Capstone Research Manual Doctor of Acupuncture and Oriental Medicine Capstone Research Manual 1 Capstone Research Manual Contents Introduction AOM Research: Group Applications Time Line Research Project Approval Project Completion STYLE MANUAL RESEARCH FORMAT USE OF NUMBERS PREFERRED TERMS AND COMMON MISSPELLINGS CITATIONS AND REFERENCE LIST References 2 Capstone Research Manual Introduction This handbook will guide you through the development and completion of your DAOM research project. This project is an important part of your DAOM program and will deepen your understanding of research in acupuncture and Oriental medicine. This handbook provides a plan from the formation of your research plan through the development of your proposal, approval of your proposal to the completion of your project. The development of the research project should take several months on a part time basis. This project can take a variety of forms. Some forms are listed below. The final document for this project will be between 50 and 100 double spaced typed pages, although documents outside this range may be appropriate under specific circumstances. Capstone research is supported by the following courses. AOM Research Principles and Practices (3 unit/30 hours) This course is designed to enable our graduates to demonstrate knowledge and skills in clinical research and design sufficient to provide an understanding of currently accepted research standards and methodology, as well as the current scientific literature in the field. This sequence is designed to fulfill our objective ‘to critically evaluate research literature, design, carry out and report a study in Oriental medicine.’ The course covers the basics of biostatistical analysis and common statistical tests that are used to conduct biomedical research. It examines concepts such as probability theory, population sampling, descriptive statistics, inferential statistics, confidence intervals, statistical significance, hypothesis testing, and comparison of paired and unpaired groups. It provides the basis for the conceptual development of the research project through the subsequent courses. In addition it teaches the ability to critically analyze the quantitative portion of research from a consumer's perspective. The course examines the research methodology utilized in contemporary biomedical sciences for the assessment of clinical efficacy and physiological mechanisms related to Oriental medicine. Upon completion of this module, DAOM Students will be able to discuss design, qualities and challenges in various types of clinical research projects in AOM. Processes of IRB and historical issues will be understood. DAOM Students will be able to access data base retrieval programs and produce a research proposal by the end of the class. Students will be able to scientifically assess the value of AOM research and learn how to appropriately evaluate evidence based research. They are expected to be able to access these tools when evaluating the use of new treatment techniques understanding how to carefully evaluate 3 Capstone Research Manual the viability of the research. DAOM Students will be able to design, direct and implement rudimentary clinical research projects in AOM. AOM Research: Group Applications (3 unit/30 hours) DAOM students will design and participate in groups of three and four in various types of clinically based research projects. The group proposal must include a description of the problem area, a specific research question, a review of relevant literature and identify research methods to examine the clinical question in a scholarly manner. Formal proposals must be submitted to faculty and IRB for approval prior to start of the project. This course begins the process of designing data collection/ implementation for the final research project and the final approval process. Content and format issues as well as recommendations for further research are highlighted. In this course students design, direct and implement their clinical research projects. They will meet with the research advisor to finalize and refine the research project, and continue working with their committees on their research project. They will be able to determine the different resources available to them to help them complete their written projects. Candidates will also learn the different methods and forms of acceptable research. They will be able to design, work on, and conclude an acceptable project and this course may be extended until the completion of the final written research report. All DAOM Students must satisfactorily complete and defend a research project before the DPC as a requirement for graduation. The project must incorporate the use of current literature and research in acupuncture and Oriental medicine. The DAOM Student must demonstrate the application of knowledge in the design and critique of approaches to systematic inquiry and to the use of qualitative and qualitative methods. The project must make a unique and meaningful contribution to acupuncture, herbal medicine or Oriental medicine and not merely a replication of an existing study. The project must meet academic form and style suitable for peer review professional publications. Research project formats may include: ● ● ● ● ● ● Theoretical Analysis, Surveys & analysis of archival data, Outcomes Research, Systematic Qualitative Investigations, Public Policy Issues, Case Studies (outcomes must be unique and have significant 4 Capstone Research Manual impact), ● Evaluative research, ● Interpretive Translation Research and ● Educational Research. Approved research projects must be submitted on paper designated for formal documents. Four copies of the project suitable for binding