Family Perspectives on the Complexities of Pursuing Integrated Employment for Adults With Intellectual and Developmental Disabilities.

The road to employment is not often easy for individuals with intellectual and developmental disabilities (IDD). Families know firsthand the complexities and challenges of obtaining employment for their members with extensive support needs. The purpose of this qualitative study was to identify the critical barriers they encounter in this important pursuit. We interviewed 60 parents (and other caregivers) whose family members with intellectual disability and/or autism had sought and/or obtained paid work. The difficulties they described were extensive and multifaceted. Specifically, participants identified 64 different barriers attributed to six primary areas: individuals, families, schools, service systems, workplaces, and communities. Their unique insights amplify the need for new approaches for promoting integrated employment. We offer recommendations for research and practice aimed at better understanding and ameliorating barriers to meaningful work for adults with IDD.

"More Than a Paycheck": Parent Perspectives on Meaningful Work for Individuals With Intellectual and Developmental Disabilities.

Increasing employment outcomes for individuals with intellectual and developmental disabilities (IDD) remains an enduring emphasis of research, policy, and practice. Parents are often primary partners in the pursuit of meaningful work for their family members with IDD. This qualitative study examined the views of 55 parents regarding the importance of this pursuit and the features of employment that matter most to them. Participants discussed a range of reasons they valued employment for their family members with IDD, including factors that extended beyond a paycheck. Likewise, they described an array of features that they considered to be important to their family member thriving in the workplace (e.g., inclusivity, match with interests, opportunities for growth). We offer recommendations for promoting integrated employment among families and conceptualizing employment outcomes within future research.

Romantic Relationships and Adults with IDD in Inclusive Supported Living: Considerations, Complexities, and Opportunities.

The love and companionship provided from romantic relationships is a right for all adults, yet many adults with intellectual and developmental disabilities (IDD) have been unable to experience these forms of relationship. This study investigates the experiences and perspectives on romantic relationships regarding adults with IDD involved in an inclusive supported living program. We asked residents with IDD, their parents, graduate student residents (without disabilities), and organization staff for their insights into the romantic relationships of adults with IDD and how the organization could better support those relationships. The residents with IDD described romantic relationships in various ways, but all emphasized their importance. Participants discussed an array of challenges in this area, including difficulty meeting people to date, challenges with social skills, and a lack of comprehensive sexual education. Likewise, the study noted a number of tensions that arise when supporting adults with IDD to pursue romantic relationships, including their comfort addressing this area, navigating dignity of risk, and acceptance from family members. The residents, parents, and staff members also provided helpful recommendations for how supported living organizations can most effectively support individuals with IDD in romantic relationships.

Promoting System Thinking and Professionalism Through Simulated Hospital Experiences for Nursing and Clinical Laboratory Science Students.

ABSTRACT: A simulation laboratory was developed for prelicensure nursing and undergraduate clinical laboratory science students using scripted patient cases with laboratory test results. The experience was guided by TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety). Participants ( n = 66) completed the modified Interprofessional Professionalism Assessment pre- and postsimulation. Journal reflections provided qualitative data. All aspects of interprofessional professionalism increased after the simulation; the most significant gain was confidence in working with other health care professionals. Analysis of journal themes indicated the students perceived increased communication and collaboration skills concerning patient care and safety.

Addressing Accessibility Within the Church: Perspectives of People with Disabilities.

People with disabilities often lack full access to corporate worship and participation in their faith communities. Yet many church leaders experience uncertainty about the steps they should take to remove barriers and widen the welcome for members of their community who are impacted by disability. This study examined the recommendations of people with disabilities regarding how churches should pursue greater accessibility. We interviewed 37 Christians who were members of a local church in Tennessee and who experienced various disabilities (i.e., visual impairments, intellectual disability, autism, physical disabilities, hearing impairments). Their guidance coalesced around nine primary actions: advocating, reflecting, asking, researching, equipping, embracing, proacting, including, and praying. We address key implications for churches striving to be inclusive of people with and without disabilities, as well as offer recommendations for future research.

Peptide Triazole Inhibitors of HIV-1: Hijackers of Env Metastability.

