Journal Article Writing and Publication

Your Guide to Mastering Clinical Health

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 Sharon A. Gutman, PhD, OTR, FAOTA
Associate Professor of Rehabilitation and Regenerative
Medicine
Columbia University Medical Center
Programs in Occupational Therapy
New York, New York
www.Healio.com/books

ISBN: 978-1-63091-335-9

Copyright © 2017 by SLACK Incorporated

Dr. Sharon A. Gutman has no financial or proprietary interest in the

materials presented herein.

All rights reserved. No part of this book may be reproduced, stored in a

retrieval system or transmitted in any form or by any means, electronic,
mechanical, photocopying, recording or otherwise, without written
permission from the publisher, except for brief quotations embodied in
critical articles and reviews.

The procedures and practices described in this publication should be

implemented in a manner consistent with the professional standards set for
the circumstances that apply in each specific situation. Every effort has been
made to confirm the accuracy of the information presented and to correctly
relate generally accepted practices. The authors, editors, and publisher
cannot accept responsibility for errors or exclusions or for the outcome of
the material presented herein. There is no expressed or implied warranty of
this book or information imparted by it. Care has been taken to ensure that
drug selection and dosages are in accordance with currently
accepted/recommended practice. Off-label uses of drugs may be discussed.
Due to continuing research, changes in government policy and regulations,
and various effects of drug reactions and interactions, it is recommended
that the reader carefully review all materials and literature provided for each
drug, especially those that are new or not frequently used. Some drugs or
devices in this publication have clearance for use in a restricted research
setting by the Food and Drug and Administration or FDA. Each
professional should determine the FDA status of any drug or device prior to
use in their practice.
Any review or mention of specific companies or products is not intended as
an endorsement by the author or publisher.

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Library of Congress Cataloging-in-Publication Data

Names: Gutman, Sharon A., author.

Title: Journal article writing and publication : your guide to mastering
clinical health care reporting standards / Sharon A. Gutman.
Description: Thorofare, NJ : Slack Incorporated, [2017] | Includes
bibliographical references and index.
Identifiers: LCCN 2016034966| ISBN 9781630913342 (paperback : alk.
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Subjects: | MESH: Medical Writing--standards | Health Services Research--
standards | Manuscripts as Topic | Periodicals as
Topic--standards | Authorship--standards
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 Contents
Copyright
Acknowledgments
About the Author

Chapter 1 Introduction: The Importance of Writing to Advance Your

Career and Profession

Chapter 2 Writing Resources—Mentors, Writing Partners, and Self-

Discipline

Chapter 3 Manuscript Structure and Content for General Research

Studies

Chapter 4 Manuscript Structure and Content for Intervention

Effectiveness Studies

Chapter 5 Manuscript Structure and Content for Instrument

Development and Testing Studies

Chapter 6 Manuscript Structure and Content for Case Reports

Chapter 7 Reporting Statistical Data in Text and Tables

Chapter 8 Preparing and Submitting Manuscripts for Publication

Chapter 9 The Revision Process

Chapter 10 Writing a Scholarly Discussion Paper

Chapter 11 Turning Academic and Clinical Work Into Publishable
Journal Articles

Chapter 12 Ethical Considerations in Publication

 Acknowledgments
I thank Dr. Jane Case-Smith and Dr. Rondalyn Whitney for help with the
conceptualization of this book. I also thank Dr. Janet Falk-Kessler for
sharing our article, “Development and Psychometric Properties of the
Emotional Intelligence Admission Essay Scale,” in Chapter 9.
 About the Author
Sharon A. Gutman, PhD, OTR, FAOTA is an occupational therapist and
associate professor at Columbia University Medical Center. In a career
spanning 25 years, she has published 42 peer-reviewed articles, 7 textbooks,
6 textbook chapters, 24 editorials as editor-in-chief of the American Journal
of Occupational Therapy (AJOT), and 5 continuing education articles and
courses. Dr. Gutman served as the editor-in-chief of AJOT between 2008
and 2014, during which time she helped practitioners and researchers better
understand manuscript writing, clinical study reporting standards,
intervention fidelity, research methodologies, health literacy, and copyright
issues. A major initiative of her editorship was to help researchers better
understand the need for evidence-based research to support health care
practice and the design and implementation of intervention effectiveness
studies. By the end of her AJOT editorship, she had increased the
publication of clinical intervention studies by 50% and helped to increase
the journal impact factor score from an average of 0.641 over a 10-year
period (1998–2007) to a 5-year score of 2.021 in 2014. In this book Dr.
Gutman summarizes her 25 years of experience and knowledge to help
students and researchers better understand the use of health care reporting
standards in manuscript preparation, the reporting of statistical data in text,
and the manuscript review and revision process. Readers will find this book
easy to use and critical to a successful writing career in academia and
research.
 1

Introduction
The Importance of Writing to Advance
Your Career and Profession
Health care professions have an implicit contract with society to provide
services that are effective and cost-efficient. Until recently, however, health
care professions were not held accountable by society to demonstrate clinical
effectiveness. Although the Food and Drug Administration has for years
required a rigorous protocol for pharmaceutical and medical device testing
(U.S. Department of Health and Human Services, 2015), this same demand
for accountability of service has not been required of most health care
practices. Managed care’s denial of reimbursement for new, experimental,
and unproven interventions has largely been the impetus for health care
researchers to demonstrate the effectiveness of treatment. Increased health
care litigation and malpractice costs have similarly compelled health care
professionals to demonstrate service effectiveness through empirical
research.
The ability to demonstrate that a specific health care profession provides
valuable and effective services that meet society’s health needs is a major
objective for all health care academicians and researchers. Such skills are
critical to ensure service reimbursement from an increasingly small pool of
health care dollars. Demonstrating clinical effectiveness depends on the
ability to obtain funding support for clinical research. Obtaining funding
depends on research skills and the ability to convey through writing how a
study will contribute to the health of society’s members. Grant funding has
become critical to obtain the resources needed to implement research that
can support the effectiveness of health care practices.
More critical is the reporting of written research results through journal
publication so that the health care community and larger society will be able
to access and read evidence supporting health care services. Good writing
skills, however, are not sufficient for journal publication. Today, several
clinical reporting standard guidelines have been created by researchers to
enhance the ability of readers to evaluate the quality and value of studies. To
my knowledge, this book is a first attempt to compile those clinical research
reporting standards in one source. Health care researchers must begin using
these reporting standards in order to write manuscripts that are correctly
formatted and transparently convey all critical study strengths and
limitations. Educators must teach these reporting standards to students, who
must evaluate research reports as consumers and who, in the future, may
contribute to the literature through their own writing. As a former editor of
the American Journal of Occupational Therapy (AJOT), I can attest that most
authors, even seasoned writers, were unaware of these guidelines and
needed moderate guidance to reformat their manuscripts in accordance
with them.
Learning about and consistently using reporting standards in journal
publication is important to the advancement of health care professions. But
such advancement begins with our own individual efforts. As of this writing,
many health care professions have a shortage of well-prepared educators and
researchers. To earn a position in the academy—to be employed as a faculty
member in an institution of higher learning—educators must have obtained
a research doctoral degree. In most institutions of higher learning,
promotion and tenure require a 7-year period of teaching, service, and
publication. These have been the traditional measures of success in
academia for the last century and will not change. To be accepted as a peer
in an academic setting, health care educators must follow the same route of
earning a research doctoral degree and contributing to the scientific
community through teaching and scholarship. As educators, we must
advance our own careers by earning research doctoral degrees and
publishing innovative health care studies that can be applied for the good of
society. If we want to be respected by our academic peers who hold research
doctoral degrees and have grant and publication histories, we must follow
the same path. If we want to advance in the academic environment—receive
promotion and tenure and participate in important committees making
decisions about university governance—we must earn the same credentials
and produce the same level of scholarship as our non-health care academic
peers. If we want our health care education programs to be securely situated
in, valued by, and respected by the university, we must meet and exceed the
university’s prescribed measures of academic success.
This is not an easy path. Many of us have come to our health professions
as practitioners. We graduated from health care programs and practiced for
a number of years before earning a doctoral degree. After the awarding of
our doctoral degree, we found that positions as educators were plentiful and
did not require postdoctoral work or the need for continued income delay,
as is traditional in the basic sciences. There was a price to be paid, however,
for forgoing the postdoctoral experience, through which research and
writing skills are learned directly through immersion in clinical studies
overseen by a team of seasoned mentors. Such an experience is not offered
in many doctoral degree programs, particularly online study formats.
Students in entry-level clinical doctoral programs face the same hurdles.
The high cost of tuition will be an impediment to continued higher
education after the entry-level clinical degree is earned. Postdoctoral
positions and the continued delay of income they require will be cost
prohibitive. Yet the same criteria for success will exist for health care
educators in academia: scholarship through grant submission, research, and
journal publication. How will health care professions answer this call? How
will individual educators advance their academic careers?
This book will help educators and novice researchers better understand
the skills needed for journal publication—perhaps the most essential skill
for a successful academic career. The book provides specific guidelines,
based on the most commonly accepted reporting standards, for the
preparation and writing of general research studies, intervention
effectiveness studies, instrument development and testing studies, and case
reports. A section is devoted to helping authors understand the rules
governing the reporting of statistical data in text and tables. Separate
sections help authors understand the manuscript preparation and
submission process, the revision process, and the etiquette guiding
communication with editors and reviewers. Guidelines for the preparation
of scholarly discussion papers and editorials are provided.
Additionally, one section aims to help doctoral students and newly
minted faculty turn academic work (e.g., dissertations and theses) into
publishable journal articles. In this section I also provide suggestions to help
clinicians turn clinical data into research databases that could serve as the
foundation for pilot studies. Lastly, I provide information to help authors
better understand the ethical considerations of publication including
plagiarism, dual submissions, inappropriate authorship, copyright, and
conflict of interest.
The book is based on my work as an editor and author. As a former
editor I was able to identify the most commonly made errors in manuscript
writing and research reporting. I have compiled this knowledge in an easy-
to-use-format to help authors avoid commonly made mistakes and instead
develop thorough and detailed manuscripts in accordance with reporting
standards accepted by the health care and scientific communities.
Understanding the knowledge in this book will better help individual
academicians succeed in journal publication and advance their academic
careers. Such individual advancement will in turn promote health care
professions as producers of respected and valued bodies of scholarship that
benefit society’s welfare.

