Big five personality traits, gaming motives, and regular and disordered gaming: A cross-national examination among college student gamers in seven countries.

INTRODUCTION: Previous research has shown that personality traits and gaming motives are important predictors for explaining regular and disordered gaming. However, the mediating role of gaming motives in the relation between personality traits and video game outcomes (e.g., time spent gaming or disordered gaming) has been scarcely studied and limited cross-national studies have addressed this issue. The present study aimed to examine the direct and indirect effects of the Big Five personality traits on weekly gaming and disordered gaming via gaming motives across seven countries. METHOD: 3540 college student gamers (59.5% women) from the U.S., Canada, Spain, Argentina, Uruguay, South Africa and England completed the online survey. Structural equation modeling was conducted to test models. Multigroup models were employed to test model invariance across countries. RESULTS: Significant, albeit weak, relations were found between personality traits and gaming outcomes, and were mediated mostly by coping motives in predicting disordered gaming, and by social interaction and recreation (to a lesser extent) motives in predicting weekly gaming. Some minor, yet significant, differences across countries appeared and are discussed in detail. DISCUSSION: The present findings indicate that the differential interrelations between personality traits, gaming motives, and video gaming outcomes may be generalized in college students across countries.

A Cross-National Comparison of Biosimilars Pricing in Argentina, Australia, Brazil, and Italy.

BACKGROUND: Biosimilar medicines are defined as biological products highly similar to an already licensed biological product (RP). The market entry of biosimilars is expected to reduce the costs of biological treatments. OBJECTIVE: This study aims to evaluate the range of differences between the prices of biosimilars and the corresponding RP for biologicals approved in four countries. METHOD: This is a cross-national comparison of pricing of biosimilars in Argentina, Australia, Brazil, and Italy. The study examined online price databases provided by the national authorities of the investigated countries. Biosimilar price difference was calculated by subtracting the unit price of the biosimilar by the unit price of the RP, and then dividing it by the unit price of the RP. The results were presented as percentage. RESULTS: Brazil had the highest median price reduction (- 36.3%) in biosimilars price, followed by Italy (- 20.0%) and Argentina (- 18.6%). All the biosimilars in Italy were priced below the RP presenting a minimum reduction of 6.3%, while in Australia, most of the prices of biosimilars were equal to the RP. In Argentina, one infliximab-biosimilar displayed price above the RP (40.7%) while the lower priced brand had a reduction of 14.4%. Brazil had four biosimilars with prices above the respective RP, including isophane insulin (1), insulin glargine (1) and somatropin (2). CONCLUSION: The study revealed a marked dispersion in the price's differences between biosimilars and RP across the studied countries. Governments should evaluate whether their policies have been successful in improving affordability of biological therapies.

How Education Shapes Indigenous Health Inequalities in the USA and Mexico.

Indigenous peoples around the world face significant health disparities relative to the dominant groups in their countries, yet the magnitude and patterns of health disparities vary across countries. We use data from the National Health Interview Survey and Mexican Family Life Survey to examine the health of Indigenous peoples in Mexico and American Indians and Alaska Natives in the USA and to evaluate how they fare relative to the majority populations in their countries (non-Indigenous Mexicans and non-Hispanic Whites, respectively). We assess disparities in self-rated health and activity limitations, with a focus on how Indigenous health disparities intersect with educational gradients in health. Regression analyses reveal three primary findings. First, Indigenous health disparities are larger in the USA than in Mexico. Second, differences in educational attainment account for most of the differences between Indigenous and non-Indigenous populations in Mexico, but less than half in the USA. Third, in both countries, health is moderated by educational attainment such that between-group disparities are largest at the highest levels of education. However, for Indigenous Mexicans there is a "cross-over" in which Indigenous Mexicans report better health at the lowest level of education. Overall, this study finds a weak relationship between education and Indigenous health, and raises the question about the validity of using traditional measures of SES in Indigenous contexts.

Lifetime occupational skill and later-life cognitive function among older adults in the United States, Mexico, India, and South Africa.

