Understanding and supporting law enforcement professionals working with distressing material: Findings from a qualitative study

This study aimed to extend previous research on the experiences and factors that impact law enforcement personnel when working with distressing materials such as child sexual abuse content. A sample of 22 law enforcement personnel working within one law enforcement organisation in England, United Kingdom participated in anonymous semi-structured interviews. Results were explored thematically and organised in the following headings: “Responses to the material”, “Impact of working with distressing evidence”, “Personal coping strategies” and “Risks and mitigating factors”. Law enforcement professionals experienced heightened affective responses to personally relevant material, depictions of violence, victims’ displays of emotions, norm violations and to various mediums. These responses dampened over time due to desensitisation. The stress experienced from exposure to the material sometimes led to psychological symptoms associated with Secondary Traumatic Stress. Job satisfaction, self-care activities, the coping strategies used when viewing evidence, detachment from work outside working hours, social support and reducing exposure to the material were found to mediate law enforcement professionals’ resilience. Exposure to distressing material and the risks associated with this exposure were also influenced by specific organisational procedures implemented as a function of the funding available and workload. Recommendations for individual and organisational practices to foster resilience emerged from this research. These recommendations are relevant to all organisations where employees are required to view distressing content

A review of selected indicators of particle, nutrient and metal inputs in coral reef lagoon systems

This review presents environmental and biological indicators of the impact of three major categories of inputs in coral reef lagoons i.e. particles, nutrients and metals. Information was synthesized to extract well established indicators together with some interesting new concepts currently under development, and to provide the reader with an assessment of their respective advantages and drawbacks. The paper has been organized according to the capacity of three categories of indicators to respond either in a specific or a non specific way to a given source of input. The first section focuses on abiotic indicators which main interest is to respond instantaneously and in a truly specific way to a given source of input. The second and third sections present informations on bioindicators either at the sub-individual level or at the individual to community level, indicator specificity generally decreasing as a direct function of biological or ecological complexity. This review showed that even though significant work has already been done on coral reef ecosystems, much more scientific studies are still needed to answer the growing local demands for simple and truly validated tools to be used in environmental surveys. It is further stressed that, due to the biological and environmental diversity of coral reef lagoons, a preliminary step of on-site validation must be considered as an absolute prerequisite when indicators are planned to be used in the frame of a local environmental monitoring programme

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

Background: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. Methods: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). Findings: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29–146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0– 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25–1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39–1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65–1·60]; p=0·92). Interpretation: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention

Effects of antiplatelet therapy after stroke due to intracerebral haemorrhage (RESTART): a randomised, open-label trial

BACKGROUND: Antiplatelet therapy reduces the risk of major vascular events for people with occlusive vascular disease, although it might increase the risk of intracranial haemorrhage. Patients surviving the commonest subtype of intracranial haemorrhage, intracerebral haemorrhage, are at risk of both haemorrhagic and occlusive vascular events, but whether antiplatelet therapy can be used safely is unclear. We aimed to estimate the relative and absolute effects of antiplatelet therapy on recurrent intracerebral haemorrhage and whether this risk might exceed any reduction of occlusive vascular events. METHODS: The REstart or STop Antithrombotics Randomised Trial (RESTART) was a prospective, randomised, open-label, blinded endpoint, parallel-group trial at 122 hospitals in the UK. We recruited adults (≥18 years) who were taking antithrombotic (antiplatelet or anticoagulant) therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage, discontinued antithrombotic therapy, and survived for 24 h. Computerised randomisation incorporating minimisation allocated participants (1:1) to start or avoid antiplatelet therapy. We followed participants for the primary outcome (recurrent symptomatic intracerebral haemorrhage) for up to 5 years. We analysed data from all randomised participants using Cox proportional hazards regression, adjusted for minimisation covariates. This trial is registered with ISRCTN (number ISRCTN71907627). FINDINGS: Between May 22, 2013, and May 31, 2018, 537 participants were recruited a median of 76 days (IQR 29-146) after intracerebral haemorrhage onset: 268 were assigned to start and 269 (one withdrew) to avoid antiplatelet therapy. Participants were followed for a median of 2·0 years (IQR [1·0- 3·0]; completeness 99·3%). 12 (4%) of 268 participants allocated to antiplatelet therapy had recurrence of intracerebral haemorrhage compared with 23 (9%) of 268 participants allocated to avoid antiplatelet therapy (adjusted hazard ratio 0·51 [95% CI 0·25-1·03]; p=0·060). 18 (7%) participants allocated to antiplatelet therapy experienced major haemorrhagic events compared with 25 (9%) participants allocated to avoid antiplatelet therapy (0·71 [0·39-1·30]; p=0·27), and 39 [15%] participants allocated to antiplatelet therapy had major occlusive vascular events compared with 38 [14%] allocated to avoid antiplatelet therapy (1·02 [0·65-1·60]; p=0·92). INTERPRETATION: These results exclude all but a very modest increase in the risk of recurrent intracerebral haemorrhage with antiplatelet therapy for patients on antithrombotic therapy for the prevention of occlusive vascular disease when they developed intracerebral haemorrhage. The risk of recurrent intracerebral haemorrhage is probably too small to exceed the established benefits of antiplatelet therapy for secondary prevention. FUNDING: British Heart Foundation