must be submitted to the Doctoral Director’s office. PROJECT TYPES: NOT RECOMMENDED Clinical Trials Research involving developing and executing a prospective study assessing a treatment modality, herbal formula, or some other clinical intervention on human volunteers is NOT Recommended. This project is often the most demanding of time and resources, and will require approval of an Institutional Research Board (IRB). Because of the significant time commitment for such a project, especially in the context of a doctoral program, it is imperative to consider your time availability realistically, and to consider a team based clinical project with one or more collaborators. At the level of the research project, clinical research is most often in the form of a phase 1 trial, which is a trial with one arm, more specifically without a control arm, and involves a limited number of human subjects. This study may be combined with a laboratory study under certain circumstances. In some extraordinary circumstances a phase 2-controlled study may be considered, but such a project will require time, resources and collaboration that is beyond the scope of a research project. A laboratory study involves the development and implementation of a design that in part or exclusively employs laboratory methodologies to complete the research protocol. As this type of project often involves highly technical laboratory skills, the successful candidate for a laboratory based research project must have experience using the laboratory equipment involved, or have taken coursework on these procedures. This type of project is NOT Recommended and will require IRB review unless human subjects are not are involved. Such a project tends to be somewhat expensive with respect to equipment and supplies, so project cost may limit the scope of the study. Unless you already have the appropriate training and skills for this type of study, you will be required have extensive preparation for work in the analytical laboratory. 5 Capstone Research Manual RECOMMENDED PROJECT TYPES Meta analysis. A meta analysis is a quantitative examination of a series of research papers in a particular area of interest in order to summarize this research and develop global conclusions based on the review of a group of research papers. Because this type of research involves a review of previously published papers and not human subjects directly IRB review is not necessary. Such a study does involve the use of sophisticated statistical analysis and should only be attempted by you if you are comfortable with the statistical review of published data. A meta analysis does not require expensive resources and can be done on a flexible schedule. Literature review. A literature review consists of the examination of the literature in a particular area of interest. Such a review is less statistically rigorous when compared to a meta analysis. A literature review can be far ranging in the primary (research) and secondary (review, meta analysis) and source text of the subject being studied. This type of project is involves examination of a large number of papers and other written and electronic resources. As such, a literature review will have a highly flexible study design and schedule, but require a large investment in time reading and analysis of the documents contributing to the project. No IRB approval is required. Expenses are generally limited to the procurement of references that may not be available except by purchase from non-university resources. Translation study. For those DAOM candidates with fluency in languages other than English, a translation study may be considered. A translation project involved translating one or more documents into English from another language either to complete as a translation as a final project, or in order to develop an analysis of the subject from the point of view of the non-English source material. While translation can be challenging, it is a rewarding type of study, and vital to the progress of a medical tradition in which so many of the important textual sources are in Chinese, Japanese, and Korean, and other languages. If a student does translation work in a language not represented on the faculty of the university, there may be additional financial costs to the student in terms of hiring outside translators to assist with evaluating the project. 6 Capstone Research Manual Case study/case series A case study involves the uncontrolled observations of one subject. (By uncontrolled, we mean observing a subject without comparing them to another subject meeting the same inclusion and exclusion criteria.). A case series involves the uncontrolled observation of more than one subject. These types of studies allow a researcher to complete observations on human subjects without the restrictions or resource requirements of more complex research protocols. Case study and case series projects involved human subjects and as such must be reviewed by the IRB. Retrospective clinical case review. A retrospective clinical case series is an analysis of a group of cases regarding history, examination, assessment and treatment. This study is historical, that is done using preexisting clinical records. Such a case series can be a valuable introduction to the analysis of a group of patients without some of the time and resource challenges of a prospective clinical study. Retrospective case series projects are limited in that they involve the examination of a group of cases not originally intended as research patients. Even when records are extensive, they may not be systematic and as such several records may not be directly comparable. As human subjects are involved, IRB approval is needed, and patient privacy must