With 1.5 million new infections and 690,000 AIDS-related deaths globally each year, HIV- 1 remains a pathogen of significant public health concern. Although a wide array of effective antiretroviral drugs have been discovered, these largely target intracellular stages of the viral infectious cycle, and inhibitors that act at or before the point of viral entry still require further advancement. A unique class of HIV-1 entry inhibitors, called peptide triazoles (PTs), has been developed, which irreversibly inactivates Env trimers by exploiting the protein structure's innate metastable nature. PTs, and a related group of inhibitors called peptide triazole thiols (PTTs), are peptide compounds that dually engage the CD4 receptor and coreceptor binding sites of Env's gp120 subunit. This triggers dramatic conformational rearrangements of Env, including the shedding of gp120 (PTs and PTTs) and lytic transformation of the gp41 subunit to a post-fusion-like arrangement (PTTs). Due to the nature of their dual receptor site engagement, PT/PTT-induced conformational changes may elucidate mechanisms behind the native fusion program of Env trimers following receptor and coreceptor engagement, including the role of thiols in fusion. In addition to inactivating Env, PTT-induced structural transformation enhances the exposure of important and conserved neutralizable regions of gp41, such as the membrane proximal external region (MPER). PTT-transformed Env could present an intriguing potential vaccine immunogen prototype. In this review, we discuss the origins of the PT class of peptide inhibitors, our current understanding of PT/PTT-induced structural perturbations and viral inhibition, and prospects for using these antagonists for investigating Env structural mechanisms and for vaccine development.

Scaling Up a Peer-Mediated Program Statewide: Lessons Learned Through Peer to Peer.

Peer-mediated interventions are a powerful and practical way of promoting the social relationships, learning, and inclusion of students with disabilities. In this article, we describe one state's efforts to scale up a research-based, peer-mediated program called Peer to Peer throughout Michigan. Among the more than 700 schools that now offer this program, as many as 18,000 peers are involved in supporting nearly 5,000 schoolmates with autism and other developmental disabilities in their learning and relationships. We share our perspectives on eight key factors that have contributed to the growth and widespread adoption of Peer to Peer over the last 20 years. We discuss enduring challenges in this long-haul work and conclude with recommendations for future research focused on schoolwide peer-mediated programs.

When Holistic Admissions Review Is Not Enough: Barriers to Diversity.

BACKGROUND: Patient populations are increasingly diverse; however, the health care workforce often fails to reflect the diversity of the populations it serves. Holistic admission review (HAR) has been proposed as a strategy to diversify the student body and create a more diverse workforce. METHOD: This article describes the development, application, and evaluation of a holistic admissions process for freshman undergraduates admitted directly to a College of Nursing located in a nonaffirmative action state. RESULTS: There was an increase in the diversity of applicants; however, the selected metric of SAT (Scholastic Aptitude Test)/ACT (American College Test) scores resulted in a decrease in the number of qualified applicants. This decrease disproportionately affected underrepresented students, illustrating that the inability to consider race, ethnicity, or gender continues to restrict the admission of a diverse student body even with HAR. CONCLUSION: Our findings highlight the need to consider all aspects of HAR, particularly the effect of the chosen metrics on the applicant pool. [J Nurs Educ. 2022;61(7):375-382.].

Community conversations on independent living: understanding the perspectives and support needs of persons with disabilities living in the southeast United States.