REFERENCE
U.S. Department of Health and Human Services. (2015). U.S. Food and Drug Administration:
Protecting and promoting your health. Retrieved from http://www.fda.gov/default.htm
 2

Writing Resources—Mentors, Writing

Partners, and Self-Discipline

Writing is an integral part of becoming a scholar, researcher, and

academician. Our success in these roles is measured by our ability to
produce published journal articles, books, research reports, grant proposals,
and educational materials. While a command of English composition is
prerequisite, academic authors must understand the differing style
guidelines, formats, and objectives of various written materials—books,
published research studies, published discussion papers, and grant
applications. Each of these forms of written material requires different
writing skill sets.
Sometimes academic authors can learn desired written skill sets by
reading examples. Reading the articles published in professional journals
can help authors better understand the formats and writing style required by
specific journals. Colleagues may be willing to share accepted grant
proposals to help new faculty better understand the grant writing process.
Reading examples is critical, but the practice of writing multiple drafts,
obtaining feedback, and making revisions is essential to learning academic
writing skills. All new faculty and researchers must go through this process
of drafting, obtaining feedback, and revising to become good academic
writers. The process of requesting and using feedback to revise drafts of
papers continues throughout an entire academic career. The best academic
writers commonly seek feedback from colleagues on drafts of written
materials. Feedback is commonly provided in any type of peer-reviewed
submission process. For example, after authors submit a manuscript to a
journal, editors and reviewers provide written feedback that the authors use
to strengthen the manuscript. Novice academic authors must engage in the
process of drafting, seeking feedback, and revising to gain writing expertise.
To engage in this learning process, new academic authors must continuously
write and become emotionally neutral in response to feedback and critique.

MENTORSHIP
The most important resource when learning academic writing is having
one or more seasoned academic mentors who can provide feedback on
multiple drafts until the paper is published. Because academicians’
workloads are often intense and they may not have time to mentor new
faculty, it is sometimes beneficial for new faculty to offer paper co-
authorship to secure mentorship. New faculty and researchers can also form
writing support groups in which they share their writing and receive
constructive critique. Participating in writing support groups can feel less
intimidating than requesting feedback from a seasoned academic; however,
the critique offered may not be as valuable because the group members have
less experience in academic writing. Engaging in mentorship with a
seasoned academic writer and participating in a writing support group are
both highly recommended to help novice academic writers gain expertise.

PERSONAL COMMITMENT
While seasoned academic mentors and writing support groups are
essential in the learning process, neither can enhance writing skills if
authors do not make the commitment to write. To become a proficient
academic writer—to become skilled and successful in journal publication,
book publication, and grant submission—authors must engage in writing
continuously. In other words, authors must devote a minimum of 3 hours
per week to writing in one uninterrupted block of time. Attempting to write
in smaller time periods will be unfruitful, because authors commonly need
approximately 20 minutes to regain mental focus for a specific writing piece
and begin writing where they last left off. Multitasking and writing are
incompatible; authors must create a writing environment in which they are
free from distractions such as cell phones, students, colleagues, clients,
family, and email. Creating a distraction-free writing environment and
committing to a minimum 3-hour writing period per week require time
management and self-discipline. A writing time period of 3 or more hours
should be scheduled into the work week along with all other work-related
commitments. Honoring this scheduled time and adhering to this weekly
schedule must become as sacrosanct as a covenant. To be a successful
academic author, academicians must make a contract with themselves to
devote time needed to write.
The more authors adhere to a weekly writing schedule, the easier it
becomes to sit down at a computer, free oneself from daily distractions, and
regain the flow of writing. Each time that authors reschedule their weekly
writing time period or make excuses to forgo a writing session, the more
difficult it becomes to regain writing flow. Soon writing projects become
abandoned and the thought of writing becomes a distasteful chore that is
consistently avoided.

DECREASING WRITING ANXIETY

One way that authors can prevent writing anxiety and avoidance is to
outline all writing projects at the beginning and create a map or set of
instructions that can be followed at each writing session. At the end of each
writing session authors should make notes to themselves about how to
restart writing and identify the next writing steps. The day or evening prior
to their next scheduled writing session, authors should read their previous
notes to direct their mental focus back to the writing project. Sleeping with
those notes and directions in mind and then embarking upon writing the
next day will help authors ease back into their writing.
Sometimes having a writing partner effectively helps authors commit to a
weekly writing schedule and set and meet deadlines. A writing partner can
be a colleague who may also be new to academia and who is similarly
embarking on his or her own writing career. Writing partners can schedule
appointments together to write at the library (or another quiet
environment), and they can act as coaches to make sure each author is
setting and adhering to deadlines.
 Authors must also depersonalize feedback and recognize that it pertains
to a set of sentences on a page rather than to themselves. It is also beneficial
to recognize that articles are published in a polished form after multiple
drafts, revisions, and professional editing. Authors must remember that first
drafts, even those written by seasoned writers, often read very differently
from final papers ready for publication. The more comfortable we become
sharing our preliminary drafts with others, the more feedback we will
receive that can ultimately help us reach publication readiness. The more we
write, the less anxiety writing will cause us.

CHECKLIST FOR GATHERING AND USING

WRITING RESOURCES
Read the professional literature consistently to gain an understanding of
the writing styles and formats that are used in the journals in which you
wish to publish.
Understand that writing a paper involves the development of multiple
drafts, seeking feedback for each draft, and making several sets of
revisions. This is a lengthy process, and one writing project can require
weeks or months for completion.
Seek a mentor who is a seasoned academic writer with a strong publication
history and who can provide feedback on drafts of your written material.
Cowriting with mentors and offering coauthorship on papers is a
constructive solution that benefits both the learner and mentor.
Participate in a writing support group with academic colleagues who are
similarly seeking to develop writing skills in a supportive environment.
Commit to a weekly writing schedule of 3-hour or greater blocks. Schedule
this writing period into your workweek and adhere to it.
Avoid multitasking during your 3-hour weekly writing session. Write in a
nondistracting environment free of cell phones, email, and interruptions.
Outline all writing projects before beginning to write. At the end of each
writing session, make notes or a set of directions that will help you to
restart writing at your next scheduled session.
The day or night before each scheduled writing session, review your notes
so that your mind begins to regain focus on the project while you sleep.
Begin writing again the next day.
If you have difficulty with self-discipline and avoid writing, seek a writing
partner who is similarly a new academician with the objective of a writing
career. Schedule writing sessions together and help each other set and
adhere to writing deadlines.
Depersonalize feedback and become comfortable receiving critique on
written drafts. Recognize that preliminary drafts read very differently from
final, publication-ready papers that have gone through multiple drafts,
revisions, and professional editing.
 3

Manuscript Structure and Content for

General Research Studies

This section reviews in depth the basic content and structure of a

research paper (general research studies refers to basic research and
nonexperimental designs such as descriptive, qualitative, correlational,
survey, longitudinal, cross-sectional, etc.). A primary concern for publishers
is the cost of publication space. Even online publication has costs associated
with copyediting and journal website maintenance. General manuscript
length requirements are usually 5,000 words including references; however,
it is critical to check the page and word count lengths in the author
guidelines of the specific journal to which you intend to submit and adhere
to those requirements. Not adhering to journal page length and word count
will often result in returned manuscripts.
Research manuscripts for scientific, health, and social science journals
should be written concisely and use the least amount of words to convey
clear, in-depth meaning. There is a specific formula for writing research
manuscripts that most editors and reviewers seek. Writing your research
manuscript in accordance with this formatting structure will ensure that you
have addressed the elements critical to clearly and transparently describe
your study and reporting results. If a journal’s author guidelines diverge
from the following formatting structure, authors should use the structure
recommended by the journal. If no structure is provided in the journal’s
author guidelines, use the following structure (whose heading levels are
based on the Publication Manual of the American Psychological Association,
6th ed. [American Psychological Association, 2010]). The following
headings are provided for a masked manuscript, or one in which the
authors’ identifying information and affiliated institutions are removed.

MANUSCRIPT HEADINGS FOR GENERAL

RESEARCH STUDIES
Title
(Begin the manuscript with a title on a separate title page. The title
should be centered and typed in uppercase and lowercase letters.)

Abstract
(The Abstract should be placed on the page directly following the title
page. The word Abstract should be capitalized and centered.)

Introduction
(The Introduction begins on the page directly following the abstract. The
heading Introduction is not typed in the manuscript because the beginning
of the manuscript text alerts the reader that the Introduction has begun.)

