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As early as Aristotle's Problem XXX , intellectual superiority has been linked to melancholy. The association between sickness and genius continued to be a topic for discussion in the work of early modern writers, most recognizably in Robert Burton's The Anatomy of Melancholy . But it was not until the eighteenth century that the phenomenon known as the \"suffering scholar\" reached its apotheosis, a phenomenon illustrated by the popularity of works such as Samuel-Auguste Tissot's De la santé des gens de lettres , first published in 1768. Though hardly limited to French-speaking Europe, the link between mental endeavor and physical disorder was embraced with particular vigor there, as was the tendency to imbue intellectuals with an aura of otherness and detachment from the world. Intellectuals and artists were portrayed as peculiarly susceptible to altered states of health as well as psyche-the combination of mental intensity and somatic frailty proved both the privileges and the perils of knowledge-seeking and creative endeavor. In Suffering Scholars , Anne C. Vila focuses on the medical and literary dimensions of the cult of celebrity that developed around great intellectuals during the French Enlightenment. Beginning with Tissot's work, which launched a subgenre of health advice aimed specifically at scholars, she demonstrates how writers like Voltaire, Diderot, Rousseau, and Mme de Staël, responded to the \"suffering scholar\" syndrome and helped to shape it. She traces the ways in which this syndrome influenced the cultural perceptions of iconic personae such as the philosophe , the solitary genius, and the learned lady. By showing how crucial the so-called suffering scholar was to debates about the mind-body relation as well as to sex and sensibility, Vila sheds light on the consequences book-learning was thought to have on both the individual body and the body politic, not only in the eighteenth century but also into the decades following the Revolution.

A partir de algunos escritos médicos colombianos sobre higiene escolar de finales del siglo XIX y las dos primeras décadas del siglo XX, se estudia la \"higiene intelectual\" como condición de posibilidad para la definición de la anormalidad infantil y la psiquiatrización de la infancia. La fatiga intelectual o surmenage y el instinto sexual son dos elementos importantes para comprender de qué manera en el ámbito más general de la higiene escolar, los médicos higienistas explican las relaciones entre lo mental y lo físico. Los estudios sobre higiene intelectual inauguran un nuevo campo de intervención médica, el espacio escolar, así como un nuevo objeto de análisis: el niño en edad escolar.

Objective Congenital hypothyroidism (CHT) is a common cause of preventable mental retardation, and the quantification of intellectual disability due to CHT is needed to assess the public health benefit of newborn screening. Design Review of published studies conducted among children born prior to the introduction of newborn screening for CHT and reporting cognitive test scores. Setting Population-based studies. Patients Children with clinically diagnosed CHT. Interventions Thyroid hormone substitution. Main outcome measures Intelligence quotient (IQ) (mean and distribution). Results The prevalence of recognised CHT rose from one in 6500 prior to screening to approximately one in 3000 with screening. In four population-based studies in high-income countries, among children with clinically diagnosed CHT 8–28% were classified as having intellectual disability (defined as an IQ <70) and the mean IQ was 85 (a leftward shift of 1 SD). Among children with subclinical CHT, the risk of overt intellectual disability was lower (zero in one study), but decreased intellectual potential and increased behavioural abnormalities were documented. Conclusions Although the prevalence of overt disability among children with CHT in the absence of screening may be less than previously estimated, the preventable burden of intellectual disability due to CHT is substantial and justifies newborn screening. However, changes in existing newborn screening protocols to capture more cases are unlikely to prevent overt cases of disability and should therefore be justified instead by the documentation of other benefits of early detection.

Objective Advances in mobile technology are helping with health management practices, and smart toothbrushes provide proper dental care by collecting and analyzing users’ toothbrushing data. The purpose of this study is to assess the effect of a telemonitoring device on oral hygiene management in individuals with intellectual or developmental disabilities and its role in promoting oral health. Materials and methods Participants were split into two groups: one initially using the telemonitoring device (telemonitoring device/manual toothbrush) and the other using it later (manual toothbrush/telemonitoring device), with a one-month washout period. The study compared plaque index, halitosis, changes in oral microbiota, and guardian questionnaire responses between the groups. Results In period 1, the QHI index score significantly decreased from 1.93 to 0.83 in the group using the remote monitoring device, compared to an increase from 1.75 to 2.01 in the manual toothbrush group. Additionally, toothbrushing frequency, time, and cooperation increased by 0.82 ± 0.60, 0.82 ± 1.16, and 1.09 ± 0.94, respectively, with initial telemonitoring device use. However, these measures decreased by -1.45 ± 0.68, -1.09 ± 0.70, and − 1.00 ± 1.00 after switching to a manual toothbrush, and decreased by -0.64 ± 0.67, -0.27 ± 1.19, and 0.09 ± 0.94 overall, respectively. However, there were no significant differences in oral microbiota between the groups at these different time points. Conclusions The study shows that telemonitoring devices effectively reduce plaque index and improve toothbrushing frequency, time, and cooperation. However, these benefits decrease after switching to a manual toothbrush. Follow-up is needed to assess satisfaction and compliance with telemonitoring device use. Clinical relevance Using telemonitoring devices in the oral health management of individuals with intellectual and developmental disabilities can improve their oral health quality.