PURPOSE: The pursuit of independent living outcomes has been a longstanding emphasis of disability policy, practice, and research. Yet the ways in which the experience of independent living is understood and advanced locally warrants more focused attention. This article describes a collaboration among a regional Center for Independent Living (CIL) and university researchers focused on developing more informed programs and supports to promote independent living for persons with disabilities in their service area. METHOD: A total of 75 adults with disabilities attended four "community conversations" during which they provided diverse definitions of independent living and shared a wide range of supports they needed and currently accessed to meet their independent living goals. RESULTS: Attendee conversations generated 14 unique dimensions of independent living and 11 categories of independent living supports. Findings align with existing research asserting independent living as a multifaceted construct and extend the literature to include perspectives across a wider range of disability categories. CONCLUSION: This study suggests that collaborations among Centers for Independent Living and researchers can be a fruitful context for conducting "needs assessments" and soliciting the perspectives of individuals with disabilities on (a) how they conceptualize independent living and (b) the local services and supports they need to attain their independent living goals.IMPLICATIONS FOR REHABILITATIONCommunity conversations are an efficient and engaging way of soliciting the perspectives of community members with a variety of disabilities.Establishing a planning team fluent in universal design, accessibility options, and local needs is critical to implementing effective community conversations.For Centers for Independent Living (CILs), community conversations offer a valuable approach for obtaining substantive stakeholder input to inform strategic planning.CILS could play an active role in equipping transition-age students with the skills, knowledge, relationships, and linkages needed to attain their independent living goals in early adulthood.

Friendships Through Inclusive Postsecondary Education Programs: Perspectives of Current and Former Students With Intellectual and Developmental Disabilities.

The formation of friendships is central to the college experience. Yet little is known about the relationships young adults with intellectual and developmental disabilities form through their inclusive postsecondary education programs or maintain after graduation. We interviewed 12 current students and alumni about their social networks and their views regarding friendships. Participants shared their perspectives on the multiple meaning of friendship, the size and composition of their social networks, and the areas in which college has positively impacted their social lives. We offer recommendations for research and practice aimed at understanding and enhancing friendship formation within the inclusive higher education movement.

Peptide Triazole Thiol Irreversibly Inactivates Metastable HIV-1 Env by Accessing Conformational Triggers Intrinsic to Virus-Cell Entry.

KR13, a peptide triazole thiol previously established to inhibit HIV-1 infection and cause virus lysis, was evaluated by flow cytometry against JRFL Env-presenting cells to characterize induced Env and membrane transformations leading to irreversible inactivation. Transiently transfected HEK293T cells were preloaded with calcein dye, treated with KR13 or its thiol-blocked analogue KR13b, fixed, and stained for gp120 (35O22), MPER (10E8), 6-helix-bundle (NC-1), immunodominant loop (50-69), and fusion peptide (VRC34.01). KR13 induced dose-dependent transformations of Env and membrane characterized by transient poration, MPER exposure, and 6-helix-bundle formation (analogous to native fusion events), but also reduced immunodominant loop and fusion peptide exposure. Using a fusion peptide mutant (V504E), we found that KR13 transformation does not require functional fusion peptide for poration. In contrast, simultaneous treatment with fusion inhibitor T20 alongside KR13 prevented membrane poration and MPER exposure, showing that these events require 6-helix-bundle formation. Based on these results, we formulated a model for PTT-induced Env transformation portraying how, in the absence of CD4/co-receptor signaling, PTT may provide alternate means of perturbing the metastable Env-membrane complex, and inducing fusion-like transformation. In turn, the results show that such transformations are intrinsic to Env and can be diverted for irreversible inactivation of the protein complex.

The Case for S2: The Potential Benefits of the S2 Subunit of the SARS-CoV-2 Spike Protein as an Immunogen in Fighting the COVID-19 Pandemic.

As COVID-19 cases continue to rise, it is imperative to learn more about antibodies and T-cells produced against the causative virus, SARS-CoV-2, in order to guide the rapid development of therapies and vaccines. While much of the current antibody and vaccine research focuses on the receptor-binding domain of S1, a less-recognized opportunity is to harness the potential benefits of the more conserved S2 subunit. Similarities between the spike proteins of both SARS-CoV-2 and HIV-1 warrant exploring S2. Possible benefits of employing S2 in therapies and vaccines include the structural conservation of S2, extant cross-reactive neutralizing antibodies in populations (due to prior exposure to common cold coronaviruses), the steric neutralization potential of antibodies against S2, and the stronger memory B-cell and T-cell responses. More research is necessary on the effect of glycans on the accessibility and stability of S2, SARS-CoV-2 mutants that may affect infectivity, the neutralization potential of antibodies produced by memory B-cells, cross-reactive T-cell responses, antibody-dependent enhancement, and antigen competition. This perspective aims to highlight the evidence for the potential advantages of using S2 as a target of therapy or vaccine design.