Method
(The Method section is positioned directly after the Introduction. The
heading Method is centered and bolded.)
Research Design
(Research Design is the first subheading in the Method section. It is
bolded and flush left.)
Participants
(Participants is the second subheading in the Method section. It is
bolded and flush left.)
Instruments
 (Instruments is commonly the third subheading in the Method section.
It is bolded and flush left.)
Procedures
(Procedures is commonly the fourth subheading in the Method section.
It is bolded and flush left.)
Data Collection
(Data Collection is the subheading that directly follows the Procedures
section. It is bolded and flush left.)
Data Analysis
(Data Analysis is the subheading that directly follows the Data Collection
section. It is bolded and flush left.)

Results
(The Results section directly follows the Data Analysis section and begins
a new section of the manuscript. The heading Results is bolded and
centered.)

Discussion
(The Discussion section directly follows the Results and begins a new
section of the manuscript. The heading Discussion is bolded and centered.)
Limitations
(The Limitations subsection is part of the Discussion section but should
be highlighted for the reader by a separate subheading within the Discussion
section. The subheading Limitations is bolded and flush left.)
Future Research
(The Future Research subsection directly follows the Limitations
subsection. This section is also part of the Discussion and should be
highlighted for the reader by a separate subheading label. The subheading
Future Research is bolded and flush left.)
 Conclusion or Implications for Practice
(The Conclusion section, also labeled Implications for Practice, is often
the final section of a manuscript. It is a new manuscript section directly
following the Discussion section. The heading is bolded and centered.)

References
(References begin on a separate page following the conclusion. The
heading is centered and not bolded.)

Tables
(Tables should be provided after the end of the references and should
begin on a separate page. Each table should be presented on its own page.
Tables are named and presented in accordance with the order in which they
are mentioned in the text.)

Figures
(Figures should be provided after the end of the tables and begin on a
separate page. Each figure should be presented on its own page. Figures are
named and presented in accordance with the order in which they are
mentioned in the text.)

MANUSCRIPT HEADING CONTENT FOR

GENERAL RESEARCH STUDIES
There should be no repetition of content in the manuscript. The
following sections and subsections should not contain overlap, which they
will not if written as suggested.

Title
Titles help indexers categorize articles so that they can be easily accessed.
If critical information is missing from titles, articles may never be accessed
by their intended audience. The title of general research manuscripts should
concisely describe the topic and identify the main variables examined. Titles
should contain the following elements:
The population addressed
The independent variable (or topical issue addressed)
The dependent variable (or topical issue addressed)
The research design
Examples of good research manuscript titles include the following:
Relationship Between Pencil Grasp and Handwriting Precision in
1st Graders With ADHD
Factors That Facilitate and Impede Transition to Housing in the
Chronically Homeless: A Phenomenological Study
A Survey of Program Director Perceptions About Transitioning to
OTD Entry-Level Programs
Abbreviations should be avoided unless commonly used and understood
in the health care community.

Abstract
Unless otherwise specified by a journal’s author guidelines, general
research manuscripts should summarize the paper content using the
subheadings (a) objectives, (b) method, (c) results, and (d) conclusions.
Using these subheadings will ensure that you provide the reader with critical
information needed to understand paper content and select papers from
database searches. Although most abstracts are between 150 to 200 words,
authors should check and adhere to the word count specifications outlined
in a journal’s author guidelines.
Objectives: In one to two sentences, authors should describe the
purpose of the study.
Method: In one to two sentences, authors should provide
information about participants (population, sample size,
 recruitment—convenience or random sampling, etc.), research
design, and data collection procedures.
Results: In one to two sentences, authors should report the primary
findings along with statistical test results and p values.
Conclusions: In one to two sentences, authors should describe the
implications of their study for the population and profession.

Introduction
The Introduction should be approximately four to five double-spaced,
typed pages and should present the background of the problem (as it relates
to the population, the profession, and society), the need for the present
study, and an analysis of the current related research to date. A brief review
of the current related literature is embedded in the Introduction but is
usually not separately labeled as “Literature Review.” The review of related
literature should be concisely summarized and highlight key studies and
findings. Articles reviewed should have been published within the last 5
years. Classic studies published more than 5 years ago can be reviewed and
are the exception to the 5-year rule. If literature published in the last 5 years
is lacking, authors should clearly identify this insufficiency. After concisely
reviewing the literature, authors should help readers understand the gaps
existing in the current literature and the need for the present study.
The purpose statement is the final paragraph of the Introduction. Here,
authors state the purpose of the present study, and research questions or
hypotheses are clearly and explicitly stated. Research questions for a general
research manuscript should contain the population, independent and
dependent variables, and/or the topical issue examined.
Examples of good research questions include the following:
What is the relationship between sensory processing disorders and
food refusal in children with autism spectrum disorders?
Do adolescents who are at risk for school failure demonstrate
differences in cognitive problem-solving strategies compared to
academically sound adolescents?
 What are the perceptions of five homeless adults who received
occupational therapy services to transition from a shelter to
supportive housing?

Definitions
In the Introduction and throughout the text, authors should define all
new and unfamiliar terms for readers as soon as the term is presented. Many
authors make the common mistakes of failing to define terms, unclearly
defining terms, presenting terms early in the paper and defining them in
later sections, or changing the definitions of terms in a paper. There is a
formula for writing good definitions. Unless a term is technically defined in
the health care community using precise language that could significantly
alter the term’s meaning if changed, definitions should not be quoted from
another source. Instead, all definitions should either be created by the
authors or paraphrased and cited.
Good definitions contain the following three elements (Mosey, 1996):
1. Label: The label is the term used to describe a specific concept. The
label chosen should be used consistently throughout the paper and
should not change.
2. Superordinate concept: The superordinate concept is the larger
umbrella term or category under which the term falls.
3. Distinguishing characteristics: Distinguishing characteristics are
the concepts that differentiate the term from similar concepts.
Examples of good definitions include the following:
1. Repetitive strain disorders are overuse syndromes in which the soft
tissues of a joint become inflamed as a result of repeated
engagement in activities that require continued movement.
Repetitive strain disorders [label] are overuse syndromes
[superordinate concept] in which the soft tissues of a joint become
inflamed as a result of repeated engagement in activities that
require continued movement [distinguishing characteristics].
 2. Cognitive problem-solving strategies are executive functions
mediated by the frontal lobe that require the ability to identify a
problem, plan a strategy, execute the strategy, evaluate the
strategy’s effect, and modify the strategy as needed.
Cognitive problem solving strategies [label] are executive functions
mediated by the frontal lobe [superordinate concept] that require
the ability to identify a problem, plan a strategy, execute the
strategy, evaluate the strategy’s effect, and modify the strategy as
needed [distinguishing characteristics].
3. Food refusal is the rejection of specific food types based on tastes,
textures, consistencies, scents, and appearances that are aversive to
the child.
Food refusal [label] is the rejection of specific food types
[superordinate concept] based on tastes, textures, consistencies,
scents, and appearances that are aversive to the child
[distinguishing characteristics].

Quotations
In scholarly writing in the health sciences, quotations should only be
used to quote a historical or legal document, a technical definition that has
been accepted by the scientific community and whose meaning may
significantly change if the exact wording is altered, or a specific participant
response in a qualitative study. With the exception of the previous instances,
quotations should not be used. Instead, paraphrase content and cite the
source.

Method
The Method section provides a blueprint of your study procedures so
that others can replicate your findings. Using the subheadings listed below to
structure your Method section will ensure that you report critical and
essential information needed by editors, reviewers, and readers to evaluate
the quality of your methods and assess how adequately such methods
addressed your study’s research questions.
 Research Design
Research Design should be the first subheading of the Method section
because this information is needed by the reader to understand which study
design has been used and whether it can adequately answer the research
question. If the research design does not match the study question, the study
will be flawed. When the specific research design is not clearly stated in its
own section or is embedded within another section, editors and reviewers
must search for this essential information. The research design should be
clearly stated and described in several sentences. At the end of this
subsection, authors should state that the study was approved (or exempted)
by an institutional review board (or ethics committee). Authors should also
state that adult participants or guardians provided consent (and that
children provided assent).

Participants
Participants is the second subheading in the Methods section. The term
participants, as opposed to subjects, is used in health care research to imply
that those selected to participate in the study have willingly volunteered and
are actively engaged in the research project. Subjects implies that those
selected may or may not know that they are in a study and are manipulated
by the researcher instead of actively participating in the research process.
The term participants should be used consistently throughout the text.
In this subsection, authors should concisely describe the recruitment
process and inclusion/ exclusion criteria for study enrollment. The
recruitment process description should specifically address how participants
were selected (i.e., from convenience sampling or randomization, etc.), by
whom, and from what setting. Both inclusion and exclusion criteria for
participant selection should be explicitly stated.
Participant demographics, participant flow, and final sample size should
not be addressed in this subsection; instead, this information should be
provided in the beginning of the Results section.

Instruments
 The third subheading in the Methods section is Instruments. All
instruments used to measure outcomes or dependent variables should be
cited and addressed with regard to intended purpose, population for which
the instrument was designed and assessed, type of data collected (e.g., self-
report, performance-based observer rating, Likert scale, open-ended
questions, total score yielding ratio data, etc.), and administration length.
An instrument’s psychometric properties should be reported in numerical
value with statistical test and p values indicated. All psychometric properties
should be cited. If no psychometric properties have been established, or if
the instrument was developed specifically for the present study, the authors
should state this clearly in the Instruments section rather than addressing
these conditions only in the Limitations subsection of the Discussion
section. It is often helpful to readers to provide sample item questions in a
table or figure when an instrument has been developed by the authors
specifically for the present study.

