Site glossary and help guide
> Browsing current and previous issues
> Pay for journal access
> Tips for better searching
> Search across multiple journals
> Find a word or phrase in text
> Save searches and articles using My Folders
> Finding similar and related articles
> Accessing cited articles
> Skip the 'sign in' page
> Faster web-page navigation
> Open the same page in multiple windows
> Save papers as an HTML web page
> Increase the font size for your browser
> Turn off moving images on a web page
> Upgrade your web browser
> Using PDF documents
> I can't connect to the website
> I can't get past the sign-in page
> Why don't you have the current issue online?
> Viewing multimedia (video, audio)
> Reading the site offline
> Why are some author names misspelled?
> Why are the figures in articles so small? I can't read them
> Why are the figures listed out of order?
> Why are "torn piece of paper" or "question mark" icons showing up all over the article?
> Cookies and your privacy: why we use them
> Contact us
Browsing current and previous issues
To view the contents of the current issue, click on the 'Current Issue' link or journal cover image on the home page. The table of contents also includes a link to an index of authors for the current issue.
To view the contents of any issue, click the 'Archive' button at the top of most pages. This will display a list of the issues that are available for browsing. To search the contents of all issues, use the quick search box at the top of most pages.
When viewing the table of contents, you can search for words in the text of the articles in that issue by entering words in the search box and clicking the Enter button. Read Tips for better searching to learn how searching works in BMJ journals.
To view contents of upcoming issues, click on the 'Forthcoming Table of Contents' link on the home page. You can then use the Find function in your browser to find words in the titles listed in the table of contents.
To see an article, click on its [Full Text] link. To see one Abstract, click on its [Abstract] link. To review many Abstracts, check the boxes to the left of the titles you want and click Get All Checked Abstract(s).
Pay for journal access
You can purchase access to individual articles. Browse through the available content and select the article you wish to access. When you are prompted to sign in, select the 'Pay for Access' option. You can purchase access to any content. At any point when you are prompted to sign in to the journal, select the 'SitePass' option.
Tips for better searching
Please see Help with Searching for detailed information about searching.
To search a site, enter an author name, keywords, or volume and issue number in the search box at the top right of every page. For more advanced search options click the 'Advanced' link on the search box. Advanced search options include citation, DOI, author and keywords, result limit by date, and search result ordering options.
As a default, titles of articles retrieved as a result of searching are returned in relevance ranked order. The 'closest matches' will be articles that match more of your search terms, that match your terms more closely, that have more occurrences of any one term, and that have occurrences earlier in the Abstract or article. You have several choices as to the number of 'closest matches' retrieved.
In the list of titles retrieved by your search, To see one Abstract, click on its [Abstract] link. To review many Abstracts, check the boxes to the left of the titles you want and click on Get All Checked Abstract(s).
Search across multiple journals
On any BMJ journal website you can search across multiple journals. Use the advanced search option by clicking the 'Advanced' link on the search box (see Tips for better searching above). Complete the search boxes as required, then scroll to the end of the page and click the link at the bottom left of the page: 'Search across hundreds of full text journals'. A drop down list will appear listing all HighWire hosted journals. Click the check box against any journal listed that you wish to search. All checked journals will be included in your search results.
Find a word or phrase in text
The search engine employed by all our websites highlights your search terms in the articles your search retrieves. The find function in your browser can be used to quickly find words or phrases within a single webpage. Use 'control + f' to open your web browser's find dialogue box.
Save searches and articles using My Folders
My Folders allows you to save articles and searches for future use. If you see an article that you want to keep for future reference, click the 'Add article to my folders' link on the menu bar at the right of the page. You can also save searches by clicking the 'Save this search' link at the top of the search results page. You may create multiple 'file folders' on specific topics. It's like having a virtual file cabinet with all your favourite articles and searches. Create / modify folders preferences:
Finding similar and related articles
When reading an article of interest, a quick and easy way to find similar articles is through the use of the 'Related Articles' link in the right hand menu bar of any article page. This will retrieve a list of related articles from PubMed and display it in your browser. Clicking on the citation to any of these related articles will retrieve the full citation and abstract in MEDLINE format.
