While the majority of the papers from February’s top ten are still hanging onto their places in the chart, there are three new entries in this month’s top ten. In this blog, we take a closer look at March’s new entries. 

Women’s experiences of both prescription and over-the-counter medications during pregnancy in the UK. 

Using an online survey and in-depth interviews, Sanders et al. explored women’s experiences of both prescription and over-the-counter medications during pregnancy. While the quantitative survey data are reported elsewhere, this paper focuses on the qualitative analysis of the data derived from the in-depth interviews. In total, 34 women were interviewed, including those with experience of medication for hyperemesis gravidarum and antenatal medication use for mental health conditions. Sanders et al. identified four themes from these interviews, including fear of medications and self regulation, feeling overmedicated, conflicting opinions and “running the gauntlet”. The authors concluded that this study highlighted areas of antenatal prescribing where improvements in communication, practice or knowledge are necessary to help ensure further efficacy, safety and personalisation of prescribing in pregnancy. However, they acknowledge the limitation that women who do not speak English or did not have access to the internet were excluded from the study. 

Characteristics and prevalence of anti-indigenous bias among physicians in Alberta, Canada.  

In this paper, Roach et al. report on a subsection of results, which focus on anti-Indigenous bias, from a larger cross-sectional survey. Explicit anti-Indigenous bias was measured using two-feeling thermometer approaches that prompted participants to slide a pointer on a scale to indicate their preferences towards white or Indigenous people and how favourably they felt towards Indigenous people. Implicit bias was measured using a Indigenous–European implicit association test. The results from the survey items measuring explicit anti-Indigenous bias indicated that 25.0% of participants preferred white people to Indigenous people and 8.3% of participants felt unfavourably towards Indigenous people. Results of the implicit bias measure indicated that participants who were white cisgender men had the most implicit bias compared to other demographic groups that took part in the survey. Free-text responses from the participants discussed concerns about “reverse racism” and discomfort at the questions posed in the survey. Roach et al. concluded that explicit anti-Indigenous bias was present among Albertan physicians and that concerns over “reverse racism” and discomfort in discussing racism could be a barrier to addressing anti-Indigenous bias. However, the authors do acknowledge that, as the questions regarding explicit and implicit bias were often skipped by participants, there is a potential for non-response and selection bias among the participants. 

Education mediating the associations between early life factors and frailty. 

Using data from the UK Biobank, Maharani et al. conducted a cross-sectional study to assess the associations between early life risk factors and the development of frailty in middle-aged and older adults. They also aimed to identify whether any of the observations between these factors may be mediated by educational attainment. The results suggested that normal birth weight and a history of breast feeding was associated with a lower frailty index, whereas perinatal diseases and maternal smoking were associated with a high frailty index. The results also suggest that educational level mediated the relationship between early life factors and frailty index. Maharani et al. conclude that both biological and social risk factors occurring at different stages of life are associated with variations in frailty index in later life. The authors also suggest that early life disadvantages may be offset by education. Maharani et al. acknowledge that, while the cohort studied in this manuscript was large and well characterised, the information obtained regarding early life was based on self-report and it is therefore subject to recall error.