Procedures
The Procedures subsection commonly follows the Instruments
subsection. Here, authors should report the steps of the study in sufficient
detail so the study can be replicated and so that editors, reviewers, and
readers can evaluate it. Procedures should begin with steps that occurred
once the study commenced. Recruitment and consent procedures should
not be reported here; this information should be addressed in the Research
Design and Participants subsections. To promote transparency, authors
should report which researcher was responsible for and executed each
specific procedure. Authors must clearly report whether researchers and
participants were blinded to participant group assignment and study
purpose because these conditions may significantly bias results.

Data Collection
The Data Collection subsection commonly follows the Instruments
subsection. The data collection schedule should be clearly reported here—
describing how, when, and by whom each set of data was collected. Training
procedures for data collectors should be documented and if multiple data
collectors were used, authors should report interrater reliability scores.
Authors must also state whether data collectors were blinded to participant
group assignment and whether they were different members of the research
team than those who had other roles (such as participant recruiter and
participant group allocator). All of this information must be provided so
that editors, reviewers, and readers can evaluate whether compromised data
collection procedures may have biased results. If any of the above
procedures were not addressed in the study, such omissions should be
disclosed in the Data Collection subsection rather than discussed only in the
Limitations subsection.

Data Analysis
The final subsection of the Methods section is Data Analysis. Here,
authors should describe and cite all statistical tests and qualitative methods
used to analyze data. The use of nontraditional statistical procedures that are
not congruent with traditional parametric and nonparametric data analysis
should be justified and cited. Similarly, the use of statistical and qualitative
analytic methods that are congruent with established norms but are not
familiar to most readers should be described and cited. Authors should
indicate which software program was used for statistical or qualitative data
analysis, and for quantitative studies, at what significance level probability
was set.
A concisely written Method section that provides all of the essential
information previously listed should consist of approximately five double-
spaced, typed pages.

Results
The Results section begins after the end of the Data Analysis subsection
in the Method section and commences a new manuscript section. In the
Results section, you will report your findings without interpreting them;
interpretation of findings will be made in the Discussion section. The
objective of the Results section is to report your findings in a concise, clear,
and sufficient way so that readers can verify reported results. Although it is
not customary to provide participant raw scores, authors are increasingly
providing this information through online repositories. It is important to
report the results in absolute numbers rather than percentages. When
percentages are given, they should be accompanied by the absolute numbers
from which percentages were derived.
Begin the Results section with information about participant flow and
demographics. Participant flow includes information about the number of
participants recruited, the number enrolled in the study, the number of
participants who withdrew or whose participation was terminated by the
researchers, and the final sample size. Reporting standards require that age,
gender, race, ethnicity, education level, socioeconomic level, and topic-
specific characteristics such as functional status be provided for all
participants. Authors should describe power analyses, sample size
estimations, and confidence level estimations that were calculated to ensure
that the study sample size was adequate to yield reliable statistical results.
After participant flow and demographic information are provided, the
remainder of the Results section should be organized in accordance with the
order of research questions outlined in the purpose statement (of the
Introduction). Findings should be reported for each research question.
Missing data should be acknowledged and the protocol for handling missing
data should be described. In a quantitative study, results should be reported
using statistical test and p values. In a qualitative study, findings should be
organized by themes with supporting participant quotations.
See Chapter 7, Reporting Statistical Data in Text and Tables, to
understand how to correctly report statistical tests and symbols in the
Results section.
A concisely written Results section that provides all of the essential
information previously mentioned should consist of approximately three to
four double-spaced, typed pages.

Discussion
The Discussion section follows the Results section and begins a new
manuscript section. While the Results is a reporting of your findings
without interpretation, the Discussion provides the opportunity to interpret
your findings. Findings, however, should not be repeated from the Results
section. For clarity, the Discussion section should be organized in
accordance with the order of research questions addressed in the Results
section. It is the author’s objective to answer each research question based
on study findings. Unexpected findings should be explained. Authors should
discuss whether findings are novel or support previous work. It is critical
that authors do not overstate the meaning of findings, but rather present
interpretations neutrally and without qualifiers. Authors should clearly state
that interpretations apply only to the study sample and not to the larger
population. Readers should be left to make decisions regarding
interpretation based on the presented data in the Results section.

Limitations
The Limitations subheading is inserted in the Discussion section after the
previously mentioned information is addressed. Here, authors acknowledge
the study limitations that may have biased the results, including small
sample size, lack of control and randomization, compromised blinding
procedures, and the use of assessments without established reliability and
validity. Authors should discuss the generalizability of the sample to the
larger population and address differences between the target population and
the study sample.

Future Research
The Future Research subheading is inserted after the Limitations
subheading. Here authors should indicate how future research can address
the present study’s limitations. Authors can also identify research questions
that remain unanswered and suggest directions for future studies.
Because the separate subsections Limitations and Future Research are
often brief, authors may combine them under one subheading, Limitations
and Future Research.
A concisely and well-written Discussion section should be approximately
five double-spaced, typed pages in length.

Conclusion or Implications for Practice

Most manuscripts end with a Conclusion section or a section labeled
Implications for Practice. This section should summarize the study’s primary
findings and discuss their application to practice. A concisely, well-written
Implications for Practice section should be approximately 250 to 300 words.
 After the Implications for Practice section, the remaining manuscript
sections in the order in which they should be presented are as follows:
References
Tables
Figures

CHECKLIST FOR MANUSCRIPT STRUCTURE

AND CONTENT OF GENERAL RESEARCH
STUDIES
Title
Include the population, independent variable, dependent variable, and
research design.
In a professional issue manuscript, include the topical issue in the title.

Abstract
Objectives: In one to two sentences, describe the purpose of the study.
Method: In one to two sentences, provide information about participants
(population, sample size, recruitment—convenience or random sampling,
etc.), research design, and data collection procedures.
Results: In one to two sentences, report the primary findings along with
statistical test results and p values.
Conclusions: In one to two sentences, describe the implications of the
study for the population and profession.

Introduction
Present the background of the problem as it relates to the population,
profession, and society.
Present the need for the present study.
Present an analysis of the current related literature to date.
Help readers understand the gaps existing in the literature that warrant the
need for the present study.
Purpose statement: State the purpose of the present study.
Provide primary and secondary research questions or hypotheses.
Make sure that all terms are well defined as soon as they are presented in
the manuscript.

Method
Research Design
Describe the research design.
State that institutional review board or ethics committee approval was
obtained.
State that participant consent was obtained (when children are
participants, their parents/ guardians provide consent and children
provide assent).

Participants
Describe the recruitment process and the sampling methods through
which participants were selected.
State who completed recruitment and from what settings participants were
recruited.
Provide inclusion and exclusion criteria for participant selection.

Instruments
Describe and cite all instruments used to measure outcomes. Describe
intended purpose, population for which the instrument was designed and
assessed, type of data collected (e.g., self-report, performance-based
observer rating, Likert scale, open-ended questions, total score yielding
ratio data, etc.), and administration length.
Report and cite the reliability and validity for all instruments in numeric
values with statistical tests and p values indicated.
Indicate whether the instrument was developed for the present study and
describe the development process; provide sample items in a table or figure
if possible.

Procedures
Report the steps of the study in sufficient detail so that the study can be
evaluated and replicated by readers.
Procedures should begin with steps that occurred once recruitment and
consent procedures were completed.
Report which researcher was responsible for and carried out each specific
procedure.
Report whether researchers and participants were blinded to participant
group assignment and study purpose.

Data Collection
Report the data collection schedule: describe how, when, and by whom
each set of data was collected.
Document the training procedures for data collectors; if multiple data
collectors were used, report interrater reliability scores.
State whether data collectors were blinded to participant group
assignment.
State whether data collectors were different from other members of the
research team than those performing other roles (such as participant
recruiter and participant group allocator).

Data Analysis
Describe and cite all statistical tests and qualitative methods used to
analyze data.
Justify and cite the use of nontraditional statistical procedures that are not
congruent with traditional parametric and nonparametric data analysis.
 Describe and cite the use of statistical and qualitative analytic methods
that are congruent with established norms but are not familiar to most
readers.
Identify the software program used for statistical or qualitative analysis.
For quantitative studies, state at what significance level probability was set.

Results
Report all findings without interpreting them.
Report results in absolute numbers rather than percentages; when
percentages are provided, also indicate the absolute numbers from which
percentages were derived.
Begin the Results section with information about participant flow and
demographics.
Describe power analyses, sample size estimations, and confidence level
estimations that were calculated to ensure that the study sample size was
adequate to yield reliable statistical results.
Organize the remainder of the Results section in accordance with the
order of research questions outlined in the purpose statement (of the
Introduction).
Report findings for each research question.
Acknowledge missing data and describe the protocol for handling it.
Report quantitative findings in numerical values, with statistical tests and p
values indicated.
Organize and report qualitative findings by themes with supporting
participant quotations.

Discussion
Interpret all findings without repeating the results.
Organize the Discussion section according to the order of research
questions addressed in the Results section.
Explain unexpected findings.
 Describe whether findings are novel or support previous work.
Be sure that the interpretation of findings relates only to the study sample.

Limitations
Acknowledge the study limitations that may have biased the results,
including small sample size, lack of control and randomization,
compromised blinding procedures, and the use of assessments without
established reliability and validity.
Discuss the generalizability of the sample to the larger population and
address differences between the target population and the study sample.

