CINAHL for Medical Laboratory Science

by Cindy Schmidt, M.D., M.L.S. and Roxanne Cox, M.L.S.

Updated 8/6/2014

 Instructions:

• Complete the "PubMed for Medical Laboratory Science" tutorial before you begin work on this tutorial.  The CINAHL tutorial is a continuation of the PubMed tutorial, and certain concepts are only explained in the PubMed tutorial.

Navigate this tutorial in the same way you navigated the PubMed tutorial:

• Follow the instructions on a page and then, immediately, click the right-facing arrow at the bottom of that page.
• Do not work ahead of the tutorial instructions. Nearly every step of the search process is explained.
• Your searches may retrieve more results than shown in the tutorial's screenshots. Some of the screenshots were taken over a month ago.
• Only use the "Contents" drop-down if you need to move between distant portions of the tutorial

The McGoogan Library homepage (http://www.unmc.edu/library) is shown on the right hand side of this screen. In the future, you can always get to this page by going to www.unmc.edu or info.unmc.edu, scrolling to the bottom, and clicking the "Library" link at the bottom of the "Quick Links" list.

Adjust the size of your browser window so that you can see the "Quick Links" column on the right-hand side of the McGoogan Library homepage.

1. What's CINAHL?

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You have already completed a PubMed MEDLINE search for articles about the sensitivity and specificity of immunologic and genetic/PCR assays for diagnosis of C. Difficile infection when  compared to the gold standard toxigenic culture.

This tutorial will guide you as you search The Cumulative Index of Nursing and Allied Health Literature, also known as CINAHL (pronounced sin-all), for articles on the same topic. 

Why search CINAHL?

CINAHL indexes some nursing and allied health journals not indexed by MEDLINE.

1. What's CINAHL?

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Reaching CINAHL:

• If you use this tutorial before the launch of the Library's new webpage, you will see a buff colored column on the right-hand side of the page (you may need to scroll right).  It contains links to our most frequently used resources.

When you reach the "Literature Databases" list, click on the "CINAHL" link.

If you are working on this tutorial from an off-campus location, you may be asked to log in with your UNMC Net ID (e-mail username and password).

2. CINAHL headings

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CINAHL like PubMed MEDLINE has a subject heading system that makes Medical Laboratory Science searches much easier. 

When you reach the CINAHL homepage, click on the "CINAHL Headings" button in the blue ribbon at the top of the page.

 

2. CINAHL headings

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The CINAHL heading for a concept is often, but not always, identical to the MeSH heading for the concept.

This means that you can start building your  CINAHL search strategy/ies by attempting to replicate your MeSH search/es using CINAHL headings.

Reminder of PubMed search strategy

Here's a reminder of the search strategy used in PubMed:

(((((("Investigative Techniques"[Mesh]) OR "Genetic Techniques"[Mesh])) AND (("Clostridium Infections/diagnosis"[Mesh]) OR "Clostridium difficile/isolation and purification"[Mesh])) AND ("Sensitivity and Specificity"[Mesh])) AND cultur*) AND difficile[Title]

2a. CINAHL Headings for immunologic/genetic assays

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Start your CINAHL search, as you started the PubMed search, with the immunologic and genetic assays concept.  In PubMed, the search strategy you used for this concept was:

"Immunologic techniques"[Mesh] OR "Genetic Techniques"[MeSH]

Enter --  Immunologic techniques -- in the CINAHL Headings database search box and hit the "Browse" button.

2a. CINAHL Headings for immunologic/genetic assays

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You will find that an immunologic techniques heading is available.

Click on the "Immunologic Techniques" link to see the trees of broader and narrower headings. 

2a. CINAHL Headings for immunologic/genetic assays

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Note that in CINAHL the broader heading is "Miscellaneous Techniques."  This is certainly too broad for your search.

To use the "Immunologic Techniques heading, click to check the box in front of the heading (red arrow in figure).  The "Explode" box will be checked automatically (red box in figure).

Leave the "Explode" box checked.  When do an exploded search with the "Immunologic Techniques" heading, articles indexed with the "Immunologic Techniques" heading and articles indexed with the narrower headings, including those that appear when you click on the "+" boxes next to the narrower headings (blue arrow in figure, for example), will be retrieved.