Accumulation des métaux dans les organismes marins tropicaux, application au lagon de Nouvelle-Calédonie

Le travail présenté s’inscrit dans le cadre de la recherche d’outils biologiques permettant la surveillance de la qualité chimique du milieu côtier lagonaire en Nouvelle Calédonie. Celui ci a un double objectif : i) identifier un ensemble d’espèces macrobenthiques lagonaires susceptibles d’être utilisables en tant que bioindicateurs de contamination de l’environnement côtier par certains métaux, et ii) en utilisant conjointement ces espèces, dresser un premier bilan des apports en métaux présents sous formes dissoutes et particulaires biodisponibles dans différents sites côtiers du lagon sud-ouest.Dans une première étape, une étude bibliographique de la biodiversité littorale en Nouvelle Calédonie a été effectuée afin de dresser une première liste des espèces lagonaires les plus communément rencontrées. Des prospections in situ sur un ensemble d’environ quatre vingt dix stations réparties dans quatre sites côtiers soumis à des apports terrigènes ou anthropiques ainsi que dans deux sites de référence relative ont ensuite été réalisées. A partir des inventaires biologiques établis et sur la base de différents critères écologiques, dix espèces relativement communes et présentant des modes de vie et des régimes alimentaires variés ont été sélectionnées : les macroalgues Lobophora variegata (Lamouroux) Womersley (Phaeophyta), Halimeda incrassata (Ellis) Lamouroux, Halimeda macroloba Decaisne, Caulerpa taxifolia (Vahl) C. Agardh et Caulerpa sertularioides (Gmelin) Howe (Chlorophyta), les bivalves Gafrarium tumidum Röding (Veneridae), Isognomon isognomon L. (Isognomonidae) et Hyotissa hyotis L. (Gryphaeidae), l’échinoderme Holothuria (Halodeima) edulis Lesson (Holothuridae) et l’octocoralliaire Sarcophyton sp. (Alcyonidae).Dans une seconde étape, les concentrations en Al, Co, Cr, Cu, Fe, Mn, Ni et Zn présentes dans les tissus entiers de ces espèces ont été mesurées. L’étude des niveaux atteints et de la variabilité géographique des concentrations chez chaque espèce a permis d’établir que la plupart d’entre elles semblent être des candidats intéressants en tant que bioindicateurs dans la zone côtière du lagon sud-ouest de la Nouvelle-Calédonie, à l’exception toutefois de l’algue Halimeda macroloba et du bivalve Hyotissa hyotis. Les espèces les plus prometteuses semblent être l’algue Lobophora variegata et le bivalve Isognomon isognomon. L’utilisation conjointe de l’ensemble des espèces étudiées a révélé une contamination des deux baies anthropisées par différents métaux, soit Cu, Mn, Ni, Zn et dans une moindre mesure Co, Cr et Fe pour celle soumise à des rejets principalement industriels (baie de la Grande Rade) et par Zn et Cu (de moindre importance toutefois) pour celle recevant des apports urbains (baie de Sainte Marie). La présence d’apports très significatifs en Co, Cr, Fe et Ni biodisponibles a également été détectée dans les deux baies estuariennes sous influence terrigène (baies de Dumbéa et de Boulari). Sur la base de ces premiers résultats, des études expérimentales in situ et en laboratoire sont cependant nécessaires pour préciser les cinétiques d’accumulation et d’élimination des métaux ainsi que les voies préférentielles de transfert afin de valider l’utilisation de certaines de ces espèces en tant que bioindicateurs quantitatifs de contamination des milieux côtiers tropicaux par les métaux