Future Research
Indicate how future research can address the present study’s limitations.
Identify research questions that remain unanswered and suggest directions
for future studies.

Conclusion or Implications for Practice

Summarize the study’s primary findings and discuss their application to
practice.

EXAMPLES OF WELL-WRITTEN GENERAL

RESEARCH JOURNAL ARTICLES
Hwang, E. J., Peyton, C. G., Kim, D. K., Nakama-Sato, K. K., & Noble, A. E.
(2014). Postdeployment driving stress and related occupational limitations
among veterans of Operation Iraqi Freedom and Operation Enduring
Freedom. American Journal of Occupational Therapy, 68(4), 386–394.
doi:10.5014/ajot.2014.011668
Pollack, M. R., Metz, A. E., & Barabash, T. (2014). Association between
dysfunctional elimination syndrome and sensory processing disorder.
American Journal of Occupational Therapy, 68(4), 472–477.
doi:10.5014/ajot.2014.011411
 REFERENCES
American Psychological Association. (2010). Publication manual of the American Psychological
Association (6th ed.). Washington, DC: Author.
Mosey, A. C. (1996). Applied scientific inquiry in the health professions: An epistemological
orientation (2nd ed.). Bethesda, MD: American Occupational Therapy Association.
 4

Manuscript Structure and Content for

Intervention Effectiveness Studies

The call for evidence-based practice has inspired health care researchers
to generate studies evaluating the effect of clinical guidelines. To enhance
the quality and transparency of articles describing the methods and results
of clinical studies, health care stakeholders have called for the development
of reporting standards for intervention studies. This chapter will focus
specifically on intervention study reporting standards and the unique
information that should be detailed in these types of manuscripts. The
information presented next is based on American Psychological Association
guidelines (2010) and the CONSORT Statement (Shulz, Altman, & Moher,
2010) and addresses manuscript structure for clinical research designs
including randomized controlled studies, two-group designs with control
(but no randomization), one-group pretest/posttest designs, and single-
subject design studies (with several participants). Case reports with one
participant are described in Chapter 6.
The headings of an intervention effectiveness manuscript are similar to
those of a general research study as described in Chapter 3, and readers are
urged to review this section. Using the following headings, and addressing
the content that belongs in each, will help to ensure that you have included
essential information sought by editors, reviewers, and readers.
Intervention effectiveness manuscripts should be approximately 5,000
words in length and 20 to 25 double-spaced, typed pages. Authors should
adhere to the word and page count specifications for intervention
effectiveness studies in a selected journal’s author guidelines.
 MANUSCRIPT HEADINGS FOR INTERVENTION
EFFECTIVENESS STUDIES
The following heading levels are based on American Psychological
Association guidelines formatting.

Title
(Begin the manuscript with a title on a separate title page. The title
should be centered and typed in uppercase and lowercase letters.)

Abstract
(The Abstract should be placed on the page directly following the title
page. The word Abstract should be capitalized and centered.)

Introduction
(The Introduction begins on the page directly following the abstract. The
heading Introduction is not typed in the manuscript because the beginning
of the manuscript text alerts the reader that the Introduction has begun.)

Method
(The Method section is positioned directly after the Introduction. The
heading Method is centered and bolded.)
Research Design
(Research Design is the first subheading in the Method section. It is
bolded and flush left.)
Participants
(Participants is the second subheading in the Method section. It is bolded
and flush left.)
Instruments
 (Instruments is the third subheading in the Method section. It is bolded
and flush left.)
Intervention
(Intervention is the fourth subheading in the Method sections. It is
bolded and flush left.)
Intervention description.
(Intervention description is the first subheading of the Intervention
subsection. It is indented, bolded, and ends with a period. Only the first
letter of the first word is capitalized. The manuscript text begins directly
after the period.)
Interveners.
(Interveners, or Interventionists, is the second subheading of the
Intervention subsection. It is indented, bolded, capitalized, and ends with a
period. The manuscript text begins directly after the period.)
Intervention fidelity.
(Intervention fidelity is the third subheading of the Intervention
subsection. It is indented, bolded, and ends with a period. Only the first
letter of the first word is capitalized. The manuscript text begins directly
after the period.)
Data Collection
(Data Collection is the subheading that directly follows Intervention
fidelity. It is bolded and flush left.)
Data Analysis
(Data Analysis is the subheading that directly follows Data Collection. It
is bolded and flush left.)

Results
(The Results section directly follows Data Analysis and begins a new
section of the paper. The heading Results is bolded and centered.)

Discussion
 (The Discussion section directly follows the Results and begins a new
section of the paper. The heading Discussion is bolded and centered.)
Limitations
(The Limitations subsection is part of the Discussion section but should
be highlighted for the reader by a separate subheading within the Discussion
section. The subheading Limitations is bolded and flush left.)
Future Research
(The Future Research subsection directly follows the Limitations
subsection. This section is also part of the Discussion section and should be
highlighted for the reader by a separate subheading label. The subheading
Future Research is bolded and flush left.)

Conclusion or Implications for Practice

(The Conclusion section, also labeled Implications for Practice, is often
the final section of a manuscript. It is a new manuscript section directly
following the Discussion section. The heading is bolded and centered.)

References
(References begin on a separate page following the Conclusion. The
heading is centered and not bolded.)

Tables
(Tables should be provided after the end of the references and begin on a
separate page. Each table should be presented on its own page. Tables are
named and presented in accordance with the order in which they are
mentioned in the text.)

Figures
(Figures should be provided after the end of the tables and begin on a
separate page. Each figure should be presented on its own page. Figures are
named and presented in accordance with the order in which they are
mentioned in the text.)

MANUSCRIPT HEADING CONTENT FOR

INTERVENTION EFFECTIVENESS STUDIES
There should be no repetition of content in the manuscript. The sections
and subsections that follow next should not contain overlap and will not if
written as suggested.

Title
The title of an intervention study should contain four essential elements
to help indexers categorize the article and assist readers to clearly identify
the intervention and population addressed.
1. Intervention (independent variable)
2. Targeted population
3. Outcome measures (dependent variable)
4. Research design
The acronym PICO is also used to help authors develop good titles:
P = population
I = intervention
C = control or comparison (research design)
O = outcome measures
Examples of good research titles include the following:
Effect of a Sensory-Based Social Skill Program for Adolescents With
Autism Spectrum Disorder: A Multiple-Baseline, Single-Subject
Design
Effect of a Self-Regulation Intervention for Children With ADHD:
A One-Group Pretest/Posttest Design
 Effect of an Educational Community Group for Caregivers of Adult
Family Members With Dementia: A Two-Group Controlled
Pretest/Posttest Design
A Comparison of Neurodevelopmental Therapy vs Modified
Constraint-Induced Therapy for Adults With Stroke: A Randomized
Controlled Trial
Abbreviations in the title should be avoided unless commonly used and
understood in the health care community.

Abstract
Similar to a general research manuscript, the abstract of an intervention
effectiveness manuscript is best organized by the use of the following
subheadings: (a) objectives, (b) method, (c) results, and (d) conclusions. The
content of each subheading, however, differs from that of a general research
manuscript with regard to intervention study details. Addressing the specific
content of each subheading, as recommended next, will ensure that you
provide editors, reviewers, and readers with critical information needed to
understand the intervention, targeted population, and research design.
Because readers select papers primarily based on abstracts, the provision of
this essential information is critical for transparent intervention
effectiveness reporting.
Objectives: In one to two sentences, authors should describe the
purpose of the study.
Method: In one to two sentences, authors should provide
information about participants (population, sample size,
recruitment strategy—convenience, random sampling, etc.),
research design, intervention (for treatment and control groups),
length of intervention, follow-up points, and outcome measures.
Results: In one to two sentences, authors should report the primary
findings along with statistical test results, p values, and effect sizes.
Conclusions: In one to two sentences, authors should (a) describe
the implications of their study for the population and profession and
(b) address how the findings can be used to inform best practice.
Another random document with
no related content on Scribd:
 TITLE VI.—CONCERNING DIVORCE, AND THE SEPARATION OF PERSONS
WHO HAVE BEEN BETROTHED.

I. Where a Woman, justly or unjustly, is Separated from her Husband.

II. There shall be No Divorce between Married Persons.
III. There shall be No Separation between Persons who are Betrothed.

