Rules for writing an Osteopathy Thesis

RULES FOR WRITING AN OSTEOPATHY THESIS

ONLY SCIENTIFIC RESEARCH WORK WILL BE ACCEPTED. THESES ARE INDIVIDUAL WORK. GENERAL THESIS PLAN:

The presentation should include a clear, structured plan, with numbered pages, header and footer:

• running header: title of the thesis
• footer: first name and surnames of the author of the thesis, page numbers

Clear layout with numbered paragraphs:

1.
1.1
1.1.1
1.1.2
2.

The thesis should include, in this order:

COVER PAGE.

Title of the thesis

Author of the thesis:

Thesis committee of …… of 200

Madrid School of Osteopathy  (Escuela de Osteopatía de Madrid)

Scientific European Federation of Osteopaths

President of the Committee: François Ricard

Members of the Committee:

Thesis Supervisor:

MARGENS, LINE SPACING, HEADER, FOOTER, PAGE NUMBERING

Different types of presentation are accepted at present since not all disciplines accept just one possibility. However, there should be a certain degree of uniformity in the presentation of scientific documents (even more so if they are going to be sent for publication to scientific journals).

Paper

• Plain white paper (DINA-4), certain quality is advisable, at least for the copies for the committee
• Left and top margin 4 cm.
• Right and bottom margin 2.5 cm.

Spacing

Double spacing should be used in the text of the thesis except in the following cases:

• Single spacing should be used for notes and textual quotes.
• After chapter or section headings, triple spacing should be used.
• For the bibliography, single spacing should be used within the paragraph and double spacing between every quote.
• Single spacing should be used for illustration and table indices.
• When inserting a figure, a triple space should be left between the text and the figure. Double spacing between the end of the figure and its title. Triple spacing between the last line of the title and the first line of the continuing text.
• When inserting a table, the same spacing should be used as for figures.

Fonts

For fonts, use Arial 12 or Times New Roman 14. Do not use italics except for words whose origin is a language other than Spanish. Use the same font for numbering the illustrations and the tables, which may be different from the font used for the text of the thesis. Small-sized letters may only be used in appendices, in the illustrations, tables and footnotes.

The font of the preliminary pages may be different from the fonts used for the text of the thesis. Do not use italics for numbers.

Page numbering

Two types of page numbering are used:

• Lower-case Roman numerals for the preliminary body of the thesis, beginning at the cover page of the thesis, which is not numbered but is taken into consideration; the dedication; acknowledgements; contents page; Illustration tables and tables and summary.
• Arabic numerals for the rest of the text, beginning with the introduction or from the first chapter onwards if there is no introduction.

Copies

All copies must be identical to the original. They should contain the same complementary materials.

Text layout

The following rules should be followed for the text layout:

• Start each chapter on a new page.
• Start the headings on the second line down from the top margin of the page, centred and written in bold capital letters.
• Start the text three spaces under the title.
• Leave an extra space between paragraphs.
• Text printed on one side of the page only.
• Use grammar rules for the separation of syllables.
• Use capital letters in the headings of the preliminary pages.
• Use lower-case letters in the sub-titles, except for the first letter of the first word.

ACKNOWLEDGEMENTS

Only acknowledge people who have contributed substantially to the study itself; this includes people like statistic consultants or those who have reviewed the manuscript, but not patients who took part in the study or administrative staff. Indicate clearly what each contributor has provided. Authors are responsible for obtaining permission in writing from people, institutions or companies with well-known names since readers may deduce their approval in the data and conclusions. Other people such as relatives (husband, wife, children), friends, etc. are not included in the acknowledgements in a scientific thesis.

SUMMARY

It should not have more than 250 words. Structured summaries are required for all original data reports, literature reviews, clinical guidelines and case series reports. The summary should consist of 4 paragraphs, with the following headings: Purpose, Methods (includes design, the study and statistical methods), Results and Conclusions. An indication should be given in the summary and in the methodological part as to the type of study presented (for example, non-blinded simple randomized experimental clinical study with ANOVA analysis, etc). A summary should be given in Spanish and in English (the text in English should be done by a professional translator).

