Craniofacial growth and SITAR growth curve analysis.

BACKGROUND: SITAR (SuperImposition by Translation And Rotation) is a shape invariant growth curve model that effectively summarizes somatic growth in puberty. AIM: To apply the SITAR model to longitudinal mandibular growth data to clarify its suitability to facial growth analysis. SUBJECTS AND METHODS: 2D-cephalometric data on two mandibular measurements (AP: articulare-pogonion; CP: condylion-pogonion) were selected from the Denver Growth Study, consisting of longitudinal records (age range: 7.9-19.0 years) of females (sample size N: 21; number of radiographs n: 154) and males (N: 18; n: 137). The SITAR mixed effects model estimated, for each measurement and gender separately, a mean growth curve versus chronological age, along with mean age at peak velocity (APV) and peak velocity (PV), plus subject-specific random effects for PV and mean size. The models were also fitted versus Greulich-Pyle bone age. RESULTS: In males, mean APV occurred at 14.6 years (AP) and 14.4 years (CP), with mean PV 3.1 mm/year (AP) and 3.3 mm/year (CP). In females, APV occurred at 11.6 years (AP and CP), with mean PV 2.3 mm/year (AP) and 2.4 mm/year (CP). The models explained 95-96 per cent of the cross-sectional variance for males and 92-93 per cent for females. The random effects demonstrated standard deviations (SDs) in size of 5.6 mm for males and 3.9 mm for females, and SDs for PV between 0.3 and 0.5 mm/year. The bone age results were similar. CONCLUSION: The SITAR model is a useful tool to analyse epidemiological craniofacial growth based on cephalometric data and provides an array of information on pubertal mandibular growth and its variance in a concise manner.

[Cultural Perspectives on Counseling andTherapy]. / Kulturelle Perspektiven auf Beratung und Therapie.

This paper briefly characterizes two conceptions of child development, attachment theory and psychobiological approaches. Both share commonalities (e. g. focusing on infancy; relying on ethological approaches; studying parent - child regulations). They also show marked differences, e. g. in methodology and moral evaluations. However, both approaches are based on the same implicit, taken for granted assumptions that are outlined with respect to cultural differences. Particularly caregiving networks and interaction strategies can be distinctly different in different cultural environments. Two socialization strategies with different values and practices of child development are introduced.Western middle-class families and traditional rural farmers in non-Western countries are selected because information is available in a research landscape where participants from non-Western middle class are rare.They can be regarded as embodying different cultural models with different emphases on autonomy and relatedness. Finally, implications for the clinical practice are discussed.

Joint Attention in Human and Chimpanzee Infants in Varied Socio-Ecological Contexts.