The National Library of Medicine (NLM), creators and maintainers of MEDLINE®, have developed a process for identifying closely related articles in the MEDLINE database. This allows you to identify articles which address similar research topics quickly and easily. Direct links have been provided to this function, enabling you to access the list of Related Articles from any online article.
Accessing cited articles
When an article cites another from a HighWire-hosted journal, hyperlinks have been created from reference citations to the articles to which they refer that allow you to move from the original article to the abstract of the cited article. These inter-journal links take you to the abstract of the cited reference.
Skip the 'sign in' page
You can skip the sign in page by saving your user name and password to your computer. To save your user information, check the 'Auto Sign In' box on the sign in page. Your information will be saved in an encrypted form on your hard disk as a 'cookie' file, which is used by your web browser to facilitate your access to the site. Other internet sites cannot access or read the information placed in this cookie file.
For more information about cookies, please read the related tip: Cookies and your privacy: why we use them.
Note: Auto sign-in is not recommended if you use a shared computer because it would allow others to access your subscription, and change your password / Subscriber Services. At any time you may sign out of the site using the "Sign Out" option at the top of most pages which deletes the cookie file from your computer. If you use a computer that others have access to, we strongly recommend that you sign out when you have finished.
Faster web-page navigation
To return to your previous location after clicking on a link that takes you to another section on the page, or to a different page, click on the 'Back' button of your browser. The 'Back' button will return you to your previous location more quickly and without the need for lengthy scrolling. See the related tip: Open the same page in multiple windows.
Open the same page in multiple windows
many situations it is helpful to have different sections of an article
appear in two different browser windows. To open a link from your
current page in a new window:
1 Click the right mouse button on a link to open the browser options menu.
2 Select 'New Window with this Link' or 'Open in New Window' form the pop-up menu and release the mouse button.
3 The selected link will open in a separate window which can be resized and moved around the screen (click and drag on the blue title bar at the top of the window) so that it sits adjacent to the original window.
4 Switch between these two windows by clicking on the title bar of the window or by using the 'Window' menu in your browser.
The second window may obscure the first so that it will be necessary to
move and resize the new window before both can be viewed on your
More: This technique can be helpful in many situations:
- To view the Table of Contents in a second window while reading abstracts in the main window, right-click on an [Abstract] link in the Table of Contents.
- To view an expanded Figure in a second window while reading the article text in the main window, right-click on a [View Larger Version of this Image] link.
- To view the References list in the second window while reading the text of the article in the main window, right-click on a reference link or on the [References] link at the top of an article.
Save papers as an HTML web pageUsing Internet Explorer, Firefox, etc.:
1 Open the HTML version of the article you wish to save.
2 Choose 'Save' or 'Save as' and select the 'Web page, complete' or 'Web archive' option and save the article to a new directory (folder) that you've created for this purpose. This last step is important because you will be saving all of the graphics files contained within the article so saving it to your desktop can cause considerable clutter!
Increase the font size for your browser
In most browsers you can change the font size through the 'View' menu. Look for something called 'Text Zoom', 'Text Size', 'Increase Font', 'Make Text Bigger' or similar. Alternatively, hold down the 'control' key on your keyboard whilst using the scroll wheel on your mouse to change the font size.
Turn off moving images on a web page
Upgrade your web browser
How do you get the best appearance, speed and features from your browser? You get the newest version! As web browser technology develops, new capabilities become available which can improve the appearance of online articles as well as offer new features to facilitate your research activities. Download the latest version of any of the browsers below.
Suggested browser configuration: Set a bookmark for the site's homepage. To view the PDF articles, you should have the Adobe Acrobat Reader installed on your computer and your browser should be configured to open PDF files in Acrobat.
Using PDF documents
To view the PDF version of an article click on the Full Text (PDF) link in the content box of the relevant article, or on the [PDF] link in the issue table of contents. If Adobe Acrobat Reader is installed on your computer and if your browser is configured to open PDF files in Acrobat, you will retrieve a version of the article that looks very much like the article in the printed Journal. Select Print under Acrobat's File menu to print this version. If you are unable to open a PDF article we recommend you upgrade your browser and try again.
PDF files are very large and retrieving them may take several minutes. The speed depends primarily on the speed of your network connection, the volume of Internet traffic, and the speed of your own computer. You must display the PDF version in the Acrobat Reader before it can be printed. Because PDF files are large, you might wish to close any open PDF documents before opening a new one to avoid memory limitations.
