CHAPTER 35 INDEXING PRINCIPLES FOR CATEGORY N (HEALTH CARE) 35.1 Category N was designed to describe the literature of the expanding field of health care throughout the world, especially in the United States and the industrialized world. It provides terminology that is designed to answer a variety of questions with cohesive groups of headings in these subcategories: N1 - Population Characteristics What kinds of people use health care? (Demography, vital statistics, health and disease, socioeconomic factors) N2 - Facilities, Manpower and Services Where is care given? Who gives the care? What are the types of health care? (Health facilities, health personnel, health services, patient care characteristics) N3 - Economics, Organizations and Social Controls How is society involved? (Economics, costs and fees, financial management, financing, insurance, health planning, organizations, formal social control, policy) N4 - Health Services Administration How are services and facilities organized and administered? (Health facility administration, management information systems, personnel management, professional practice, public relations, records, patient care management, quality) N5 - Quality, Access, Evaluation How can the appropriateness, accessibility, efficacy, efficiency, and quality of health care be evaluated? (Delivery of health care, ethics, quality, evaluation mechanisms, statistics, study characteristics, study design) Except for a few terms in Categories N1 through N4 serving as NIM parameters, most terms in these four categories are IM. However, many of the terms in N5 indented under STATISTICS, under STUDY CHARACTERISTICS (NON MESH), and under STUDY DESIGN (NON MESH), are research parameters and are usually NIM, except when they are discussed in general as subjects. Consult ANNOTATED MESH for suggestions and restrictions on making individual terms IM or NIM. All of the terms in Category N5 also appear in other categories, except for the following two NON MESH leading hierarchical terms: QUALITY, ACCESS, EVALUATION and EVALUATION MECHANISMS, HEALTH CARE. This Category was designed to group together terms that involve health services research, technology assessment, and the evaluation of diagnostic/therapeutic procedures in order to make online searching easier for health service researchers. For indexers, it provides the convenience of one category to locate these terms. 35.2 The subheadings available for use with trees in N Category are: N1 List - Population Characteristics CL /class HI /hist SN /statist N2 List - Facilities, Manpower and Services CL /class LJ /legis OG /organ SD /supply EC /econ MA /man ST /stand TD /trends HI /hist MT /methods SN /statist UT /util N3 - Economics, Organizations, Control CL /class LJ /legis ST /stand TD /trends EC /econ OG /organ SN /statist UT /util HI /hist N4 - Health Services Administration CL /class LJ /legis ST /stand TD /trends EC /econ OG /organ SN /statist UT /util HI /hist N5 - Quality, Access, Evaluation CL /class LJ /legis ST /stand TD /trends EC /econ OG /organ SN /statist UT /util HI /hist The array above represents a general assignment of subheadings by subcategory. In addition, every MeSH heading is assigned either a listing of allowed subheadings specific to that term or is allowed no subheadings at all. Naturally, every assigned subheading does not fit with every term in the subcategories above, and even specifically allowed main heading/subheading combinations should be given some thought. For example, although HOSPITAL ADMINISTRATION is in Categories N2, N4, and G2 to which /organization & administration has been assigned, the combination HOSPITAL ADMINISTRATION/organization & administration is redundant and is not allowed. Similarly, although COSTS AND COST ANALYSIS is in the N3 Tree to which /economics has been assigned, the combination COSTS AND COST ANALYSIS/economics is questionable, even though it is allowed. Use common sense in applying allowed subheadings. N Category specialty terms that are also in Category G2 allow the assignment of subheadings from the Specialties List, as well as those from applicable N Category lists. The subheadings available for use with the G2 Category are: Specialties List (G2 - Health Occupations) CL /class HI /hist MA /man ST /stand EC /econ IS /instrum MT /methods SN /statist ED /educ LJ / legis OG /organ TD /trends See Manual Chapter 28 for more information on Category G2. 35.2.1 Administrative subheadings are not as specific as clinical subheadings--they overlap greatly. Therefore, it is preferable not to add strings of administrative subheadings to one term. Identify any prevailing subheading, make it IM, and assign few other subheadings. In assigning administrative subheadings, remember the following subheading hierarchy: organization & administration economics legislation & jurisprudence manpower standards supply & distribution trends utilization 35.2.2 When assigning the subheading /economics, consult the N3 Category for specific economic terms in order to coordinate main headings. Financial audit in nursing homes: NURSING HOMES / * econ *FINANCIAL AUDIT (N3) Watch for pre-coordinated economics terms in N3. ECONOMIC COMPETITION ECONOMIC VALUE OF LIFE ECONOMICS, DENTAL ECONOMICS, HOSPITAL ECONOMICS, MEDICAL ECONOMICS, NURSING ECONOMICS, PHARMACEUTICAL INFLATION, ECONOMIC MODELS, ECONOMETRIC MODELS, ECONOMIC See also Section 19.8.27 (/economics) for illustrations. 