I. Where a Woman, justly or unjustly, is Separated from her

Husband.
No one can legally marry a freewoman who has been repudiated
by her husband, unless he knows that they have been divorced,
either by written evidence, or in the presence of witnesses. And if
any one should act otherwise, as soon as the governor of the city, or
his deputy, or the judge of the district, shall become aware of the
fact, where the parties are noble, and the judge is unable to imprison
or separate them; he must straightway bring the affair to our
attention, that they may receive the punishment which they deserve.
But if they are persons of inferior rank, the judge shall immediately
cause them to be separated. And the woman who, without the
consent of her former husband, has married again, as well as the
man who ventured to take her as a wife, shall be delivered up
absolutely to her former husband, to be dealt with according to his
pleasure. If, however, the case between the former husband and his
wife has not yet been decided; or if her former husband has married
another woman; or, indeed, if he has left his wife unjustly; he shall
lose the dowry which he gave her, and it shall absolutely belong to
her, nor shall he be entitled to receive any of her property. If he
should have sold, or fraudulently disposed of, any of the property of
his wife, the judge shall compel him to make restitution. Where the
woman, through fear of her husband, or deceived by any of his
representations, should have made any written agreement
concerning her property for his benefit, her agreement shall be null
and void, and all the property which it disposed of shall be restored
to her.
FLAVIUS CHINTASVINTUS, KING.
II. There shall be No Divorce between Married Persons.
 If the violation of the wife of another is a crime, how much more is
she to be condemned who voluntarily commits this sin. For the
reason that there are many reckless men who, either through
ambition or desire, or induced by some fraud, and despising their
own wives, seek those of others, we therefore decree by this law,
which is to be perpetually observed; that no man, except for the
manifest cause of fornication, shall at any time, leave his wife, nor
shall he divorce himself from her, either in the presence of a witness,
or by any instrument in writing, or under any pretext whatever.
Where her husband is able to prove her guilty of adultery, the crime
having been established by sufficient evidence, she shall be given
up to him by the judge to be disposed of as he pleases; in
accordance with the provisions of a former law. If, however, she
should manifest a desire to enter a religious order, the priest shall
ascertain the wishes of both of them, so that, afterwards, neither will
be able to offer any excuse for their conduct, in case either should
marry again. But if, under any other circumstances, a man, rejecting
his wife, should fraudulently obtain from her a document in writing,
relating to a separation, such document shall have no validity
whatever, and the wife shall be entitled to recover the sum she
received as a dowry; and if the unprincipled husband should have
any property, it shall be given to their children. But if there should be
no children by this marriage, or by a former one of the husband, the
wife shall receive his entire property, in addition to her dowry, as
aforesaid; and if she should be dead, her sons shall have the right to
bring the matter before the court; so that, the crime being proved, the
man may undergo the sentence of the law. All the children either by
this marriage or by a preceding one of the husband, shall, as we
have said, share equally in the property. But if the parties should
have no children; and there should be none living of the first
marriage of the husband; and it should appear that the woman has
children by a previous marriage of her own; it shall be lawful for the
latter to share in their mother’s rights in this property; and, on their
application, under the present law, they may obtain the entire
possessions of the man who has been condemned. Where there are
no children of the aforesaid persons, husband and wife, her nearest
relatives shall be entitled to the inheritance of her property, providing
they should have instituted proceedings leading to the conviction of
the husband. Where a husband, for the sake of divorce, or for
security to himself, extorts any instrument in writing from his wife, or,
without doing this, having abandoned his wife, should marry another;
he shall receive two hundred lashes in public, and shall be scalped,
as a mark of degradation; or he may be condemned to perpetual
exile, or be given as a slave to any one whom the king may select.
Any woman who, knowing at the time, or having discovered
subsequently, that her husband has another wife living, shall make
no objection to this; shall, at once, be given up to the former wife of
her husband; so that, with the exception of depriving her of life, she
may have the privilege of disposing of her as she pleases. And if,
even after the death of the first wife, this crime should be proved by
her children, or, if there should be no children, by such heirs as have
the right to prosecute; the guilty woman shall be given into their
power, to be disposed of in the same manner as the injured wife
would have had a right to dispose of her, the infliction of death alone
being excepted. And, for the reason that women are accustomed
very frequently to cause scandal by leaving their own husbands, on
account of their attachment to kings and judges; therefore, we
decree that if any woman either by the aid of the king, or through
inducements held out to her by any one else, should separate from
her husband, or consent to marry another man; she shall be
surrendered, with all her property, into the hands of her lawful
husband, and shall be liable to the same penalty imposed upon the
husband under similar circumstances, as hereinbefore stated, and
her property shall be disposed of in a similar manner.
Likewise, this same rule shall apply to men, where one shall
presume to marry the wife or the betrothed of another; the following
cases being excepted: where the husband of the woman should
have been found guilty of pederasty; or should have surrendered his
wife to another man against her will; or should have permitted this to
be done; and, for the reason that such villainy ought always to be
condemned by Christians, that man shall never be permitted to
marry another woman, if he should desire to do so. Where the
spurious marriage has actually taken place, the husband must be
delivered up as a slave to some one, according to due process of
law; and if the woman should be unwilling to longer live with her legal
husband, she must afterwards live a chaste life; nor shall she be
permitted to marry again until her aforesaid husband is dead.
FLAVIUS RECESVINTUS, KING.
III. There shall be No Separation between Persons who are
Betrothed.
We have elsewhere prescribed the same punishment for
transgressions committed by persons of equal rank. Therefore, the
provisions of a former law relating to the persons as well as property,
of men and women who have been betrothed, shall be, and is,
hereby confirmed; and if any person after the dowry has been given,
or the marriage contract has been legally drawn up, in violation of
his, or her, solemn obligations, should marry any one else, without
the consent of all parties; he, or she, shall be liable to all the
penalties of a former law; and if it should appear that on account of
sickness, rather than through fraud, such person is desirous of
entering some religious order, he or she shall be permitted to do so,
subject to the regulations of the above-mentioned former law.
 BOOK IV.
CONCERNING NATURAL LINEAGE.

TITLE I. CONCERNING THE DEGREES OF RELATIONSHIP.

I. The Nature of the First Degree.

II. The Affinity of the Second Degree.
III. The Relationship of the Third Degree.
IV. The Consanguinity of the Fourth Degree.
V. The Origin of the Fifth Degree.
VI. The Limits of the Sixth Degree.
VII. The Persons in the Seventh Degree who are not Mentioned by the Laws.

I. The Nature of the First Degree.

In the first rank of the first degree are included the father and the
mother; in the second rank, the son and the daughter; but no other
persons.

II. The Affinity of the Second Degree.

In the second degree and the first rank, are included the
grandfather and the grandmother; in the second, the grandson and
the granddaughter; in the collateral line, the brother and the sister,
which persons have a twofold origin, for the father and the mother
are derived from both the grandfather and grandmother; the
grandson and granddaughter, from both son and daughter; the
brother and sister, from both father and mother. And likewise, the
persons in the following degrees, in whatever relationship they stand
to each other, are, in the same manner, of twofold origin. Persons in
the second degree are thus said to be of double derivation, because
there are two grandparents, paternal and maternal; and two kinds of
grandchildren, descended either from the son or from the daughter.
The brother of the father, or the brother of the mother, who are called
respectively the paternal or maternal uncles, belong to the collateral
line, and they, in like manner, are of double origin.
ANCIENT LAW.
 III. The Relationship of the Third Degree.
The third degree includes, first the great-grandfather and the
great-grandmother; second, the great-grandson and the great-
granddaughter; in the collateral line, the son and the daughter of the
brother and the sister; the paternal uncle and the paternal aunt, that
is to say, the brother and the sister of the father; and the maternal
uncle and the maternal aunt, that is to say, the brother and sister of
the mother.
ANCIENT LAW.
IV. The Consanguinity of the Fourth Degree.
In the fourth degree come first the great-great-grandfather and
the great-great-grandmother, and then the son and daughter of a
great-grandchild; in the collateral line, the grandson and
granddaughter of the brother and the sister; then the cousins of both
sexes, the sons and daughters of the paternal uncle, and the
children of the maternal uncle and aunt; then other cousins, the
children of the father’s sister; and also cousins who are born of two
sisters; and besides, the great-uncle and the great-aunt by the
father’s side; then the great-uncle and great-aunt by the mother’s
side. There is no necessity of explaining this any further than is here
stated.
ANCIENT LAW.
V. The Origin of the Fifth Degree.
The fifth degree includes, in the first place, the great-great-great-
grandfather and the great-great-great-grandmother; secondly, the
great-great-great-grandson and the great-great-great-granddaughter,
and, in the collateral line, the greatgrandsons and great-
granddaughters of brothers and sisters; male and female cousins by
the father’s side, the sons and daughters of cousins by the father’s
side, and the children of great-uncles and aunts on both father’s and
mother’s side. Next come the brothers and sisters of the paternal
great-grandfather and the brothers and sisters of the maternal great-
grandfather. The above-mentioned degrees of relationship we
cannot define by other means, or in other words, than those in which
they are here set forth.
ANCIENT LAW.
VI. The Limits of the Sixth Degree.
To the sixth degree belong, first, the great-great-great-great-
grandfather and the great-great-great-great-grandmother; then the
great-great-great-great-grandson and the great-great-great-great-
granddaughter; next, in the collateral line, the son and the daughter
of a great-grandchild of the sister; the sons of a father’s brother and
the sons of a father’s sister; cousins on both sides of the house;
paternal and maternal great-aunts, and the grandsons and
granddaughters of paternal great-uncles and maternal great-aunts.
To whom are added, in the collateral line, the children of the great-
uncles and the great-aunts of both father and mother; that is to say,
of the brother and the sister of the paternal great-great-grandfather,
and of the brother and sister of the maternal great-great-
grandmother. No better explanation of this matter can be given than
we have written above.

VII. The Persons in the Seventh Degree who are not

Mentioned by the Laws.
In the seventh degree those who are related in the direct line are
not specifically designated by name; but the collateral line embraces
the sons and daughters of great-grandchildren of brothers or sisters,
and the sons and daughters of their cousins of both sexes. There
exist, then, seven degrees of relationship, and no more, because,
according to the nature of things, names could not be found for
others, nor more heirs be begotten in the space of an ordinary
lifetime.
 TITLE II. CONCERNING THE LAWS OF INHERITANCE.