Although caring for a child with intellectual and developmental disabilities (IDD) can have positive outcomes, parents may be at a greater risk of depression and anxiety, due to a number of associated stressors, such as increased caregiver demands and financial strain. This systematic review updates previous data, exploring the relationship between parenting a child with IDD and parental depression and anxiety. Five electronic databases were searched for eligible English-language articles, published between January 2004 and July 2018. All epidemiological study designs were eligible, provided the level of depression and/or anxiety was compared between parents of children (aged <18) with and without IDD. No limit was placed on geographic location. The proportion of positive associations between parenting a child with IDD and depression/anxiety were disaggregated by disability type, geographic region, and sample size. The percentage of parents at risk of moderate depression or anxiety were calculated using recognised clinical cut-off scores for each screening tool. Meta-analyses, in which pooled effect sizes of elevated depression and anxiety symptoms were calculated, were conducted across two IDD conditions, autism and cerebral palsy. Of the 5,839 unique records screened, 19 studies fulfilled the inclusion criteria. The majority of studies were conducted in high-income (n = 8, 42%) or upper-middle income countries (n = 10, 53%). Of the 19 studies, 69% focused on parents of children with cerebral palsy (n = 7, 37%) or autism (n = 6, 32%). Nearly all studies found a positive association between parenting a child with IDD and depression (n = 18, 95%) and anxiety (n = 9, 90%) symptoms. Factors associated with higher levels of depression symptoms amongst parents of children with IDD included disability severity (n = 8, 78%) and lower household income (n = 4, 80%). Approximately one third (31%) of parents of children with IDD reach the clinical cut-off score for moderate depression, compared with 7% of parents of children without IDD. 31% of parents of children with IDD reach the cut-off score for moderate anxiety, compared with 14% of parents of children without IDD. The meta-analyses demonstrated moderate effect sizes for elevated depression amongst parents of children with autism and cerebral palsy. Results indicate elevated levels of depressive symptoms amongst parents of children with IDD. Quality concerns amongst the existing literature support the need for further research, especially in low- and middle-income countries.

Background: Manganese is an essential nutrient, but in excess it can be a potent neurotoxicant. Despite the common occurrence of manganese in groundwater, the risks associated with this source of exposure are largely unknown. Objectives: Our first aim was to assess the relations between exposure to manganese from drinking water and children's intelligence quotient (IQ). Second, we examined the relations between manganese exposures from water consumption and from the diet with children's hair manganese concentration. Methods: This cross-sectional study included 362 children 6—13 years of age living in communities supplied by groundwater. Manganese concentration was measured in home tap water (MnW) and children's hair (MnH). We estimated manganese intake from water ingestion and the diet using a food frequency questionnaire and assessed IQ with the Wechsler Abbreviated Scale of Intelligence. Results: The median MnW in children's home tap water was 34 µg/L (range, 1-2,700 µg/L). MnH increased with manganese intake from water consumption, but not with dietary manganese intake. Higher MnW and MnH were significantly associated with lower IQ scores. A 10-fold increase in MnW was associated with a decrease of 2.4 IQ points (95% confidence interval: — 3.9 to -0.9; p < 0.01), adjusting for maternal intelligence, family income, and other potential confounders. There was a 6.2-point difference in IQ between children in the lowest and highest MnW quintiles. MnW was more strongly associated with Performance IQ than Verbal IQ. Conclusions: The findings of this cross-sectional study suggest that exposure to manganese at levels common in groundwater is associated with intellectual impairment in children.

The present study aimed to evaluate longitudinally the oral conditions of athletes with intellectual disabilities who participated in at least 2 Italian editions of Special Olympics with a minimum follow-up of 5 (to 10) years. Data concerning home oral hygiene, oral signs and symptoms were recorded, and oral hygiene instructions were provided. The data of the first timepoint (t0) were compared with those from the second one (t1). Out of 2081 visits, 114 athletes met the inclusion criteria (mean age 26.8 years at t0 and 33.4 at t1). Toothbrushing once or more a day was reported by 83.3% of the sample at t0 and 95.6% at t1 ( p  < 0.05), while gingival signs in 47.5% at t0 and 52.5% at t1, respectively. The % of subjects with decayed, missing, filled and sealed teeth increased between t0 and t1. Oral lesions were observed more frequently at t1 ( p  < 0.05). A significant difference emerged for the mean missing (1.7 at t0 vs. 2.9 at t1) and filled teeth (2.9 at t0 vs. 3.7 at t1) values and DMFT index (5.7 at t0 vs. 7.6 at t1). A substantial stability/improvement concerning some indicators of general, oral, and dental health was observed in the studied population.

