Investigating online psychological treatment for adolescents with a visible difference in the Dutch YP Face IT study: Protocol of a randomised controlled trial

Introduction This paper outlines the study protocol for the Dutch Young People (YP) Face IT Study. Adolescents with a visible difference (ie, disfigurement) often experience challenging social situations such as being stared at, receiving unwanted questions or being teased. As a consequence, some of these adolescents experience adverse psychosocial outcomes and appearance-related distress. To address this appearance-related distress, an online psychotherapeutic intervention, YP Face IT, has been developed. YP Face IT uses social interaction skills training and cognitive-behavioural therapy. The Dutch YP Face IT Study tests whether this intervention is effective in reducing social anxiety and improving body esteem. Methods and analysis Participants are adolescents aged 12-18 with a visible difference and experiencing appearance-related distress. In this two-armed randomised controlled trial, 224 adolescents will be randomised to care as usual or YP Face IT. Adolescents will complete questionnaires at baseline, at 13 weeks and at 25 weeks. Primary outcomes are differences in social anxiety and body esteem between YP Face IT and care as usual. Secondary outcomes are differences in aspects of self-worth, perceived stigmatisation, health-related quality of life, life engagement, appearance-related distress and depressive symptoms between the two groups. Ethics and dissemination Research ethics approval was obtained from the medical ethics review committee in Rotterdam (reference number MEC-2018-052/NL63955.078.18). Findings will be disseminated through academic peer-reviewed publications, conferences and newsletters to patient associations and participants of the study. Trial registration number The Netherlands Trial Register (NL7626)

Impact on air quality of measures to reduce CO2 emissions from road traffic in Basel, Rotterdam, Xi'an and Suzhou

Two traffic scenarios to reduce CO2 emissions from road traffic in two European cities (Basel and Rotterdam) and two Chinese cities (Xi'an and Suzhou) were evaluated in terms of their impact on air quality. The two scenarios, one modelling a reduction of private vehicle kilometres driven by 10% on urban streets and the other modelling the introduction of 50% electric-powered private vehicle kilometres on urban streets, were both compared to a scenario following "business-as-usual": 2020-BAU. The annual average concentrations of NO2, PM2.5, PM10 and elemental carbon (EC) were modelled separately in busy street canyons, near urban motorways and in the remainder of the urban area. It was concluded that traffic-related CO2 emissions in 2020-BAU could be expected to remain at the levels of 2010 in Basel and Rotterdam, while in Xi'an and Suzhou to increase 30-50% due to growth in the traffic volume. Traffic-related CO2 emissions may be reduced by up to 5% and 25%, respectively using the first and second scenarios. Air pollution in the Chinese cities is a factor 3 to 5 higher than in the European cities in 2010 and 2020-BAU. The impact of both CO2 reduction scenarios on air quality in 2020-BAU is limited. In Europe, due to implementation of stringent emission standards in all sectors, air quality is expected to improve at both the urban background and near busy road traffic. In China, the regional background is expected to improve for EC, stabilize for PM2.5 and PM10, and decrease for NO2. The urban background follows this regional trend, while near busy road traffic, air pollution will remain elevated due to the considerable growth in traffic volume. A major constraint for modelling air quality in China is access to the input data required and lack of measurements at ground level for validation