I. Brothers and Sisters shall Share Equally in the Inheritance of their

Parents.
II. The Children shall Come First in the Order of Succession.
III. Where there are no Heirs in the Direct Line, Collateral Heirs shall Inherit
the Property.
IV. Who shall Succeed to the Property of Those who have left no Written
Wills, or have made no Disposition of their Possessions in the
Presence of Witnesses.
V. Concerning Inheritance by Brothers and Sisters, and by such of these as
are not descended from the same Parents.
VI. Where he who dies leaves Grandfathers or Grandmothers.
VII. Where he who Dies leaves Aunts.
VIII. Where he who Dies leaves Nephews.
IX. A Woman shall be entitled to a Share in an Entire Inheritance.
X. As a Woman has a Right to a Share of an Entire Inheritance, so he who
is next in Succession shall Inherit the Remainder of the Property.
XI. Concerning the Inheritance of Husband and Wife, respectively.
XII. Concerning the Inheritance of Property from Clerks and Monks.
XIII. After the Death of their Mother, Children shall remain under Control of
their Father; and What Disposition he shall make of their Property.
XIV. Where a Mother remains a Widow, she shall have an Equal Portion of the
Inheritance with her Children; and How a Mother ought to Dispose of
the Property of her Children.
XV. No Wife can lay Claim to what her Husband has Gained by the Labor of
her Slaves.
XVI. Concerning such Property as the Husband and Wife, together have
Accumulated during their Married Life.
XVII. In what way a Child may Inherit Property.
XVIII. How the Parents of a Child can Inherit from Him.
XIX. Concerning Posthumous Children.
XX. He who leaves no Children, has full Power to Dispose of his Property as
he Pleases.

I. Brothers and Sisters shall Share Equally in the Inheritance

of their Parents.
If the father or mother should die intestate, the sisters shall have
the property equally with their brothers.

II. The Children shall Come First in the Order of Succession.

 If a man should die intestate, his children shall stand first in the
order of succession; if there are no children, the inheritance shall
descend to the grandchildren; if there are no grandchildren, then the
great-grandchildren shall have a right to it; and if the decedent
should leave neither children nor grandchildren, nor father nor
mother, then his grandfather or grandmother, should either be living,
may claim the inheritance of his estate.
ANCIENT LAW.
III. Where there are no Heirs in the Direct Line, Collateral
Heirs shall Inherit the Property.
When any of the above-named persons of the first or second
degree, in the direct line of succession, are not living, then collateral
heirs shall be sought for to inherit the property of the man who died
intestate. And such persons as are only distantly related can claim
nothing while nearer heirs are still living.

IV. Who shall Succeed to the Property of Those who have left
no Written Wills, or have made no Disposition of their
Possessions in the Presence of Witnesses.
In the case of those who die, and make no disposition of their
property either by gift or by will, or do not declare their intentions in
the presence of witnesses; their next of kin shall inherit from them.

V. Concerning Inheritance by Brothers and Sisters, and by

such of these as are not descended from the same Parents.
Where a man leaves only brothers and sisters, they shall inherit
his property, share and share alike, provided they are all children of
the same father and mother. But if some should be descended from
a different father or mother from the others, the inheritance shall go
to the brothers and sisters having the same father and mother as the
decedent. Such children as are born of different parents, but of the
same mother, shall inherit the property of the mother, share and
share alike. Those also who are descended from different mothers,
but the same father, shall share in a like manner.
 VI. Where he who Dies leaves Grandfathers or
Grandmothers.
If any one should leave a paternal grandfather and grandmother,
his entire property shall descend to them. So also if he should leave
a paternal grandfather and maternal grandmother, they shall inherit
his estate equally; and the same disposition of it shall be made, if he
should leave both a paternal and a maternal grandmother. This
equitable division of his estate shall apply only to such portions of it
as he has acquired by his own efforts; and whatever he may have
inherited from his ancestors, or his parents, shall descend to the
heirs of the latter in the direct line of succession.

VII. Where he who Dies leaves Aunts.

Where the decedent dies intestate, and leaves only a paternal
uncle and aunt, and a maternal uncle and aunt, they shall inherit the
property in equal parts.
ANCIENT LAW.
VIII. Where he who Dies leaves Nephews.
Where the decedent does not leave any brothers or sisters, but
does leave nephews and nieces; if one of them should be the son of
one brother, and the others the children of another brother or sister,
the inheritance shall be divided among them, share and share alike.

IX. A Woman shall be entitled to a Share in an Entire

Inheritance.
A woman shall inherit, equally with her brothers, the property of
their father or mother; of their grandparents, on the paternal and the
maternal side, as well as of their brothers and sisters; and also any
property which may be left by a paternal uncle, or a cousin, or a
nephew, or a niece. For it is only just that those who are nearly
related by blood, should enjoy the benefit of hereditary succession.

X. As a Woman has a Right to a Share of an Entire

Inheritance, so he who is next in Succession shall Inherit the
Remainder of the Property.
 Women shall share all property left by relatives on the maternal
side, with those in the same degree of relationship, whether they be
uncles, aunts, or cousins. For those should have the inheritance who
are the most nearly related to the deceased.
ANCIENT LAW.
XI. Concerning the Inheritance of Husband and Wife,
respectively.
Husband and wife shall inherit from each other, respectively,
when they leave no relatives nearer than the seventh degree.

XII. Concerning the Inheritance of Property from Clerks and

Monks.
The church to which they are attached shall inherit the property of
all clerks, monks, and other persons in orders, who have left no heirs
under the seventh degree, and who have made no disposition of
their estate.

XIII. After the Death of their Mother, Children shall remain

under the Control of their Father; and What Disposition he shall
make of their Property.
If the mother should die, the children shall remain under the
control of the father. And, if she should die while her husband is still
living and he should not marry again, he shall have charge of the
children born of the marriage, and may retain possession of their
property, with the understanding that he is not to sell, damage, or
dispose of it in any way, but shall preserve it intact for the benefit of
his children. But, in common with his children, he shall enjoy the
income from said property, and shall be entitled to reserve from it all
their necessary expenses. If, however, the father should marry
again, he shall not relinquish the care of the children, because it is
not just that his authority over them having been abandoned, they
should be placed under the guardianship of another; but he shall still
retain control over them and their property, as hereinbefore
mentioned. But he must at once draw up an inventory of their
property in his own hand, in the presence of a judge, or of the heirs
of his deceased wife; and he must also bind himself by a written
obligation, that those relatives who are legally entitled to it shall have
the guardianship of the children in the case of his death; in order that
none of the property of the latter may be lost, but may be protected
by him, in every way, from injury or diminution in value. If the father,
after having married a second time, should refuse to act as guardian
of his children, then the judge shall appoint the nearest relative of the
mother to take charge of them as guardian. And if either his son or
daughter should marry, they shall at once receive their portion of
their mother’s estate; excepting the third part, which he may reserve
for himself, as authorized by law.
The father, as soon as a son or daughter has reached the age of
twenty years, shall give to them half of what they are entitled to from
their mother’s estate, provided that they should not have already
married. The remaining half the father shall reserve for himself
during his lifetime, and, after his death, it shall descend to his
children. This same regulation shall apply also to grandchildren.
When the father has alienated any of the aforesaid property, or has
retained it beyond the time prescribed by law, everything belonging
to his children by right of inheritance from their mother, shall be given
to them, at once, by way of complete restitution.
ANCIENT LAW.
XIV. Where a Mother remains a Widow, she shall have an
Equal Portion of the Inheritance with her Children; and How a
Mother ought to Dispose of the Property of her Children.
A mother, during her lifetime, or so long as she remains a widow,
shall share equally with her children in the income derived from the
estate of her deceased husband. But she cannot give away, or sell,
or bestow upon any of her children her share of the aforesaid
property. And if the children should become aware that their mother,
either through negligence, or through hatred of them, was about to
dispose of any of said property, they may, at once, make application
to the governor of the city, or to the judge, in order that the latter may
warn their mother not to alienate such property, and only to use the
income of it. She, however, shall have the right to give to her children
any or all of said income, and she can unquestionably dispose of any
profits derived from the same. And if it should be proved that she has
alienated any of her portion, full restitution must be made therefor
after her death.
After the death of the mother, whatever she received from her
husband shall be equally distributed among the children, because
they must not be defrauded of their paternal inheritance. If the
mother should marry again, from that very day the children can claim
as their own that portion of their father’s property which their mother
received at his death.[20]

XV. No Wife can lay Claim to what her Husband has Gained
by the Labor of her Slaves.
If the husband should acquire any property through the labor of
his wife’s slaves, or in any foreign enterprise, his wife shall have no
right to such property, either during his lifetime, or after his death for
a husband who has control of his wife, as stated in the law of the
Holy Scriptures, shall also have full authority over her slaves; and
everything which he has gained by the services of the latter, or by
those of his own slaves, in any undertaking, shall belong to him
absolutely. And if the said slaves, while they are engaged with their
master in any expedition or enterprise, should commit any wrong, or
do any injury, he who brought them with him shall be responsible for
their conduct, and shall make restitution, should they be found guilty.
It has thus very properly been determined that, as their master
profits by their labors, he should also be responsible for any damage
they may cause.
THE GLORIOUS FLAVIUS RECESVINTUS, KING.
XVI. Concerning such Property as the Husband and Wife
together have Accumulated during their Married Life.
When persons of equal rank marry one another, and, while living
together, either increase or waste their property, where one is more
wealthy than the other; they shall share in common the gains and
losses, in proportion to the amount which each one holds. If the
value of their possessions is the same, neither has a right to assume
superiority over the other. For, it is not unusual, where such property
is equal in amount, for one party, in some way, to take advantage of
the other. And if it should be evident that the possessions of one
exceed those of the other in value, as above stated, there shall be
an apportionment of it made, showing what either shall have the right
to claim after the death of the other, and what either shall have a
right to dispose of to his or her children, or to heirs, or in any other
way that may be desired. This provision shall apply to, and be
observed in, all cases relating to the estates of both husbands and
wives. The distribution and possession of other property concerning
which an agreement in writing has been entered into by both parties,
shall be held and enjoyed by them according to the terms of that
written agreement. If the husband should acquire any property, either
from strangers, or during any public expedition, or by the donation of
the king, or of a patron, or of any of his friends, his children or his
heirs shall have a right to claim it, and shall have absolute power to
dispose of it as they wish. The same rule shall apply to women who
have received gifts from any source.