INTRODUCTION: We conducted a cross-national comparison of the association between main lifetime occupational skills and later-life cognitive function across four economically and socially distinct countries. METHODS: Data were from population-based studies of aging and their Harmonized Cognitive Assessment Protocols (HCAPs) in the US, South Africa, India, and Mexico (N = 10,037; Age range: 50 to 105 years; 2016 to 2020). Main lifetime occupational skill was classified according to the International Standard Classification of Occupations. Weighted, adjusted regression models estimated pooled and country-specific associations between main lifetime occupational skill and later-life general cognitive function in men and women. RESULTS: We observed positive gradients between occupational skill and later-life cognitive function for men and women in the US and Mexico, a positive gradient for women but not men in India, and no association for men or women in South Africa. DISCUSSION: Main lifetime occupations may be a source of later-life cognitive reserve, with cross-national heterogeneity in this association. HIGHLIGHTS: No studies have examined cross-national differences in the association of occupational skill with cognition. We used data from Harmonized Cognitive Assessment Protocols in the US, Mexico, India, and South Africa. The association of occupational skill with cognitive function varies by country and gender.

Cross-cultural adaptation of the Job Insecurity Scale (JIS) in Brazil and cross-national analysis of Job Insecurity effects in Brazil and Spain.

BACKGROUND: Job flexibilisation has increased interest in job insecurity and its consequences. Job insecurity, understood as a fear of losing employment, is linked to a deterioration of mental health, social relations or job satisfaction. Its study has been developed primarily in Europe, in the absence of validated psychometric scales in the Latin American context. To bridge this knowledge gap, the aim of this study is to cross-culturally adapt the Job Insecurity Scale (JIS) in Brazil, and secondly, to establish a cross-national analysis between people employed in Brazil and Spain. METHODS: As criteria for the sample, people with formally established employment in Brazil and Spain were selected. For the scale adaptation process, a sequence of EFA, CFA and validity tests are carried out, as well as a multigroup invariance according to the gender variable. The cross-national comparison compares the effect sizes of affective and cognitive job insecurity on the mental health variable measured with the GHQ-28 scale in both countries. RESULTS: 1165 employed people participate in the study, of whom 573 reside in Brazil and 592 in Spain. The results of the scale adaptation show that the JIS is suitable for use in the Brazilian employment context. The scale offers a factorialisation in two dimensions (affective and cognitive) (CFI = 0.993; TLI = 0.987; RMSEA = 0.04; SRMR = 0.049; GFI = 0.999; NFI = 0.980) with good reliability (ω > 0.84). The cross-national comparison shows that job insecurity has a greater weight in explaining the mental health of the employed population in Brazil than in Spain, which is related to higher indicators of job insecurity in the Brazilian context. CONCLUSIONS: With this validation we now have a validated scale of job insecurity validated for the Brazilian context. The comparison between countries shows the need to establish these analyses, since the behaviour of the phenomenon is different in the contexts studied.

The Importance of the 5Cs of Positive Youth Development to Depressive Symptoms: A Cross-Sectional Study with University Students from Peru and Spain.

BACKGROUND: Prior research has documented the protective role of the 5Cs of Positive Youth Development (PYD) on adjustment problems, such as depressive symptoms. Nonetheless, more research is needed, especially in non-US contexts. The main objective of the present study was to assess associations between the 5Cs and depressive symptoms in Peru and Spain, considering gender differences across contexts. METHODS: Cross-sectional data was collected from undergraduate students from Peru [n = 250] and Spain [n = 1044]. RESULTS: The results revealed significant negative associations of Competence, Confidence, Character and Connection with depressive symptoms, while Caring was positively and significantly related to depressive symptoms in both samples. Regarding gender differences, female undergraduates in both samples reported high levels of Caring, while Competence was predominant among males compared to females in both countries. Likewise, higher scores in Competence and Confidence were registered among Peruvian male undergraduates compared to Spanish students, while Caring and Character were more prevalent in Spanish female undergraduates compared to Peruvian students. CONCLUSIONS: These findings confirm the importance of targeting the 5Cs of PYD alongside the role of gender and country context in intervention programs, put together to address the mental health of students in Peru and Spain.

Motives to play videogames across seven countries: Measurement invariance of the Videogaming Motives Questionnaire.

