Sarah's Baby 7n: Preparing for a presentation

 

by Cynthia M. Schmidt, M.D., M.L.S.

Published December 2015

Updated July 2019

 

You should complete the first, second, third, fourth, fifth, and sixth episodes of this tutorial miniseries before beginning this seventh episode.

 

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You're asked to present

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You run into Dr. Li, Sarah's family practitioner, in the cafeteria.   Dr. Li asks you a few questions about dietary recommendations for obese, pregnant patients and then asks you if you would  give a presentation to the Family Practice faculty and residents about dietary interventions for obese, pregnant patients.  You agree to give the requested presentation.

You decide to do a PubMed search to review the literature published on the topic of dietary recommendations/therapy for obese pregnant women.  

You're asked to present

2 of 2The PubMed search you completed during episode 5 of this tutorial series used keywords.  You guessed the words an author might have used in the title or abstract of an article when discussing congenital toxoplasmosis.  

It would be hard to conduct a keyword search on the topic of dietary interventions for obese, pregnant women.

Why?

Because there are many types of dietary interventions, and an author does not have to use a form of the word "diet" when describing these interventions.  An author might discuss -

restricted calorie intake,

vegetable-rich meals, 

a weight control intervention

etc.

Fortunately, searches for articles about various dietary interventions are relatively easy to construct using Medical Subject Headings (MeSH).

What is MeSH?

Each article represented in MEDLINE is read by a human indexer who decides what topics are the focus of the article. The indexer then adds medical subject headings (MeSH) corresponding to each of these topics to the PubMed record for the article.

The searcher can look up MeSH corresponding to his/her interests and use these to search PubMed.

Why use MeSH?

Why is MeSH searching helpful?

• Each concept usually has just one MeSH heading. You don't have to think of all the terms that might be used to discuss the topic. (diet, nutrition, portion size, calorie intake, etc.)

• Subject headings are arranged in 'trees.' If you search with a broad subject heading, it will retrieve all records indexed with that heading or a narrower heading. You can search for all "nutrition disorders" with a single heading!

• Each MeSH heading has subheadings that can help you focus on your topic.

• When you find a record with a subject heading search, the corresponding article will actually focus some attention on that subject. On the other hand, when you search with a keyword, you will retrieve all records that include the keyword whether or not any of the article's content is focused on the keyword concept.  For example, a search using "malnutrition ' as a keyword,  would retrieve a record that contained the sentence "Here we review all aspects of weight control and nutrition during pregnancy except malnutrition."

PubMed: Searching with MeSH -- steps

The tutorial will guide you through the steps involved in a MeSH search:

1. List search concepts

2. Determine which concepts should be represented by headings versus subheadings.

3. Look up headings using the MeSH database and add headings and/or subheadings to the "PubMed Search Builder."

4. Correct any problems with operators and parentheses

5. Run PubMed search.

6. Add keywords if needed.

7. Add filters.

8. Obtain full-text

PubMed MeSH -- 1. List search concepts

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Always begin a search by listing the major topics.

You want to see the research and review papers that have been written about diet therapy for obesity in pregnancy.

What are the major concepts in this search?

 

PubMed MeSH -- 1. List search concepts

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Did you list -- 

diet therapy

obesity

pregnancy

--as your major search topics?

PubMed MeSH -- 2. Which concepts are heading versus subheading concepts?

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In this search, two topics, are names of conditions/diseases -- 

obesity

pregnancy

Conditions/disease are always heading concepts.

PubMed MeSH -- 2. Which concepts are heading versus subheading concepts?

2 of 4Many therapies have corresponding headings and subheadings.  For example, the --

diet therapy

-- concept may be represented by a subheading, or by a heading, or both.

When "diet therapy" is an important search concept, it's usually best to construct a search that requires either the presence of the "diet therapy" subheading OR the presence of the "diet therapy" heading (or a broader heading).

PubMed MeSH -- 2. Which concepts are heading versus subheading concepts?