Accumulation des métaux dans les organismes marins tropicaux, application au lagon de Nouvelle-Calédonie

Le travail présenté s’inscrit dans le cadre de la recherche d’outils biologiques permettant la surveillance de la qualité chimique du milieu côtier lagonaire en Nouvelle Calédonie. Celui ci a un double objectif : i) identifier un ensemble d’espèces macrobenthiques lagonaires susceptibles d’être utilisables en tant que bioindicateurs de contamination de l’environnement côtier par certains métaux, et ii) en utilisant conjointement ces espèces, dresser un premier bilan des apports en métaux présents sous formes dissoutes et particulaires biodisponibles dans différents sites côtiers du lagon sud-ouest.Dans une première étape, une étude bibliographique de la biodiversité littorale en Nouvelle Calédonie a été effectuée afin de dresser une première liste des espèces lagonaires les plus communément rencontrées. Des prospections in situ sur un ensemble d’environ quatre vingt dix stations réparties dans quatre sites côtiers soumis à des apports terrigènes ou anthropiques ainsi que dans deux sites de référence relative ont ensuite été réalisées. A partir des inventaires biologiques établis et sur la base de différents critères écologiques, dix espèces relativement communes et présentant des modes de vie et des régimes alimentaires variés ont été sélectionnées : les macroalgues Lobophora variegata (Lamouroux) Womersley (Phaeophyta), Halimeda incrassata (Ellis) Lamouroux, Halimeda macroloba Decaisne, Caulerpa taxifolia (Vahl) C. Agardh et Caulerpa sertularioides (Gmelin) Howe (Chlorophyta), les bivalves Gafrarium tumidum Röding (Veneridae), Isognomon isognomon L. (Isognomonidae) et Hyotissa hyotis L. (Gryphaeidae), l’échinoderme Holothuria (Halodeima) edulis Lesson (Holothuridae) et l’octocoralliaire Sarcophyton sp. (Alcyonidae).Dans une seconde étape, les concentrations en Al, Co, Cr, Cu, Fe, Mn, Ni et Zn présentes dans les tissus entiers de ces espèces ont été mesurées. L’étude des niveaux atteints et de la variabilité géographique des concentrations chez chaque espèce a permis d’établir que la plupart d’entre elles semblent être des candidats intéressants en tant que bioindicateurs dans la zone côtière du lagon sud-ouest de la Nouvelle-Calédonie, à l’exception toutefois de l’algue Halimeda macroloba et du bivalve Hyotissa hyotis. Les espèces les plus prometteuses semblent être l’algue Lobophora variegata et le bivalve Isognomon isognomon. L’utilisation conjointe de l’ensemble des espèces étudiées a révélé une contamination des deux baies anthropisées par différents métaux, soit Cu, Mn, Ni, Zn et dans une moindre mesure Co, Cr et Fe pour celle soumise à des rejets principalement industriels (baie de la Grande Rade) et par Zn et Cu (de moindre importance toutefois) pour celle recevant des apports urbains (baie de Sainte Marie). La présence d’apports très significatifs en Co, Cr, Fe et Ni biodisponibles a également été détectée dans les deux baies estuariennes sous influence terrigène (baies de Dumbéa et de Boulari). Sur la base de ces premiers résultats, des études expérimentales in situ et en laboratoire sont cependant nécessaires pour préciser les cinétiques d’accumulation et d’élimination des métaux ainsi que les voies préférentielles de transfert afin de valider l’utilisation de certaines de ces espèces en tant que bioindicateurs quantitatifs de contamination des milieux côtiers tropicaux par les métaux