ABSTRACT. Objective. During recent years, coincident with the recommendation to position infants supine, the incidence of posterior deformational plagiocephaly has increased dramatically. The purpose of our study was to determine whether early signs of cranial flattening could be detected in healthy neonates and to document incidence and potential risk factors.Design. A cross-sectional study was performed in healthy newborns. Physical findings, anthropometric cranial measurements, and data on pregnancy and birth were recorded.Results. The incidence of localized cranial flattening in singletons was 13%; other anomalous head shapes were found in 11% of single-born neonates. In twins, localized flat areas were much more frequent with an incidence of 56%. The following risk factors for cranial deformation were identified: assisted vaginal delivery, prolonged labor, unusual birth position, primiparity, and male gender. ABBREVIATIONS. SIDS, sudden infant death syndrome; TCD, transcranial difference. Conclusion. We propose that localized lateral or occipital cranial flattening at birth is a precursor to

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The teaching toolbox expands the ACGME core communication competencies, adds 20 subcompetencies and connects these competencies to teaching strategies at each level of medical training. It represents the collaboration and consensus of a diverse international group of medical education leaders in a variety of medical specialities and institutions, all involved in teaching communication skills. The toolbox is applicable globally across different settings and specialities, and is sensitive to different definitions of health care.

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Cross-cultural psychology has made important contributions to research and interventions in education and health. In education, cross-cultural research includes the application of Piagetian tests cross-culturally and the discovery of cultural variability in styles of learning. Research using the constructs of individualism and collectivism has shown that a variety of cultural values and parenting styles can be related to school success, and awareness of such differences has been used to enhance the effectiveness of educational intervention. In health, cross-cultural psychology has contributed to the identification of culture-specific patterns of illness and beliefs about illness. Research has shown complicated relationships between cultural expectations of behavior and cross-cultural variability in children's observed behavior. The role of cultural beliefs and related practices is highlighted in research on temperament. Theoretical models derived from crosscultural research are shown to be useful in creating a framework for systematic consideration of education and health in cultural context.