Key words

Provide approximately 4-6 cross-index key terms for your article which can be published with the summary. These terms should come from the Index Medicus Medical Subject Headings (MeSH) which is a free-of-charge thesaurus on Pubmed (Medline) and in the Virtual Health Library in Spanish – the words should be translated afterwards (DeCS).

INDEX

• 1. Introduction
• 2. Bibliographic review
  • 2.1. Review of anatomy and physiology
  • 2.2. Review of pathology
  • 2.3. Osteopathic diagnosis
  • 2.4. Osteopathic treatment protocol
• 3. Methodology
  • 3.1. Justification of the study
  • 3.2. Hypothesis and objectives
    • 3.2.1 Hypothesis
    • 3.2.2 Objectives
  • 3.3. Patients, materials and methods
  • 3.4. Design
  • 3.5. Study subjects
    • 3.5.1. Inclusion criteria
    • 3.5.2.Exclusion criteria
  • 3.6. Randomization and blinding of the treatment
  • 3.7. Study groups
  • 3.8. Treatments applied
    • 3.8.1 .To the intervention group
    • 3.8.2. To the control group
  • 3.9. Variables
    • 3.9.1 Independent variables
      • 3.9.1.1. Age
      • 3.9.1.2. Sex
    • 3.9.2. Dependent variables (of result)
    • 3.9.3. Strange or confusing variables
  • 3.10. Calculation of sample size
  • 3.11. Description of diagnostic techniques and treatment used
  • 3.12. Ethical considerations
    • 3.12.1. Declaration of Helsinki of the World Medical Association
    • 3.12.2. Ethical principles for medical research in humans
  • 3.13. Measurement of results
  • 3.14. Data obtaining procedure
• 4. Statistical analysis
  • 4.1. Levels of significance
  • 4.2. Data management
• 5. Statistical results
  • 5.1. Principal results observed
  • 5.2. Description of monitoring and loss of cases
  • 5.3. Comparison of the study variables
  • 5.4. Study of the changes: Intragroup comparisons
• 6. Discussion
  • 6.1 Limitations of the study
  • 6.2. Discussion of the results
• 7. Conclusions
• 8. Indices
  • 8.1.Index of figures
  • 8.2. Index of tables
  • 8.3. Index of abbreviations
• 9. Appendices
  • 9.1.Appendix I. Table of experimental data
  • 9.2.Appendix II. Study data collection sheet
  • 9.3.Appendix III. Patient information sheet and consent form
• 10. Bibliography

INTRODUCTION

Indicate clearly the purpose of the thesis. Summarize the reasoning for the study or the observation. Only give relevant references and do not review the subject extensively; the introduction should serve only to introduce what was done and why it was done. Mention the purpose, the objective of the research, or the hypothesis tested for the study (it should be found typically at the end of the introduction section).

BIBLIOGRAPHIC REVIEW

In the bibliographic review, fundamental basis of the theoretical section, no personal contribution, opinion or deduction should appear. Each affirmation, paragraph, argument, etc. should be accompanied by the necessary bibliographic references.

The bibliographic references should for the most part be current, recent. Many old bibliographic quotes show little interest of the scientific community for the subject dealt with and a knowledge gap which is difficult to fill rapidly and consistently.

The bibliographic review is FUNDAMENTAL and you should use a search strategy which presents different premises:

• You can (and should) consult a wide variety of sources ranging from great works and compendiums to articles from current and relevant scientific articles (indexed, impact, etc).
• You should work (in the essay too) from general aspects (anatomy, physiology, general concepts, etc.) to specific aspects (the techniques, pathology, the specific antecedents of this type of study, etc.).
• The bibliographic search should make clear and show the permissible, specific aspects etc, of the study and should be very clear in its arguments (continuous discussion line which is explained in the Introduction).

More than 50 bibliographic references. There are different trends concerning the number of references and about how long the theoretical section should be (produced from the bibliographic search). At present, in the most well-known areas, specific references, from relevant sources and not too many, are preferred, as well as text lengths which are not too long (100 pages). However, we should take into account that osteopathy still has a great deal to research, so more references and a longer theoretical section are allowed.