188.8.131.52 Index MODELS, ECONOMETRIC (IM) for models that apply mathematical formulas and statistical techniques in the testing and quantifying of broad economic theories or the solution of broad economic problems. Do not use it for the application of statistical formulas to very specific economic or financial subjects, such as cost benefit analysis, for which MODELS< ECONOMICis correct term. Note that MODELS ECON is the short form for MODELS, ECONOMIC. Economic theories of competition in health care delivery: DELIVERY OF HEALTH CARE / * econ *MODELS, ECONOMETRIC *ECONOMIC COMPETITION Economic formulas used to calculate statistically the cost effectiveness of magnetic resonance imaging: MAGNETIC RESONANCE IMAGING / * econ COST BENEFIT ANALYSIS / methods MODELS, ECONOMIC 184.108.40.206 Index the broad, pre-coordinated economic subject field or specialty terms (IM) for general articles only. These articles usually cover an entire geographic area or time period. Trends in hospital economics under the Medicare prospective reimbursement system: ECONOMICS, HOSPITAL / * trends MEDICARE A / * econ PROSPECTIVE PAYMENT SYSTEM / * econ UNITED STATES Assign the subheading /economics to index articles about particular health facilities, their departments or units, and coordinate with the term for that specific economic aspect discussed. Do not also index the broad, pre- coordinated economic subject field or specialty term. Financial management in pediatric hospitals: HOSPITALS, PEDIATRIC / * econ *FINANCIAL MANAGEMENT, HOSPITAL (Do not also index ECONOMICS, HOSPITAL) 35.2.3 Although /education is not available to Category N, it is available to N Category headings indented under HEALTH PERSONNEL that are also in Category M and to N Category specialty terms that are also in Category G2. For example, the following combinations are permitted: HOSPITAL ADMINISTRATION / educ (specialty) GERIATRIC NURSING / educ (specialty) PUBLIC HEALTH / educ (specialty) NURSE CLINICIANS / educ (personnel) PERSONNEL, HOSPITAL / educ (personnel) MEDICAL STAFF, HOSPITAL / educ (personnel) Do not use /education with the following personnel headings: DENTISTS, NURSES, PHARMACISTS, and PHYSICIANS. These are correctly indexed instead as EDUCATION, DENTAL; EDUCATION, NURSING; EDUCATION, PHARMACY; EDUCATION, MEDICAL respectively. The specific type of education indented under each may be substituted. However, /education is available with all remaining personnel headings in Category N2 indented under HEALTH PERSONNEL except for FACULTY, DENTAL; FACULTY, MEDICAL; and FACULTY, NURSING. When assigning /education, consult the I2 Category (Education--Professional and Nonprofessional) for specific education terms in order to coordinate main headings. Graduate education in hospital administration: HOSPITAL ADMINISTRATION / * educ *EDUCATION, GRADUATE (I2) Watch for pre-coordinated education terms in I2. See also Section 19.8.28 (/education) for illustrations. 35.2.4 When assigning the subheading /legislation & jurisprudence, consult the N3 Category under SOCIAL CONTROL, FORMAL for specific terms implying legislative, regulatory, or private sector control in order to coordinate main headings. Legal liability in failing to implement the Americans with Disabilities Act: DISABLED / * legis *LIABILITY, LEGAL (N3) UNITED STATES Watch for pre-coordinated legislative terms in N3. ANTITRUST LAWS LIABILITY, LEGAL LEGISLATION, DENTAL LEGISLATION, DRUG LEGISLATION, FOOD LEGISLATION, HOSPITAL LEGISLATION, MEDICAL LEGISLATION, NURSING LEGISLATION, PHARMACY LEGISLATION, VETERINARY See also Section 19.8.42 (/legislation & jurisprudence) for illustrations. 220.127.116.11 MeSH contains the following see reference: HEALTH LEGISLATION see LEGISLATION. However, prefer a health service, facility, personnel, or planning term with the subheading /legislation & jurisprudence to express this concept. In its broadest application, this could be one of the following: HEALTH SERVICES / * legis DELIVERY OF HEALTH CARE / * legis 18.104.22.168 Index the broad, pre-coordinated legal subject field or specialty terms (IM) for general articles only. Hospital antitrust legislation in the United States: *LEGISLATION, HOSPITAL *ANTITRUST LAWS UNITED STATES Assign the subheading /legislation & jurisprudence to index articles about particular health facilities, their departments or units, and coordinate with the term for that specific legal or judicial aspect discussed. Do not also index the broad, pre-coordinated legal subject field or specialty term. Legality of emergency room patient transfer in Texas: EMERGENCY SERVICE, HOSPITAL / * legis PATIENT TRANSFER / * legis TEXAS (Do not also index LEGISLATION, HOSPITAL) 35.2.5 The subheadings /manpower