Online Health Information
Online resources carry the advantage of constant updating which is important for the quickly evolving nature of disease management. Agencies that have responsibilities impinging on the issues of eldercare are highlighted.
Medicare/Medicaid and The National Nursing Home Surveys
Medicare and Medicaid programs play strong roles in the long term care (LTC) of the elderly since their enactment in 1965 as supplements to the Social Security Act of 1935.
Reports on the Elderly
Grey literature are papers not distributed by normal channels such as commercial or university presses, or through government printing offices. These are papers published by research institutions, think tanks and non-governmental organizations (NGOs).
Searching the Medical Literature in PubMed
Secondary sources can be used profitably for public health research, both for studying current issues and learning about historical developments for a number of reasons:
- Scholars capture a point in time to review and summarize developments for a number of years in review which is most helpful especially when health care legislation and policy are evolving continuously with social values and successive political administrations.
- By using secondary sources, one benefits from critical analyses of large primary data sets which require subject expertise, time and resources one may not have.
The most useful database for biomedical research is MedLine (which is searched through PubMed). PubMed is a search interface for retrieving bibliographic citation and abstracts from MEDLINE, the premier bibliographic database of biomedical literature indexing more than 5,665 biomedical journals from around the world. The time coverage is from 1946 and ongoing. There are now over 24 million journal articles and is the largest biomedical database in the world.
Keyword searches in PubMed
Keywords can be connected by Boolean operators AND, OR, NOT. PubMed requires that you capitalize them. The default operator is AND.
Pubmed has built-in artificial intelligence that parses your search statement made up of keywords. For example, you want to find out how Alzheimer disease is treated in nursing homes. You search for:
Alzheimer treatment nursing homes
Notice how PubMed automatically looks for the medical subject headings (MESH) that match my keywords and searched for them. It also finds the proper "therapy" subheading for Alzheimer while still searching for treatment in all fields.
This is the automapping function in PubMed that broadens the search and maximizes retrieval of answers. We will look at ways to refine and narrow the initial answer set later.
Subject Heading search in PubMed
Medical subject headings (MeSH) describe the concepts in the MEDLINE database to give it uniformity and consistency. Users reliably retrieve relevant articles when they use MeSH without having to hit on all the correct keywords and their synonyms or foreign language spellings. There is also the ability to fine tune your search by specifying whether a heading should be a major focus (major heading), and whether the terms that are below the current subject heading within the MESH tree (i.e. narrower in scope) should also be searched (a.k.a. “exploding” a term).
You are curious if you are capturing all residential facilities for the elderly when you use the term nursing homes
Using the dropdown menu, you search for nursing homes
You discover by navigating up one level to Residential Facilities that there are other terms describing other settings. Now you have the option to search higher or lower from your place in the tree. PubMed's default is to "explode" the term Nursing Homes, so that you will also search for Intermediate Care Facitilities and Skilled Nursing Facilities unless you check the box to not explode.
Discovering is not optimizing
Constructing search statements is an iterative process. Once you get an initial set, it is appropriate to scan your answers to learn the information landscape of your topic. Go into each one that looks on target to find more subject headings for your subsequent searches, and look at related articles listed on the right side. PubMed's automapping feature provides a useful way to discover subject headings so that searches can be adjusted by searching specific MESH along with suitable subheadings. It is also useful to search using keywords in specific fields such as title and abstracts. If there are exact phrases (enclose your phrase in " ")and word stems (use wildcard * for any number of characters) you want to use, by all means use them in your fielded search to gain more precision in your results.
Refine and Filter
Since research is an iterative process, after each set of answers are displayed, evaluate whether their relevance and refine the search statement accordingly.
Click on the article title to read the abstract, keywords, MeSH and other descriptors. Look at the Related Citations for each article. These are often very helpful.
The default sort order is reverse chronological order – newest first. You can also sort by relevance. If too many results appear, you can refine by using filters.
Filter types are on the left side. Some useful filters are “Article Type”, “Publication Dates” etc. Within each type of filter, you can see more choices by clicking on “More…”
To display more filter types, click on “Show additional filters.” Check the filter items to apply. Click again to uncheck.
Article Type filter – the most useful ones are “reviews” which gives a review of the literature, an overview, on your topic.
Publication Date filter – popular options are the 5-years and 10-year brackets. When more than 1,000 hits are found, you can see a histogram of publications by year. Click on any year to limit.
To save answers from your searches, click on the double arrows next to the Send to widget. You can email, print, or export your clipboard items.
To export, check the Citation Manager radio button. The saved file will have the filename citations.nbib.
- If your citation manager is Endnote Basic (Endnote Web) you can import this file using either the Refman RIS or PubMed(NLM) import filter.