Configurable Digital Virus Counter on Robust Universal DNA Chips.

Here, we demonstrate real-time multiplexed virus detection by applying a DNA-directed antibody immobilization technique in a single-particle interferometric reflectance imaging sensor (SP-IRIS). In this technique, the biosensor chip surface spotted with different DNA sequences is converted to a multiplexed antibody array by flowing antibody-DNA conjugates and allowing for specific DNA-DNA hybridization. The resulting antibody array is shown to detect three different recombinant vesicular stomatitis viruses (rVSVs), which are genetically engineered to express surface glycoproteins of Ebola, Marburg, and Lassa viruses in real time in a disposable microfluidic cartridge. We also show that this method can be modified to produce a single-step, homogeneous assay format by mixing the antibody-DNA conjugates with the virus sample in the solution phase prior to incubation in the microfluidic cartridge, eliminating the antibody immobilization step. This homogenous approach achieved detection of the model Ebola virus, rVSV-EBOV, at a concentration of 100 PFU/mL in 1 h. Finally, we demonstrate the feasibility of this homogeneous technique as a rapid test using a passive microfluidic cartridge. A concentration of 104 PFU/mL was detectable under 10 min for the rVSV-Ebola virus. Utilizing DNA microarrays for antibody-based diagnostics is an alternative approach to antibody microarrays and offers advantages such as configurable sensor surface, long-term storage ability, and decreased antibody use. We believe that these properties will make SP-IRIS a versatile and robust platform for point-of-care diagnostics applications.

T cells in the brain enhance neonatal mortality during peripheral LCMV infection.

In adult mice the severity of disease from viral infections is determined by the balance between the efficiency of the immune response and the magnitude of viral load. Here, the impact of this dynamic is examined in neonates. Newborns are highly susceptible to infections due to poor innate responses, lower numbers of T cells and Th2-prone immune responses. Eighty-percent of 7-day old mice, immunologically equivalent to human neonates, succumbed to extremely low doses (5 PFU) of the essentially non-lethal lymphocytic choriomeningitis virus (LCMV-Armstrong) given intraperitoneally. This increased lethality was determined to be dependent upon poor early viral control, as well as, T cells and perforin as assessed in knockout mice. By day 3, these neonatal mice had 400-fold higher viral loads as compared to adults receiving a 10,000-fold (5X104 PFU) higher dose of LCMV. The high viral load in combination with the subsequent immunological defect of partial CD8 T cell clonal exhaustion in the periphery led to viral entry and replication in the brain. Within the brain, CD8 T cells were protected from exhaustion, and thus were able to mediate lethal immunopathology. To further delineate the role of early viral control, neonatal mice were infected with Pichinde virus, a less virulent arenavirus, or LCMV was given to pups of LCMV-immune mothers. In both cases, peak viral load was at least 29-fold lower, leading to functional CD8 T cell responses and 100% survival.

Examining Growth Among College Students With Intellectual and Developmental Disability: A Longitudinal Study.

Inclusive postsecondary education programs for adults with intellectual and developmental disabilities (IDD) are proliferating across the United States. Although college can be a formative time for any student, there has been limited research on the growth that college students with IDD may experience during their time on campus. We address this gap by using a longitudinal design to examine the adaptive behavior, self-determination, executive functioning, and social skills of college students with IDD across three points in time-upon initial entry into the program, at the end of their first year, and at the end of their second year. Analyses suggested significant improvements in adaptive behavior and self-determination across the first year of the program. We offer recommendations for research and practice aimed at documenting and promoting growth for students with IDD throughout their collegiate experience.

Peer Perspectives Within the Inclusive Postsecondary Education Movement: A Systematic Review.

