Using a fixed-wing UAS to map snow depth distribution: An evaluation at peak accumulation

We investigate snow depth distribution at peak accumulation over a small Alpine area ( 3c0.3 km 2 ) using photogrammetry-based surveys with a fixed-wing unmanned aerial system (UAS). These devices are growing in popularity as inexpensive alternatives to existing techniques within the field of remote sensing, but the assessment of their performance in Alpine areas to map snow depth distribution is still an open issue. Moreover, several existing attempts to map snow depth using UASs have used multi-rotor systems, since they guarantee higher stability than fixed-wing systems. We designed two field campaigns: during the first survey, performed at the beginning of the accumulation season, the digital elevation model of the ground was obtained. A second survey, at peak accumulation, enabled us to estimate the snow depth distribution as a difference with respect to the previous aerial survey. Moreover, the spatial integration of UAS snow depth measurements enabled us to estimate the snow volume accumulated over the area. On the same day, we collected 12 probe measurements of snow depth at random positions within the case study to perform a preliminary evaluation of UAS-based snow depth. Results reveal that UAS estimations of point snow depth present an average difference with reference to manual measurements equal to -0.073 m and a RMSE equal to 0.14 m. We have also explored how some basic snow depth statistics (e.g., mean, standard deviation, minima and maxima) change with sampling resolution (from 5 cm up to 3c100 m): for this case study, snow depth standard deviation (hence coefficient of variation) increases with decreasing cell size, but it stabilizes for resolutions smaller than 1 m. This provides a possible indication of sampling resolution in similar conditions

Randomised controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website: cost-effectiveness analysis

To evaluate the 12-month costs and quality-adjusted life years (QALYs) gained to the Italian National Health Service of facilitated access to a website for hazardous drinkers compared with a standard face-to-face brief intervention (BI)

The Walsh family resilience questionnaire: The Italian version

Background: Resilience focuses on strength under stress, in the context of adversity. Walsh\u2019s theoretical model identifies relational processes that allow families to tackle and overcome critical situations, dividing them into three domains of family function. The aim of this study was to assess resilience in families of patients with a chronic disease by adapting and validating the Italian version of the Walsh Family Resilience Questionnaire (Walsh-IT). Patients and methods: An Italian adult sample of 421 participants (patients and relatives) was collected with the aim to assess the reliability and validity of the Walsh-IT. Concurrent validity was carried out by comparing this instrument with the Family Adaptability and Cohesion Evaluation Scale III (FACES III) administered at the same time as the Walsh-IT. Results: Reliability showed high correlation between repeated measurements. The alpha coefficient was 0.946. Both parallel analysis and minimum average partial criteria suggested that the best number of domains is equal to 3, explaining 50.4% of the total variance. Based on the results obtained from the Rasch analysis, items 10, 11, 16, 22, and 23 have been removed resulting in a short-form questionnaire (Walsh-IT-R) of 26 items with three domains: shared beliefs and support (SBS, \u3b1=0.928); family organization and interaction (FOI, \u3b1=0.863); and utilization of social resources (USR, \u3b1=0.567). The total score of the Walsh-IT-R was strongly correlated with the total score of FACES III Real Family Scale (r=0.68; p,0.0001). Conclusion: Results support that the Walsh-IT-R is a valid instrument for the assessment of family resilience in Italy when contending with the challenges of chronic disease. It could be used in pre- and post-assessment in practice effectiveness research, offering a profile of family resilience processes at the start and end of interventions and follow-up

Alcohol dependence and treatment utilization in Europe - a representative cross-sectional study in primary care

Alcohol dependence (AD) in Europe is prevalent and causes considerable health burden. Recognition by general practitioners (GPs) and provision of or referral to treatment may contribute to reduce this burden. This paper studied AD prevalence in varying European primary care settings and examined who received treatment

Download Your Doctor: Implementation of a Digitally Mediated Personal Physician Presence to Enhance Patient Engagement With a Health-Promoting Internet Application.