be preserved. Academic study. This last category is intentionally broad. Any innovative idea will be considered as long as it meets several critical factors. The proposal must be scholarly, that is represents an in depth examination of the field of inquiry. Second, the proposal must be rigorous, representing an examination of the topic in the proposal that is well organized and academically sound. Third, the proposal must represent the review of the literature available in the area of inquiry. Sources may include theoretical literature, clinical studies, review papers, source material of a historical nature and philosophical treatises. Lastly the proposal must represent a body of work commensurate with the level required of a research project in a doctoral program. Survey. Surveys are instruments that are completed by a population of subjects such as prospective patients, healthcare providers, or healthcare consumers. Surveys may cover a wide range of topics, including attitudes about healthcare, patterns of utilization of healthcare. In each case, the subjects’ responses to a variety of questions are recorded. Surveys that accurately assess the subject population’s responses with respect to the subject you are interested are challenging to develop. Survey questions must be carefully crafted to assess the knowledge, attitudes and demographics that 7 Capstone Research Manual will enable you to test the hypothesis in question. Time Line Training for your research project begins your first term. Each term you will take one research oriented class. These classes are summarized below in table 1. You will also meet each term with the DAOM Director. The DAOM Director will help you develop your project and locate the resources to complete your project. These resources may be intellectual, that is faculty mentors who have skills that you need to learn to complete your research project, equipment and materials, and financial resources based on the demands of the project. The timeline for your research project is in figure 1 below. Your goal is to have your research project done by the end of the final term in year 2. This means that your research project paper has been written, submitted and approved by the end of your second year. If you are on a part time schedule, then your research timeline will be worked out in consultation with the DAOM director and the academic advisor for the DAOM program. It is important to work on the research document throughout the Research series. Drafts of earlier sections of the research document will be reviewed, edited and returned with comments and suggestions. In this way, the document remains a work in progress, and is constantly being improved. The stress of completing the research document will be reduced if a steady pace is kept up with regular feedback, rather than attempting to write the entire document at the end of the winter term during the second year. It is important for you to submit your draft research thesis to the DAOM director before you have completed the rest of your DAOM program credits. Research project flow chart Research Development Term 1 Meet with DAOM Director to discuss research project Term 2 Follow up meeting to formulate possible topics Term 3 Develop project proposal and if needed IRB EXEMPTION documents 8 Course/Staff Support Capstone Research Manual Term 4 Project is approved by DAOM Review Committee and IRB EXEMPT Research begins Term 5 Develop research Question and literature search Develop methods. Start Project Continue Project. Progress Meeting Term 6 Term 7 Term 8 Complete research document and submit to DAOM Director Research Project Development The critical phase of your research project is consideration of what project to do. The most important facet of your project is; what project interest you? What ideas do you want to think about? What area of oncology or pain management do you want to explore? Are you interested in clinical research? Laboratory research? Scholarly investigation of the literature of Oriental medicine or biomedicine? Once you have settled on an area of interest within oncology or advanced pain management, the next step is to think about the size of the project. Project size is important for three reasons. First and foremost you need to be able to complete your research project in the time allowed. If you are on a full time track you will have four terms to develop and complete the research track of your DAOM program in addition to your other academic and clinical work. The project must be significant enough to demonstrate scholarly work in the field, but must not be so large that it is difficult for you to finish your program on time. The project must be of a size that can be completed with the available resources. This means that funding and resources for research projects are limited. Research projects must be designed to use available resources so that they can be completed. You need to look at your skills, what you can bring to the research project. It is important to do an inventory of your abilities and decide if the project is right for you. If you are interested in doing a translational project, do you have the language skills to complete this type of project? If you are interested in doing a laboratory based project, do you have the laboratory skills and experience to complete such a project? If you do not have all the laboratory skills 9 Capstone Research Manual are you willing to take the additional coursework on laboratory research needed to develop laboratory skills needed to complete the project? If you are interested in doing clinical research, are you interested and emotionally prepared to do work research on human subjects. This self inventory is a critical