and /supply & distribution are two commonly applicable Category N2-N4 subheadings. When they are used to indicate personnel in the field, they should be applied as follows: /manpower Who is available? What type of person is available? Use with specialties, services, and facilities. Do not use with personnel headings. /supply & distribution How many of these people are there? Where are they? Use with personnel headings. Consider the following examples. Availability of physicians: PHYSICIANS / supply Availability of internists: INTERNAL MEDICINE / man When assigning /manpower, consult the HEALTH PERSONNEL terms listed in N2 in order to coordinate main headings. Using nurse clinicians in skilled nursing facilities: SKILLED NURSING FACILITIES / * man NURSE CLINICIANS / * util See also Sections 19.8.43 (/manpower) and 19.8.69 (/supply & distribution) for illustrations. 35.2.6 When assigning /organization & administration, consult the N4 Category for organizational terms in order to coordinate main headings. Governance in university hospitals: HOSPITALS, UNIVERSITY / * organ * GOVERNING BOARD (N4) Watch for numerous pre-coordinated organizational, management, and administration terms. Remember, this subheading is at the top of a hierarchy of subheadings--it includes economics, legislation & jurisprudence, manpower, standards, supply & distribution, trends, and utilization aspects. Assign the subheading /organization & administration to index articles about particular health facilities, their departments or units, and coordinate with the term for that specific administrative aspect discussed. Do not also index the broad, pre-coordinated administrative subject field or specialty term. Management innovation in community hospitals: HOSPITALS, COMMUNITY / * organ *ORGANIZATIONAL INNOVATION (Do not also index HOSPITAL ADMINISTRATION) See Section 19.8.49 (/organization & administration) for illustrations. 35.2.7 When assigning /standards as an aspect of quality, consult the N4 Category for specific terms under QUALITY OF HEALTH CARE in order to coordinate main headings. Quality assurance in hospital nursing: NURSING SERVICE, HOSPITAL / * stand *QUALITY ASSURANCE, HEALTH CARE Look for the following words as indications for using /standards: adequacy, appraisal, assessment, audit, competence, criteria, evaluation, guideline, improvement, quality. See also Section 19.8.67 (/standards) for illustrations. 35.2.8 The subheading /statistics & numerical data is used frequently with N Category terms for the expression of numerical values which describe particular sets or groups of data. Although /statist is an allowed qualifier for most N Category terms, prefer a more specific subheading. Statistics on economics, manpower, supply and distribution, and utilization are indexed as /econ, /man, /supply, and /util, respectively. /statist may be added as a second (NIM) subheading if significant statistical or numerical data is present. Statistical analysis of the hospital economy in California: ECONOMICS, HOSPITAL / * statist CALIFORNIA Statistical data on personnel turnover in urban emergency departments: EMERGENCY SERVICE, HOSPITAL / * man / statist HOSPITALS, URBAN / * man / statist PERSONNEL TURNOVER / * statist Numerical data on the distribution of physicians in the United States: PHYSICIANS / * supply / statist UNITED STATES Statistical analysis of community hospital patient admission rates: HOSPITALS, COMMUNITY / * util / statist PATIENT ADMISSION / * statist When using /statistics & numerical data, consult the N5 Category under STATISTICS for specific statistical techniques. MODELS, STATISTICAL is also available. See also Section 19.8.68 (/statistics & numerical data) for illustrations. 35.2.9 The subheading /trends expresses aspects of change over time. It may be coordinated with FORECASTING for future trends. Look for the following words as indications for using /trends: changing, emerging, forecast, future, outlook, projecting, shifting, transition. Although /trends is allowed with most N Category terms, prefer a more specific subheading. Trends in economics, manpower, supply and distribution, and utilization are indexed as /econ, /man, /supply, and /util, respectively. Trends in health manpower: HEALTH MANPOWER / * trends New developments in positron emission tomography: TOMOGRAPHY, EMISSION-COMPUTED / * trends Trends in staffing home care services: HOME CARE SERVICES / * man PERSONNEL STAFFING AND SCHEDULING / * trends Forecasting trends in the utilization and need for heart catheterization: HEART CATHETERIZATION / * util HEALTH SERVICES NEEDS AND DEMAND / * trends FORECASTING See also Section 19.8.76 (/trends) for illustrations. 