To save a copy of the PDF article use the Save a Copy option in Acrobat Reader (use the Save a copy tool bar button or select the option under Acrobat's File menu). If you are using an early version of Acrobat this feature may not be available, in which case we recommend that you download the latest version of Acrobat Reader using the link above.
I'm trying to read a PDF online, but it is very difficult
PDFs are designed to be printed out and read, but if you prefer to read them online, you may find it easier if you increase the view size to 125%.
I'm having trouble printing PDFs using Adobe Acrobat on Macintosh or Windows. What can I do?
- You must be using at least version 3.01 of Adobe Acrobat Reader software. You may upgrade or install the latest version of Acrobat using the Adobe icon above.
- Try printing one page at a time.
- Try printing with the 'Print as Image' option selected.
- Try printing to a newer printer. (NOTE for Macintosh users: A number of users have reported problems printing PDFs with the LaserWriter Driver version 8.4. We suggest using an earlier or later version).
- Try saving the file to disk before printing rather than opening it 'on the fly.' This requires that you configure your browser to 'Save' rather than 'Launch Application' for the file type 'application/pdf,' and can usually be done in the 'Helper Applications' options.
- Are you getting Postscript errors on your Mac? A frequent cause is a lack of communication of postscript commands between your computer and your printer. Postscript communication on a Mac is handled by the Control Panel called ~ATM. To see if you have installed ~ATM, go to the System Folder / Control Panels folder and look for ~ATM. If the control panel is not present you will need to install it. If the ~ATM is installed, check to make sure that you are using the most recent version, v4.0 or higher. You can check the version number by selecting the ~ATM icon and choosing Get info... from the File menu. If you do not have ~ATM installed or need to upgrade to the latest version, you can get this software from the Acrobat web site. If you recently downloaded Acrobat, you may already have this Control Panel on your computer and just need to install it. When you download Acrobat, ~ATM comes along in a folder called Fonts and will be located in the Acrobat folder. Drag the ~ATM icon onto your System Folder to install it.
- Are some lines on each page being cut off? Are you running Mac OS version 8? The default paper size is 'Letter Small.' Change this setting to 'US Letter' in 'File/Page Setup' and you should be able to print full pages.
Can I use the Adobe Acrobat Reader Plugin?
The Windows 3.x, Windows 95, and Windows NT versions of the Acrobat Reader Plugin seem to be reliable. However, we don't recommend using the Macintosh version. Use the Acrobat Reader application instead.
Why can't I just check a box next to all the papers I want PDFs for and download them all at once?
Unfortunately, there's no way to implement a feature like this; web browsers currently do not support automated simultaneous downloads.
When I try to print PDFs, I get an error saying Acrobat Reader can't write to the file (i.e., the printer), that the disk is full. What can I do?
It's possible that your printer doesn't have enough installed memory to handle an entire PDF, especially one that contains a lot of images. Try printing the file to a printer with more memory, or, alternatively, print the PDF one page at a time.
After downloading, I can't open the PDF file with Acrobat Reader. I get a message: 'There was an error opening this document. Could not repair file.
It's probable that the file was incompletely downloaded, or corrupted during the network transfer. Your best bet is to try a new download of the file.
I'm having problems downloading PDF files. My browser downloads about 20% of the file and then stops. Any suggestions?
This problem is frequently caused by unusually high network traffic, and the best solution is to try downloading the files at a time when transatlantic network traffic is lighter - generally when the east coast of the US is not at work.
Track topics, authors and articles
CiteTrack will immediately alert you by email whenever new content in any BMJ Journal is published that matches criteria based on the topics, authors and articles you want to track.
Sign up for email alerts
Sign up for email alerts for information direct to your inbox for new issue tables of content, publication ahead of print articles (Online First) and journal announcements.