Background High prevalence of sleep problems have been reported in children with Autism Spectrum Disorder (ASD). This study aims to investigate the sleep conditions of ASD children in China, and explore the relationship between the common sleep problems and core symptoms and developmental levels. Methods Using a cross-sectional design, we included 2 to 7-year-old children from 13 cities in China: 1310 with ASD and 1158 with typically-developing (TD) children. The neurodevelopmental level was evaluated with the revised Children Neuropsychological and Behavior Scale (CNBS-R2016). ASD were diagnosed with DSM-5 and Child Autism Rating Scale (CARS). the Social Responsiveness Scale (SRS), the Autism Behavior Checklist (ABC) and the communication warning behavior sub-scale in CNBS-R2016 valued autism behaviors. The children’ s sleep habits questionnaire (CSHQ) assessed sleep conditions. Results The prevalence of sleep disorders in ASD children was significantly higher than that in TD (67.4% vs. 51%, p  < 0.01), and among them the four dimensions with the highest prevalence of sleep problems were bedtime resistance (25.6%), sleep anxiety (22.7%), sleep onset delay (17.9%) and daytime sleepiness (14.7%). ASD children with sleep onset delay or sleep anxiety had higher ABC, SRS scores and higher scores on communication warning behavior with sleep anxiety, with daytime sleepiness had higher ABC, SRS and CARS scores, and with bedtime resistance had higher SRS total scores. Differences in the neurodevelopmental level were not significant. Conclusion Children with ASD have a higher prevalence of sleep problems. Bedtime resistance, anxiety, sleep onset delay and daytime sleepiness may be related to the core symptoms, but not be related to the developmental level in ASD children. In the clinic, sleep assessment should be included in the routine of ASD visits, and during the intervention, sleep hygiene education is as important as the treatment of biological factors. Trial registration The study was approved by the ethics committee of the Children’s Hospital of Chongqing Medical University, Approval Number: (2018) IRB (STUDY) NO. 121, and registered in the Chinese Clinical Trial Registry (Registration number: ChiCTR2000031194 ).

Aim The aim of this study was to analyze the interrelationships between oral health status and dental visits among athletes participating in the Special Olympics World Games Berlin, Germany 2023. Methods This cross-sectional study was conducted within the framework of the Healthy Athletes Program at the Special Olympics World Games Berlin 2023, where 2109 athletes with intellectual disabilities (ID) from all over the world participated in voluntary oral health screenings. Data were collected through interviews and clinical oral examinations, following a standardized protocol. Statistical analyses included descriptive statistics, logistic regression models, and chi-square tests to assess regional disparities, with significance set at p  < 0.05. Results From a total of 7500 athletes that participated during the Special Olympics World Games 2109 athletes (28.1%) with intellectual disabilities from 152 countries participated in the oral health screening at the Special Olympics World Games Berlin 2023. Untreated caries were present in 40.6% of the athletes ( n  = 856). If the dentist was visited at least once a year neither the occurrence of untreated carious lesions (OR 1.02; p  = 0.868) nor the rate of untreated lesions (OR 1.10, p-value 0.630), the number of missing teeth (OR 0.65) or gingivitis (OR 1.076) was significantly reduced. Conclusion /clinical relevance This study highlights an overall insufficient oral health status in athletes with ID. Even those who visited a dentist within the last year, treatment needs were not reduced significantly. More efforts compensating reduced oral hygiene capabilities and optimizing a barrier-free provision of dental care are needed.

Background Studies show that different socio-economic and structural factors can limit access to healthcare for women with disabilities. The aim of the current study was to review barriers in access to healthcare services for women with disabilities (WWD) internationally. Methods We conducted a systematic review of relevant qualitative articles in PubMed, Web of Science and Scopus databases from January 2009 to December 2017. The search strategy was based on two main topics: (1) access to healthcare; and (2) disability. In this review, women (older than 18) with different kinds of disabilities (physical, sensory and intellectual disabilities) were included. Studies were excluded if they were not peer-reviewed, and had a focus on men with disabilities. Results Twenty four articles met the inclusion criteria for the final review. In each study, participants noted various barriers to accessing healthcare. Findings revealed that WWD faced different sociocultural (erroneous assumptions, negative attitudes, being ignored, being judged, violence, abuse, insult, impoliteness, and low health literacy), financial (poverty, unemployment, high transportation costs) and structural (lack of insurance coverage, inaccessible equipment and transportation facilities, lack of knowledge, lack of information, lack of transparency, and communicative problems) factors which impacted their access healthcare. Conclusions Healthcare systems need to train the healthcare workforce to respect WWD, pay attention to their preferences and choices, provide non-discriminatory and respectful treatment, and address stigmatizing attitudinal towards WWD. In addition, families and communities need to participate in advocacy efforts to promote WWD’s access to health care.