35.2.10 The subheading /utilization is used with personnel, services, facilities, and diagnostic and therapeutic procedures and techniques to answer the following types of quantitative questions and also to express overuse and underuse: Personnel How are the people used? Where are they used? How often are they used? Services How often are the services used? Who uses the services? Facilities How often are the facilities used? Who uses the facilities? Procedures & techniques How often are the procedures and techniques used? What are the rates of use? Who uses them? Do not use /utilization for discussions of how they are used. Consider the following examples: How often are physicians' assistants used in family practice?: PHYSICIANS' ASSISTANTS / * util FAMILY PRACTICE / * man What types of patients use preventive health services?: PREVENTIVE HEALTH SERVICES / * util PATIENTS / * class Use of hospital emergency rooms for primary care: EMERGENCY SERVICE, HOSPITAL / * util *PRIMARY HEALTH CARE Utilization review of cesarean section: CESAREAN SECTION / * util *UTILIZATION REVIEW Watch for pre-coordinated terms that imply utilization. Among them are the following terms: CONCURRENT REVIEW DIAGNOSTIC TESTS, ROUTINE DRUG UTILIZATION DRUG UTILIZATION REVIEW HEALTH SERVICES MISUSE INSURANCE CLAIM REVIEW UTILIZATION REVIEW Such pre-coordinated terms are often assigned together with the specific service, personnel, or facility term, as follows: Overuse of ultrasonography: ULTRASONOGRAPHY / * util *HEALTH SERVICES MISUSE See also Section 19.8.80 (/utilization) for illustrations. 35.3 If Category N main headings are central concepts (IM), and the geographic location is known, always add the given geographic location from Category Z (NIM). (Note: Z Category terms are always NIM.) It is important to health administrators, planners, policy makers, and researchers to know the specific geographic location of the study, facility, or service. Health policy reform in Canada: *HEALTH CARE REFORM CANADA (NIM) Hospital restructuring in Guy's Hospital, London: *HOSPITAL RESTRUCTURING LONDON (NIM) In some cases, N Category main headings are unique to the United States. In such cases, while ANNOTATED MESH so instructs the indexer and the AIMS system adds UNITED STATES automatically, the indexer must add a state or city name when substantially discussed. The Medicaid program in Oregon: *MEDICAID OREGON (NIM) UNITED STATES (NIM) (AIMS validation) 35.4 Most clinical disease studies take place within health facility populations. If the essence of this type of article is clinical, rather than administrative, use the terms HOSPITALIZATION (NIM), INSTITUTIONALIZATION (NIM), or the health facility term (NIM) to express where the therapeutic or diagnostic procedures under study took place, if this is significant. Do not add an IM health facility term unless it is highly relevant to the substance of the article that the study took place in a certain type of health facility or health facility department or unit. Clinical study on treating asthma in an emergency room population: ASTHMA / * ther EMERGENCY SERVICE, HOSPITAL (NIM) Organizing the emergency room to treat asthma patients efficiently: ASTHMA / * ther EMERGENCY SERVICE, HOSPITAL / * organ 35.5 Index AGE FACTORS or AGE DISTRIBUTION generally as NIM coordinates when used with specific diseases, physiological processes, social, cultural, sociological, psychological, and demographic concepts. They will usually appear in articles discussing a specific subject from various viewpoints, such as age, sex, economics, marital status, educational background, etc. In AGE FACTORS the emphasis is usually on age and other factors with cause and effect implications. In age factor articles the aging process (AGING, see below) is not at issue. In AGE DISTRIBUTION the emphasis is largely statistical and concerns the frequency of different ages or age groups in a given population. Indexed as one of the parameters for depth indexing, AGE FACTORS and AGE DISTRIBUTION are NIM. The relative percentages of different age groups in the homeless population: HOMELESS PERSONS / * statist AGE DISTRIBUTION (NIM) Age is one of several factors in health services accessibility: *HEALTH SERVICES ACCESSIBILITY AGE FACTORS (NIM) In occasional articles where age is the sole factor and is the main point, AGE FACTORS is IM. Cancer treatment as affected by age: NEOPLASMS / * ther *AGE FACTORS 35.5.1 When indexing AGE FACTORS and AGE DISTRIBUTION, check the age groups if given (MeSH age groups are human age groups). If no specific age groups are given, check ANIMAL or HUMAN. These concepts are not restricted to humans or to medicine. 35.5.2 Do not confuse AGE FACTORS with AGING (Category G), a physiological concept. Articles discussing aging will deal usually with the aging process and should be indexed under AGING. In articles on AGING the author sometimes illustrates with subjects whose ages are specified. In these cases check the age tags required, but do not add AGE FACTORS. 