1. Anatomy and physiology review

Only give the anatomical, biomechanical or physiological descriptions which are directly related to osteopathy, with a view to demonstrating something: use drawings and photos (number them and give them captions; the name of the author, the title of the book, publisher, year, number of pages should appear in the caption).

Never copy whole chapters from a book.

Example:

The spinal cord presents an orthosympathetic neurovegetative part, the metameres in relation to the innervation of the stomach (1-5-7-8) are T4-T5-T6 (see drawing X according to…)

1. Pathology

Medical pathology in relation, for example, to ulcers, cancer, gastritis, etc. Try to explain the medical symptoms through osteopathic relationships. Try to explain the symptoms using anatomy, biomechanics and physiology. Study whether other possible explanations in medicine exist (study physiopathology well).

NOTE: give all the references: books, articles, courses, conferences

Example:

The most well-known case is that of cervical epicondylitis (2-3)… pain at the level of the spine apophysis translates spinal facilitation (1-3). The pain is related to the irritation of the LUSCHKA sinus vertebral nerve (3-4-5)…

1. Osteopathic diagnosis

Use osteopathic tests which have been validated scientifically: if this is not the case, validate them with a double-blinded interexaminer procedure, comparing the interexaminer results with another diagnostic means (X-rays, MRI, etc) and applying a Kapper coefficient to obtain validity.

1. Protocol of osteopathic treatment, techniques used or technique to study depending on the type of thesis.

This chapter should show the permissibility (justification) of the use of osteopathy in the subject of the thesis.

All theses should have a chapter which relates osteopathy to the pathology to be treated.

The number of chapters is not fixed and depends on the need for a more or less long theoretical section.

FIGURES

Figures should be numbered as and when they appear in the text (Fig.1). Illustrations should include the characters, enumeration and/or symbols.

For each illustration: Illustration number, caption, according to Author-title of the Book-Publisher-Year-Page. Do not put titles or detailed explanations about the illustration; this information should be given in the captions of the figure.

If photographs of people are used, the subject should not be identifiable or authorisation should be obtained to publish the photographs.

An index of figures (iconography) similar to the bibliography should be included.

CAPTIONS OF TABLES AND FIGURES

Identify each caption with Arabic numerals in a similar way and order them as they were mentioned in the text in brackets (Fig. 1). Captions should not be typed inside the pictures.

When symbols, arrows, numbers or letters are used to identify part of the illustrations, identify and explain each one clearly in the caption.

METHODOLOGY

We should remember that by reading Material and Methods and Results, we should be able to know everything about what the Thesis is and what it contributes.

The selection and description of the participants, the technical information and the statistics used should be reported in this section. Describe the selection method of the observational or experimental subjects (patients or experimental animals, including the controls). Specific study designs should follow current and relevant guidelines and include the appropriate materials in the text. Identify the methods, the apparatus used (the name of the manufacturer and address in brackets) and the procedures with enough details to enable others to reproduce the work in order to compare results.

Give references to establish the methods, provide references and brief descriptions of the methods which have been published but which might not be well-known, describe new methods or substantially modified methods and the reasons for using them and for evaluating their limitations.

When reporting experiments with human subjects, indicate the procedures used in accordance with the ethical standards of the committee on human experimentation with regard to the Declaration of Helsinki of 1975. When reporting experiments on animals, indicate if the guidelines established by the Research Council for the care and use of laboratory animals were followed. 

Do not use names, initials or numbers of hospital patients or any information which may enable the patients to be identified.

This chapter should include:

• Justification of the study
• Hypothesis and objectives
  • Hypothesis
  • Objectives

PATIENTS, MATERIALS AND METHODS

1. Design
2. Study subjects
   • Experimental group: subjected to the experiment
   • Control group: observational or with placebo
3. Inclusion criteria
4. Exclusion criteria
5. Randomization and blinding of the treatment
6. Study groups
7. Treatments applied:
   • To the intervention group
   • To the control group

VARIABLES OF THE STUDY

1. Independent variables
   • Age
   • Sex
2. Dependent variables (of result)
3. Strange or confusing variables

CALCULATION OF THE SAMPLE SIZE

When calculating the sample size, and taking into account the scarce antecedents in research in osteopathy (compared to other disciplines), it is recommended that a pilot study be carried out for this calculation, recalling the usefulness of using non-parametric measures which do not require extraordinarily large populations, or normal distributions of their variables.