Joint attention (JA) is an early manifestation of social cognition, commonly described as interactions in which an infant looks or gestures to an adult female to share attention about an object, within a positive emotional atmosphere. We label this description the JA phenotype. We argue that characterizing JA in this way reflects unexamined assumptions which are, in part, due to past developmental researchers' primary focus on western, middle-class infants and families. We describe a range of cultural variations in caregiving practices, socialization goals, and parenting ethnotheories as an essential initial step in viewing joint attention within inclusive and contextualized perspectives. We begin the process of conducting a decolonized study of JA by considering the core construct of joint attention (i.e., triadic connectedness) and adopting culturally inclusive definitions (labeled joint engagement [JE]). Our JE definitions allow for attention and engagement to be expressed in visual and tactile modalities (e.g., for infants experiencing distal or proximal caregiving), with various social partners (e.g., peers, older siblings, mothers), with a range of shared topics (e.g., representing diverse socialization goals, and socio-ecologies with and without toys), and with a range of emotional tone (e.g., for infants living in cultures valuing calmness and low arousal, and those valuing exuberance). Our definition of JE includes initiations from either partner (to include priorities for adult-led or child-led interactions). Our next foundational step is making an ecological commitment to naturalistic observations (Dahl, 2017, Child Dev Perspect, 11(2), 79-84): We measure JE while infants interact within their own physical and social ecologies. This commitment allows us to describe JE as it occurs in everyday contexts, without constraints imposed by researchers. Next, we sample multiple groups of infants drawn from diverse socio-ecological settings. Moreover, we include diverse samples of chimpanzee infants to compare with diverse samples of human infants, to investigate the extent to which JE is unique to humans, and to document diversity both within and between species. We sampled human infants living in three diverse settings. U.K. infants (n = 8) were from western, middle-class families living near universities in the south of England. Nso infants (n = 12) were from communities of subsistence farmers in Cameroon, Africa. Aka infants (n = 10) were from foraging communities in the tropical rain forests of Central African Republic, Africa. We coded behavioral details of JE from videotaped observations (taken between 2004 and 2010). JE occurred in the majority of coded intervals (Mdn = 68%), supporting a conclusion that JE is normative for human infants. The JA phenotype, in contrast, was infrequent, and significantly more common in the U.K. (Mdn = 10%) than the other groups (Mdn < 3%). We found significant within-species diversity in JE phenotypes (i.e., configurations of predominant forms of JE characteristics). We conclude that triadic connectedness is very common in human infants, but there is significant contextualization of behavioral forms of JE. We also studied chimpanzee infants living in diverse socio-ecologies. The PRI/Zoo chimpanzee infants (n = 7) were from captive, stable groups of mixed ages and sexes, and included 4 infants from the Chester Zoo, U.K. and 3 from the Primate Research Institute, Kyoto University, Japan. The Gombe chimpanzee infants (n = 12) were living in a dynamically changing, wild community in the Gombe National Park, Tanzania, Africa. Additionally, we include two Home chimpanzee infants who were reared from birth by a female scientist, in the combined U.S., middle-class contexts of home and university cognition laboratory. JE was coded from videotaped observations (taken between 1993 and 2006). JE occurred during the majority of coded intervals (Mdn = 64%), consistent with the position that JE is normative for chimpanzee infants. The JA phenotype, in contrast, was rare, but more commonly observed in the two Home chimpanzee infants (in 8% and 2% of intervals) than in other chimpanzee groups (Mdns = 0%). We found within-species diversity in the configurations comprising the JE phenotypes. We conclude that triadic connectedness is very common in chimpanzee infants, but behavioral forms of joint engagement are contextualized. We compared JE across species, and found no species-uniqueness in behavioral forms, JE characteristics, or JE phenotypes. Both human and chimpanzee infants develop contextualized social cognition. Within-species diversity is embraced when triadic connectedness is described with culturally inclusive definitions. In contrast, restricting definitions to the JA phenotype privileges a behavioral form most valued in western, middle-class socio-ecologies, irrespective of whether the interactions involve human or chimpanzee infants. Our study presents a model for how to decolonize an important topic in developmental psychology. Decolonization is accomplished by defining the phenomenon inclusively, embracing diversity in sampling, challenging claims of human-uniqueness, and having an ecological commitment to observe infant social cognition as it occurs within everyday socio-ecological contexts. It is essential that evolutionary and developmental theories of social cognition are re-built on more inclusive and decolonized empirical foundations.

Universality claim of attachment theory: Children's socioemotional development across cultures.

The first part of this paper reviews the basic tenets of attachment theory with respect to differences in cultural socialization strategies. In one strategy infants have the lead, and the social environment is responsive to the infant's wishes and preferences. In another strategy the caregivers-children or adults-are experts who know what is best for a baby without exploring his or her mental states. Accordingly, the definition of attachment is conceived as a negotiable emotional bond or a network of responsibilities. Attachment theory represents the Western middle-class perspective, ignoring the caregiving values and practices in the majority of the world. However, attachment theory claims universality in all its components. Since the claim of universality implies moral judgments about good and bad parenting, ethical questions need to be addressed. These issues are discussed in the second part of the paper. It is first demonstrated that sensitive responsiveness in attachment theory is built on a different concept of the person and self than concepts of good caregiving in many rural subsistence-based farming families. Evaluating one system with the standards of another ignores different realities and different value systems. The common practice of large-scale interventions in rural subsistence-based contexts promoting Western-style parenting strategies without knowing the local culture positions a false understanding of scientific evidence against cultural knowledge. This practice is unethical. Diversity needs to be recognized as the human condition, and the recognition of diversity is an obligation for better science as well as for improving people's lives.

The Myth of Universal Sensitive Responsiveness: Comment on Mesman et al. (2017).