BACKGROUND: Brief interventions delivered in primary health care are effective in reducing excessive drinking; online behavior-changing technique interventions may be helpful. Physicians may actively encourage the use of such interventions by helping patients access selected websites (a process known as "facilitated access"). Although the therapeutic working alliance plays a significant role in the achievement of positive outcomes in face-to-face psychotherapy and its development has been shown to be feasible online, little research has been done on its impact on brief interventions. Strengthening patients' perception of their physician's endorsement of a website could facilitate the development of an effective alliance between the patient and the app. OBJECTIVE: We describe the implementation of a digitally mediated personal physician presence to enhance patient engagement with an alcohol-reduction website as part of the experimental online intervention in a noninferiority randomized controlled trial. We also report the feedback of the users on the module. METHODS: The Download Your Doctor module was created to simulate the personal physician presence for an alcohol-reduction website that was developed for the EFAR-FVG trial conducted in the Italian region of Friuli-Venezia-Giulia. The module was designed to enhance therapeutic alliance and thus improve outcomes in the intervention group (facilitated access to the website). Participating general and family practitioners could customize messages and visual elements and upload a personal photo, signature, and video recordings. To assess the perceptions and attitudes of the physicians, a semistructured interview was carried out 3 months after the start of the trial. Participating patients were invited to respond to a short online questionnaire 12 months following recruitment to investigate their evaluation of their online experiences. RESULTS: Nearly three-quarters (23/32, 72%) of the physicians interviewed chose to customize the contents of the interaction with their patients using the provided features and acknowledged the ease of use of the online tools. The majority of physicians (21/32, 57%) customized at least the introductory photo and video. Barriers to usage among those who did not customize the contents were time restrictions, privacy concerns, difficulties in using the tools, and considering the approach not useful. Over half (341/620, 55.0%) of participating patients completed the optional questionnaire. Many of them (240/341, 70.4%) recalled having noticed the personalized elements of their physicians, and the majority of those (208/240, 86.7%) reacted positively, considering the personalization to be of either high or the highest importance. CONCLUSIONS: The use of a digitally mediated personal physician presence online was both feasible and welcomed by both patients and physicians. Training of the physicians seems to be a key factor in addressing perceived barriers to usage. Further research is recommended to study the mechanisms behind this approach and its impact. TRIAL REGISTRATION: Clinicaltrials.gov NCT 01638338; https://clinicaltrials.gov/ct2/show/NCT01638338 (Archived by WebCite at http://www.webcitation.org/6f0JLZMtq)

Randomised controlled non-inferiority trial of primary care based facilitated access to an alcohol reduction website (EFAR-FVG)

Introduction There is a strong body of evidence demonstrating effectiveness of brief interventions by primary care professionals for risky drinkers but implementation levels remain low. Facilitated access to an alcohol reduction website constitutes an innovative approach to brief intervention, offering a time-saving alternative to face to face intervention, but it is not known whether it is as effective. Objective To determine whether facilitated access to an alcohol reduction website is equivalent to face to face intervention. Methods Randomised controlled non-inferiority trial for risky drinkers comparing facilitated access to a dedicated website with face to face brief intervention conducted in primary care settings in the Region of Friuli Venezia-Giulia, Italy. Adult patients are given a leaflet inviting them to log on to a website to complete the AUDIT-C alcohol screening questionnaire. Screen positives are requested to complete an online trial module including consent, baseline assessment and randomisation to either standard intervention by the practitioner or facilitated access to an alcohol reduction website. Follow up assessment of risky drinking is undertaken online at 1 month, 3 months and 1 year using the full AUDIT questionnaire. Proportions of risky drinkers in each group will be calculated and non-inferiority assessed against a specified margin of 10%. The trial is being undertaken as an initial pilot and a subsequent main trial. Results 12 practices have participated in the pilot, and more than 1300 leaflets have been distributed. 89 patients have been recruited to the trial with a one month follow-up rate of 79%. Discussion The findings of the pilot study suggest that the trial design is feasible, though modifications will be made to optimize performance in the main trial which will commence in January 2014. Plans are concurrently underway to replicate the trial in Australia, and potentially in the UK and Spain

A randomized controlled non-inferiority trial of primary care-based facilitated access to an alcohol reduction website (EFAR-FVG): preliminary results

Background The effectiveness of brief interventions for risky drinkers by GPs is well documented.[1] However, implementation levels remain low. Facilitated access to an alcohol reduction website offers an alternative to standard face-to-face intervention, but it is unclear whether it is as effective.[2] This study evaluates whether online brief intervention, through GP facilitated access to an alcohol reduction website for risky drinkers, is not inferior to the face-to-face brief intervention conducted by GPs. Material and methods In a northern Italy region participating GPs actively encouraged all patients age 18 attending their practice, to access an online screening website based on AUDIT-C.[3] Those screening positive underwent a baseline assessment with the AUDIT-10[4] and EQ-5D[5] questionnaires and subsequently, were randomly assigned to receive either online counselling on the alcohol reduction website (intervention) or face-to-face intervention based on the brief motivational interview[6] by their GP (control). Follow-up took place at 3 and 12 months and the outcome was calculated on the basis of the proportion of risky drinkers in each group according to the AUDIT-10. Results More than 50% (n= 3974) of the patients who received facilitated access logged-on to the website and completed the AUDIT-C. Just under 20% (n = 718) screened positive and 94% (n= 674) of them completed the baseline questionnaires and were randomized. Of the 310 patients randomized to the experimental Internet intervention, 90% (n = 278) logged-on to the site. Of the 364 patients of the control group, 72% (263) were seen by their GP. A follow-up rate of 94% was achieved at 3 months. Conclusions The offer of GP facilitated access to an alcohol reduction website appears to be an effective way of identifying risky drinkers and enabling them to receive brief intervention