DESCRIPTION OF DIAGNOSTIC TECHNIQUES AND TREATMENT USED

Describe extensively the techniques, tests used and other procedures and give the bibliographic references which support them: they should be reproducible. Apparatus of all types, software, hardware.

The need to pass an Assessment Council by the EOM on the technique to be used in order to check its performance will be assessed.

MEASURING THE RESULTS

ETHICAL CONSIDERATIONS

• Declaration of Helsinki of the World Medical Association
• Ethical principles for medical research involving humans

STATISTICAL ANALYSIS

Describe the statistical methods in quite a lot of detail to enable the reader to have access to the original data (only with regard to the Committee, not so much for later publications if this occurs) to verify the results. The results should include appropriate measurement error or uncertainty indicators, such as confidence intervals, etc.

Examples of the statistical details which should be included in the methods section include the eligibility of the experimental subjects, details about randomization, blinding methods, treatment complications, number of observations, loss of cases in a clinical trial, statistics programmes used.  

Indicate the statistics methods used in order to analyze the results. All the terms, abbreviations, and statistics symbols should be defined.

Include the number of observations and the statistical significance of the results when this is appropriate. Detailed statistical analyzes, mathematical derivations and similar information may be presented conveniently in the form of one or more appendices.

This chapter should include:

1. Data obtaining procedure
2. Data management
3. Levels of significance and statistics tests used

RESULTS

Present your results in a logical sequence in the text, tables and figures. Do not repeat the results in many places (do not include the same data in text and tables).

Each table, pie-chart or bar graph should include an explanation of what can be seen and should be understood.

The tables should be numbered according to their order of appearance in the text (Table 1). Identify the statistical measures of variation, such as standard deviation and standard error, mean, etc. If the data comes from another source, the author should acknowledge and indicate the original source in the text and include the permission in writing to reproduce the material.

Number each table consecutively (in the order in which they were numbered in the text in brackets) with Arabic numerals and give a brief title to appear at the top of the table; put any necessary explanation in footnotes and identify them with symbols in the footnotes *, §, **, etc.

LIMITATIONS OF THE STUDY

The type of study itself, the number of patients, the material used.

DISCUSSION OF THE RESULTS

The discussion should stress the important aspects of the study and include the conclusions which follow on from these observations. Do not repeat data present in the results section and do not include information or work which is not directly relevant in the study.

Point out new hypotheses when appropriate, label them clearly as such. Declarations which do not have scientific grounds, which generalize or extrapolate results should not be included. The limitations of the study should be clearly indicated.

Generally speaking, we can divide the discussion in two parts:

• The first part is given over to discussing, commenting the results which we have presented. Their relationships, the relevance of the differences (significant or not), the similarities and correlation (significant or not). This part permits “certain” speculation about the reasons for the results which may also give rise to new research in the future.
• The second part has to be capable of situating these results in the scientific context, comparing the results obtained with other previous studies, other methodologies, discussing the possible reasons for the differences and similarities with them, carrying out constructive criticism of our research and of the rest.

The conclusions which can be drawn from the study can be included in the discussion; however, they can be presented more appropriately in a separate section. The main conclusions should be directly linked to the aims of the study.

Declarations and conclusions which are not supported by your data should not be included. Avoid giving priority or referring to work which has not been finished or has not been published. Indicate the new hypotheses when there are guarantees but clearly label them as such. Recommendations may be included (for future additional studies), when they are appropriate.

CONCLUSIONS

The conclusion should be supported by the figures in the statistics.

INDICES

1. Index of figures
2. Index of tables
3. Index of abbreviations

APENDICES

1. Appendix I. Table of experimental data
2. Appendix II. Study data collection sheet
3. Appendix III. Patient information and consent form
4. Appendix IV. Characteristics of the material used

There may be more or fewer appendices as long as they are justified.

BIBLIOGRAPHY

A minimum of 60 references should be included (better to have more references).

IT IS RECOMMENDED THAT YOU USE THE ENDOTE 6.0 PROGRAMME and Microsoft Office Word.