INTRODUCTION: Gaming motives appear to be an important predictor of time spent gaming and disordered gaming. The Videogaming Motives Questionnaire (VMQ) has shown adequate psychometric properties to assess gaming motives among Spanish college students. However, the utility of this measure has not yet been explored in other cultures. This research aimed to examine the structure and measurement invariance of the VMQ across seven countries and gender groups, and to provide criterion-related validity evidence for VMQ scores. METHOD: College students who reported having played videogames in the last year (n = 5192; 59.07 % women) from the US, Canada, South Africa, Spain, Argentina, England, and Uruguay completed an online survey to measure time spent gaming, disordered gaming, and the VMQ. RESULTS: Findings support a 24-item 8-intercorrelated factor model structure for the VMQ in the total sample. Our results also support configural, metric, and scalar invariance of the VMQ across gender groups and countries. Students from North America (US and Canada) scored higher on most gaming motives (except recreation and cognitive development) than students from the other countries. The correlations between VMQ and non-VMQ variables were similar across gender and countries, except in England where VMQ correlations with time spent gaming were stronger. DISCUSSION: These results suggest that the VMQ is a useful measure for assessing gaming motives across young adults from different countries.

Global Pain and Aging: A Cross-Sectional Study on Age Differences in the Intensity of Chronic Pain Among Middle-Aged and Older Adults in 20 Countries.

OBJECTIVES: This study aims to examine age differences in the intensity of chronic pain among middle-aged and older adults, where intensity is measured on a scale differentiating between chronic pain that is often troubling and likely requires intervention versus more endurable sensations. We aim to explore whether individual health and national gross domestic product (GDP) explain these differences as well. METHODS: Cross-nationally harmonized data from 20 countries on self-reported intensity of chronic pain (0 = no, 1 = mild, 2 = moderate, 3 = severe) in 104,826 individuals aged 50+ observed in 2012-2013. Two-level hierarchical ordinal linear models with individuals nested within countries were used to isolate estimations from heterogeneity explained by methodological differences across single-country studies. RESULTS: Overall, mean participant age was 66.9 (SD = 9.9), 56.1% were women, and 41.9% of respondents reported any chronic pain. Chronic pain intensity rose sharply with age in some countries (e.g., Korea and Slovenia), but this association waned or reversed in other countries (e.g., the United States and Denmark). Cross-country variation and age differences in chronic pain were partly explained (85.5% and 35.8%, respectively) by individual-level health (especially arthritis), country-level wealth (as indicated by GDP per capita), and demographics. DISCUSSION: Chronic pain intensity is not an inevitable consequence of chronological age, but the consequence of potential selection effects and lower activity levels combined with individual-level health and country-level wealth. Our findings suggest further investigation of health conditions and country affluence settings as potential targets of medical and policy interventions aiming to prevent, reduce, or manage chronic pain among older patients and aging populations.

Data sources for drug utilization research in Latin American countries-A cross-national study: DASDUR-LATAM study.

PURPOSE: Drug utilization research (DUR) contributes to inform policymaking and to strengthen health systems. The availability of data sources is the first step for conducting DUR. However, documents that systematize these data sources in Latin American (LatAm) countries are not known. We compiled the potential data sources for DUR in the LatAm region. METHODS: A network of DUR experts from nine LatAm countries was assembled and experts conducted: (i) a website search of the government, academic, and private health institutions; (ii) screening of eligible data sources, and (iii) liaising with national experts in pharmacoepidemiology (via an online survey). The data sources were characterized by accessibility, geographic granularity, setting, sector of the data, sources and type of the data. Descriptive analyses were performed. RESULTS: We identified 125 data sources for DUR in nine LatAm countries. Thirty-eight (30%) of them were publicly and conveniently available; 89 (71%) were accessible with limitations, and 18 (14%) were not accessible or lacked clear rules for data access. From the 125 data sources, 76 (61%) were from the public sector only; 46 (37%) were from pharmacy records; 43 (34%) came from ambulatory settings and; 85 (68%) gave access to individual patient-level data. CONCLUSIONS: Although multiple sources for DUR are available in LatAm countries, the accessibility is a major challenge. The procedures for accessing DUR data should be transparent, feasible, affordable, and protocol-driven. This inventory could permit a comparison of drug utilization between countries identifying potential medication-related problems that need further exploration.

Consumer attitudes to vertical farming (indoor plant factory with artificial lighting) in China, Singapore, UK, and USA: A multi-method study.

