which stumbled upon a number of barriers related to the viability and continued existence of a number of academic journals in Nepal. Finally, we offer some advice to help health journals to survive when their editors leave. Background In 2007 the first two authors conducted a bibliographic study on the state of health and health-care research in Nepal 1 . One of the key conclusions was that Nepal needs more training on evidence-based practice in health care training and particularly exposure to systematic reviewing. Corresponding Author: Dr. Padam Simkhada PhD, Senior Lecturer in International Health, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield. UK. Email: p.simkhada@sheffield.ac.uk The long and winding road to publication Nepal Journal of Epidemiology 2012;2(4):213-15 Copyright © 2012 CEA&INEA Published online by NepJOL-INASP 214 www.nepjol.info/index.php/NJE On the basis of this paper’s conclusions we applied for a grant with academic colleagues at Stupa College (Kathmandu) to do systematic review training with higher education staff. This application for a DELPHE grant from Department for International Development (DfID) was not successful at the time, but it also made us think about the importance of writing a short methods paper outlining the systematic review method to health care providers, researchers and policy-makers in Nepal. At the time we had already worked on several systematic reviews 2-3 and written methods papers on the subject 4 . A year later we applied again. This time we were successful with an improved application under the title ‘Partnership to improve Access to Research literature for higher education Institutions in Nepal (PARI)’. This project was led by the Central Department of Population Studies at Tribhuvan University and involved the collaboration between the University of Sheffield, the University of Aberdeen and Bournemouth University as well as the Development Resource Center based in Kathmandu. PARI was funded by DFID within the Development Partnerships in Higher Education (DelPHE) programme 5 . The systematic review methods paper Early 2012 saw the publication of our methods paper on systematic reviews in the Nepal Journal of Epidemiology 6 . This was quite an achievement considering that various versions had previously been submitted and accepted by three other English-language academic journals based in Nepal over a five-year period. We originally submitted a first version of this paper in the summer of 2008 to STUPA Health Journal. We had good experience with this academic journal as the first two authors had published in it before 7 . Unfortunately, shortly after our paper was accepted the journal’s editor left STUPA College, where the journal was based, to go abroad and the journal collapsed. This gave us an opportunity to update the paper and submit it to the newly planned Manmahon Memorial Health Science Institute Journal. We were encouraged to submit after a discussion with the highly enthusiastic editor. We received an email from the editor that our paper was accepted for the inaugural issue of the journal. Unfortunately, this journal never got started. The main reason was again because the editor, the driving force behind the journal, got a new job elsewhere. In September 2009 we revised and updated the paper again and submitted it to the Nepal Medical College Journal after having worked with one of the editorial board members in a different capacity. In late 2009 the paper was formally accepted by the Nepal Medical College Journal which at that time had been running for seven or eight years prior to our submission. Unfortunately, not a single issue was published in 2011 and after September 2011 the editor stopped replying to any of our email reminders. Therefore, we decided to take the paper back and submit it elsewhere. The fourth and final journal we targeted in late 2011 was the Nepal Journal of Epidemiology, which was fairly new at the time. We did some more work on the paper and decided to submit to this journal after we met the editor in Nepal. The review process was fairly swift and, as mentioned above, the paper was eventually published in 2012. Lessons for journals & editors The process described above made us think about what lessons there might be for budding editors in Nepal. Combining our experience from this particular case with our combined experience of being members of a number of editorial boards we came up with the following ideas. • Good journals should not depend on one single editor, one person needs to be in overall control, the chief editor, but he or she needs to be supported by an active editorial board. Journals in Nepal should constitute of an editorial board which includes qualified editors from developed and developing countries 8 . • The chief editor can reduce the workload by delegating work to other editors or editorial board members. With a good working editorial board there is more likely to be succession planning when the chief editor resigns. An experienced editorial board member will find it easier to take over from a chief editor than a completely new person. • With a good editorial board more information will be shared, requiring better records of which papers have been (a) submitted; (b) sent out for review; (c) returned by reviewers and are now waiting for comments; and (d) final editorial decisions about acceptance or rejection of a manuscript. Sharing the workload means less information is solely in the head of the chief editor, making the journal less dependent on one single person. • When a chief editor leaves there needs to be time for appropriate handover to new editor, explaining in detail editorial process, but also the progress of the various papers already submitted, and tasks still outstanding. • Another way to increase long-term viability is to employ a good editorial assistant. Editors often conduct “the necessary text and layout editing” as NJE editorial board reminds us 9 . Employing a good editorial assistant will take some of the editing work from the editor. A good editor will be of great value when the chief editor leaves as there will be someone left with knowledge of journal’s processes and culture. • Journals and their editors need appropriate organisational, financial and institutional support to ensure the journal can survive in the long-term. Perhaps too many journals in Nepal are run by very enthusiastic individuals, who as editor do all the work. When these editors move on to other jobs the journal often runs into serious trouble. If a journal has some financial support and some institutional back-up, perhaps to pay for web design, or editorial admin The long and winding road to publication Nepal Journal of Epidemiology 2012;2(4):213-15 Copyright © 2012 CEA&INEA Published online by NepJOL-INASP 215 www.nepjol.info/index.php/NJE assistance, it is much more likely to continue publishing. Final thoughts Publishing is a process, which can have a considerable number of built-in barriers. The ‘story’ of our systematic review methods papers shows that getting published in Nepal is not always a straightforward process. At the level of the individual paper we hope it also shows that believing in the quality of your own paper and being determined to get it published will in the end get your work into print. At the level of the journal we have offered some advice to help increase the sustainability of health journals in Nepal. Conflict of Interests The authors have no conflict of interest arising from the

scientific papers being published.Many published scientific papers differ from the original submitted manuscript since papers go through a process of peer-review, editing and rewriting.However, there are other potential obstacles in the field of academic publishing.This paper is a case-study of one methods paper which stumbled upon a number of barriers related to the viability and continued existence of a number of academic journals in Nepal.Finally, we offer some advice to help health journals to survive when their editors leave.

