Analysis of the Legal Meaning of Article 27 of the UN CRPD: Key Challenges for Adapted Work Settings

The UN CRPD marks a shift of thinking in the disability sector; it lays down the premises for the enjoyment of human rights by persons with disabilities and it demands State parties to put into place proper structures and services to make sure the conditions for enjoyment of human rights are respected. From the experience of the UN Standard Rules, the United Nations have further elaborated on the current international treaty on disability, the UN CRPD, and further deepened its impact at international level. Adapted work settings, commonly known also as sheltered workshops, are not referred to in the UNCRPD. This requires clarifications for the thousands of people that benefit from their services and whose future looks therefore uncertain. This report focuses on the role of adapted work settings in the international framework provided by the UNCRPD; in particular, special attention has been given to Article 26 and 27, as they both deal with principles, measures and services offered by adapted work settings. The analysis was carried out starting from three main subjects: - what the Convention brought in general terms through its paradigm shift and the subsequent challenges for social services - the analysis of the current text of Article 26 and 27 and the links to the role of sheltered workshop matters - the history of the discussions around the inclusion of sheltered workshops in the UN CRPD. Article 26 dealing with issues concerning the “functioning” of the individual, renews the entitlement to habilitation and rehabilitation service, the latter considered as going beyond the medical sense of it, keeping a connotation of a non-permanent treatment. Article 27 concerns the right to work, which should lead to the possibility to gain a living and lead a life of dignity. Most sheltered workshops, that are providing rehabilitation and work related activities, seem, according to some, to be not fully compliant with either of the two articles as they provide rehabilitation-based activities on an on-going basis and offer work without fully guaranteeing conditions applying under the labour law. This concern emerged as well during the negotiation activities of the UN CRPD and was partly responsible for their exclusion from the current article on the right to work. However, the implementation of the Convention presents some challenges, especially when it comes to rights and obligations concerning overlapping fields of action, as may be the case for Article 26 and 27. Services like sheltered workshops may sometimes and very often fulfill more than one function for persons with disabilities, and thus their compliance to the UN CRPD articles is particularly sensitive. In the framework of a holistic approach to persons with disabilities, where disability itself is not the focus of attention, but everything is about the individual and the enjoyment of his rights, it is of utter importance to keep a good balance between the multitude of skills, personal choices, possibilities of individual development and society’s response. This report looks at the possible links existing between sheltered workshops and the UN CRPD in order to gain a view on the state of play and on future developments needed in the provision of work opportunities to persons with (intellectual) disabilities

Coding of self and other's future choices in dorsal premotor cortex during social interaction

Representing others’ intentions is central to primate social life. We explored the role of dorsal premotor cortex (PMd) in discriminating between self and others’ behavior while two male rhesus monkeys performed a non-match-to-goal task in a monkey-human paradigm. During each trial, two of four potential targets were randomly presented on the right and left parts of a screen, and the monkey or the human was required to choose the one that did not match the previously chosen target. Each agent had to monitor the other's action in order to select the correct target in that agent's own turn. We report neurons that selectively encoded the future choice of the monkey, the human agent, or both. Our findings suggest that PMd activity shows a high degree of self-other differentiation during face-to-face interactions, leading to an independent representation of what others will do instead of entailing self-centered mental rehearsal or mirror-like activities. Understanding others’ intentions is essential to successful primate social life. Cirillo et al. explore the role of dorsal premotor cortex (PMd) in discriminating between self and others’ behavior while macaques interacted with humans. They show that the majority of neurons encoding the future choice did so selectively for the monkey or the human agent. PMd thus differentiates self from others’ behavior, leading to independent representations of future actions

Visual salience of the stop signal affects the neuronal dynamics of controlled inhibition

The voluntary control of movement is often tested by using the countermanding, or stop-signal task that sporadically requires the suppression of a movement in response to an incoming stop-signal. Neurophysiological recordings in monkeys engaged in the countermanding task have shown that dorsal premotor cortex (PMd) is implicated in movement control. An open question is whether and how the perceptual demands inherent the stop-signal affects inhibitory performance and their underlying neuronal correlates. To this aim we recorded multi-unit activity (MUA) from the PMd of two male monkeys performing a countermanding task in which the salience of the stop-signals was modulated. Consistently to what has been observed in humans, we found that less salient stimuli worsened the inhibitory performance. At the neuronal level, these behavioral results were subtended by the following modulations: when the stop-signal was not noticeable compared to the salient condition the preparatory neuronal activity in PMd started to be affected later and with a less sharp dynamic. This neuronal pattern is probably the consequence of a less efficient inhibitory command useful to interrupt the neural dynamic that supports movement generation in PMd

Neuronal modulation in the prefrontal cortex in a transitive inference task: evidence of neuronal correlates of mental schema management

