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Background: Early identification and treatment of chronic disease is associated with better clinical outcomes, lower costs, and reduced hospitalisation. Primary care is ideally placed to identify patients at risk of, or in the early stages of, chronic disease and to implement prevention and early intervention measures. This paper evaluates the implementation of a technological intervention called Future Health Today that integrates with general practice EMRs to (1) identify patients at-risk of, or with undiagnosed or untreated, chronic kidney disease (CKD), and (2) provide guideline concordant recommendations for patient care. The evaluation aimed to identify the barriers and facilitators to successful implementation. Methods: Future Health Today was implemented in 12 general practices in Victoria, Australia. Fifty-two interviews with 30 practice staff were undertaken between July 2020 and April 2021. Practice characteristics were collected directly from practices via survey. Data were analysed using inductive and deductive qualitative analysis strategies, using Clinical Performance - Feedback Intervention Theory (CP-FIT) for theoretical guidance. Results: Future Health Today was acceptable, user friendly and useful to general practice staff, and supported clinical performance improvement in the identification and management of chronic kidney disease. CP-FIT variables supporting use of FHT included the simplicity of design and delivery of actionable feedback via FHT, good fit within existing workflow, strong engagement with practices and positive attitudes toward FHT. Context variables provided the main barriers to use and were largely situated in the external context of practices (including pressures arising from the COVID-19 pandemic) and technical glitches impacting installation and early use. Participants primarily utilised the point of care prompt rather than the patient management dashboard due to its continued presence, and immediacy and relevance of the recommendations on the prompt, suggesting mechanisms of compatibility, complexity, actionability and credibility influenced use. Most practices continued using FHT after the evaluation phase was complete. Conclusions: This study demonstrates that FHT is a useful and acceptable software platform that provides direct support to general practice in identifying and managing patients with CKD. Further research is underway to explore the effectiveness of FHT, and to expand the conditions on the platform. [ABSTRACT FROM AUTHOR]

Thousands of people are reported lost in the wilderness in the United States every year and locating these missing individuals as rapidly as possible depends on coordinated search and rescue (SAR) operations. As time passes, the search area grows, survival rate decreases, and searchers are faced with an increasingly daunting task of searching large areas in a short amount of time. To optimize the search process, mathematical models of lost person behavior with respect to landscape can be used in conjunction with current SAR practices. In this paper, we introduce an agent-based model of lost person behavior which allows agents to move on known landscapes with behavior defined as independent realizations of a random variable. The behavior random variable selects from a distribution of six known lost person reorientation strategies to simulate the agent's trajectory. We systematically simulate a range of possible behavior distributions and find a best-fit behavioral profile for a hiker with the International Search and Rescue Incident Database. We validate these results with a leave-one-out analysis. This work represents the first time-discrete model of lost person dynamics validated with data from real SAR incidents and has the potential to improve current methods for wilderness SAR. [ABSTRACT FROM AUTHOR]