Major changes are needed both with regard to what we eat and how food is produced. The latter is the focus of the present research, specifically the rise of controlled environment agriculture. In this context, empirical research is presented on consumer attitudes to vertical farming (VF) (i.e., indoor plant factory with artificial lighting), conducted in four countries (USA, UK, Singapore, and China) using online surveys (637-683 participants per country with matched gender and age group distributions). A multi-method research approach was used, including a novel methodology of text highlighting, which requires that participants read a descriptive text about VF with mentions of pros and cons and use highlighter functions to select aspects of the text that they 'like' and 'dislike'. Based on the information provided in the text, attitudes towards VF were largely positive in the four countries. The characteristics of VF that aligned with the United Nations Sustainable Development Goals were identified as key drivers of positive attitudes (i.e., higher yield, reduction of carbon emissions, and securing access to food). On the other hand, high energy use and premium prices contributed to negative attitudes about VF. Although the majority of participants responded to the text with an overall positive attitude towards VF, there were smaller groups of participants in every country who expressed a negative or neutral/ambivalent attitude. These between-segment differences were larger than cross-cultural differences, although the latter did exist, particularly for selected aspects of VF. For example, Chinese participants tended to be the least negative about the use of robots to help planting and harvesting. Future research is needed to understand consumer responses to aspects VF not covered in the text (e.g., powering VF with renewable energy, product range), and consumer insights about VF should be sought in other countries.

The Current Situation Regarding Long-Acting Insulin Analogues Including Biosimilars Among African, Asian, European, and South American Countries; Findings and Implications for the Future.

Background: Diabetes mellitus rates continue to rise, which coupled with increasing costs of associated complications has appreciably increased global expenditure in recent years. The risk of complications are enhanced by poor glycaemic control including hypoglycaemia. Long-acting insulin analogues were developed to reduce hypoglycaemia and improve adherence. Their considerably higher costs though have impacted their funding and use. Biosimilars can help reduce medicine costs. However, their introduction has been affected by a number of factors. These include the originator company dropping its price as well as promoting patented higher strength 300 IU/ml insulin glargine. There can also be concerns with different devices between the manufacturers. Objective: To assess current utilisation rates for insulins, especially long-acting insulin analogues, and the rationale for patterns seen, across multiple countries to inform strategies to enhance future utilisation of long-acting insulin analogue biosimilars to benefit all key stakeholders. Our approach: Multiple approaches including assessing the utilisation, expenditure and prices of insulins, including biosimilar insulin glargine, across multiple continents and countries. Results: There was considerable variation in the use of long-acting insulin analogues as a percentage of all insulins prescribed and dispensed across countries and continents. This ranged from limited use of long-acting insulin analogues among African countries compared to routine funding and use across Europe in view of their perceived benefits. Increasing use was also seen among Asian countries including Bangladesh and India for similar reasons. However, concerns with costs and value limited their use across Africa, Brazil and Pakistan. There was though limited use of biosimilar insulin glargine 100 IU/ml compared with other recent biosimilars especially among European countries and Korea. This was principally driven by small price differences in reality between the originator and biosimilars coupled with increasing use of the patented 300 IU/ml formulation. A number of activities were identified to enhance future biosimilar use. These included only reimbursing biosimilar long-acting insulin analogues, introducing prescribing targets and increasing competition among manufacturers including stimulating local production. Conclusions: There are concerns with the availability and use of insulin glargine biosimilars despite lower costs. This can be addressed by multiple activities.

Retirement, Pensions, and Depressive Symptoms Among Older Adults in China, England, Mexico, and the United States.

This study explores the associations of retirement, and of public and private pensions, with older adults' depressive symptoms by comparing differences between countries and age groups. Harmonized data were analyzed from the family of Health and Retirement Study in 2012-2013 from China, England, Mexico, and the United States (n = 97,978). Respondents were asked if they were retired and received public or private pensions. Depressive symptom was measured by the Center for Epidemiologic Studies Depression Scale. Retirement was significantly associated with higher depressive symptoms for the United States and with lower depressive symptoms for Mexico and England. Public pension was significantly associated with lower depressive symptoms for Mexico and with higher depressive symptoms for the United States and China. Private pension was significantly associated with lower depressive symptoms for the United States, China, and England. Our study shows that continuity theory demonstrates cross-national variation in explaining the association between retirement and depressive symptoms.

Cross-national dataset from Chile, Spain, Venezuela and Colombia to analyze the meanings students attribute to the pedagogical authority of teachers.

The data displayed here were collected through a Likert scale that measures the meanings attributed to the pedagogical authority. The final sample comprised 913 teacher training university students from four Ibero-American countries (Chile, Spain, Colombia, and Venezuela). The value of the data relies, among others, on the possibility to analyse similarities and differences of those meanings among countries. This database allows for an increase of the sample, whether by applying the instrument to the same countries or to different ones. The main contributions of the article "Scale of Pedagogical Authority Meanings in the Classroom (ESAPA) for Ibero-America built on the opinions of teaching students" [1] belong to the psychometrics and education fields.