When informed that A > B and B > C, humans and other animals can easily conclude that A > C. This remarkable trait of advanced animals, which allows them to manipulate knowledge flexibly to infer logical relations, has only recently garnered interest in mainstream neuroscience. How the brain controls these logical processes remains an unanswered question that has been merely superficially addressed in neuroimaging and lesion studies, which are unable to identify the underlying neuronal computations. We observed that the activation pattern of neurons in the prefrontal cortex (PFC) during pair comparisons in a highly demanding transitive inference task fully supports the behavioral performance of the two monkeys that we tested. Our results indicate that the PFC contributes to the construction and use of a mental schema to represent premises. This evidence provides a novel framework for understanding the function of various areas of brain in logic processes and impairments to them in degenerative, traumatic, and psychiatric pathologies. SIGNIFICANCE STATEMENT: In cognitive neuroscience, it is unknown how information that leads to inferential deductions are encoded and manipulated at the neuronal level. We addressed this question by recording single-unit activity from the dorsolateral prefrontal cortex of monkeys that were performing a transitive inference (TI) task. The TI required one to choose the higher ranked of two items, based on previous, indirect experience. Our results demonstrated that single-neuron activity supports the construction of an abstract, mental schema of ordered items in solving the task and that this representation is independent of the reward value that is experienced for the single items. These findings identify the neural substrates of abstract mental representations that support inferential thinking

Retention Among New Graduate RNs With and Without Transition to Practice Nurse Residency Programs

Question: Does a structured nurse residency program affect the rate of retention among newly graduated RNs? Hypothesis: A structured nurse residency program will impact the retention of new graduate RNs. Methods: Articles reviewed for RN retention rates for nurses with and without nurse residency programs. Results: Research supports that transition to practice (TTP) programs have been successful in new graduate RN retention rates. TTP programs help the new graduate develop skills to cope more effectively with their transition and lead to healthier, more balanced careers. Typical TTP programs were generally 12 months in length, had a dedicated program coordinator and a preceptor acting as a mentor. RNs participating in a nurse residency program provided by Vizient/AACN were shown to have a 90.4% retention rate when compared with the national average of 82.5%. Components of residency programs included leadership modeling, promoting well-being, resilience, and work-life balance. Tools used to support well-being included journaling, reflection, huddling, identifying a peer, finding joy in work, expressing gratitude and positivity. Conclusion: Findings demonstrated an increase in resilience, highlighting the importance of providing a resiliency program for new graduate nurses. New graduate RNs staying beyond two years reported that a healthy work environment, a supportive workplace, and a sense of belonging all contributed to their decision to stay. Implications: TTP programs are successful at increasing retention rates among new graduate RNs. Further work should focus on identifying the best TTP structure for use at Rochester Regional Health and promote a resiliency approach versus a theoretical task-layered approach.https://scholar.rochesterregional.org/nursingresearchday_2023/1007/thumbnail.jp

Neural correlates of cognitive control of reaching movements in the dorsal premotor cortex of rhesus monkeys

Mirabella G, Pani P, Ferraina S. Neural correlates of cognitive control of reaching movements in the dorsal premotor cortex of rhesus monkeys. J Neurophysiol 106: 1454-1466, 2011. First published June 22, 2011; doi: 10.1152/jn.00995.2010.-Canceling a pending movement is a hallmark of voluntary behavioral control because it allows us to quickly adapt to unattended changes either in the external environment or in our thoughts. The countermanding paradigm allows the study of inhibitory processes of motor acts by requiring the subject to withhold planned movements in response to an infrequent stop-signal. At present the neural processes underlying the inhibitory control of arm movements are mostly unknown. We recorded the activity of single units in the rostral and caudal portion of the dorsal premotor cortex (PMd) of monkeys trained in a countermanding reaching task. We found that among neurons with a movement-preparatory activity, about one-third exhibit a modulation before the behavioral estimate of the time it takes to cancel a planned movement. Hence these neurons exhibit a pattern of activity suggesting that PMd plays a critical role in the brain networks involved in the control of arm movement initiation and suppression.Mirabella G, Pani P, Ferraina S. Neural correlates of cognitive control of reaching movements in the dorsal premotor cortex of rhesus monkeys. J Neurophysiol 106: 1454-1466, 2011. First published June 22, 2011; doi: 10.1152/jn.00995.2010.-Canceling a pending movement is a hallmark of voluntary behavioral control because it allows us to quickly adapt to unattended changes either in the external environment or in our thoughts. The countermanding paradigm allows the study of inhibitory processes of motor acts by requiring the subject to withhold planned movements in response to an infrequent stop-signal. At present the neural processes underlying the inhibitory control of arm movements are mostly unknown. We recorded the activity of single units in the rostral and caudal portion of the dorsal premotor cortex (PMd) of monkeys trained in a countermanding reaching task. We found that among neurons with a movement-preparatory activity, about one-third exhibit a modulation before the behavioral estimate of the time it takes to cancel a planned movement. Hence these neurons exhibit a pattern of activity suggesting that PMd plays a critical role in the brain networks involved in the control of arm movement initiation and suppression