3 of 4The "diet therapy" subheading could be associated with a heading in your search, as in--

"Obesity/diet therapy"[Mesh]

The [Mesh] tag is used with headings or heading/subheading combinations, and stands for "medical subject heading."

Alternately, the "diet therapy" subheading could be added to the search without an associated heading (as a floating subheading)--

("Obesity"[Mesh]) AND "diet therapy" [Subheading]

In your search, a floating subheading may work better.

Why?

Because it's not certain whether the diet therapy subheading would be associated with the "obesity" or the "pregnancy" heading.

PubMed MeSH -- 2. Which concepts are heading versus subheading concepts?

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At this point you might plan to use the following in your search

• "pregnancy"[mesh]
• "obesity"[mesh]
• "diet therapy"[subheading] OR "diet therapy"[mesh]

 But, at this point, you don't know how the actual headings for your concepts are worded.  

PubMed MeSH - 3. Look up headings using the MeSH database

To access PubMed and it's MeSH database:

• Go the Library's homepage

• Click on the "Literature Databases" button.

 

• Click on the "MEDLINE via PubMed" link.

•  If asked to do so, login with your UNMC Net ID and password.

PubMed MeSH -- 3a. Pregnancy

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One must use MeSH database to look up the actual heading for a concept.  The MeSH database is just a list of subject headings (it's like a thesaurus or dictionary). It gives you the tools you need to find a the correct wording for one heading at a time and to add that heading to a PubMed search.

To find the heading for "pregnancy":

• Use the drop-down next to the search box that says "PubMed" to switch to the "MeSH" database (red arrows in the figure).

 

• Search for the heading that is used for -- 

pregnancy

PubMed MeSH -- 3a. Pregnancy

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• A list of options that have something to do with pregnancy will appear.

• Click the box in front of the -- Pregnancy -- heading.

 

• Click the "Add to Search Builder" button on the right-hand side of the page.  

 

• The search builder will add the formatted "pregnancy" heading to the search builder.

 

PubMed MeSH -- 3b. Obesity

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Now move on to the "obesity" heading.

• Use the "MeSH" search box at the top of the page to search for -- 

obesity

• Click in the box in front of the  -- Obesity -- heading.

PubMed MeSH -- 3b. Obesity

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PubMed MeSH -- 3b. Obesity

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• The -- AND -- operator is the default option for joining MeSH terms.  So no change in the menu selection is necessary.

• Use the "Add to Search Builder" button to add the formatted obesity medical subject heading (MeSH) to your search. 

What if you wanted an obesity/diet therapy heading/subheading combo?

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You are planning to use a 'floating' "diet therapy" subheading.  

But, what if you wanted to associate the diet therapy subheading with the obesity subheading?  

In that case you would:

• Click on the heading.

 

 

• check the box/es in front of the needed subheading/s,

• Don't do this now, but if you wanted the heading/subheading combo you would then click the "Add to search builder" button to add the heading/subheading combination/s to the search builder.

What if you wanted an obesity/diet therapy heading/subheading combo?

2 of 2Perhaps you're wondering whether the "Obesity"[MeSH] in your search will retrieve articles indexed with "Obesity/diet therapy"[mesh].  You certainly don't want to lose those.

The answer is yes!  A heading without subheadings will retrieve any combination of that heading with a subheading.  

If you think about it, this is a bit like a broad heading retrieving narrower headings.  In this case a general term is retrieving a specific aspect of the term.

PubMed MeSH -- 3c. diet therapy

As mentioned earlier, you need a search that look for either the "diet therapy" subheading OR the "diet therapy" (or a broader) heading:

• Use the MeSH search box to search for -- 

diet therapy

 

• Select the diet therapy subheading.

• Choose AND, OR, or NOT to join the diet therapy concept to the obesity concept.

• Click on the "Add to Search Builder" button.

Should you use the "Diet Therapy" Heading or a broader heading?