The next heading you need is the "Genetic Techniques" heading.   This "Genetic Techniques" heading is a heading at the same level as the "Immunologic Techniques" heading in the "Miscellaneous Techniques" tree.  Scroll up to the "Genetic Techniques" heading.  Click on the  "+" in front of the heading to see the narrower headings.  When you are satisfied these may be relevant, click to check the box in front of the "Genetic Techniques" heading.  The "Explode" box will be checked automatically.

2a. CINAHL Headings for immunologic/genetic assays

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Look at the right side of the screen to find the table containing the headings you've selected.  You may need to scroll or adjust the screen size to see the table.  

 As in the PubMed search, you will want to join the "Immunologic techniques" and "genetic techniques" headings with "OR" (see red arrow in figure). 

After selecting "OR", click on the "Search Database" button. 

2a. CINAHL Headings for immunologic/genetic assays

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When the page refreshes, you should see your search strategy in the CINAHL search box.  Lower on the page you will see the "Search history/alerts" table containing your search history (blue box in figure below), and below the search history you will see the beginning of the list of over 66,000 CINAHL results for your first concept.

 It's time to find the headings for the Clostridium infection concept.  Click on the "CINAHL Headings" button (red arrow) to return to the headings database.

2b. CINAHL headings for Clostridium infections

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Your PubMed search strategy for the Clostridium difficile infections concept was:

"Clostridium infections/diagnosis"[mesh] OR "clostridium difficile/isolation and purification"[mesh]

Search the CINAHL Headings database for -- clostridium infections.

 

2b. CINAHL headings for Clostridium infections

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Click to check the box in front of "Clostridium Infections". 

 The "Explode" box will be checked automatically and a list of available subheadings will appear to the right of the "Explode" and "Major Concept" boxes. As in the PubMed search, you will want to use the "Diagnosis" (in CINAHL "Diagnosis/DI") subheading. Check this subheading (see red arrow in figure below).

 

2b. CINAHL headings for Clostridium infections

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You've probably already noticed that the "Clostridium Difficile" heading appears below the "Clostridium Infections" heading.  Click to check the box in front of the "Clostridium Difficile" heading.  The "Explode" box is greyed out because there are no narrower headings.

 Look at the subheadings available for "Clostridium Difficile."  You can read a description of how a subheading is used (the scope note) by clicking on the "talking bubble" icon next to the subheading.

"Analysis/AN" is used for identification.  If you are going to use one of the subheadings available with "Clostridium difficile" heading, this would probably be the best subheading for this particular search.  You could choose to include all subheadings instead of choosing a specific subheading.

2b. CINAHL headings for Clostridium infections

4 of 5Scroll to the right to find the table containing your selected headings. 

Join the terms for the  Clostridium Infection concept with "OR" and click the "Search database" button.

2b. CINAHL headings for Clostridium infections

5 of 5Your search strategy will appear in the CINAHL search box.  The search history with your first and second searches shown will appear below the search boxes (blue box in figure).  Below the search history, you will be able to see the CINAHL records retrieved by your Clostridium infections search.

 Click the "CINAHL Headings" button to return to the CINAHL Heading database so that you can search for a "sensitivity and specificity" heading.

2c. CINAHL heading - sensitivity and specificity

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Enter -- sensitivity -- in the search box and hit the "Browse" button.

 

2c. CINAHL heading - sensitivity and specificity

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The results appear and direct you to use the "Sensitivity and Specificity" heading.

Click to check the box in front of the "Sensitivity and Specificity" heading.

2c. CINAHL heading - sensitivity and specificity

3 of 4If you needed to search for a second heading for the "Sensitivity and Specificity" heading, you would need to scroll down to the area below the list of headings retrieved by your search.  There you will find the "Browse additional headings" link.  You can use this link to start another heading search without losing the previously selected heading/s.

You don't need a second heading for this concept so scroll to the right to find the table of selected CINAHL headings.

2c. CINAHL heading - sensitivity and specificity

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Since there is only one heading in the table, you do not need to choose AND, OR or NOT.

Click the "Search Database" button.

 

3. Combine CINAHL Heading searches

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The beginning of the >25,000 results will appear.

Click the "Clear button (red arrow in figure above) to empty the search boxes.

3. Combine CINAHL Heading searches

2 of 2You can check the "Select/deselect all" box  and the use "Search with AND" button to AND the three searches you've conducted so far in a single search. 