35.5.3 Do not confuse AGE FACTORS with TIME FACTORS. The response of lower organisms with the passage of time is sometimes referred to in titles and text as "aging" or "age-dependent", for example with regard to cultures. This is not to be indexed as AGE FACTORS despite the wording. Demographic factors, including age, in per capita income of physicians: *INCOME PHYSICIANS / * econ *DEMOGRAPHY AGE FACTORS Age factor in kidney function during acclimatization to cold: KIDNEY / * physiol *COLD *ACCLIMATIZATION AGING / * physiol (Do not add AGE FACTORS despite wording of example) Techniques for synchronization and aging of large-scale bacterial cultures: *BACTERIOLOGICAL TECHNIQUES TIME FACTORS (Do not add AGE FACTORS or AGING) 35.5.4 There are many additional age-related terms in N Category and other MeSH Categories that are alternatives to or more specific than AGE FACTORS and AGE DISTRIBUTION. These include, for example: ADOLESCENT, HOSPITALIZED ADOLESCENT HEALTH SERVICES AGE OF ONSET CHILD, HOSPITALIZED CHILD CARE CHILD HEALTH SERVICES DENTAL CARE FOR AGED GESTATIONAL AGE HEALTH SERVICES FOR THE AGED HOMES FOR THE AGED INFANT CARE INTERGENERATIONAL RELATIONS MATERNAL AGE OLD AGE ASSISTANCE PATERNAL AGE Consider these in preference to AGE FACTORS or AGE DISTRIBUTION when applicable. 35.6 Index SEX FACTORS and SEX DISTRIBUTION generally as NIM coordinates when used with specific diseases, physiological processes, social, cultural, sociological, psychological, and demographic concepts. They will usually appear in articles discussing a specific subject from various viewpoints, such as sex, age, economics, marital status, educational background, etc. In SEX FACTORS the emphasis is usually on sex and other factors with cause and effect implications. In SEX DISTRIBUTION, the concept is largely statistical with emphasis on the number of males and females in a given population. Indexed as one of the parameters for depth indexing, SEX FACTORS and SEX DISTRIBUTION are NIM. Relative percentages of males and females in Canadian intermediate care facilities: INTERMEDIATE CARE FACILITIES / * util SEX DISTRIBUTION (NIM) CANADA Sex factors are one of several factors in overuse of health services: *HEALTH SERVICES MISUSE SEX FACTORS (NIM) In occasional articles where sex is the sole factor and is the main point, SEX FACTORS is IM. Utilization of life support care as affected by sex: LIFE SUPPORT CARE / * util *SEX FACTORS Comparing physician responsiveness to womens' and mens' health complaints: *PHYSICIAN-PATIENT RELATIONS *SEX FACTORS 35.6.1 When indexing SEX FACTORS and SEX DISTRIBUTION, also check MALE, FEMALE, or both, along with ANIMAL or HUMAN. These concepts are not restricted to humans or to medicine. 35.6.2 Do not index with SEX FACTORS at all for straightforward epidemiological material, but consider SEX DISTRIBUTION. The occurrence of disease in women is indexed under the name of the disease with the subheading /epidemiology (IM) and the check tags FEMALE and HUMAN. The same policy is true of the incidence of a disease in men: the name of the disease with the subheading /epidemiology (IM) and the check tags MALE and HUMAN. However, an article on the relative occurrence of a disease in male and female populations is indexed with the name of the disease with the subheading /epidemiology, the check tags MALE, FEMALE, and HUMAN, and SEX DISTRIBUTION. SEX FACTORS is indexed only if the author discusses sex as a determining factor in disease incidence. Incidence of tuberculosis in male and female populations in New York City: TUBERCULOSIS / * epidemiol SEX DISTRIBUTION (NIM) NEW YORK CITY / epidemiol 35.6.3 There are many additional sex-related terms in N Category and other MeSH Categories that are alternatives to or more specific than SEX FACTORS and SEX DISTRIBUTION. These include, for example: FATHERS MEN MOTHERS MATERNAL HEALTH SERVICES PHYSICIANS, WOMEN SEX BEHAVIOR SEX CHARACTERISTICS SEX DETERMINATION SEX DIFFERENTIATION SEX RATIO SEXUAL HARASSMENT WOMEN WOMEN, WORKING WOMEN'S HEALTH WOMEN'S HEALTH SERVICES WOMEN'S RIGHTS Consider these in preference to SEX FACTORS and SEX DISTRIBUTION when applicable. 35.7 SOCIOECONOMIC FACTORS in general, like AGE FACTORS and SEX FACTORS, will usually be NIM as a coordinate to an IM disease or other subject discussed. Read the instructions in 35.5 and 35.6 above to get the general tenor of our approach. Occurrence of AIDS within certain groups defined by income, social class, unemployment, and educational status: ACQUIRED IMMUNODEFICIENCY SYNDROME / * epidemiol SOCIOECONOMIC FACTORS (NIM) SOCIOECONOMIC FACTORS is IM when it is the point of the article, as shown in the following example: Homelessness is determined by socioeconomic factors: *HOMELESS PERSONS *SOCIOECONOMIC FACTORS The specific terms indented under SOCIOECONOMIC FACTORS in N1 Category are frequently IM. As with AGE FACTORS and SEX FACTORS, check all relevant age and sex check tags. While the SOCIOECONOMIC FACTORS tree hierarchy is inherently human, the indexing of MALE or FEMALE requires HUMAN also. Consider also Category N3 for more specific economic terms. 