part of deciding what project is right for you. It will be important to consider these issues in consultation with the DAOM program director. Be prepared to make changes in your project. It will also be important to have a “back up plan” in the event that your first project does not go through either because of review by the DAOM director, the faculty, or for resource or financial reasons. All research projects, from research project to large project funded by the National Institutes of Health go through extensive review. It is a rare project that is not significantly modified as a result of the review process. Research Project Approval Approval of your research project will go through several stages. First, the DAOM director will review your project proposal to confirm that the project is sound and the university has the intellectual, material and financial resources to support your project. The DAOM director will also help you develop a project that you can complete in the time constraints of the DAOM program. Your consultation with the DAOM director will be ongoing and develop over a series of meetings with year 1 and extending to final research document approval. Your research project proposal will be graded by the instructor of your Research course. It is during this course that your proposal will be developed and evaluated by an experienced researcher, who will assess the merits of the proposal, as well as the form and completeness of the final research proposal document. Your IRB EXEMPTION will be reviewed by the DAOM Director. IRB EXEMPTION approval must be confirmed before research project can begin. The IRB may also provide provisional approval and request changes in the protocol or documents before protocol can be begun. These changes will be coordinated with the DAOM Program Director for final review and approval. Project Completion Project completion is determined by the DAOM director upon the submission of the written research project document. The final 10 Capstone Research Manual document must be submitted to the DAOM director by the deadline set for the project. The format for the final document must meet the style requirements outlined in Table 2 below. Review of the final document will be completed by the DAOM director, and may also be reviewed by other reviewers with skills and knowledge in the subject area of the research project. In the event that editorial changes are required, these changes must be completed prior to final acceptance of the document. Your research project document must be free of errors. Your prose must be clear, readable and succinct. There must be no hand corrections or typographical errors. If your research required supervision of a consultant, such as a translation project consultant fluent in a specific language, that consultant will have to review the thesis and sign off for its accuracy and completion. Once your draft thesis has been reviewed by the DAOM director, the Academic Dean must also review it. In the event that the DAOM director feels that there are a significant number of grammar, punctuation or spelling errors, your draft research thesis will be returned to you. You will be required to get outside editorial assistance with these errors before your document is reviewed for content. Editorial review must be completed at your own expense and with an editor of you choosing. Project Grading Your thesis will be graded on the following criteria: 1. 2. 3. 4. Completeness of the project Quality of the writing Organization of the research document Quality of the work described in the project In order to achieve the most positive outcome for this project, it is important to remember several points. First, scholarship must be as complete as possible to achieve the best possible outcome. While it is impossible to specify the number of references for a given project, there must be good evidence that a thorough literature review was done, and that the literature reviewed represents the scholarly activity needed to support the project. Second, the information in the document should be well written and without spelling and grammatical errors. Third, the document should conform to the formatting requirements outlined in this manual. Fourth, the document must represent a level of scholarship, academic work and thinking commensurate with a research project in a doctoral program. The document will be graded on a pass/no pass bases. On 11 Capstone Research Manual submission, if the document is not at a passing level, it will be returned with recommended changes that must be completed and the document resubmitted for a new review. If the document is rejected a second time, at the discretion of the DAOM program director a learning contract may be required before the document can be re-edited a third time. 12 Capstone Research Manual Style Sheet Manual STYLE MANUAL ● Use the Publication Manual of the American Psychological Association (hereafter referred to as the APA manual) as a general reference for style. ● For more detailed issues of grammar and punctuation that are not covered in the APA manual, use The Chicago Manual of Style. RESEARCH FORMAT Table of Contents The table of contents must be digitally generated, using the appropriate function in Microsoft Word. Please do not type the table of contents manually. In the table of contents, include only the main headings. Do not include subheadings, table headings or appendices labels. Referencing Appendices and Tables Make sure that any page number references to other items within the document stay accurate. For example, if you write, “See page 96 for Table 3,” make sure that this reference is still correct after you are done with final formatting and edits. One good way to do this is by linking the reference to the page that the table or appendix is found on. If you would like a tutorial/refresher on this skill, or have any other formatting questions, contact the AOM program assistant in room 338 (ext. 3132) to set up an appointment. Length The length of the project is highly variable and should be determined with assistance from the DAOM program director. An average length is 50-100 pages. Margins Left margin: 1.5 inches. All other margins: 1 inch. This includes every document in the Research Thesis, including inserted tables and appendices. 