This article considers claims of Mesman et al. (2017) that sensitive responsiveness as defined by Ainsworth, while not uniformly expressed across cultural contexts, is universal. Evidence presented demonstrates that none of the components of sensitive responsiveness (i.e., which partner takes the lead, whose point of view is primary, and the turn-taking structure of interactions) or warmth are universal. Mesman and colleagues' proposal that sensitive responsiveness is "providing for infant needs" is critiqued. Constructs concerning caregiver quality must be embedded within a nexus of cultural logic, including caregiving practices, based on ecologically valid childrearing values and beliefs. Sensitive responsiveness, as defined by Mesman and attachment theorists, is not universal. Attachment theory and cultural or cross-cultural psychology are not built on common ground.

The Development of Implicit Memory From Infancy to Childhood: On Average Performance Levels and Interindividual Differences.

The present multimethod longitudinal study aimed at investigating development and stability of implicit memory during infancy and early childhood. A total of 134 children were followed longitudinally from 3 months to 3 years of life assessing different age-appropriate measures of implicit memory. Results from structural equation modeling give further evidence that implicit memory is stable from 9 months of life on, with earlier performance predicting later performance. Second, it was found that implicit memory is present from early on, and no age-related improvements are found from 3 months on. Results are discussed with respect to the basic brain structures implicit memory builds on, as well as methodological issues.

Bringing the Real World Into Developmental Science: A Commentary on Weber, Fernald, and Diop (2017).

This article examines the parent intervention program evaluated by Weber et al. (2017) and argues that there are scientific and ethical problems with such intervention efforts in applied developmental science. Scientifically, these programs rely on data from a small and narrow sample of the world's population; assume the existence of fixed developmental pathways; and pit scientific knowledge against indigenous knowledge. The authors question the critical role of talk as solely providing the rich cognitive stimulation important to school success, and the critical role of primary caregivers as teachers of children's verbal competency. Ethically, these programs do not sufficiently explore how an intervention in one aspect of child care will affect the community's culturally organized patterns of child care.

Waiting for the Second Treat: Developing Culture-Specific Modes of Self-Regulation.

The development of self-regulation has been studied primarily in Western middle-class contexts and has, therefore, neglected what is known about culturally varying self-concepts and socialization strategies. The research reported here compared the self-regulatory competencies of German middle-class (N = 125) and rural Cameroonian Nso preschoolers (N = 76) using the Marshmallow test (Mischel, 2014). Study 1 revealed that 4-year-old Nso children showed better delay-of-gratification performance than their German peers. Study 2 revealed that culture-specific maternal socialization goals and interaction behaviors were related to delay-of-gratification performance. Nso mothers' focus on hierarchical relational socialization goals and responsive control seems to support children's delay-of-gratification performance more than German middle-class mothers' emphasis on psychological autonomous socialization goals and sensitive, child-centered parenting.

Cross-cultural value mismatch in German day care institutions: Perspectives of migrant parents and day care teachers.

Immigrant parents encounter educational approaches in the host country that differ from what they know and expect from institutional childcare. With our study we would like to contribute to the understanding of these differences. We collected information concerning developmental goals and educational strategies from 151 mothers with children between 0 and 6 years, differing in level of education and ethnic background (German, Turkish, and Russian) and from 36 childcare teachers also of different ethnic origin (German, Turkish, and Russian). Interview and questionnaire data were analysed with qualitative content analysis and inferential statistics. Results indicate that in all childcare teachers prefer autonomy-oriented developmental goals and a constructivist approach to education. More educated German mothers agree widely with the teachers. In contrast, migrant mothers and less-educated German mothers differ significantly from the teacher's perspectives. These mothers prefer developmental goals oriented towards relatedness and a didactic approach to education. They are also more focused on the physical well-being and the bodily integrity of their children. The discrepancies were most striking between childcare teachers and less-educated Turkish and Russian migrant mothers. The results are discussed with respect to the claim of providing equal chances for all children.

Evidence of secular trend in mandibular pubertal growth.