35.8 CONGRESSES is used for general articles about congresses, conferences, or meetings as a means of communication. It is not to be used for announcements of individual congresses. The value of congresses in promoting cooperation between the United States and China: *CONGRESSES *INTERNATIONAL COOPERATION UNITED STATES (NIM) CHINA (NIM) How to organize a successful conference: CONGRESSES / * organ While announcements of individual congresses are not selected for indexing, a publisher sometimes presents as an article a list of national or international congresses on a specific subject area. Since this information is useful to reference librarians, the indexer will index this article, if it appears to have reference value. Index under the specific subject (IM), CONGRESSES (IM), and DIRECTORY (PT) (see Section 17.30), adding a geographic heading if congress locations are given and relevant. Family practice conferences in the U.S. and Canada: *FAMILY PRACTICE *CONGRESSES UNITED STATES (NIM) CANADA (NIM) DIRECTORY (PT) A calendar of hematology congresses for the next five years: *HEMATOLOGY *CONGRESSES DIRECTORY (PT) 35.8.1 Do not confuse CONGRESSES, the main heading, with MEETING REPORT (PT), the publication type. The former is about congresses or conferences, while the latter is used for collections of reports, papers, or abstracts that are presented at congresses, conferences, or meetings. The report of the scientific or administrative material presented at a conference or congress is indexed as if it were an independent article, with the addition of MEETING REPORT (PT) (see Section 17.51). Selection of reports of material presented at congresses is detailed in Section 4.6.4. 35.8.2 Specific types of congresses are indented under CONGRESSES in Category N3: CONSENSUS DEVELOPMENT CONFERENCES and CONSENSUS DEVELOPMENT CONFERENCES, NIH. Again, do not confuse these main headings which are about these types of conferences, with the publication types which are the reports of the scientific materials presented at these conferences. See CONSENSUS DEVELOPMENT CONFERENCE (PT), Section 17.24, and CONSENSUS DEVELOPMENT CONFERENCE, NIH (PT), Section 17.25, for instructions on the use of these publication types. 35.9 The terms in Category N referring to organized bodies (FOUNDATIONS; ORGANIZATIONS; ACADEMIES AND INSTITUTES; SOCIETIES; SOCIETIES, MEDICAL; etc.) overlap in the dictionary definition of these words, in the MeSH definition or intent, in the corporate structure of the bodies, and in the names adopted by the bodies themselves. Index under the term closest to that used by the organization or association in its corporate name. The least frequently used of these MeSH headings is ORGANIZATIONS: avoid it as a generic designation and as of little meaning. 35.9.1 SOCIETIES will be used as a synonym for "Association" and applies to those bodies left over after the indexer has considered more specific terms, such as: AMERICAN HOSPITAL ASSOCIATION; SOCIETIES, DENTAL; SOCIETIES, HOSPITAL; SOCIETIES, MEDICAL; SOCIETIES, NURSING; SOCIETIES, PHARMACEUTICAL; and SOCIETIES, SCIENTIFIC. SOCIETIES will be used for physical therapy associations, sociological associations, and similar organizations for which there are no specific terms. SOCIETIES, SCIENTIFIC should be reserved for such bodies as the American Association for the Advancement of Science or the members of Federation of American Societies for Experimental Biology (FASEB). Index articles on the various organized bodies in MeSH under the name of the subject field or specialty to which the members are dedicated (IM), the correct society or other organizational heading (IM), and the geographic location of the society (NIM). If no MeSH subject field or specialty term is available, index under an applicable personnel term (IM). American Association for Respiratory Therapy: *SOCIETIES *RESPIRATORY THERAPY (subject field) UNITED STATES American Society for Hospital Materials Management: *SOCIETIES, HOSPITAL *MATERIALS MANAGEMENT, HOSPITAL (subject field) UNITED STATES American College of Hospital Administrators: *SOCIETIES, HOSPITAL *HOSPITAL ADMINISTRATION (specialty) UNITED STATES American Health Information Management Association *SOCIETIES *MEDICAL RECORD ADMINISTRATORS (personnel) UNITED STATES Index state hospital or medical societies under SOCIETIES, HOSPITAL (IM) or SOCIETIES, MEDICAL (IM) and the state (NIM). Maryland Hospital Association: *SOCIETIES, HOSPITAL MARYLAND 35.9.2 Membership lists and directories of societies and other organizations are indexed under the society heading (IM), the specialty heading (IM), the geographical term (NIM), and DIRECTORY (PT). See Sections 36.15, 36.16, and 36.17 for societies in relation to geographics. 35.10 Addresses given by presidents of societies appear most frequently in state hospital and medical journals, but are published in other types of journals too. These are to be indexed, but since they are usually nostalgic, philosophical, organizational, of immediate interest, and sometimes querulous in tone, they are hard to index. Often American ones speak of the status of medical care in this country and of the impact of Medicare and other governmental enterprises on physicians. Many are quite editorial in nature. Presidential addresses, however, are indexable. The marking of titles of presidential addresses is discussed in 14.5.2. If the presidential address is substantive and on a specific indexable subject, index under the subject (IM) as you do with any article, assigning all required main headings, subheadings, and check tags. Make no mention, however, about its nature as a presidential address. Do not index under any society term and do not supply a geographical heading for the society. If little is said beyond the general words of an incoming or outgoing figure in any office, index under the society heading (IM), under the specialty heading (IM), and under the geographical location of the society. 