Download an article to Citation Manager
provide a simple and direct method of acquiring article citations in
the Medlars format compatible with import into personal bibliographic
management software such as RefWorks, EndNote, Reference Manager, or
To export citations with Abstracts for any article to a citation manager program, the following steps are suggested:
1 View the abstract or Full Text article of interest
2 Click the [Download to Citation Manager] link above the article title.
3 When the tagged version of the citation is displayed, scroll until the 'Save' button can be seen.
4 Select your preferred format (Macintosh, PC or Unix) from the 'Save' menu and click the Save button.
5 Select the directory you wish to save the file in and give the file a unique name.
6 Follow the instructions that came with your citation manager to import the reference into your personal bibliographic database
If your citation manager does not support import of Medlars format, you may still use the Download function. After saving the citation to your local disk, open the citation file and manually copy/paste the information in the file into the appropriate fields in your personal bibliographic database.
I can't connect to the website
Please note that our standard maintenance window is Saturday from 8:00 am-10:00 am Pacific time. During this window each weekend, there is a possibility of an approximately 10 minute long period of unavailability. Our sites will never be offline for the entire two hour window - that is the time frame for possible maintenance.
If applicable, see if you can reach other web sites in your building
(e.g., a server that is located in your building). If you can not, the
problem is likely in your machine; otherwise continue to the next step.
2 See if you can reach other internet sites outside of your building. If you can not, the problem is likely in your connection to the internet; otherwise continue to the next step.
3 See if you can reach other west coast US internet sites, such as http://www.sun.com or http://www.apple.com.If you can not, the problem may be in the networks in the Silicon Valley (many of which are routed via Stanford University where our servers are located); otherwise continue to the next step.
For problems #1-3, contact your local network administrator or your Internet Service Provider (ISP)
4See if you can reach other sites at Stanford, e.g., http://www.stanford.edu. If you cannot, then the problem may be with Stanford's connectivity to the internet; otherwise continue to the next step.
5 See if you can reach non-journal sites at HighWire Press (located at Stanford and assists in the online publication of Annals of the Rheumatic Diseases) e.g., http://highwire.stanford.edu. If you cannot, then the problem may be with HighWire Press's connectivity to the internet; otherwise continue to the next step.
6 Try to access the main HighWire site via its international URL http://intl.highwire.org. If you can't, then the problem is likely at the servers or their sub-net. If you can, then the problem is with a network connection or router between you and our servers' network.
7 See if you can reach another journal site at HighWire other than the journal you are currently attempting to access. If you can not, then the problem may be with the journal software or hardware.
For problems #4-7, please wait 15 minutes and try again
I can't get past the sign-in page
You haven't activated your subscription
If you have subscribed to a BMJ journal you must activate your subscription to access our website. Activate your account here.
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Make sure that your browser's preferences are set to accept cookies (Tools > Internet options... > Cookies).
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This confuses our cookies (they have expiration dates). Check to see that your date is set accurately (click on the clock in your launcher bar - usually in the bottom right corner of your screen).
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You will need to upgrade your browser.
You are accessing our sites via a "proxy server" that is deleting cookies automatically
You should contact your network administrator to determine whether your institution's proxy server is the source of the trouble.
If you still have difficulty, please send us feedback.
Why don't you have the current issue online?
We publish new issues on the same schedule as the print edition. If you know that a new issue of the print journal has been published but don't see that issue appearing on the site you may be experiencing a caching problem. The most likely source of this caching problem is your own computer. To remove out-of-date pages from your cache you should clear the cache manually, in your web browser; usually: Tools > Internet options...> Cache > Clear cache. After clearing the cache you should close your browser, restart it and return to the home page. If you still see the incorrect date reload the page several times using your browser's REFRESH button. If these steps fail to remove the outdated page, this would suggest that your internet traffic may be going through a proxy server which is failing to update itself properly. Unfortunately, you'll need to speak with your Internet Service Provider to resolve this problem.
Viewing multimedia (video, audio)
To view multimedia files you will need to have installed on your computer the appropriate helper application for the specific file type you wish to view. Your browser must also be configured to recognize the file type and open the file with the appropriate software. Most up to date browsers, are automatically configured to recognize the types of multimedia files used on our sites. However, if your browser prompts you to select an application to open a multimedia file, use the guide below to select the application from the list. If you do not have the relevant application installed on your computer you may download them below. Windows users: Please note that you must also have video and sound cards on your computer and the appropriate driver software. Please consult your computer's owner manual for information on video and software cards/drivers.
