Social representations of breastfeeding in health science students: A first step to strengthening their training.

AIM: This study aims to describe the social representations of breastfeeding among Mexican health science students. BACKGROUND: Breastfeeding is a complex phenomenon involving biological, affective and sociocultural aspects. Its definition includes diverse beliefs, attitudes, traditions and myths. Being aware of the connections between biological and sociocultural concepts in the social representations of breastfeeding in health science students may facilitate our comprehension of their attitudes/behaviors towards breastfeeding. DESIGN: A qualitative study was carried out based on the structuralist approach of the social representations theory. METHODS: Data were collected with free-listing questionnaires with breastfeeding as an inducer word among a random sample of nutrition, medical and nursing undergraduate students (n=124). The analyses used were similitude/meanings of words, prototypical and categorical analyses. RESULTS: The findings suggest that the structure of the social representation is composed of breastfeeding essentials (baby, mother, & milk), affective (attachment, love & link), biological (nutrition, breasts, & health) and sociocultural elements (taboo, responsibility, & economic). Only instrumental elements are found in the nucleus, whereas biological, affective and sociocultural elements are observed in the peripheries. Moreover, emerging thematic categories such as the "affective bond" and "feeding" introduced additional dimensions, thereby emphasizing the complexity and richness of the social representation of breastfeeding in the context of health science students. CONCLUSIONS: The structure of the social representation of breastfeeding among some Mexican undergraduate health science students focuses on the instrumental aspects, emphasizing essential elements. However, they downplay more scientifically oriented elements specific to their academic training. These findings, when extrapolated to different contexts, present an opportunity that could assist the development of tailored and culturally adapted educational strategies to strengthen breastfeeding training for health students. This approach can significantly contribute to enhancing breastfeeding promotion in society by addressing practical, scientific and language-inclusive aspects in the training of health professionals.

Prevention of household transmission crucial to stop the catastrophic spread of COVID-19 in cities

After weeks under lockdown, metropolitan areas fighting the spread of COVID-19 aim to balance public health goals with social and economic standards for well-being. Mathematical models of disease transmission seeking to evaluate mitigation strategies must assess the possible impacts of social distancing, economic lockdowns and other measures. However, obscure relations between model parameters and real-world phenomena complicate such analyses. Here, we use a high-resolution metapopulation model of Guadalajara (GDL, Western Mexico) to represent daily mobility patterns driven by economic activities and their relation to epidemic growth. Given the prominence of essential activities in the citys economy, we find that strategies aiming to mitigate the risk of out-of-home interactions are insufficient to stop the catastrophic spread of COVID-19. Using baseline reproduction numbers R0 = [2.5, 3.0] in the absence of interventions, our simulations suggest that household transmission alone can make Rt [~] 1, and is estimated to drive 70 {+/-}15% of current epidemic growth. This sets an upper bound for the impact of mobility-based interventions, which are unlikely to lower Rt below 1.3 and must be complemented with aggressive campaigns for early case detection and isolation. As laboratory testing and health services become insufficient to meet demand in GDL and most other cities, we propose that cities facilitate guidelines and equipment to help people curb spreading within their own homes. Postponing these actions will increase their economic cost and decrease their potential returns. Author summaryPublic health strategies to mitigate the spread of COVID-19 in metropolitan areas have focused on preventing transmission in schools, work sites and other public spaces. Here, we use a demographically- and spatially-explicit model of Guadalajara (GDL, Western Mexico) to represent economic lockdowns and their impact on disease spread. Our findings suggest that viral exposure within households accounts for 70{+/-}15% of the epidemics current growth rate. This highlights the importance of early case detection and isolation as necessary measures to prevent the spread of COVID-19 between strangers and close contacts alike.