Associations between stuttering avoidance and perceived patient-centeredness of health care interactions.

PURPOSE: To determine the relationships between (1) stuttering severity and (2) avoidance of speaking on patient centeredness of healthcare system interactions in a sample of persons who stutter. METHODS: This quantitative study utilized cross-sectional electronic surveys to assess the experiences of one-hundred-twenty-two adults who stutter in the United States with primary care physicians. The surveys evaluated: (1) self-reported stuttering severity and avoidance of speaking; and (2) self-reported patient-centeredness of healthcare interactions. We used multivariate linear regression to model relationships between independent and dependent variables, controlling for age, gender, patient-provider relationship duration, race/ethnicity, the presence of comorbid conditions, and household income. RESULTS: Patient self-reported avoidance of speaking was significantly negatively associated with self-reported patient-centeredness of healthcare interactions. Patient self-reported stuttering severity was not significantly associated with patient-centeredness. CONCLUSION: Our findings present evidence that internal non-observable behaviors among persons who stutter, such as avoiding speaking, are associated with negative impact on healthcare interactions. Speech-language pathologists may want to discuss healthcare challenges with their clients and elicit communication barriers to inspire positive interactions within the healthcare system.

Intersectionality Within Critical Autism Studies: A Narrative Review.

The aim of this narrative review was to examine intersectionality within critical autism studies. A growing body of evidence has demonstrated the importance of intersectional frameworks in highlighting the diverse experiences of marginalized communities. Many disability studies researchers investigated intersectionality to elucidate the impact of race, gender, sexuality, class, and other constructs on disability identification. Within critical autism studies, a field that emerged to challenge the deficit-laden, pathologizing autism discourses favored by the medical community, intersectionality has started to become an integral component of the literature. This review highlights intersectional frameworks utilized to explore autism in both academic and nonacademic contexts, to provide a foundation for future study. Upon analysis, we found overarching themes regarding the explicit, implicit, and descriptive approaches to intersectionality, racial and gender biases within critical autism studies, and the multidisciplinary nature of intersectionality and critical autism studies. We finish the review with recommendations for how to more fully address the experiences of all autistic people-particularly of racial, gender, and sexual minority individuals-in future study. Our recommendations include utilizing intersectionality as an analytical lens for describing previously overlooked phenomena and questioning central tenets of methodology and processes, including developing research questions, analyzing data, and writing results.

Why is this topic important?: Intersectionality means that many different social influences make up a person's experiences. Examples of these social influences are gender and sexism, ethnicity and racism, and disability and ableism. This topic is important because different autistic people may have different experiences depending on these other social factors. Studying intersectionality helps us to understand these differences and better serve those autistic communities that may be ignored. What is the purpose of this article?: We looked at how authors of published studies and community projects have thought about intersectionality in autistic communities. What personal or professional perspectives do the researchers bring to this topic?: Both authors have invisible disabilities. We have both done research on disability and social influences, and we have worked with people in disability communities, including autistic communities. We have also noticed how our gender, race, and sexual orientation have affected how we experience our disabilities. What results did the researchers find?: We found three main ways that authors talked about intersectionality. (1) Sometimes authors directly talk about intersectionality. This means that some authors use the idea of intersectionality to help them think of a research question or to help them understand their data. In these cases, authors use the word "intersectionality" in their articles. (2) Sometimes authors talk about intersectionality, but not directly. This means that some authors do not use the word "intersectionality" to talk about their research, but they still use similar ideas. For example, sometimes authors looked at what it is like to be an autistic woman. This topic is intersectional because it talks about two different social influences (autism and gender). However, the authors did not directly write that it was intersectional. (3) Finally, sometimes authors do not talk about intersectionality, but their study can be used as a starting point for talking about intersectionality later. For example, sometimes authors look at differences in whether people are diagnosed with autism, based on their race. Research such as this can be helpful because other researchers can use it to make studies to learn about why differences between autistic groups happen. What do the researchers recommend?: We recommend that researchers in many fields and people working with autistic communities think about how intersectionality and social influences affect autistic people. They can do this when thinking of research questions, understanding their data, and writing about their results. We also recommend that researchers think more about racial, gender, and sexual minority group experiences within the autistic community. This is important because sometimes researchers or stakeholders have forgotten about certain groups of autistic people. How will these recommendations help autistic adults now or in the future?: Thinking about intersectionality can help people understand autistic people's different experiences, especially in terms of how these experiences are affected by social influences. We hope that our article leads to research that makes life better for all autistic people and fits better for autistic people who have been ignored or forgotten about in some research or advocacy projects.

A pathogenic role for histone H3 copper reductase activity in a yeast model of Friedreich's ataxia.

Disruptions to iron-sulfur (Fe-S) clusters, essential cofactors for a broad range of proteins, cause widespread cellular defects resulting in human disease. A source of damage to Fe-S clusters is cuprous (Cu1+) ions. Since histone H3 enzymatically produces Cu1+ for copper-dependent functions, we asked whether this activity could become detrimental to Fe-S clusters. Here, we report that histone H3­mediated Cu1+ toxicity is a major determinant of cellular functional pool of Fe-S clusters. Inadequate Fe-S cluster supply, due to diminished assembly as occurs in Friedreich's ataxia or defective distribution, causes severe metabolic and growth defects in Saccharomyces cerevisiae. Decreasing Cu1+ abundance, through attenuation of histone cupric reductase activity or depletion of total cellular copper, restored Fe-S cluster­dependent metabolism and growth. Our findings reveal an interplay between chromatin and mitochondria in Fe-S cluster homeostasis and a potential pathogenic role for histone enzyme activity and Cu1+ in diseases with Fe-S cluster dysfunction.

The histone H3-H4 tetramer is a copper reductase enzyme.

Eukaryotic histone H3-H4 tetramers contain a putative copper (Cu2+) binding site at the H3-H3' dimerization interface with unknown function. The coincident emergence of eukaryotes with global oxygenation, which challenged cellular copper utilization, raised the possibility that histones may function in cellular copper homeostasis. We report that the recombinant Xenopus laevis H3-H4 tetramer is an oxidoreductase enzyme that binds Cu2+ and catalyzes its reduction to Cu1+ in vitro. Loss- and gain-of-function mutations of the putative active site residues correspondingly altered copper binding and the enzymatic activity, as well as intracellular Cu1+ abundance and copper-dependent mitochondrial respiration and Sod1 function in the yeast Saccharomyces cerevisiae The histone H3-H4 tetramer, therefore, has a role other than chromatin compaction or epigenetic regulation and generates biousable Cu1+ ions in eukaryotes.