XVII. In what way a Child may Inherit Property.

Ambiguity frequently produces error where a reasonable
explanation is not given to elucidate a fact that is doubtful. Many
persons deny that a child dead in infancy can have, at any time, a
right to inherit from its parents, and we desire now to put an end to
such disputes. For the origin of nature is such, that he who is born
uses the senses of sight and touch before anything else. Who,
therefore, can inherit any earthly possessions who died almost
before he was sensible to light? And in what way can he be the
possessor or property for whose control he was not destined, and
who has scarcely had the use of the elements of which he was
formed? And he who has hardly been blessed by the light of heaven;
how can the unexpected inheritance of the world enrich him when
suddenly removed by death? With what reason can he claim the
rights of the living, who is more nearly associated with death than
with life, and who thus quickly dying in the midst of light, has fallen
back into darkness? Therefore, that the inheritance of an infant may
belong to its nearest relatives, and the fact that he was living be
clearly proved; and as the child had a right to eternal life, so also that
it may have a right to terrestrial life; we hereby decree that no child
of either sex shall inherit, unless it has been proved that it lived for
the space of ten days after its birth, and shall have received the holy
sacrament of baptism, so that the father or mother of the child who
shall be entitled to its inheritance, may, before its death, prepare it
for its entrance into heaven; and that while still living, it shall obtain
the possessions of the earth with their transitory benefits. And thus,
while heavenly possessions are provided for it, it shall also be
permitted to acquire those of the earth; and although while dead, it
cannot benefit by the things of earth, it can, at least, enjoy those of
heaven.
FLAVIUS CHINTASVINTUS, KING.
XVIII. How the Parents of a Child can Inherit from Him.
Where the father is dead and the son or daughter should have
lived ten days or longer, should have been baptized, and then should
die; whatever either would have inherited from the estate of his or
her father, may be claimed by his or her mother. And, in like manner,
if the mother should die, the father shall not be entitled to the share
of the deceased child, unless he be able to prove that that child has
lived ten days, or longer, and has been baptized. And if neither father
nor mother in whom these rights are vested, should leave any
children, the entire inheritance shall be divided among the other
descendants; but they shall not have the power to give to each
grandchild more than the third part of the aforesaid property. And if
they should wish to give any of it to the Church, or to freedmen, or to
any one else, they shall have the right to dispose of only the fifth part
of it in this manner, as prescribed by a former law. But where neither
children nor grandchildren, nor great-grandchildren should be living,
they shall have the right to make such disposition of their property as
they desire.
If said parents should die intestate, then such other of their
relatives as are next of kin shall be entitled to the aforesaid property.
Thus, if after the death of a child, the father should inherit its estate,
and should die intestate, the inheritance shall belong to those heirs
who are entitled to it by law. In like manner, if the mother should
inherit the estate of her deceased child, and should die intestate, all
interest in that estate shall belong to her nearest heirs; on this
condition, that the grandchildren of the son or daughter who died
while their father and mother were living, shall inherit such a portion
of the estate of their grandfather or grandmother as their own
parents would have inherited had they been living. But if a son
having a wife and children should die during the life of his father,
before his father has given him all that he was entitled to from his
estate, and his sons should also die during the life of their
grandfather, the daughter-in-law shall receive only so much as the
father had formerly set aside for her husband. Nor can the widow
claim any more than this from her father-in-law or any of his
relatives. But if the son had been living with the father, and had not
yet received anything from him; the son’s widow shall then only be
entitled to what she obtained as a dowry at the time of her marriage.
Where the son, in obedience to his father’s wishes, permitted the
latter to retain what he was entitled to from his mother’s estate, and
should bequeath it at his death to his wife, or to any one else; such
bequest for the benefit of the wife or of others, if made in writing,
shall be valid: provided his mother did not have other sons by the
same husband. If, however, other sons should be living, the
provisions of the former law must be carried out.
FLAVIUS CHINTASVINTUS, KING.
XIX. Concerning Posthumous Children.
We fulfil the injunctions of the Divine Law when we provide for
those who are yet unborn. Therefore, when a man cut off by death,
leaves his wife pregnant, we decree that the child who is born
afterwards shall share equally with those who are already born. But if
he should leave no issue, and should bequeath his property to any
person, the latter shall only be entitled to receive the fourth part of it.
The three remaining parts shall descend, without question, to the
posthumous child. Where a husband and wife before they have
children, enter into a written agreement, mutually bestowing their
property upon one another, and, afterwards, should have children;
such a disposition of property, if their children are living, shall be
void; and the children may take and hold the entire property of their
parents, with the exception of the fifth part, which the parents shall
have the right to dispose of otherwise. But if one of them, that is to
say, either the husband or wife, before the marriage was
consummated, should be proved to have made for the benefit of the
other a written agreement disposing of property, it shall remain in full
force; and such donation cannot, in any way, be overthrown by
children subsequently born of their marriage.
THE GLORIOUS FLAVIUS CHINTASVINTUS, KING.
XX. He who leaves no Children, has full Power to Dispose of
his Property as he Pleases.
Every freeborn man and woman, whether belonging to the
nobility, or of inferior rank, who has no children, grandchildren, or
great-grandchildren, has the unquestionable right to dispose of his or
her estate at will; nor can any arrangement that either may make, be
set aside by any relatives of theirs belonging either to the direct or to
the collateral line. For those belonging to degrees of relationship
other than the above, in the direct line, cannot, in the order of nature,
receive the inheritance. Such relatives can, however, inherit from the
intestate in accordance with the law which defines their rights.
 TITLE III. CONCERNING WARDS AND THEIR GUARDIANS.

I. What a Minor Is.

II. From what date Time is to be Computed in Bringing Lawsuits relating to
Minors.
III. How the Guardianship of Wards shall be Entered upon; what Portion of
their Property they shall Receive, and what Portion shall be Given to
their Guardians.
IV. Guardians shall have no Right to Exact from Wards in their Charge any
Instruments in Writing whatever.

FLAVIUS CHINTASVINTUS, KING.

I. What a Minor Is.
It is a part of the practice of the duties prescribed by law, to so
care for the rights of minors that they shall suffer no loss of their
inheritance. Up to this time, little children left by a father have been
called minors, for the reason that the mother has not less
responsibility and care, on their account, than when both parents
were living; and therefore we now decree, that henceforth any
children left by father or mother, and who have not yet attained the
age of fifteen years, shall be designated minors.
FLAVIUS CHINTASVINTUS, KING.
II. From what date Time is to be Computed in Bringing
Lawsuits relating to Minors.
Where a question arises concerning the time within which an
action at law can be maintained for the recovery of property in which
minors are interested, we decree that an estimate must be made of
the period which has elapsed since the parents have lost possession
of said property; that is to say, it must be determined whether the
entire number of years from that date, when added to those of the
minor shall amount to fifty; and, if the number should be greater than
that, the minor shall not be entitled to recover. And, moreover, if the
parents of the minor in their lifetime, shall have neglected to assert
their rights for the space of thirty years, the said minor shall not be
permitted to prosecute such a claim as their representative.[21]
 III. How the Guardianship of Wards shall be Entered upon;
what Portion of their Property they shall Receive, and what
Portion shall be Given to their Guardians.
After the death of the father, the mother shall have the
guardianship of the minor children, if she should wish it, provided
she remains a widow; and she shall make an inventory of the
property to which the children are entitled, by means of which their
rights to their inheritance may be established. But if the mother
should marry again, any one of the sons who has attained his
majority, that is, who has reached the age of twenty years, may
assume the guardianship of his younger brothers; and shall see that
their property is not alienated, or dissipated through neglect, by
themselves, or by any one else. But, in case he himself should use it
up, or sell it, or give it away, or permit it to be lost through his own
negligence: as soon as his brothers shall have become of age, he
shall be compelled to make restitution out of his own share, of
whatever was wasted by him. He shall, however, be allowed the
tenth part of the income for the purpose of living, to the end that he
may not burden with extravagant expenses what should be reserved
for the minor heirs. Where he spends his own money, or uses his
own property for the necessaries and business of all, and this fact is
brought to the attention of the judge, he shall be reimbursed for his
expenditures out of the entire estate left by his father. If any of the
brothers should not be of lawful age, or of proper character to
undertake the guardianship of orphans, a paternal uncle of a cousin
may assume this duty; and if neither the paternal uncle nor his son
should be found worthy, then a guardian shall be selected by the
other relatives in the presence of the judge.
Where neither the mother, nor any one else, assumes the
guardianship, an inventory of all the property which the father left
shall be drawn up and signed by her and by witnesses, from the
number of three to five, and shall be placed in the keeping of any
bishop or priest whom the relatives may select, to be delivered to the
children when they have attained their majority.
It is also hereby provided that if any suits are brought against
minors, their guardian, should he desire it, has a right to defend such