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Do you know what's included in the "Diet therapy" heading search?

To find out:

• Click on the "Diet therapy" heading.

 

• Scroll to the bottom of the page so that you can see the MeSH trees for "Diet therapy"

• Always look at the broader headings. 

The broader heading, "Nutrition Therapy", might retrieve some additional relevant records.

Because PubMed explodes headings by default, a search using the "Nutrition Therapy" heading will retrieve records indexed with the "Nutrition Therapy" heading, and all the narrower headings (including "Diet Therapy" and its narrower headings).

• Click the "Nutrition Therapy" heading.

• Choose the operator (AND, OR, NOT) you want to use to join "Nutrition Therapy"[MeSH] to the "diet therapy"[subheading]

• Click the "Add to Search Builder" button.

Should you use the "Diet Therapy" Heading or a broader heading?

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Did you use -- OR -- to join the "diet therapy"[subheading] to "nutriton therapy"[mesh]?

If so, good job!

If not, correct your search.

PubMed MeSH -- 4. Correct any problems with operators and parentheses

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Look over the whole search strategy currently in the PubMed Search Builder.

Are any changes in the AND, or ORs or parentheses needed?

In the search shown in the figure, there are no problems with the ANDs and  ORs.  However, there is a problem with the parentheses. 

PubMed MeSH -- 4. Correct any problems with operators and parentheses

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Always be careful to check any OR'd together terms to be sure they're enclosed in a set of parentheses.  In this search, the two "diet therapy"-related terms should be OR'd together and enclosed in parentheses. 

("diet therapy"[subheading] OR "Nutrition Therapy"[mesh]) 

The OR between the terms tells PubMed to find records containing either one term OR the other.

The parentheses tell PubMed to do the operations inside the parentheses first and to treat the results as a set.  

The PubMed search engine will retrieve records that are retrieved by either the "diet therapy"[subheading] or the "Nutrition Therapy"[MeSH]. Then it will read from left to right.  It will find records that have both a pregnancy heading and an obesity heading.  Then PubMed will find the subset of these records that also are in the set of results previously retrieved for ("diet therapy"[subheading] OR "Nutrition Therapy"[mesh]) . 

PubMed MeSH -- 4. Correct any problems with operators and parentheses

3 of 4When you check parentheses around OR'd terms, check to be sure that there is no single parenthesis in the middle of the OR'd section.  For example, if a parenthesis followed the "Diet therapy"[subheading] as the errant, bold-face parenthesis shown in the search below --

((("pregnancy"[mesh]) AND "Obesity"[mesh]) AND ("diet therapy"[subheading]) OR "Nutrition Therapy"[mesh])

--PubMed would find the set of records retrieved by "pregnancy"[mesh] AND "obesity"[mesh] AND "diet therapy"[subheading] and would then include (OR in) all the records that are retrieved by the "nutrition therapy"[MeSH] whether or not they had anything to do with pregnancy or obesity.

 

PubMed MeSH -- 4. Correct any problems with operators and parentheses

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If all the unneeded parentheses and the errant parentheses are removed from the search it will look as shown below:

"Pregnancy"[mesh] AND "Obesity"[mesh] AND ("diet therapy"[subheading] OR "Nutrition Therapy"[mesh])

PubMed MeSH -- 5. Run the PubMed Search

Click the "Search PubMed" button under the search builder.

How many results did your search retrieve?  As of, July 2019, this search retrieved over 360 results.  

If you are seeing a lower number of results, it's possible that you applied a filter to a PubMed search you performed earlier.  Is there an "i" icon above the search results with information about "Filters activated"?  If article type filters are active, click the "Clear all" link to see the results of your search without the article type filter.

PubMed MesH -- 6. keywords, 7. filters

At this point, keywords could be added if you had any search concept/s that had no corresponding medical subject heading/s.

Any desired filters could also be added.