4. Add keywords for concepts not addressed by headings

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Do you remember which keywords were used in the PubMed MeSH Search?

4. Add keywords for concepts not addressed by headings

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If you said --

cultur*

-- and --

diffcile

-- (as a title word), you're correct.

1) Type --

cultur*

--in the second search box (blue box in figure below). 

2a)Type--

difficile

-- in the third search box and

2b) select "Title" from the drop-down on the right (red box in figure below).

3) hit the "Search" button.

4. Add keywords for concepts not addressed by headings

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Your final search strategy (red box) will appear in the search table and the results will appear below the search table.

 

5. Add filters/limits

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You can add filters/limits using the options under "Refine your results" in the left-hand column.

The "Peer reviewed" limit is very useful.  Check the box in front of "peer reviewed" (red arrow in figure).  The page will refresh.

 

5. Add filters/limits

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Only 9 results are retrieved (as of the tutorial update on 08/05/2015)

You can add additional limits on the "Show more" page (see red arrow in figure above).

 

5. Add filters/limits

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 Click the "Show more" link just to see the limits that are available.

The "research article" limit in CINAHL is very popular.  There is no "research article" limit in PubMed MEDLINE.

Click on the box next to "Research article" (on the right-hand side of the page) --

 

-- and on the box next to "English" (on the left-hand side of the page).

 Hit the "Search" button (not the "reset" button).

6. Accessing full-text

When you have limited your search as desired, browse through the results.  

6a. EBSCOhost full-text

Occasionally the full-text of interest is provided by EBSCOHost. In these cases, an .html full-text icon or a .pdf/Acrobat full-text icon will be present at the bottom of the record. 

6b. "Check here for full-text" link -->"Order Articles" link

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When full-text is not available from EBSCOHost, you may be able to get full-text by clicking on the "Check here for full text" links (see blue arrow in figure).

 Try clicking on one of these "Check here for full text" links.   These links produce a new window or tab just like the windows/tabs produced by PubMed's "GetIt!@UNMC" buttons.

6b. "Check here for full-text" link -->"Order Articles" link

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Does the new window or tab say "Sorry no holdings were found for this journal" (see blue box in figure below)?  Remember, in this case you can order the article through our McGoogan Docs/interlibrary loan service.

Once you create your McGoogan Docs account, you can hit an "Order Articles" link and just sign-in to reach a pre-populated order form.

6c. "Check here for full-text" link --> article

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One of the CINAHL records retrieved by this search is for an article entitle:

"Two-step glutamate dehydrogenase antigen real-time polymerase chain reaction assay for detection of toxigenic Clostridium difficile."

Find this record and click on the "Check here for full text" link below the record.

 

6c. "Check here for full-text" link --> article

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 Click either  the "Also available online from:" tab (yellow box & green arrow) for Science Direct or for Clinical Key.  If one option in the box doesn't work, close the new tab or window that was opened by clicking the link and try the other source.

6c. "Check here for full-text" link --> article

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The citation and abstract will appear and you will just need to find the .pdf/acrobat icon. 

Unfortunately, each publisher puts it's .pdf/acrobat icons in a slightly different place.  You will have to look around for the icons. 

Occasionally, you will just be taken to a resource homepage and will have to find the "back issues"/"archives"/"past issues"/etc.  link or search box.

7. Ask a librarian or check the McGoogan Library's FAQ

Other systems are also possible.  Please call the library for help if you encounter difficulties accessing full-text, need help with a search, etc.  We're happy to help. 

You can contact reference librarians by e-mail, phone, toll-free phone, text, or chat, or even visit with us in person.  Our contact info and links to the "AskUs" information request form are prominently displayed on the library's homepage.  There's even a "chat" box on the homepage.

The reference desk is staffed Monday - Friday from 8AM to 5PM. The circulation staff (402-559-4006) will try to assist you if you need immediate help in the evening or on the weekends.

Some of the questions asked frequently by UNMC faculty/staff/students are answered in our FAQ database. 

 

The End

Congratulations!  

You've reached the end of the CINAHL tutorial.  The next screen mentions a quiz.  There is no quiz within this tutorial.  The statement about the quiz is just a feature of the tutorial-producing software that we haven't been able to remove yet.

We will pay attention to any feedback you provide.  Just use the "What did you think of this tutorial" link on the next page to submit your feedback anonymously.

 

 

 

 

 

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