Standard versus prosocial online support groups for distressed breast cancer survivors: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>The Internet can increase access to psychosocial care for breast cancer survivors through online support groups. This study will test a novel prosocial online group that emphasizes both opportunities for getting and giving help. Based on the helper therapy principle, it is hypothesized that the addition of structured helping opportunities and coaching on how to help others online will increase the psychological benefits of a standard online group.</p> <p>Methods/Design</p> <p>A two-armed randomized controlled trial with pretest and posttest. Non-metastatic breast cancer survivors with elevated psychological distress will be randomized to either a standard facilitated online group or to a prosocial facilitated online group, which combines online exchanges of support with structured helping opportunities (blogging, breast cancer outreach) and coaching on how best to give support to others. Validated and reliable measures will be administered to women approximately one month before and after the interventions. Self-esteem, positive affect, and sense of belonging will be tested as potential mediators of the primary outcomes of depressive/anxious symptoms and sense of purpose in life.</p> <p>Discussion</p> <p>This study will test an innovative approach to maximizing the psychological benefits of cancer online support groups. The theory-based prosocial online support group intervention model is sustainable, because it can be implemented by private non-profit or other organizations, such as cancer centers, which mostly offer face-to-face support groups with limited patient reach.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT01396174">NCT01396174</a></p

The use of a GIS-based inventory to provide a regional risk assessment of standing waters in Great Britain sensitive to acidification from atmospheric deposition

Previous attempts to identify regions of Britain vulnerable to acidification have used sensitivity maps based on the distribution of soils, geology, and land cover across Great Britain. Additionally, a systematic survey of freshwaters undertaken as part of the U.K. critical loads mapping programme provides a regional assessment of both sensitivity (critical loads) and, in tandem with deposition data, potential impact (critical load exceedance). Both approaches, while useful for identifying regional patterns, do not enable estimates of the number of affected water bodies to be made. Recent EU legislation (e.g., The Water Framework Directive) requires member states to set water quality objectives for all water bodies. We developed a GIS-based inventory of standing water bodies in response to the need for legislation-driven assessments of the status of the U.K. lake population. This paper describes how the inventory can be used to assess the number of standing water bodies in Britain that are vulnerable to acid deposition (at current levels), building on the sensitivity mapping undertaken previously. Using this approach, approximately 31% of all standing waters in Great Britain (excluding the Shetlands and Orkney) larger than 0.02 ha are identified as 'at risk' from acidification. Higher proportions are vulnerable in Scotland and Wales. Additionally, large numbers of standing waters in areas designated for environmental protection purposes are also vulnerable.</p