Monkeys Monitor Human Goals in a Nonmatch-to-Goal Interactive Task

We designed a new task, called nonmatch-to-goal, to study the ability of macaque monkeys to interact with humans in a rule-guided paradigm. In this task the monkeys were required to choose one of two targets, from a list of three. For each choice, they were required to switch from their choice on the previous trial to a different one. In a subset of trials the monkeys observed a human partner performing the task. When the human concluded his turn, the monkeys were required to switch to a new goal discarding the human's previous goal. We found that monkeys were very skillful in monitoring goals, not only of their own choice by also those of their human partner. They showed also a surprising ability to coordinate their actions, taking turns with the human partner, starting and stopping their own turn following the decision of the human partner in the task

Shared action spaces:a basis function framework for social re-calibration of sensorimotor representations supporting joint action

The article explores the possibilities of formalizing and explaining the mechanisms that support spatial and social perspective alignment sustained over the duration of a social interaction. The basic proposed principle is that in social contexts the mechanisms for sensorimotor transformations and multisensory integration (learn to) incorporate information relative to the other actor(s), similar to the "re-calibration" of visual receptive fields in response to repeated tool use. This process aligns or merges the co-actors' spatial representations and creates a "Shared Action Space" (SAS) supporting key computations of social interactions and joint actions; for example, the remapping between the coordinate systems and frames of reference of the co-actors, including perspective taking, the sensorimotor transformations required for lifting jointly an object, and the predictions of the sensory effects of such joint action. The social re-calibration is proposed to be based on common basis function maps (BFMs) and could constitute an optimal solution to sensorimotor transformation and multisensory integration in joint action or more in general social interaction contexts. However, certain situations such as discrepant postural and viewpoint alignment and associated differences in perspectives between the co-actors could constrain the process quite differently. We discuss how alignment is achieved in the first place, and how it is maintained over time, providing a taxonomy of various forms and mechanisms of space alignment and overlap based, for instance, on automaticity vs. control of the transformations between the two agents. Finally, we discuss the link between low-level mechanisms for the sharing of space and high-level mechanisms for the sharing of cognitive representations

Reaching activity in parietal area V6A of macaque: eye influence on arm activity or retinocentric coding of reaching movements?

Parietal area V6A contains neurons modulated by the direction of gaze as well as neurons able to code the direction of arm movement. The present study was aimed to disentangle the gaze effect from the effect of reaching activity upon single V6A neurons. To this purpose, we used a visuomotor task in which the direction of arm movement remained constant while the animal changed the direction of gaze. Gaze direction modulated reach-related activity in about two-thirds of tested neurons. In several cases, modulations were not due to the eye-position signal per se, the apparent eye-position modulation being just an epiphenomenon. The real modulating factor was the location of reaching target with respect to the point gazed by the animal, that is, the retinotopic coordinates towards which the action of reaching occurred. Comparison of neural discharge of the same cell during execution of foveated and non-foveated reaching movements, performed towards the same or different spatial locations, confirmed that in a part of V6A neurons reaching activity is coded retinocentrically. In other neurons, reaching activity is coded spatially, depending on the direction of reaching movement regardless of where the animal was looking at. The majority of V6A reaching neurons use a system that encompasses both of these reference frames. These results are in line with the view of a progressive visuomotor transformation in the dorsal visual stream, that changes the frame of reference from the retinocentric one, typically used by the visual system, to the arm-centred one, typically used by the motor system

A role for TSPO in mitochondrial Ca2+ homeostasis and redox stress signaling

The 18 kDa translocator protein TSPO localizes on the outer mitochondrial membrane (OMM). Systematically overexpressed at sites of neuroinflammation it is adopted as a biomarker of brain conditions. TSPO inhibits the autophagic removal of mitochondria by limiting PARK2-mediated mitochondrial ubiquitination via a peri-organelle accumulation of reactive oxygen species (ROS). Here we describe that TSPO deregulates mitochondrial Ca2+ signaling leading to a parallel increase in the cytosolic Ca2+ pools that activate the Ca2+-dependent NADPH oxidase (NOX) thereby increasing ROS. The inhibition of mitochondrial Ca2+ uptake by TSPO is a consequence of the phosphorylation of the voltage-dependent anion channel (VDAC1) by the protein kinase A (PKA), which is recruited to the mitochondria, in complex with the Acyl-CoA binding domain containing 3 (ACBD3). Notably, the neurotransmitter glutamate, which contributes neuronal toxicity in age-dependent conditions, triggers this TSPO-dependent mechanism of cell signaling leading to cellular demise. TSPO is therefore proposed as a novel OMM-based pathway to control intracellular Ca2+ dynamics and redox transients in neuronal cytotoxicity