Peers play a central role in supporting college access for students with intellectual and developmental disabilities (IDD). This review examines available research addressing the perspectives of college student peers on the inclusive postsecondary education (IPSE) movement and their involvement in it. Approximately 2,670 peers-most of whom were female and undergraduates-participated in these 37 studies. We review findings addressing the views of peers on the following topics: (a) motivations for volunteering, (b) effectiveness as a peer support, (c) challenges they encountered, (d) impact of involvement on themselves, (e) impact of IPSE on their campus, (f) recommendations for IPSE programs, and (g) attitudes regarding disability. This research collectively highlights the multiple factors that draw peers to become involved, the experiences peers have within their campus' programs, the myriad ways in which they and their campus may benefit from this movement, and their views regarding inclusion and disability. We offer recommendations for research and practice aimed soliciting the views and involvement of peers within the inclusive postsecondary education movement.

Social Connections Among Siblings With and Without Intellectual Disability or Autism.

Although the significance of sibling relationships is widely affirmed, little is known about these relationships in young adulthood. In this study, we examined the experiences and perspectives of 155 siblings (ages 18-30) of individuals with intellectual disability or autism. Our focus was on how young adults spend time with their brother or sister with a disability, the ways in which they view their relationship, and the expectations they hold for the future. We found that most siblings spent time together engaging in a wide range of activities, described their relationships as of high quality, and held varied expectations regarding their brother's or sister's future. Several factors were associated with more time spent together and higher quality relationships. We address implications for practice and suggest future directions for research.

Seeing strengths: Young adults and their siblings with autism or intellectual disability.

BACKGROUND: Understanding the positive qualities of individuals with intellectual and developmental disabilities can provide a much-needed counterpoint to deficit-based depictions of disability. METHOD: This study examined how 163 young adults (ages 18-30) viewed the strengths of their brothers and sisters with intellectual disability or autism using the Assessment Scale for Positive Character Traits-Developmental Disabilities (Woodard, 2009). In addition, the authors examined factors that may shape their perspectives. RESULTS: Overall, siblings' ratings of strengths were moderate to high, indicating an overall portrait of strengths. The majority of brothers and sisters with disabilities was described as having multiple strengths and their profiles on this measure were highly individualized. Lower overall ratings were associated with several variables, including not using speech as a primary mode of communication, exhibiting challenging behaviours, having autism and not currently living together. CONCLUSIONS: The authors offer recommendations for future research and practice related to supporting siblings with and without disabilities.

Facets of Faith: Spirituality, Religiosity, and Parents of Individuals With Intellectual Disability.

Although faith has particular prominence in the contemporary American landscape, its intersection with disability and families has received little attention. We examined the spiritual and religious lives of 530 parents and caregivers of family members who have intellectual disability. For most participants, faith had clear relevance and was reflected in their congregational participation, beliefs, practices, and strength of faith. Yet considerable diversity was apparent in the ways in which each was evidenced, which included a modest number of families for whom this was not a salient aspect of their lives. Most participants identified ways in which their spirituality and religious participation contributed to their well-being. However, access to social supports through a local congregation was more muted. We address implications for professionals who support these families and congregations who welcome them. We also offer recommendations for expanding the opportunities and supports parents and caregivers need to flourish in their faith.

A Scoping Review of the Involvement of Children's Communication Partners in Aided Augmentative and Alternative Communication Modeling Interventions.

Purpose The purpose of this study was to inform practice and research by identifying and synthesizing research on interventions in which natural communication partners implemented aided augmentative and alternative communication (AAC) modeling strategies. Method A scoping review yielded 29 studies. Data were charted related to participant characteristics, intervention characteristics, partner instruction and assessment, and partner perspectives of social validity. Results More than 157 peer and 100 adult communication partners (e.g., parents, special educators, paraprofessionals) implemented aided AAC modeling strategies within included studies. To teach communication partners intervention strategies, researchers frequently reported using (a) oral instruction, (b) modeling, and (c) practice or application opportunities with performance feedback. Partner instruction frequently involved both training and concurrent support (e.g., coaching, facilitation, consultation, follow-up support). Conclusion Findings from this review inform the design and delivery of aided AAC modeling interventions by children's natural communication partners. Findings also highlight important avenues for enhancing the rigor of future research on interventions involving aided AAC modeling, including the quality of reporting and application of principles from implementation science. Supplemental Material https://doi.org/10.23641/asha.8038505.