BACKGROUND: During puberty, mandibular growth follows a growth curve comparable to somatic growth. This study aimed to review the relationship between mandibular pubertal peak height velocity (PHV) and skeletal age, and to investigate the possibility of a secular trend. METHODS: Retrospective analysis was performed of two historical craniofacial growth studies (Denver Growth Study; observational time: 1943-1965, and Zurich Growth Study; observational time: 1982-1984) of healthy untreated subjects. Two mandibular growth measures (Articulare-Pogonion [Ar-Pg], Condylion-Pogonion [Co-Pg]) were retrieved from cephalograms (n: 990) and corresponding skeletal age based on hand-wrist radiographs. Mandibular growth velocity was related to skeletal age, PHV was established by use of cubic smoothing splines and variability was calculated by bootstrap resampling for every growth study and gender separately. RESULTS: Sexual dimorphism in mandibular growth was apparent in both cohorts. In subjects of the Denver Growth Study, mandibular PHV occurred at a more advanced skeletal age than in subjects of the Zurich Growth Study. This trend was more pronounced in males, for whom PHV of Co-Pg shifted from 14.4 to 13.8 years and of Ar-Pg from 14.6 to 13.7 years. This tendency was more subtle in females: PHV of Co-Pg shifted from 12.7 to 12.4 years and of Ar-Pg from 12.6 to 11.8 years. CONCLUSIONS: Mandibular growth appears to be subject to a secular trend. When related to skeletal age, this secular trend seems to be more accentuated than the established secular trend for somatic pubertal growth.

Children's Family Drawings as Expressions of Attachment Representations Across Cultures: Possibilities and Limitations.

The present study explored the cross-cultural appropriateness of children's family drawings as a measure for attachment quality. The sample consisted of 63 children aged 6 years from two diverse ecosocial contexts: middle-class families from Berlin, Germany (n = 32) and rural farming families from small villages around Kumbo, Cameroon (n = 31). The analysis of drawings with two classical attachment procedures, the Checklist of Drawing Signs (Kaplan & Main, 1986) and the Global Rating Scales (Fury, 1996), revealed substantial cultural differences. The results thus substantiated children's drawings as important cultural documents. Implications of the findings, however, are discussed in consideration of culture-specific conceptions of attachment relationships as indicated by cultural variations in mother's socialization goals.

Reactions to Receiving a Gift-Maternal Scaffolding and Cultural Learning in Berlin and Delhi.

This study shows how Berlin (n = 35) and Delhi (n = 28) mothers scaffold a common and highly scripted social situation, namely gift giving, and enable cultural learning in 19-month-olds. Using modeling and prompting to encourage appropriate responses, mothers took culture-specific directions during scaffolding that were in line with the broader cultural model as assessed by maternal socialization goals (SGs). Whereas Berlin mothers prioritized autonomous SGs, Delhi mothers emphasized autonomous and relational SGs to similar degrees. During scaffolding, Berlin mothers focused on maximizing positive affect and acknowledging the gift, whereas Delhi mothers prompted toddlers to acknowledge the giver more often. Furthermore, there were differences in toddlers' behavior in line with these culture-specific scripts guiding gift giving.

The intrinsically disordered amino-terminal region of human RecQL4: multiple DNA-binding domains confer annealing, strand exchange and G4 DNA binding.

Human RecQL4 belongs to the ubiquitous RecQ helicase family. Its N-terminal region represents the only homologue of the essential DNA replication initiation factor Sld2 of Saccharomyces cerevisiae, and also participates in the vertebrate initiation of DNA replication. Here, we utilized a random screen to identify N-terminal fragments of human RecQL4 that could be stably expressed in and purified from Escherichia coli. Biophysical characterization of these fragments revealed that the Sld2 homologous RecQL4 N-terminal domain carries large intrinsically disordered regions. The N-terminal fragments were sufficient for the strong annealing activity of RecQL4. Moreover, this activity appeared to be the basis for an ATP-independent strand exchange activity. Both activities relied on multiple DNA-binding sites with affinities to single-stranded, double-stranded and Y-structured DNA. Finally, we found a remarkable affinity of the N-terminus for guanine quadruplex (G4) DNA, exceeding the affinities for other DNA structures by at least 60-fold. Together, these findings suggest that the DNA interactions mediated by the N-terminal region of human RecQL4 represent a central function at the replication fork. The presented data may also provide a mechanistic explanation for the role of elements with a G4-forming propensity identified in the vicinity of vertebrate origins of DNA replication.

Experience with headwear influences the other-race effect in 4-year-old children.