PubMed MeSH -- 8. Scan for relevance and obtain full-text

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As you look over the first page or two of results, you notice several articles dealing with the efficacy of dietary interventions in obese pregnant women. One is specifically focused on individual meetings with dieticians

Click on the title of the article entitled "Effect of individual dietetic intervention ...." (#20 at the time of this tutorial's last update).

PubMed MeSH -- 8. Scan for relevance and obtain full-text

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You will see the full-text buttons on the right-hand side of the page. 

Since there is no "Free" or "Open Access" button, click on the "GetIt@UNMC" button ( Warning: A new window will open and you will have to click back to the tutorial "UNMC Library Tutorial" window/tab to see the tutorial instructions)

This particular journal, Australian and New Zealand Journal of Obstetrics and Gynaecology(ANZOG), shows the html version of the full-text immediately. 

Like many journals, ANZOG, provides the PDF icon/link/button in different places depending on the size of the screen.  ANZOG gives large screen users a "PDF" icon/link above the article's abstract.  Small screen users have to use an "About" menu above the journal's title to find the "PDF" icon/link.

PubMed MeSH -- 8. Scan for relevance and obtain full-text

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Want to save a nutrition therapy search?

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You may want to save a search composed of the important nutrition headings for future use. If not, you can skip this screen and the next three screens.

The following search is composed of the most important terms in the MeSH database for nutrition concepts:

("diet therapy" [Subheading] OR "Nutrition Therapy"[Mesh] OR "Feeding Methods"[Mesh] OR "Vitamins" [Pharmacological Action] OR "Food"[Mesh] OR "Nutrition Disorders"[Mesh] OR "Nutritional Physiological Phenomena"[Mesh] OR "Trace Elements" [Pharmacological Action] OR "Body Weight"[Mesh])

You can create a personal PubMed (My NCBI) account and save this search for instant access at a later date.  When you use the search in the future you can remove irrelevant terms.

To do so:

• Return to the PubMed tab.

• Click the "Sign in to NCBI" link in the upper right hand corner of the page.

• If you haven't previously registered for a "My NCBI" account, you will need to do so.

• At the end of the registration or sign-in process, you should be returned to the PubMed homepage.

• Copy the bold-faced search strategy (toward the top of this instruction panel), paste it into the PubMed search box, and hit the "Search" button.

Want to save a nutrition therapy search?

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• After the search results appear, click the "Create Alert" link under the search box

• You may wish to give the search a name other than the default beginning of the search strategy.

• You will probably want to say "No thanks" to e-mail alerts.

• Click the "Save" button.

Want to save a nutrition therapy search?

3 of 4Important:

If you don't complete the steps below, you will not have "GetIt@UNMC" buttons in your search results while you are logged into My NCBI:

• Click the "My NCBI" link at the upper right of the PubMed page.

• Scroll down to find the "Filters" box (lower right part of page).

• Click the "Manage Filters" link.

• Select "LinkOut," type --

University of Nebraska Medical Center

-- in the search box that appears, and hit the "Search" button.

 

• Select the "Link Icon" option. This will produce "GetIt@UNMC" buttons.

Want to save a nutrition therapy search?

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To see and/or use your saved search:

• Click the "My NCBI" link in the upper right corner of the window.

• You should see a link to the saved search in your "Saved Searches" box on the upper right-hand side of the page.

Want to check your MeSH knowledge?

Review

During this episode, you used:

PubMed

• PubMed is reached through the "Literature Databases" button.
• PubMed MeSH searching is helpful when it is difficult to determine what words an author might use when talking about a concept.
• A broad MeSH term will retrieve articles indexed with the broad term and also those indexed with narrower terms. You can search for all "heart diseases" with a single heading, for example.
• The --

("diet therapy"[subheading] OR "Nutrition Therapy"[mesh])

-- combination is often useful when working on nutrition-related searches.

Link to episode 8, the last episode

Link to the very brief final episode:

http://list.unmc.edu/gots/tutorial/sb8n