In May, we saw seven new manuscripts enter the BMJ Open’s top 10 most read articles since our last update in February. New in at number one is a qualitative exploration of women’s experiences of breastfeeding beyond infancy in the UK. Thompson et al. interviewed 19 women in breastfeeding support groups and found that they felt discouraged by others to continue breastfeeding beyond infancy. The women reported feeling reluctant to seek advice from medical professionals and were compelled to conceal their breastfeeding practices.
An ecological study on the birth sex ratio in Canada following the 2016 United States presidential election is new in at number three. The birth sex ratio typically shows a slightly larger number of males being born than females but temporary declines in the sex ratio can occur following adverse events such as natural disasters or economic downturns. Retnakaran et al. performed a segmented regression analysis which included all births in Ontario from 2010-2017 and found that the sex ratio was lower in the months following the presidential election than in the months preceding the election.
Another new entry is Getsoian et al. with the validation of a clinical examination to differentiate a cervicogenic source of headache at number four. Neck pain is associated with cervicogenic headaches but is also commonly reported in other types of headaches. Diagnostic blocks are currently used to determine whether cervical musculoskeletal dysfunction is the source of the pain. In this study the authors confirmed the validity of of a pattern of three physical signs (reduced cervical extension, painful cervical joint dysfunction, and impaired muscle function) to identify a cervical source of headache and neck pain.
The other new entries include a systematic review protocol from Pappal et al. to determine the incidence of accidental awareness with recall for mechanically ventilated patients under anaesthesia at number 5. A cohort study investigating whether overweight and obese women are at a higher risk of adverse outcomes during pregnancy and birth from Lawrence et al. is new at number 6.
The systematic review protocol from Godoy-Cumilaf et al. remains popular, moving from number three to number two since February.