35.11 Distinguishing between the main headings HEALTH OCCUPATIONS, HEALTH MANPOWER, HEALTH PERSONNEL, and CAREGIVERS. HEALTH OCCUPATIONS is listed in the G2 Category (Health Occupations) at the head of the category. It is indexed in very general articles about the health specialties. Specific specialty or personnel terms are almost always assigned, rather than HEALTH OCCUPATIONS. Health occupations manpower is indexed as HEALTH MANPOWER. Trends in career choice in the health occupations: HEALTH OCCUPATIONS / * trends *CAREER CHOICE HEALTH MANPOWER is listed in the N2 and N5 Categories with no terms indented under it. It is indexed (IM) in general articles about manpower availability-- policy, planning, distribution, and trends. HEALTH MANPOWER is also indexed (NIM) in coordination with a specialty/manpower or personnel/supply & distribution combination when a specific aspect of manpower in that specialty or regarding those personnel is discussed. Trends in health manpower in Great Britain: HEALTH MANPOWER / * trends GREAT BRITAIN The availability of nurse practitioners in 2020: NURSE PRACTITIONERS / * supply HEALTH MANPOWER / trends (NIM) HEALTH PERSONNEL is listed in the M1 and N2 Categories with all of the specific personnel terms indented under it. These are the people actually working in or employed in health facilities and services. Occasionally, articles will discuss health personnel in general, rather than focusing on a particular group of providers. Occupational safety of health personnel: *HEALTH PERSONNEL *OCCUPATIONAL HEALTH Articles on the availability, distribution, or supply of health personnel in general are indexed as HEALTH MANPOWER. HEALTH MANPOWER and HEALTH PERSONNEL are listed at the same level in the N2 Category--neither one is indented under the other. CAREGIVERS is used for persons who provide care to those who need supervision or assistance in illness or disability. While it includes health professionals, it is more likely to be used for non-professional health personnel, such as family members, spouses, parents, friends, clergy, teachers, etc. In Categories M1 and N2 CAREGIVERS is indented at the next level under HEALTH PERSONNEL. Home caregiver stress in caring for patients with Alzheimer's disease: CAREGIVERS / * psychol HOME NURSING / * psychol ALZHEIMER'S DISEASE / * nurs STRESS, PSYCHOLOGICAL 35.12 Distinguishing between the main headings ALLIED HEALTH OCCUPATIONS and ALLIED HEALTH PERSONNEL. ALLIED HEALTH OCCUPATIONS is listed in the G2 Category with several specialties indented under it. It is the specialty term for the allied health fields in general. Curriculum development for allied health occupations: ALLIED HEALTH OCCUPATIONS / * educ *CURRICULUM ALLIED HEALTH PERSONNEL is listed in Categories M1 and N2 at the next level under HEALTH PERSONNEL, with specific allied health personnel indented under it. These are the people actually working in or employed in health facilities and services. Fear of contracting AIDS from treating HIV-infected patients among allied health personnel: ALLIED HEALTH PERSONNEL / * psychol ACQUIRED IMMUNODEFICIENCY DISEASE / * transm *DISEASE TRANSMISSION, PATIENT-TO-PROFESSIONAL FEAR 35.13 Distinguishing between the main headings STATE MEDICINE, DELIVERY OF HEALTH CARE, NATIONAL HEALTH PROGRAMS, and PUBLIC HEALTH ADMINISTRATION. (Note: None of these terms is limited to the United States and all require the addition of a geographic main heading.) STATE MEDICINE is socialized medicine, a system of medical care regulated, controlled, and financed by the government, in which the government owns the health centers and facilities and employs the health personnel who practice in these facilities. The health services in Great Britain and Sweden are examples of state medicine. The British National Health Service is undergoing increased privatization: STATE MEDICINE / * organ *PRIVATIZATION GREAT BRITAIN DELIVERY OF HEALTH CARE is used both for health care delivery to a specific population or geographic area and for the national health care system of a country. In the latter context it is the term that expresses the organization, administration, financing, and control of the health care system in general. The U.S. health care system is financed and regulated by both the public and private sectors: DELIVERY OF HEALTH CARE / * organ / econ / legis *PUBLIC SECTOR *PRIVATE SECTOR UNITED STATES NATIONAL HEALTH PROGRAMS are components of a national health care system which administer specific services. The term does not refer to the national health care system in general. The Canadian national health