Background
In 2007 the first two authors conducted a bibliographic study on the state of health and health-care research in Nepal On the basis of this paper's conclusions we applied for a grant with academic colleagues at Stupa College (Kathmandu) to do systematic review training with higher education staff.This application for a DELPHE grant from Department for International Development (DfID) was not successful at the time, but it also made us think about the importance of writing a short methods paper outlining the systematic review method to health care providers, researchers and policy-makers in Nepal.At the time we had already worked on several systematic reviews 2-3 and written methods papers on the subject 4 .A year later we applied again.This time we were successful with an improved application under the title 'Partnership to improve Access to Research literature for higher education Institutions in Nepal (PARI)'.This project was led by the Central Department of Population Studies at Tribhuvan University and involved the collaboration between the University of Sheffield, the University of Aberdeen and Bournemouth University as well as the Development Resource Center based in Kathmandu.PARI was funded by DFID within the Development Partnerships in Higher Education (DelPHE) programme 5 .

The systematic review methods paper
Early 2012 saw the publication of our methods paper on systematic reviews in the Nepal Journal of Epidemiology 6 .This was quite an achievement considering that various versions had previously been submitted and accepted by three other English-language academic journals based in Nepal over a five-year period.
We originally submitted a first version of this paper in the summer of 2008 to STUPA Health Journal.We had good experience with this academic journal as the first two authors had published in it before 7 .Unfortunately, shortly after our paper was accepted the journal's editor left STUPA College, where the journal was based, to go abroad and the journal collapsed.This gave us an opportunity to update the paper and submit it to the newly planned Manmahon Memorial Health Science Institute Journal.We were encouraged to submit after a discussion with the highly enthusiastic editor.We received an email from the editor that our paper was accepted for the inaugural issue of the journal.Unfortunately, this journal never got started.The main reason was again because the editor, the driving force behind the journal, got a new job elsewhere.
In September 2009 we revised and updated the paper again and submitted it to the Nepal Medical College Journal after having worked with one of the editorial board members in a different capacity.In late 2009 the paper was formally accepted by the Nepal Medical College Journal which at that time had been running for seven or eight years prior to our submission.Unfortunately, not a single issue was published in 2011 and after September 2011 the editor stopped replying to any of our email reminders.Therefore, we decided to take the paper back and submit it elsewhere.
The fourth and final journal we targeted in late 2011 was the Nepal Journal of Epidemiology, which was fairly new at the time.We did some more work on the paper and decided to submit to this journal after we met the editor in Nepal.The review process was fairly swift and, as mentioned above, the paper was eventually published in 2012.

Lessons for journals & editors
The process described above made us think about what lessons there might be for budding editors in Nepal.Combining our experience from this particular case with our combined experience of being members of a number of editorial boards we came up with the following ideas.

•
Good journals should not depend on one single editor, one person needs to be in overall control, the chief editor, but he or she needs to be supported by an active editorial board.Journals in Nepal should constitute of an editorial board which includes qualified editors from developed and developing countries 8 .

•
The chief editor can reduce the workload by delegating work to other editors or editorial board members.With a good working editorial board there is more likely to be succession planning when the chief editor resigns.An experienced editorial board member will find it easier to take over from a chief editor than a completely new person.

•
With a good editorial board more information will be shared, requiring better records of which papers have been (a) submitted; (b) sent out for review; (c) returned by reviewers and are now waiting for comments; and (d) final editorial decisions about acceptance or rejection of a manuscript.Sharing the workload means less information is solely in the head of the chief editor, making the journal less dependent on one single person.• When a chief editor leaves there needs to be time for appropriate handover to new editor, explaining in detail editorial process, but also the progress of the various papers already submitted, and tasks still outstanding.

•
Another way to increase long-term viability is to employ a good editorial assistant.Editors often conduct "the necessary text and layout editing" as NJE editorial board reminds us 9 .Employing a good editorial assistant will take some of the editing work from the editor.A good editor will be of great value when the chief editor leaves as there will be someone left with knowledge of journal's processes and culture.• Journals and their editors need appropriate organisational, financial and institutional support to ensure the journal can survive in the long-term.Perhaps too many journals in Nepal are run by very enthusiastic individuals, who as editor do all the work.When these editors move on to other jobs the journal often runs into serious trouble.If a journal has some financial support and some institutional back-up, perhaps to pay for web design, or editorial admin

1 .
One of the key conclusions was that Nepal needs more training on evidence-based practice in health care training and particularly exposure to systematic reviewing.Corresponding Author: Dr. Padam Simkhada PhD, Senior Lecturer in International Health, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield.UK.Email: p.simkhada@sheffield.ac.uk