Body Image Quality of Life Inventory: cross-national study in college students from four different countries.

PURPOSE: This study was aimed to examine the psychometric proprieties of the Body Image Quality of Life Inventory (BIQLI) among Brazilian, Portuguese, Mozambican, and Italian college students. METHODS: A total of 1630 subjects (Brazilians = 446; Portuguese = 480, Mozambicans = 360, and Italians = 344) completed the Portuguese (Brazilian, Portuguese, and Mozambican students) and the Italian versions (Italian students) of the BIQLI for measuring the effects of body image on one's quality of life. Psychometric testing included confirmatory factor analysis (CFA), discriminant and convergent validity, internal consistency, and composite reliability. The cross-national invariance of the BIQLI was assessed by multi-group analysis using ΔCFI. Moreover, the global score of the BIQLI for all countries was calculated by an algorithm and compared using the Welch's ANOVA and the Games-Howell post-test (α = 5%). RESULTS: CFA showed an inadequate fit of unifactorial model of the BIQLI. Therefore, an alternative model comprising nine first-order factors and one second-order factor was proposed and evaluated. This new model showed adequate fit in all samples, despite some limitations that were found with respect to its convergent and discriminant validity. The alternative BIQLI model was invariant among countries. Global scores for the influence of body image on quality of life were significantly different across countries, with the Italians presenting the lowest scores. CONCLUSIONS: The BIQLI factorial model found in this study represents a reliable and valid alternative to its original structure for the assessment of the effect of body image on college students' perceived quality of life. This model must be further tested in other populations. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Cumulative Dis/Advantage and Health Pattern in Late Life: A Comparison between Genders and Welfare State Regimes.

This study provides a cross-national perspective to apply Cumulative Dis/Advantage (CDA) in explaining health inequality between developing and developed countries in the context of Welfare State Theory. Cross-sectional data from the international Health Retirement Study (United States, China, Mexico, and England) in 2013-2014 were used (n = 97,978). Four health indicators were included: self-reported health, depressive symptoms, functional ability, and memory. Regression models were fitted to examine the moderation roles of country and gender. Results indicated older Chinese and Mexican had poorer health status than their British and American counterparts consistently except for Mexicans' memory. Cumulative health gaps between developing and developed countries existed only for functional ability. There is no evidence of a widening gap in health status between genders in late life. CDA explains the increasing gaps of functional ability across age groups between countries. General health and mental health, may however, depend more on individuals' intrinsic capacity and human agency.

Examining regional variability in work ethic within Mexico: Individual difference or shared value.

Despite the acceptance of work ethic as an important individual difference, little research has examined the extent to which work ethic may reflect shared environmental or socio-economic factors. This research addresses this concern by examining the influence of geographic proximity on the work ethic experienced by 254 employees from Mexico, working in 11 different cities in the Northern, Central and Southern regions of the country. Using a sequence of complementary analyses to assess the main source of variance on seven dimensions of work ethic, our results indicate that work ethic is most appropriately considered at the individual level.

The social location of harm from others' drinking in 10 societies.

AIMS: Survey data from 10 diverse countries were used to analyse the social location of harms from others' drinking: which segments of the population are more likely to be adversely affected by such harm, and how does this differ between societies? METHODS: General-population surveys in Australia, Chile, India, Laos, New Zealand, Nigeria, Sri Lanka, Thailand, United States and Vietnam, with a primary focus on the social location of the harmed person by gender, age groups, rural/urban residence and drinking status. Harms from known drinkers were analysed separately from harms from strangers. RESULTS: In all sites, risky or moderate drinkers were more likely than abstainers to report harm from the drinking of known drinkers, with risky drinkers the most likely to report harm. This was also generally true for harm from strangers' drinking, although the patterns were more mixed in Vietnam and Thailand. Harm from strangers' drinking was more often reported by males, while gender disparity in harm from known drinkers varied between sites. Younger adults were more likely to experience harm both from known drinkers and from strangers in some, but not all, societies. Only a few sites showed significant urban/rural differences, with disparities varying in direction. In multivariate analyses, most relationships remained, although some were no longer significant. CONCLUSION: The social location of harms from others' drinking, whether known or a stranger, varies considerably between societies. One near-commonality among the societies is that those who are themselves risky drinkers are more likely to suffer harm from others' drinking.