The other-race effect (ORE) implies the better recognition of faces of one's own race compared with faces of a different race. It demonstrates that face recognition is shaped by daily experience with human faces. Such experience mainly includes structural information of own-race faces and also information on the way faces are usually seen, as a whole or partly covered by scarves or other headwear. In two experiments, we investigated how this mode of presentation is related to the occurrence of the ORE during childhood. In Experiment 1, 4-year-old German children (N = 104), accustomed to seeing faces without headwear in daily life, were asked to recognize female Caucasian or African faces, presented either as a whole or wearing a woolen hat, in a forced choice paradigm. In Experiment 2, 4-year-olds from rural Cameroon (N = 70), accustomed to seeing faces with and without headwear in daily life, participated in the same task. In both groups, the ORE was present in the familiar mode of presentation, that is, in whole faces in German children and in whole and partly covered faces in Cameroonian children. The results are discussed in relation to the role of experience for face recognition processes.

Telling a "baby story": mothers narrating their pre-schoolers' past across two cultural contexts.

Mothers from two middle-class contexts from Berlin, Germany (n = 35), and Delhi, India (n = 28) told a baby story to their 3-year olds about an event that had happened during the children's first year of life. The contexts represented two cultural models: the model of psychological autonomy (Berlin) and the model of autonomy-relatedness (Delhi). We investigated the culture-specific functions of this reminiscing task as reflected in the structure, content and specificity of the stories. The stories in both contexts were minimally interactive and the children contributed few elaborations themselves. Stories told by the Berlin mothers were longer, and more specific. Mothers in both contexts were similarly elaborative relative to being repetitive. The stories were highly child-centred in both contexts but even more child-centred for Delhi. Importantly, maternal narrations from the Berlin context were embedded in a frame story that characterised the child's individual past; stories thus constructed "exclusive baby stories". Most stories told by the Delhi mothers had no frame story but instead were about what the child used to do as a baby in general; they thus constructed "routine baby stories". Results are interpreted in the view of the underlying self, social and directive functions of this reminiscing task.

The N-terminus of the human RecQL4 helicase is a homeodomain-like DNA interaction motif.

The RecQL4 helicase is involved in the maintenance of genome integrity and DNA replication. Mutations in the human RecQL4 gene cause the Rothmund-Thomson, RAPADILINO and Baller-Gerold syndromes. Mouse models and experiments in human and Xenopus have proven the N-terminal part of RecQL4 to be vital for cell growth. We have identified the first 54 amino acids of RecQL4 (RecQL4_N54) as the minimum interaction region with human TopBP1. The solution structure of RecQL4_N54 was determined by heteronuclear liquid-state nuclear magnetic resonance (NMR) spectroscopy (PDB 2KMU; backbone root-mean-square deviation 0.73 Å). Despite low-sequence homology, the well-defined structure carries an overall helical fold similar to homeodomain DNA-binding proteins but lacks their archetypical, minor groove-binding N-terminal extension. Sequence comparison indicates that this N-terminal homeodomain-like fold is a common hallmark of metazoan RecQL4 and yeast Sld2 DNA replication initiation factors. RecQL4_N54 binds DNA without noticeable sequence specificity yet with apparent preference for branched over double-stranded (ds) or single-stranded (ss) DNA. NMR chemical shift perturbation observed upon titration with Y-shaped, ssDNA and dsDNA shows a major contribution of helix α3 to DNA binding, and additional arginine side chain interactions for the ss and Y-shaped DNA.

Crowdsourcing 101: a few basics to make you the leader of the pack.

Crowdsourcing is a problem-solving approach that taps the knowledge, energy, and creativity of a global, online community. Like marketing, crowdsourcing originated and continues to evolve in the private sector. Health communicators and social marketers can use crowdsourcing across the research-development-dissemination process. This article provides an overview of crowdsourcing and how it can be used to speed up and enhance social marketing and health communication. Nielsen's 1/9/90% model is presented as a guide for engaging appropriate crowds for tasks throughout the development process. The four Fs that motivate online contributors--Fun, Feeling good (fulfillment), Fame, and Fortune--are also presented as ways of incentivizing crowd engagement and matching the incentive to the task at hand. Crowdsourcing resources, such as curating agencies, websites, and crowd labor markets, can be tremendous force multipliers. If done strategically, crowdsourcing has the promise of giving well-researched and creative social marketing results for less money and in less time than traditional methods.

The cultural specificity of parent-infant interaction: Perspectives of urban middle-class and rural indigenous families in Costa Rica.