Windows Media Player
File name extension
QuickTime Player; Windows Media Player
Audio Video Interleave File
QuickTime Player; Windows Media Player
Windows Media Video
Windows Media Player
MPEG-1 Audio Layer 3 / Layer 4
QuickTime Player; Windows Media Player; Apple iTunes
Windows Media Audio
Windows Media Player
Reading a site offline
If you are using one of the popular "offline browsers" that allow you to download content from a site and read it later, be aware that we impose one restriction on their use. In order for us to provide reliable, continuous, and timely access for all readers, we require that you configure your offline browser to request no more than one page per minute. Be aware that non-compliance with this rule will result in your access to the site being blocked until you contact us and resolve the problem. If you repeatedly break this rule you will be permanently blocked from the site. Access to site pages via an Open Proxy Server is prohibited.
Why are some author names misspelled?
In some cases, author names containing accents and other diacritics and special characters are displayed incorrectly in the author index and table of contents. In these cases, the accented letters are usually dropped. Because these changes affect indexing of author names, you should avoid searching author names containing special characters until this problem is corrected.
Why are the figures in articles so small? I can't read them
The small pictures in the body text of articles are called "thumbnails." They are intended to be small enough to load quickly and large enough to get the general idea of what the image shows. Our sites support a two-step expansion of thumbnail images. Clicking on a thumbnail displays a larger version of a figure as well as the complete text of the figure's caption. You don't need any additional software to view this medium-size image. To view a high-resolution version of a figure, click on the link to "[View Larger Version of this Image]".
Why are the figures listed out of order?
We display a figure directly after the paragraph in which it is first mentioned. If an author chooses to label a figure "Figure 3" but refers to it in the text before Figures 1 or 2, the figures will appear out of order.
Why are there "torn piece of paper" or "question mark" icons throughout the article?
This could have two causes: either you have Auto Load Images turned off, or you have encountered an image which didn't get processed.
If you have enabled Auto Load Images (in your web browser's Tools > Options) and the image still doesn't display, please send us Feedback and we'll investigate the roblem.
Cookies and your privacy: why we use them
What is a Cookie?
Note: Unless you use the 'Auto Sign In' option on the sign in page, the cookie information we create in your browser is destroyed when you close your browser. If you use the 'Auto Sign In' option and accept the cookie, on future occasions, the system will set only one cookie, because the other cookies remain resident on your computer until you delete them using 'Sign Out.'
Online journals resource centre
HighWire Press -- 1,104,340+ free full-text articles.
HighWire Press at Stanford University develops and maintains the Web versions of important journals in biomedicine and other disciplines.
Centers for Disease Control and Prevention (CDC)
The CDC Web site provides access to the full text of MMWR and other CDC publications and data archives. Publications are searchable through CDC Wonder.
ISI Web of Knowledge Service for UK Education
The ISI Web of Knowledge Service for UK Education provides a single route to all the Thomson Scientific products subscribed to by your institution. Connect to the ISI Web of Knowledge Service and select individual products for searching from the list on the home page.
National Academy Press
Reports from the National Academy of Sciences, the National Academy of Engineering, the Institute of Medicine, and the National Research Council are available online free for the reading from the National Academy Press.
Project Gutenberg Electronic Public Library
Project Gutenberg produces electronic versions of texts in the public domain, mainly classic books. The project adds approximately 1,000 books per year.
An Open Archive of refereed reprints of all target articles, commentaries and responses from Psycoloquy, a peer-reviewed journal of Open Peer Commentary, sponsored by the American Psychological Association, indexed in PsycINFO, and published since 1990 (Archive is complete).
The U.S. National Library of Medicine's digital archive of life sciences journal literature. Access to PMC is free and unrestricted.
The NECI scientific literature digital library offers five million citations and over 400,000 full-text documents. Papers are derived from proceedings of symposia, journals, books, and other sources. headline to cited works and to comments from readers are available.
The UNESCO catalogue lists 100,000 UNESCO documents and provides access to the full text of many of these.
The Wellcome Trust is an independent charity funding research to improve human and animal health.
World Bank Group Documents & Reports
The World Bank Group makes more than 14,000 documents available through the Documents & Reports website. Documents include Project appraisal reports, Economic and Sector Works, Evaluation reports and studies and working papers.