Occupational contact urticaria: lessons from the French National Network for Occupational Disease Vigilance and Prevention (RNV3P)

International audience

Intelligence, Surveillance & Reconnaissance como Agente de Mudança

O século XXI introduziu profundas mudanças no espaço onde a atuação militar se desenvolve. Esta mutação, que agora inclui o domínio físico e cognitivo na ação militar, impõe a adoção de novos conceitos de operação e estruturas organizacionais mais ágeis, de forma a fazerem face a um ambiente altamente volátil, imprevisível e complexo. Tal contexto torna as organizações, hoje mais do que nunca, dependentes de informação (e dos sistemas que as geram), e no âmbito das organizações militares, uma capacidade em particular assume, na atualidade, uma preponderância fulcral para o sucesso destas, que se designa por Intelligence, Surveillance & Reconnaissance (ISR). Considerando a complexidade de sistemas, processos e pessoas que envolvem toda esta capacidade, torna-se relevante estudar como a Força Aérea Portuguesa (FAP) está a acomodar este conceito no interior da sua estrutura, uma vez que a sua adaptação requer uma organização da era da informação, onde o trabalho em rede assume particular destaque. A presente investigação analisa formas de estruturas organizacionais contemporâneas e cruza-as com as recomendações da Organização do Tratado do Atlântico Norte (também designada por Aliança), comparando-as posteriormente com a atualidade da FAP. No final, são efetuadas propostas tangíveis, que podem potenciar as capacidades existentes, de onde se destaca a criação de uma matriz de análise quanto à eficiência organizacional, uma nova forma de organização das capacidades residentes no que ao ISR concerne, bem como o modo de potenciar o trabalho em rede com base nos meios existentes. Abstract: The 21st century has caused profound changes in the areas where military action takes place. This mutation, which now includes the physical and cognitive domain in military action, requires the adoption of new concepts of operation and more agile organizational structures in order to cope with a highly volatile, unpredictable and complex environment. Thus, more than ever, this makes the present organizations dependent of information (and the systems that generate them), in the case of military organizations, a particular capability undertakes today a strong impact on the success of military organizations. It is known as Intelligence, Surveillance& Reconnaissance (ISR). Taking into account the complexity of systems, processes and people involving all this capability, it is relevant to study how the Portuguese Air Force (PAF) is accommodating this concept within its structure, since the adaptation requires an organization adapted to the information era, where networking is particularly prominent. This research aims to analyze contemporary forms of organizational structures and cross them with the recommendations of the North Atlantic Treaty Organization (also known as Alliance), later comparing them with today's PAF. At the end of this investigation, some tangible proposals are made which can enhance existing capabilities: we can highlight the creation of an analysis matrix for organizational efficiency, a new form of organization of the resident capabilities in the ISR concerns, as well as the way of enhancing networking, based on existing means.

"Portuguese Observatory of Taeniasis and Cysticercosis": A "One Health" example for epidemiological surveillance of one neglected disease in a European country

Cysticercosis results from the ingestion Taenia solium eggs directly by faecal-oral route or contaminated food or water. Human tapeworm carriers who have become infected after ingesting pork meat contaminated with cysticerci release these eggs. Cysticercosis occurs after tapeworm eggs are ingested by an intermediate host (pig or human) and then hatch, migrate, and lodge in the host's tissues, where they develop onto larval cysticerci. When they lodged in the central nervous system of humans, results in the disease condition called Neurocysticercosis (NCC), with a heterogeneous manifestations depending of the locations of cysts, number, size and their stage of evolution (1). Consequently the prognostic ranges from asymptomatic to situations leading to death in 2% to 9.8%. of cases (7) In swine’s there are few studies, but recent works have proved that animals, for the same reasons, also have neurological abnormalities, expressed by seizures, stereotypic walk in circles, chewing motions with foamy salivation included tonic muscle contractions followed by a sudden diminution in all muscle tone leading to collapse (2). Conventional domestic wastewater treatment processes may not be totally effective in inactivating parasites eggs from Taenia solium, allowing some contamination of soils and agricultural products (11). In Portugal there are some evidence of aggregation of human cysticercosis cases in specific regions, bases in ecological design studies (6). There are few information about human tapeworm carriers and social and economic factors associated with them. Success in knowledge and consequently in lowering transmission is limited by the complex network of biological and social factors that maintain the spread. Effective control of mostly zoonosis require One Health approach, after a real knowledge and transparency in the information provided by the institutions responsible for both animal and human health, allowing sustained interventions targeted at the transmission cycle's crucial nodes. In general, the model used to control, reflects a rural reality, where pigs are raised freely, poor sanitation conditions and incipient sanitary inspection. In cysticercosis, pigs are obligate intermediate hosts and so considered as first targets for control and used as sentinels to monitor environmental T. solium contamination (3). Usually environmental contamination with Taenia spp. eggs is a key issue in most of studies with landscape factors influencing presence of Taenia spp. antigens in both pigs and humans (5). Soil-related factors as well as socio-economic and behavioural factors are associated with the emergence of significant clustering human cysticercosis (4,5). However scarce studies has been produced in urban environmental and in developed countries with the finality to characterize the spatial pattern. There are still few data available regarding its prevalence and spatial distribution; Transmission patterns are likely to exhibit correlations as housing conditions, water supply, basic sanitation, schooling and birthplace of the individual or relatives, more than pigs rearing free, soil conditions (9). As a matter of fact, tapeworm carriers from endemic zones can auto-infect or transmit infection to other people or arrive already suffering NCC (as a result of travelling to or being a citizen from an endemic cysticercosis country) to a free cysticercosis country. Transmission is fecal-oral; this includes transmission through person-to-person contact, through autoinfection, or through contaminated food This has been happening in different continents as North America (5.4–18% been autochthonous), Europe and Australia (7). Recently, case reports of NCC have also emerged from Muslim countries. (10). Actually, different papers relate an epidemic situation in Spain and Portugal (7, 8). However the kind of study done does not authorize such conclusion. There are no evidence that infections were acquired in Portugal and there are not characterized the mode of transmission. Papers with these kind of information will be allow to have economic consequences resulted from artificial trade barriers with serious consequences for pig producers and pig meat trade. We need transparency in information’s that allow provide the basis to support the development and targeting of future effective control programmes (and prove we need that). So, to have a real picture of the disease, it is necessary integrate data from human, animal and environmental factors surrounding human and pig cases to characterize the pattern of the transmission. The design needs to be able to capture unexpected, and not common outcomes (routine data). We need to think “One Health” to get a genuine image of the situation.