13 Capstone Research Manual Paper Use 25% cotton bond, 8.5 x 11 inches. The same kind of paper must be used throughout, including the cover page. Font Use Times New Roman, 12 point, for text. Use Arial, 12 point, for headings and subheadings (see headings section for details) Keep typeface and size consistent throughout the text. Headings Use the five levels of headings outlined in the APA manual, as described below. Heading Level 1* Format Centered, Bold, Uppercase and Lowercase 2 Flush Left, Bold, Uppercase and Lowercase 3 Indented, bold, lowercase, period at end. 4 Indented, bold, italicized, lowercase, period at end. 5 Indented, italicized, lowercase, period at end. * Use level 1 for main section headings, such as Methods and Results. Spacing The text of the manuscript should be double spaced throughout, with the following exceptions: Tables and long quotations should be single spaced. References should be single spaced, with a space between each reference. Insert one space (not two) between sentences. Insert one space (not two) after a colon. Indent the first line of each paragraph. If footnotes are used, indent the first line of each. 14 Capstone Research Manual Pagination Two distinct page numbering systems should be used for the research , as follows. The preliminary pages are numbered with small Roman numerals (ii, iii, iv and so on). The title page is considered page “i,” though that character is not printed. Preliminary pages include all pages before the Introduction. The text pages are numbered with Arabic numerals (1, 2, 3, and so on). The text begins with the Introduction and is numbered consecutively through the References and Appendices. All page numbers should be centered, at least one-half inch from the bottom edge of the paper. Layout ● Arrange sections of research document in the order shown below. Section Page numbering Comment Title page Not numbered See attached sample Acceptance page Numbered, small Roman numerals (i, ii, iii, iv, etc.) See attached sample Acknowledgement Optional Abstract 200-250 words Table of contents Use a single level for the Table of Contents, not an outline. List of tables List of figures Introduction Numbered, Arabic Develops significance of numerals (1, 2, project and outlines 3, etc.) major ideas and hypothesis 15 Capstone Research Manual Comprehensive review of literature Review of literature of the field Methods Description of methodologies used, as well as sources of materials Results Describes the results of the study Discussion Analysis of results, conclusion, and recommendations for further study References List of all references Appendices USE OF NUMBERS ● Use words to express numbers below 10, and numerals to express numbers 10 and above (e.g., one, two, seven; 14, 21, 567). ● If a sentence (or a paragraph with many numbers) contains numbers both smaller and larger than nine, all numbers should be in numeric form, to avoid confusion. ● For example, “The dog ate 14 bananas, 2 cookies, 6 pies, and 25 carrots.” ▪ (Sentences such as “The dog ate 14 bananas, two cookies, six pies, and 25 carrots” are confusing and distracting.) ● For items in two different categories that are in the same sentence, numbers can be spelled out in one category if appropriate. ● Three students ate 5 bananas each, two students ate 10 bananas each, and seven students ate 6 bananas each. ● Common fractions in narrative text should be expressed in words (e.g. one-tenth of the class; a four-fifths majority). 16 Capstone Research Manual ● For decimal fractions, use a zero before the decimal point. ● Numbers immediately preceding a unit of measure should always be in numerals (e.g., 3 ft., 5-mg dose, 12 lbs.). ● Use numerals to express fractional quantities, percentages, ratios, percentiles, time, dates, and ages (e.g., 0.25, 6%, 20th percentile, 6 years old, 5:00 PM, 3 hr 45 min). ● Use words to express any number that begins a sentence. Where this becomes awkward, try to reword the sentence. PREFERRED TERMS AND COMMON MISSPELLINGS ● Health care (two words) ● traditional Chinese medicine (only Chinese begins with an upper case letter) ● Chinese Medicine (Medicine begins with an upper case letter) ● acupuncture and Oriental medicine (only the proper noun is upper case) ● Western medicine; Eastern medicine (Western and Eastern are upper case) Medical Terminology ● Names of diseases should be lower case, unless they contain proper nouns. For example, hypertension, cancer, Hodgkin’s disease. AOM Herbal Formulas ● The names of herbal formulas should be in italicized pinyin. All letters should be lower case. ● Names of individual herbs should also be in italicized pinyin, lower case. For example, sheng di; mai dong. ● Pathogenic Influences ● Terms such as wind, fire, damp, heat, and blood should be in regular type (not italicized or in upper case). Pinyin Terms ● Standardized terms expressed in pinyin should appear in lower case regular type. Examples: qi, pinyin, zang fu, yin, yang. Organ Systems 17 Capstone Research Manual ● The Western terms for organs should begin with a lower case letter. For example, heart, lung, blood, stomach. ● The AOM organ systems should be in