Authors are responsible for references and for the exact information of quotes, especially the accuracy of the names and surnames of authors, magazine titles, number of volumes and pages.

References should be numbered consecutively when they are first used in the text. References quoted in the text should be in italics and in brackets (for example, the dog jumped quickly on the fox. 1). References should be numbered in numerical order (not alphabetically) after the text pages. The original number of the quote allocated to a reference should be re-used every time the reference is quoted in the text, regardless of its earlier position in the text: do not give it another number. References should not be included in summaries. References which are only used in tables, figures or captions should be numbered in the sequence established by first use of the specific table or the figure in the text.

Only references which provide help for a specific declaration in the text, tables and/or figures should be used. References or referring to unpublished work should be avoided. The excessive use of references should be avoided.

Authors are responsible for checking the references. Special care should be taken to represent the original work exactly and not incorrectly interpret the original meaning of the article.

Reference sources

Only use the summary. Referring to “unpublished observations” and to “personal communications” should be avoided. Unpublished references (submitted but not accepted) should not be numbered as references.

Reference style

The style should be in line with the Vancouver specifications. Specific examples of correct references for magazine articles and other publications can be found at: http://www.nlm.nih.gov/bsd/uniform_requirements.html

The Vancouver rules and standards are found in any web page:

http://www.fisterra.com/recursos_web/mbe/vancouver.asp

http://www.terra.es/personal/duenas/vanco.htm

The format for reference to a typical article in a magazine is as follows:

• Surnames and initials in capital letters should be separated by a space, or a comma should separate each author. (List all the authors when there are 6 or less; when there are 7 or more authors, only the first 6 are listed and “et al.” is added).
• The title of the article with the first letter in upper-case and the rest of the words in lower-case, except for people’s surnames, places, etc.
• Name of the magazine, abbreviation according to the Medicus index http://www.nlm.nih.gov/tsd/serials/lji.html; year of publication (followed by semi-colon); number of the volume (followed by colon); and pages used from the article.

Book references (pages with many examples of all types of references can easily be found on the Internet, since there are currently numerous possibilities which did not exist before the internet: www.orbemed.org)

1. Hoppenfeld S. Neurología ortopédica. Ed. El Manual Moderno, México 1981- p. 11/14.
2. Ricard F., Salle J.L. Tratado de osteopatía. Mandala ediciones, 2ª edición, Madrid 1996- p.45/53.
3. Ricard F. Tratamiento osteopático de las lumbalgias y ciáticas. Tomo 1. Mandala ediciones, 2ª edición española, 1996- p. 134/162.
4. Ricard F. Cuaderno de estudio Escuela Osteopatía Madrid. 3º nivel, 4º seminario. Esfera digestiva. 1999-2000-p.12/20.

Internet references:

1. Endocrine system, hormonal metabolism, disorders of the endocrine function. Page consulted: http://www.monografias.com/trabajos16/sistema-endocrino/sistema-endocrino.shtml
2. Nervous system: the brain, the endocrine system. Page consulted: http://www.monografias.com/trabajos11/elcereb/elcereb.shtml

Magazine references:

• Surnames and initials in capital letters should be separated by a space, or a comma should separate each author. (List all the authors when there are 6 or less; when there are 7 or more authors, only the first 6 are listed and then “et al.” is added).
• The title of the article with the first letter in upper-case and the rest of the words in lower-case, except for people’s surnames, place names, etc.
• Name of the magazine, abbreviation according to the Medicus index; year of publication (followed by a semi-colon); number of the volume (followed by a colon); and pages used in the article.
  1. Tulder M, van, Koes B, Assendelft W, et al.-Chronic low back pain: exercise therapy, multidisciplinary programmes, NSAID’s back schools and behavioural therapy effective; traction not effective; results of systematic reviews. Ned Tijdschr Geneeskd2000; 144:1489-94.
  2. Tulder M, van, Koes BW. Low back pain and sciatica. In: Godlee F (ed). Clinical Evidence. London: BMJ Publishing Group, ACP, ASIM, 2000:614-631.
  3. Klaber Moffett J, Torgerson D, Bell Syer S,et al. Randomized controlled trial of exercise for low back pain: clinical outcomes, costs, and preferences. BMJ 1999;319:279-83.