insurance system: NATIONAL HEALTH PROGRAMS / * econ *INSURANCE, HEALTH CANADA Laws regulating the national medical emergency response system in the United States: NATIONAL HEALTH PROGRAMS / * legis EMERGENCY MEDICAL SERVICES / * legis UNITED STATES Note: There is a pre-coordinated term for national health insurance in the United States: NATIONAL HEALTH INSURANCE, UNITED STATES. PUBLIC HEALTH ADMINISTRATION refers to the management of public health organizations or agencies. In the United States such agencies include, among others, the DEPARTMENT OF HEALTH AND HUMAN SERVICES, the PUBLIC HEALTH SERVICE, the CENTERS FOR DISEASE CONTROL AND PREVENTION, and the DEPARTMENT OF VETERANS AFFAIRS. In the United States and other countries this term is not limited to national government, but is also used for state departments of health or agencies of other political divisions, such as counties, cities, provinces, etc. However, in countries with socialized medicine, STATE MEDICINE is used rather than PUBLIC HEALTH ADMINISTRATION. The Pennsylvania Department of Health: *PUBLIC HEALTH ADMINISTRATION PENNSYLVANIA 35.14 STATE HEALTH PLANS was formerly used solely for state plans prepared by State Health Planning and Development Agencies (SHPDA) in the United States. Currently, the term is still limited to the United States and is also used for state regulated health programs. Always supply a geographic. Oregon enacts a state program that rations Medicaid services: STATE HEALTH PLANS / * legis / econ MEDICAID / * legis HEALTH CARE RATIONING / * legis OREGON Hawaii enacts an employment-based state health insurance program: STATE HEALTH PLANS / * legis / econ HEALTH BENEFIT PLANS, EMPLOYEE / * legis HAWAII 35.15 Distinguishing between REGIONAL HEALTH PLANNING and REGIONAL MEDICAL PROGRAMS. (Note: Neither of these terms is limited to the United States and both require the addition of a geographic main heading.) REGIONAL HEALTH PLANNING is planning for the allocation of resources (facilities, manpower, services, diagnostic and therapeutic technologies) at a community or regional level. It refers to a planning activity in which facilities interact with each other or are regulated by government agencies in order to control the supply and costs of area health resources. Regional planning for lithotripsy facilities in Miami and the surrounding areas: *REGIONAL HEALTH PLANNING *LITHOTRIPSY FLORIDA REGIONAL MEDICAL PROGRAMS are established, coordinated programs between health facilities within defined geographic areas that provide improved delivery and quality of medical care to specific populations. The emphasis here is on ensuring delivery of quality care, rather than on regulating the distribution of resources or cost control and it usually involves a specific clinical service. Providing care in a rural area of Montana to seriously ill newborns through a neonatal intensive care network: *REGIONAL MEDICAL PROGRAMS INTENSIVE CARE, NEONATAL / * organ *RURAL HEALTH MONTANA 35.16 Distinguishing between RURAL POPULATION and RURAL HEALTH. (Note: Always supply a geographic term with RURAL POPULATION and RURAL HEALTH when given.) RURAL POPULATION is used for the inhabitants of rural areas or of small towns classified as rural. It is frequently statistical and is a synonym for the non- print entry terms RURAL COMMUNITIES and RURAL SPATIAL DISTRIBUTION. Use it for articles on non-health aspects of rural areas and population. Statistics on crime in rural areas of the United States: RURAL POPULATION / * statist CRIME / * statist UNITED STATES Income of physicians who practice in rural versus urban areas of Maryland: PHYSICIANS / * econ PROFESSIONAL PRACTICE LOCATION / * econ *INCOME RURAL POPULATION URBAN POPULATION MARYLAND Social problems in rural areas: *SOCIAL PROBLEMS *RURAL POPULATION RURAL HEALTH is used for articles dealing only with the problems of health in rural areas. These may be general articles about rural health or epidemiological articles about the incidence of specific diseases in rural populations. Since it is a synonym for the non-print entry terms RURAL HEALTH SERVICES and RURAL HEALTH CENTERS, it is also used for articles on aspects of rural health care delivery. When using RURAL HEALTH, consider using the more specific terms HOSPITALS, RURAL or MEDICALLY UNDERSERVED AREA. Comparison of the incidence of AIDS in urban and rural populations in England: AIDS / * epidemiol RURAL HEALTH / statist URBAN HEALTH / statist ENGLAND / epidemiol Adolescent health services in rural Kansas: *ADOLESCENT HEALTH SERVICES *RURAL HEALTH KANSAS Health status of rural Iowans: *HEALTH STATUS *RURAL HEALTH IOWA Medicare use by rural populations in the United States: MEDICARE / * util *RURAL HEALTH UNITED STATES 35.17 Distinguishing between URBAN POPULATION and URBAN HEALTH. The same holds true as is described above in Section 35.16 for RURAL POPULATION and RURAL HEALTH. When using URBAN HEALTH, consider using the more specific terms HOSPITALS, MUNICIPAL and HOSPITALS, URBAN. Always supply a geographic with URBAN POPULATION and URBAN HEALTH when given.