Assessing cross-national invariance of the Community Assessment of Psychic Experiences (CAPE).

BACKGROUND: The Community Assessment of Psychic Experiences (CAPE) is a 42-item self-report questionnaire that has been developed and validated to measure the dimensions of psychosis in the general population. The CAPE has a three-factor structure with dimensions of positive, negative and depression. Assessing the cross-national equivalence of a questionnaire is an essential prerequisite before pooling data from different countries. In this study, our aim was to investigate the measurement invariance of the CAPE across different countries. METHODS: Data were drawn from the European Union Gene-Environment Interaction (EU-GEI) study. Participants (incident cases of psychotic disorder, controls and siblings of cases) were recruited in Brazil, France, Italy, the Netherlands, Spain and UK. To analyse the measurement invariance across these samples, we tested configural invariance (i.e. identical structures of the factors), metric invariance (i.e. equivalence of the factor loadings) and scalar invariance (i.e. equivalence of the thresholds) of the three CAPE dimensions using multigroup categorical confirmatory factor analysis methods. RESULTS: The configural invariance model fits well, providing evidence for identical factorial structure across countries. In comparison with the configural model invariance, the fit indices were very similar in the metric and scalar invariance models, indicating that factor loadings and thresholds did not differ across the six countries. CONCLUSION: We found that, across six countries, the CAPE showed equivalent factorial structure, factor loadings and thresholds. Thus, differences observed in scores between individuals from different countries should be considered as reflecting different levels of psychosis.

A Cross-National Comparison of Risk Factors for Teen Dating Violence in Mexico and the United States.

Involvement in dating violence has been linked with negative health outcomes including depressive symptomology, substance use, and later expressions of aggressing and victimizing behaviors. Less is known about the prevalence and mental health correlates of teen dating violence in countries like Mexico where adult partner violence is high. Additional research on teen dating violence is also needed, as it may be an important precursor to adult partner violence and linked to other mental health problems. The current study used self-report ratings to assess the similarities and differences in risk factors associated with dating violence among middle school students in Mexico and the United States. The US sample (Nus = 15,099; Mus = 12.8; 49.5% female) included non-Hispanic Caucasian (24.9%), Hispanic American (20.3%), and African American (24.2%) adolescents. The Mexican sample (NMexico = 2211; MMexico = 13.67; 51% female) included 93.1% adolescents of Hispanic or Latin descent. Logistic regressions showed that dating violence victimization was reported at similar rates in the cross-national samples, though exposure to risk factors like deviant peers and substance use differed significantly by country. Our analyses indicated that, although the country of residence was not significantly associated with dating violence victimization, the strength of the association between some known risk factors and dating violence victimization varied as a function of nationality, such that there was a significant interaction between country of residence, Mexico or the US, and experiencing internalizing symptoms on experiencing physical dating violence victimization. This study contributes to the growing body of literature on dating violence, both inside and outside the US.

Female undergraduate's perceptions of intrusive behavior in 12 countries.

The present study examines young women's (N = 1,734) perceptions of the unacceptability of 47 intrusive activities enacted by men. Female undergraduate psychology students from 12 countries (Armenia, Australia, England, Egypt, Finland, India, Indonesia, Italy, Japan, Portugal, Scotland, Trinidad) indicated which of 47 intrusive activities they considered to be unacceptable. Responses were compared with parasite-stress values, a measure of global gender equality and Hofstede's dimensions of national cultures. There was no unanimous agreement on any of the items, even for those relating to forced sexual violence. Cluster analysis yielded four clusters: "Aggression and surveillance" (most agreement that the constituent items were unacceptable), "Unwanted attention," "Persistent courtship and impositions," and "Courtship and information seeking" (least agreement that the constituent items were unacceptable). There were no significant relationships between the "Aggression and surveillance" or "Courtship and information seeking" clusters and the measure of gender equality, Hofstede's dimensions of national cultures or the measure of parasite stress. For the "Unwanted attention" and "Persistent courtship and impositions" clusters, women residing in countries with higher gender inequality and higher parasite-stress were less accepting of behavior associated with uncommitted sexual relations, and women in more individualistic societies with higher levels of gender equality were less accepting of monitoring activities. Culture may take precedence over personal interpretations of the unacceptability of intrusive behavior that is not obviously harmful or benign in nature.