In this article, we test the hypothesis that beliefs about the ideal mother are convergent across cultures and that these beliefs overlap considerably with attachment theory's notion of the sensitive mother. In a sample including 26 cultural groups from 15 countries around the globe, 751 mothers sorted the Maternal Behavior Q-Set to reflect their ideas about the ideal mother. The results show strong convergence between maternal beliefs about the ideal mother and attachment theory's description of the sensitive mother across groups. Cultural group membership significantly predicted variations in maternal sensitivity belief scores, but this effect was substantially accounted for by group variations in socio-demographic factors. Mothers living in rural versus urban areas, with a low family income, and with more children, were less likely to describe the ideal mother as highly sensitive. Cultural group membership did remain a significant predictor of variations in maternal sensitivity belief scores above and beyond socio-demographic predictors. The findings are discussed in terms of the universal and culture-specific aspects of the sensitivity construct.

We evaluated the cost-effectiveness of HPV16/18 vaccination for girls aged 12 years in The Netherlands in addition to cervical cancer screening. For this purpose, we developed a simulation model that describes the relation between each of the high-risk human papillomavirus (hrHPV) types and cervical disease, allowing the occurrence of multiple type-specific infections. Model parameters were derived from Dutch cohort studies, including a large population-based screening trial, and from the national cervical cancer registry. The model satisfactorily reproduced Dutch data on HPV infection and the presence of cervical lesions. For our base-case scenario in which 85% of the girls aged 12 years were vaccinated against types 16/18 (95% efficacy, lifelong protection), the model predicted a decrease of 60% in the number of cervical cancer cases and cervical cancer deaths indicating that substantial health benefits can be achieved. Health savings were robust against changes in the vaccine efficacy (varied from 85% to 98%) but savings showed a substantial reduction when the efficacy started waning 10 years after vaccination. The discounted costs per qualityadjusted life year (QALY) were € 19,500/QALY (range € 11,000 to € 25,000/QALY) and lied near the cost-effectiveness threshold of € 20,000/QALY used in The Netherlands. The simulations further showed that vaccination cannot replace screening because vaccination without screening was less effective than screening in preventing cancer in women over 40 years of age. In conclusion, our model results support the implementation of HPV16/18 vaccination in young women in addition to cervical cancer screening. ' 2008 Wiley-Liss, Inc.Key words: simulation model; human papillomavirus; cervical cancer; vaccination Infection with high-risk human papillomavirus (hrHPV) is the necessary cause of cervical cancer.1 Recently, prophylactic vaccines have come available that protect against infection with the oncogenic HPV types 16 and 18.2,3 HPV 16 and/or 18 (HPV 16/ 18) is present in 60-80% of all cervical cancer cases.4,5 Therefore, mass vaccination may have a substantial impact on the burden of cervical cancer, even in countries with organized cervical screening. The safety and efficacy of HPV16/18 vaccination has been demonstrated in several large randomized trials. 3,6,7 For women without detectable HPV16/18 DNA, an efficacy of 90-98% against HPV16/18 positive cervical intraepithelial neoplasia grade 2 and 3 (CIN2/3) was reported. In addition, some evidence for cross-protection against other HPV types was reported.3 Because of the limited follow-up, long-term efficacy is still uncertain but within the first 5 years no reduction in efficacy was observed and HPV type-specific antibody levels remained at a high level. 8To decide whether or not to introduce nationwide HPV16/18 vaccination, insight into the cost-effectiveness of vaccination is needed in addition to information on safety and efficacy. For this purpose, simulation models have been developed that predict country-specific costs...

CRGNB infections are associated with previous antibiotic and health care exposure. Mortality is related to age and the severity of chronic and acute illness.

Background Antisociality across adolescence and young adulthood puts individuals at high risk of developing a variety of problems. Prior research has linked antisociality to autonomic nervous system and endocrinological functioning. However, there is large heterogeneity in antisocial behaviors, and these neurobiological measures are rarely studied conjointly, limited to small specific studies with narrow age ranges, and yield mixed findings due to the type of behavior examined. Methods We harmonized data from 1489 participants (9–27 years, 67% male), from six heterogeneous samples. In the resulting dataset, we tested relations between distinct dimensions of antisociality and heart rate, pre-ejection period (PEP), respiratory sinus arrhythmia, respiration rate, skin conductance levels, testosterone, basal cortisol, and the cortisol awakening response (CAR), and test the role of age throughout adolescence and young adulthood. Results Three dimensions of antisociality were uncovered: ‘callous-unemotional (CU)/manipulative traits’, ‘intentional aggression/conduct’, and ‘reactivity/impulsivity/irritability’. Shorter PEPs and higher testosterone were related to CU/manipulative traits, and a higher CAR is related to both CU/manipulative traits and intentional aggression/conduct. These effects were stable across age. Conclusions Across a heterogeneous sample and consistent across development, the CAR may be a valuable measure to link to CU/manipulative traits and intentional aggression, while sympathetic arousal and testosterone are additionally valuable to understand CU/manipulative traits. Together, these findings deepen our understanding of the fundamental mechanisms underlying different components of antisociality. Finally, we illustrate the potential of using current statistical techniques for combining multiple datasets to draw robust conclusions about biobehavioral associations.

Background: Definitions of child maltreatment vary widely between studies, and even more so between different cultural contexts. Objective: In this pilot study, we examine between-country variations in maternal notions about what constitutes child maltreatment. Participants and setting: The sample consisted of 466 mothers recruited in Chile,