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In Search of Evidence Presentation In Search of Evidence Presentation Presentation Transcript

  •  
  • In Search of Evidence Quarterly Updates Evidence-Based Practice for Public Health Nurses Session II November 4, 2008 Teresa Hartman, MLS / Associate Professor Head, Education Department, UNMC McGoogan Library of Medicine
  • Objectives
    • Demonstrate searching for evidence for PICO question.
    • Explain resources available to search for evidence related to PICO questions for public health nurses in Nebraska, including methods to order articles if not available online.
    • Describe services provided by McGoogan Library and the National Library of Medicine
  • PICO Question 1
    • For the 4 year old pre-K age group, are there fewer injection site complications with giving the immunizations in the thigh as compared to giving the immunizations in the arm?
    • P preschool children, pre-K, 4 years old
    • I injection in thigh
    • C injection in arm
    • O fewer site complications
  • Question 1:Searching PubMed
    • MeSH = Me dical S ubject H eadings: these are the terms that the over 18 million citations are indexed by in the database.
    • MeSH terms used for Question 1 (access the link on the left hand blue PubMed sidebar, under PubMed Services, and search terms like you do using a dictionary):
      • “ Child, preschool”[MeSH] “Injections ”[MeSH]
      • “ Vaccination ”[MeSH] “Immunization ”[MeSH]
  • You could start with a simple text word search in PubMed
  • To search for MeSH terms, click on the MeSH database link on the left side of PubMed screen.
  • Type in a term you are searching for – example, preschool.
  • Check the results to see if any of them fit your search. Click on the box next to it, then click on Send To, and select Search Box with And. The term will be added automatically to a new box that appears on the next screen.
  • Note: PubMed and MeSH tutorials: http://www.nlm.nih.gov/bsd/disted/pubmed.html
  • Now, search for your next term – example ‘injections’
  • After clicking on the box next to Injections, and then the Send to drop down menu and selecting Search Box with And, this is how your screen should look. Click on Search PubMed to run the search.
  • You can also use Clinical Queries to search for evidence.
  • Type in text words – example: preschool injections thigh
  • What other complications than ‘pain’ are you searching for?
  • Question 1: Searching PubMed
    • Clinical Queries – Find Systematic Reviews (access the link on the left hand blue PubMed sidebar, under PubMed Services):
    • Search terms used:
    • preschool injections thigh
    • Located: PMID 17473085
    • Note – could search by specific types of vaccine injections, like chickenpox, to find out the best method to reduce complications . Also, define “complications”.
  • PICO Question 2
    • For adults who are 21-50 years old, is there a higher incidence of influenza vaccination with those who attend a group education session during pre-school and elementary parent-teacher conferences as compared to those who did not attend?
    • P adults, aged 21-50
    • I attended childhood education session on benefits of flu vaccine
    • C did not attend childhood education sessions
    • O more adults vaccinated
  • Question 2: Searching PubMed
    • MeSH terms used:
    • “ Adult”[MeSH] (equals age 19-40)
    • “ Health education”[MeSH]
    • “ Patient acceptance of health care”[MeSH]
    • “ Influenza vaccines”[MeSH]
    • Best results were retrieved with this search: "Health Education"[Mesh] AND "Patient Acceptance of Health Care"[Mesh] AND "Influenza Vaccines"[Mesh]
  • Question 2: comments
    • My questions – are there other public health issues that have been shown through established research that they were changed/improved through education, during childhood or at other times? (Would seat belt/helmet use be similar?) Maybe there is research in another area that could be applied to this question. Example: there is a lot of research on health care professionals (adults) and their compliance with flu shots (possibly related to preparations for pandemic flu prevention.)
  • PICO Question 3
    • For teenage mothers enrolled in a high school teen parenting class, are their children more current with immunization guidelines/schedules as compared to children of teenage mothers who do not receive the education?
    • P teenage mothers
    • I attended high school based parenting class
    • C did not attend high school based parenting class
    • O children current on immunizations
  • Question 3: Searching PubMed
    • MeSH search used: ("Child"[Mesh] OR "Child, Preschool"[Mesh] OR "Adolescent"[Mesh]) AND "Pregnancy in Adolescence"[Mesh] AND "Parenting"[Mesh] immuniz* (  this is a truncated text word)
    • Clicking on Related Articles for the first citation retrieves promising citations that may lead to further MeSH terms to use when conduct further searches.
  • PICO Question 4
    • For parents who receive SCHIP benefits and a nurse provided telephone education intervention, are their children more current with immunization guidelines/schedule as compared to children of parents who do not receive the education?
    • P parents/families receiving SCHIP benefits, state health plans for uninsured children
    • I nurse provided telephone education/intervention
    • C no nurse provided telephone education/intervention
    • O children current on immunizations
  • Question 4: Searching PubMed
    • MeSH terms used:
    • “ Telephone”[MeSH] “Nurse”[MeSH]
    • “ State health plans”[MeSH] “Child”[MeSH]
    • “ Child, preschool”[MeSH] “Adolescent”[MeSH]
    • immuniz* (  this is a truncated text word)
    • Note: I could not locate a mention in the research of an SCHIP program that used nurse telephone intervention/education (that does not mean it isn’t there – just that I didn’t find one.). Only successful search was: “State health plans”[MeSH] AND immuniz*, resulted in 33 citations. One citation appeared particularly useful: PMID 15867017
  • Tips to improve searches
    • First and foremost: Use the expert librarians at UNMC – we are here to serve you. Email [email_address] , or call toll-free 1-866-800-5209 with your search request. Put our graduate degrees and post-graduate education to work for your information needs! (Plus, we can search the CINAHL and Cochrane full-text databases for you).
  • Tips to improve searches
    • Start with a text word search, using synonyms for the terms you are looking for. Think like an author – what terms do you think they used when writing about what you are hunting? Identify relevant citations; use the MeSH terms found on those citations to create more focused searches
  • Tips to improve searches
    • Hone in on the results you need by using Limits: limit to years published, humans, language article is written in, and level of research (note – you can limit too much):
      • Clinical Trials
      • Randomized Controlled Trials
      • Practice Guideline
      • Meta-Analyses
      • Review
  • Tips to improve searches
    • Use the Clinical Queries/Systematic Reviews search function to locate “citations for systematic reviews, meta-analyses, reviews of clinical trials, evidence-based medicine, consensus development conferences, and guidelines.”
  • Tips to improve searches
    • Limit results to free full text and McGoogan Library of Medicine holdings to your search by adding this search term:
    • AND (free full text[sb] OR loprovuneblib[sb])
  • Additional Resources
    • You can access tutorials and additional resources on the blog that has been created for this session:
    • Evidence Based Public Health Information Resources
    • http://ebpublichealth.blogspot.com/
  • Questions?
    • Call the Reference Desk:
          • 559-6221
          • 866-800-5209 (toll-free)
    • Email:
          • askus@unmc.edu