Caregiver-infant interactions in Western middle class often take place in dyadic play settings, engaged in infant-initiated object stimulation, and surrounded by a positive emotional tone, reflecting a distal parenting style. With this study we aim to investigate whether the same conception of caregiver-infant interaction is embodied in the proximal parenting style. For this purpose, we compare the context and pattern of caregiver-infant interactions in two cultural groups in Costa Rica: Urban middle-class families in San José and rural indigenous Bribri families. Naturalistic observations and caregiver interviews revealed significant differences between the groups, with San José families resembling the Western middle-class interaction pattern. Among the Bribris, adult-child play is uncommon so that children interact with adults in primary care settings and with older siblings in play settings. Bribri interactions are further characterized by emotional neutrality. The groups did not differ in terms of body contact. Also, caregivers in both samples took the lead in interactions more often than infants. The results are discussed in the context of an autonomous-relational style as combining psychological autonomy and hierarchical relatedness. We argue that early childhood theories and intervention programs need to abandon the assumption that Western middle-class strategies are universal and recognize locally relevant patterns of caregiver-infant interaction.

Content of maternal open-ended questions and statements in reminiscing with their 4-year-olds: links with independence and interdependence orientation in European contexts.

Mother's open-ended questions and elaborative statements during reminiscing were analysed for their content (child agency, co-agency, non-social, and social context) in three cultural contexts. Participants were 115 mothers and their 4-year-old children: 35 dyads from Berlin, Germany, 42 from Stockholm, Sweden, and 38 from Tallinn, Estonia. Across samples the most prominent content was talk about non-social context followed by co-agency and child agency. Tallinn mothers asked the children to talk about themselves, and Berlin mothers asked the children to talk about themselves together with other people, more frequently than they talked about these contents themselves. The content was related to the cultural orientations of mothers assessed through questionnaires: the Berlin mothers whose independence/ interdependence ratio was higher talked less about other people and asked the children fewer questions about other people; the Stockholm mothers with a higher independence/interdependence ratio talked more about child agency. In Tallinn both correlations existed on a trend level. The results are discussed in the light of common conversational practices and mothers' orientation to independence and interdependence in these cultural contexts.

The development of mirror self-recognition in different sociocultural contexts.

The overarching goal of the present study was to trace the development of mirror self-recognition (MSR), as an index of toddlers' sense of themselves and others as autonomous intentional agents, in different sociocultural environments. A total of 276 toddlers participated in the present study. Toddlers were either 16, 17, 18, 19, 20, or 21 months old at their first assessment and completed weekly MSR assessments over a period of 6 weeks (N = 1,577). The toddlers and their families were from one of four sociocultural contexts: A prototypical autonomous sociocultural context (urban German middle-class families, n = 82), two prototypical relational sociocultural contexts (rural Indian and rural Nso families living in subsistence-based ecologies, n = 54 and n = 80, respectively), or an autonomous-relational sociocultural context (urban Indian middle-class families, n = 60). In line with previous research, we hypothesized that the onset of MSR would be earlier in sociocultural contexts in which mothers value and support their toddlers' development of autonomy. In addition, we considered three factors that covary with culture and that might compromise the cross-cultural validity of MSR as a behavioral measure of toddlers' sense of themselves as independent agents: familiarity with mirrors, culture-specific norms of expressive behavior, and motivation for tactile exploration. Finally, we analyzed toddlers' reactions to their specular image (e.g., pointing, playmate, and experimenting behavior) across time and culture as well as their relation to MSR. The results indicate that MSR increased with age in all sociocultural contexts. In line with our hypotheses, MSR rates were higher in the autonomy-supporting cultural context (urban German, urban Indian) than they were in the relational cultural contexts(rural Indian, rural Nso). The sociocultural differences in MSR could not, however, be explained by differences in mirror familiarity or culture-specific norms of expressive behavior. The cross-cultural validity of MSR as an index of toddlers' sense of themselves as independent agents is further supported by positive associations between MSR and pronoun use in all sociocultural contexts. Cross-cultural variation in MSR could best be explained by caretakers' emphasis on autonomous socialization goals, followed by toddlers' motivation for tactile exploration. These findings enhance our current understanding of development in more general terms by adding one more puzzle piece to the emerging picture of culture-specific developmental pathways. In order to understand developmental processes, one must take into account caretakers' cultural models and exercise caution when generalizing beyond the specific sociocultural context at hand.