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Hemophilia is an inherited x-linked recessive disorder. It is known popularly as "The Royal Disease," as it has affected many of the royal families of Europe by virtue of Queen Victoria being a carrier for the gene and, subsequently, passing it on to her offspring. They, in turn, married and had children with other royal families of Europe. Hemophilia is certainly not limited to royalty. There are many hemophiliacs living in our communities, and they must receive both proper dental home-care education and dental treatment in order to prevent possibly life-threatening emergency dental episodes. Individuals with hemophilia pose different management issues to the dental professional. The various precautions and modifications that must be taken in order to ensure the safe delivery of dental care to hemophiliac dental patients are discussed. [ABSTRACT FROM AUTHOR]

Personal exposure to environmental substances is largely determined by time–microenvironment–activity patterns while moving across locations or microenvironments. Therefore, time–microenvironment–activity data are particularly useful in modeling exposure. We investigated determinants of workday time–microenvironment–activity patterns of the adult urban population in seven European cities. The EXPOLIS study assessed workday time–microenvironment–activity patterns among a total of 1427 subjects (age 19–60 years) in Helsinki (Finland), Athens (Greece), Basel (Switzerland), Grenoble (France), Milan (Italy), Prague (Czech Republic), and Oxford (UK). Subjects completed time–microenvironment–activity diaries during two working days. We present time spent indoors — at home, at work, and elsewhere, and time exposed to tobacco smoke indoors for all cities. The contribution of sociodemographic factors has been assessed using regression models. More than 90% of the variance in indoor time–microenvironment–activity patterns originated from differences between and within subjects rather than between cities. The most common factors that were associated with indoor time–microenvironment–activity patterns, with similar contributions in all cities, were the specific work status, employment status, whether the participants were living alone, and whether the participants had children at home. Gender and season were associated with indoor time–microenvironment–activity patterns as well but the effects were rather heterogeneous across the seven cities. Exposure to second-hand tobacco smoke differed substantially across these cities. The heterogeneity of these factors across cities may reflect city-specific characteristics but selection biases in the sampled local populations may also explain part of the findings. Determinants of time–microenvironment–activity patterns need to be taken into account in exposure assessment, epidemiological analyses, exposure simulations, as well as in the development of preventive strategies that focus on time–microenvironment–activity patterns that ultimately determine exposures.Journal of Exposure Science and Environmental Epidemiology (2007) 17, 170–181. doi:10.1038/sj.jes.7500490; published online 17 May 2006 [ABSTRACT FROM AUTHOR]

Context: Recommendations regarding the management of penile size abnormalities and dysmorphophobia are important in guiding evidence-based clinical practice., Objective: To present a summary of the 2023 European Association of Urology sexual and reproductive health evidence-based recommendations for the management of penile size abnormalities and dysmorphophobia., Evidence Acquisition: A broad and comprehensive scoping exercise covering all areas of the guidelines was performed. Databases searched included Medline, EMBASE, and the Cochrane Libraries. A level of evidence and a strength of recommendation were assigned for each recommendation according to the evidence identified. The evidence cutoff date for the 2023 guidelines is June 1, 2022., Evidence Synthesis: Well-structured studies reporting high level of evidence, with standardized PROMS were deficient on penile size abnormalities and dysmorphohobia. A shared definition for short penis/micropenis was also lacking. Categorisation of penile abnormalities according to congenital, acquired, and dysmorphophobic aetiology is deemed compulsory. A detailed medical and psychosexual history and precise measurements of penile size are essential in the diagnostic pathway. Patients with normal penile size who are seeking penile augmentation should be referred for psychological evaluation for potential dysmorphophobic disorders. Penile length and girth enhancements can be achieved via a multitude of treatments, but a personalised management plan is crucial for satisfactory results. Endocrinological therapies, when indicated, are effective in the prepubertal setting only. Vacuum therapy has a limited evidence base in treatment protocols, although acceptable outcomes have been reported for penile traction therapy. Surgical techniques to enhance penile length and girth have limited evidence and should only be proposed after extensive patient counselling., Conclusions: Management of penile abnormalities and dysmorphophobia is a complex issue with considerable ethical concerns. The adoption of a structured diagnostic and therapeutic pathway is crucial, as recommended in the guidelines., Patient Summary: Requests for medical/surgical treatments to increase penis size have increased dramatically worldwide. Several conservative and surgical treatments are available. However, few patients receive clear information on the benefits and possible harms of these treatments. These guidelines aim to provide a structured path to guide both physicians and patients in the selection of appropriate treatment(s) to increase penis size., (Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

The aim of this study was to investigate the measurement invariance of the Burnout Assessment Tool (BAT) across seven cross-national representative samples. In this study, burnout was modeled as a second-order factor in line with the conceptual definition as a syndrome. The combined sample consisted of 10,138 participants from countries in Europe and Japan. The data were treated as ordered categorical in nature and a series of models were tested to find evidence for invariance. Specifically, theta parameterization was used in conjunction with the weighted least squares (mean- and variance adjusted) estimation method. The results showed supportive evidence that BAT-assessed burnout was invariant across the samples, so that cross-country comparison would be justifiable. Comparison of effect sizes of the latent means between countries showed that Japan had a significantly higher score on overall burnout and all the first-order factors compared to the European countries. The European countries all scored similarly on overall burnout with no significant difference but for some minor differences in first-order factors between some of the European countries. All in all, the analyses of the data provided evidence that the BAT is invariant across the countries for meaningful comparisons of burnout scores.

The relationship between language and thought is controversial. One hypothesis is that language fosters habits of processing information that are retained even in non-linguistic domains. In left-branching (LB) languages, modifiers usually precede the head, and real-time sentence comprehension may more heavily rely on retaining initial information in working memory. Here we presented a battery of working memory and short-term memory tasks to adult native speakers of four LB and four right-branching (RB) languages from Africa, Asia and Europe. In working memory tasks, LB speakers were better than RB speakers at recalling initial stimuli, but worse at recalling final stimuli. Our results show that the practice of parsing sentences in specific directions due to the syntax and word order of our native language not only predicts the way we remember words, but also other non-linguistic stimuli.

Background: Monitoring obesity and overweight prevalence is important for assessing interventions aimed at preventing or reducing the burden of obesity. This study aimed to provide current data regarding the prevalence of overweight and obesity of adults, from 20 European countries., Methods: Participants were 34 814 (16 482 men) adults with mean age 50.8 ± 17.7. Data from European Social Survey round 7, 2014, were analysed. Body mass index (BMI) was calculated from self-reported height and weight., Results: The proportion of underweight was only 2%, and 44.9% for normal weight. Overweight and obese accounted for 53.1%. More men than women were overweight (44.7% vs. 30.5%). Older adults were significantly more overweight (42.4%) and obese (20.9%) than middle age and younger adults. Retired people account for a greater proportion of overweight (42.0%) and obese (21.5%), when compared with employed, unemployed and students. People from rural areas were significantly more overweight (39.1 vs. 36.1%) and obese (17.0 vs. 15.3%) than those who lived in urban areas. The estimates indicate that the highest prevalence of overweight was in Czech Republic (45.2%), Hungary (43.7%) and Lithuania (41.7%). For obesity, Slovenia (20.8%), Estonia (19.7%) and the United Kingdom (19.2%) were the countries with the highest prevalence., Conclusion: Even though data was self-reported, and individuals tend to overestimate their height and underestimate their weight, the prevalence of overweight and obesity is considered high. More than half of the European population is overweight and obese. This study strengthens and updates the claims of an excessive weight epidemic in Europe.