regular type, with an upper case first letter. Examples: Liver, Lung, Heart, Kidney, Pericardium, Spleen; Large Intestine, Small Intestine, Stomach, Gallbladder, Urinary Bladder, Sanjiao (also Triple Heater, Triple Burner, Triple Warmer). Point Names ● Point names should be expressed as follows (in this order): prefix (two upper case letters, except for REN points which are three), hyphen, point number, followed by the pinyin name in parentheses. The pinyin name should begin with an upper case letter. Example: ST-36 (Zusanli). Use of Chinese Characters in Text ● Chinese characters (in text) should appear in parentheses immediately following the English or pinyin term. Pharmaceuticals ● The first letter of a brand name drug should be upper case; the first letter of a generic drug should be lower case. Example: Tylenol; acetaminophen PUNCTUATION AND GRAMMAR Commas ● In a series of three of more items, use a comma between all items and before the final “and” or “or.” Example: She bought a textbook, a novel, a magazine, and a newspaper. ● If a series of three or more items has internal commas, use a semi-colon (instead of a comma) to separate the items. Example: On July 4th, they brought cake; cookies; and red, white, and blue candy to the picnic. Commas and Periods within Quotation Marks ● Periods and commas always go within the quotation marks. Example: 18 Capstone Research Manual “The side effects of chemotherapy include nausea, fatigue, hair loss, and loss of appetite,” said Dr. Yang. ● A question mark, exclamation point, dash, or semicolon goes inside only if it is part of the phrase or sentence quoted. Examples: He asked, “Are you ready?” Did she say, “I’m not ready”? Acronyms Spell out the full term on first use, followed by the acronym (upper case initials) in parentheses. Use only the acronym thereafter (except as below). Example: Acupuncture and Oriental Medicine (AOM) is a growing field in the United States. Many accredited AOM programs can be found across the country. ● If an acronym is first defined in the abstract, define it again on first use in the manuscript body. ● If the acronym is used infrequently, or with long sections between usage, it may be helpful to define again, for clarity. Prefixes In general, the prefixes pre and post do not require hyphens. For exceptions and more detailed information, please see the APA manual or The Chicago Manual of Style. Examples: ▪ ▪ ▪ postoperative; preoperative (But if using the abbreviation pre-op, insert a hyphen.) postchemotherapy; prechemotherapy postsurgical; presurgical CITATIONS AND REFERENCE LIST Order of Entries ● Place entries in alphabetical order, by the surname (last name) of the first author. If there is no author listed, use the first word of the agency or organization name (e.g., American Cancer Society). If there is no listed author or organization, use the first word of the title. ● If two documents are written by the same author or group of authors, order chronologically, with the earliest date first (i.e., an article from 2006 would appear before an article from 2009). 19 Capstone Research Manual ● For assistance with referencing, students may find the software program endnote helpful. A copy is available for use in the Bastyr University library. Reference List ● For articles with seven or less authors, list all authors. ● For articles with eight or more authors, list the first six authors, then insert three ellipsis points, followed by the last author’s name. ● List journal names in full, in italics ● Include doi number if available. ● Include the issue number in parentheses, after the volume number, if available. ● Examples: Document retrieved online (No retrieval date is needed for online citations. Include date of document, if available, in parentheses after organization or author.) ● All sources cited in the text must be listed in the References section; all entries in the References section must be cited in the text. ● For correct formatting of additional types of references, such as conference proceedings, presentations, doctoral dissertations, unpublished materials, etc., refer to the APA manual. 20 Capstone Research Manual Figure 2: Sample title page DONGGUK UNIVERSITY LOS ANGELES < RESEARCH TITLE > Submitted in partial fulfillment of the requirements for the degree of DOCTOR OF ACUPUNCTURE AND ORIENTAL MEDICINE BY < NAME > < YEAR > 21 Capstone Research Manual Figure 3: Advisor acceptance page ADVISOR ACCEPTANCE PAGE To the faculty of DULA: The undersigned find that the research of < NAME > is satisfactory and recommend it be accepted. RESEARCH PROJECT TITLE: < RESEARCH TITLE > ______________________________ _______________________________ Date DAOM Director _______________________________ _______________________________ Date Dean 22 Capstone Research Manual References American Psychological Association (2010). Publication manual of the American Psychological Association, sixth edition. Washington, D.C.: American Psychological Association. Bailey D, Research for the Health Profession. F.A. Davis Company, Philadelphia, 1997. Fetzer, J. (1993). Philosophy of science. New York: Paragon House. MacPhereson, H., Hammerschlag, R., Lewith, G., & Schnyer, R. (2007). Acupuncture research. Edinburgh: Churchill Livingstone. Stux, G., & Hammerschlag, R. (2001). Clinical acupuncture scientific basis. Berlin: Springer Verlag. The Chicago Manual of Style, fifteenth edition (2003). Chicago: University of Chicago Press. Uniform Requirements for Manuscripts Submitted to Biomedical Journals. International Committee of Medical Journal Editors Uniform Requirements. http://www.nlm.nih.gov/bsd/uniform_requirements.html Wilson E, An Introduction to Scientific Research. Dover Publications, New York, 1952 23