If you are reading this journal, you are probably an experienced reader of scholarly writing. Many of us spend part of each day grading papers, searching the literature to prepare a manuscript, and otherwise critically reading volumes of information written in an academic style. Sometimes, however, there are problems with expressing one's thoughts in that style, especially for new writers.

Writing in a scholarly style is hard for nurse practitioners and other healthcare professionals. It involves examining problems objectively and assessing evidence according to scientific standards. We strive to find balance between these standards and the fact that we are passionate about our work and our patients, and care deeply about them. In addressing this dissonance, authors who wish to be taken seriously will be careful to use only objective, measurable language when conveying information to readers. This is contrasted with other styles of nonfiction writing, such as creative nonfiction, biographies, and memoirs, for which the use of words intended to arouse an emotional response is entirely appropriate.

The main point about avoiding emotionally charged words in scholarly writing is that these words convey reaction and opinion. Therefore, they are inconsistent with an objective report. The goal of scholarly writing is for readers to better understand the facts, not the author's feelings. Readers should be impressed by the author's clarity of thought and skillful analysis, and not by an emotional response to the subject under study. Even if a writer believes that most readers will share his or her viewpoint, personal views should not be placed in the manuscript. This approach to writing avoids the appearance of subjectivity that could seriously undermine the scientific message of the work.

It is striking to me how much a single poorly chosen word can change the reaction of reviewers and readers to an entire manuscript. We have many descriptive words at our disposal. The following are a few examples of words that have been encountered by the reviewers and editors of JAANP and other scientific journals. These are depicted using a "stop light" method of organizing them, with red light (stop), yellow light (caution), and green light (proceed) options.

Below are a few of the "red light" words, and why they should be avoided:

* Awesome: This word conveys a value judgment rather than anything factual. The same can be said of awful, disturbing, fantastic, terrible, wonderful, and many other unmeasurable descriptors.

* Crisis: Do not label a problem with this term unless a federal or global health agency has described your topic thusly. This word is suffering from a "crisis" of overuse.

* Dramatic: To be used only when reporting extreme, rapid changes in a measured data point that are apparent to the reader.

* Great: Only for use when describing a volume or amount.

* I, we, you: Scholarly writing should reflect the third person point of view.

* Shocking: Not to be used unless you are reporting an electrical event.

A note to qualitative researchers on these "red light" words: If you are reporting mood states or responses from your subjects that include any of the terms above, the term may be used if it is the subject's word choice and part of the data collected. They are acceptable if they are the words of the subject, but not the author.

Here are some "yellow light" words to use with caution, perhaps in the Discussion or Conclusion sections of the manuscript, where the author has the opportunity to summarize and make general observations:

* Discouraging/encouraging: When describing a worsening or improvement of the outcome.

* Excellent: If used to describe a noticeable, desired improvement in the data.

* Exciting: If used for discussing potential future research opportunities.

* Frustrating, sobering: To acknowledge a finding that was not the desired outcome.Lastly, here are some generally acceptable "green light" word choices that provide options for descriptors in any section of the manuscript:

* Better/best*

* Change/changing

* Concern/concerning

* Improve/improving/improvement*

* Priority

* Problem

* Rapid/rapidly*

* Slow/slowly*

* Worse/worsening/worst*

*When measurable.

Many experienced readers and reviewers have a personal list that separates these red, yellow, and green options using somewhat different lines of demarcation. Opinions vary, but for most of us, these categories are a pretty good starting point for discussion with students and new writers, and they provide some guidance for reviewers who want to assist authors with word choices. For new authors, a mentor can provide guidance on word choices that are acceptable in the writer's academic institution or work site. Before submitting a manuscript, check it for drama and hyperbole. If you find it, remove it and be assured that the quality of the study design, procedures, and analysis are meaningful to readers without added emotional commentary.

In this month's issue, Winchester and Kittles provide a report on the successful use of self-teaching kits to improve patient confidence in performing bystander CPR in the community. The authors noted that this is a teaching method that could be implemented by NPs in a clinic setting.

Also featured is an important contribution to defining competencies for specialty practice. Bobonich and Nolan describe a process involving a national task force and validation panel to define the entry level competencies for dermatology nurse practitioners.

Mboineki, Chen, and Weihong report on a study to determine strategies needed to establish the NP role in Tanzania. The authors found multiple facility, equipment, and basic treatment needs such as medications that are lacking in this country and that will be necessary to support the training and role of future nurse practitioners. Readers will note in this article the use of the term "mid-level." This is a qualitative study in which the authors reported terms used by subjects in this international study. Therefore, the term was included in the interest of accurately reflecting the information collected.

There is a link between the presence of migraine headache and depression. Cook and Shedd examine this link and the best practices for treating these often co-occurring conditions. Also in this issue, Rossiter and team report on a newly developed resource for primary care providers caring for military-connected children. This article is also our CE feature for the month.

As those of us working in primary care know, oral health is a very overlooked component of basic healthcare. This was the topic of a study by Dolce and team. The authors examined the degree of integration of oral healthcare into the primary care NP curriculum, with a goal of improving access to oral health care nationally.

Chun, Appel, and Simmons studied the use of the Beers criteria for potentially inappropriate medications in two assisted living facilities, and report on the degree to which the use of these medications is correlated with falls and hospitalizations.

Who is best at accurately diagnosing the severity of abdominal pain? Hoyt and team conducted an analysis of consistency of abdominal pain diagnosis in the emergency department setting by NPs, PAs, and physicians. The authors noted findings that support collaboration between disciplines, and why a commitment to this will result in the best possible outcomes for patients.

We hope you enjoy these new contributions to our scientific literature.